HIV among Female Sex Workers in Five Cities in Burkina Faso: A Cross-Sectional Baseline Survey to Inform HIV/AIDS Programs

Background. Female sex workers (FSWs) are considered a vulnerable population for HIV infection and a priority for HIV/AIDS response programs. This study aimed to determine HIV prevalence among FSWs in five cities in Burkina Faso. Methods. FSWs aged 18 and older were recruited using respondent driven sampling (RDS) in five cities (Ouagadougou, Bobo-Dioulasso, Koudougou, Ouahigouya, and Tenkodogo) in Burkina Faso from 2013 to 2014. HIV testing was performed using the HIV testing national algorithm. We conducted bivariate and multivariate logistic regression analysis to assess correlates of HIV in all cities combined (not RDS-adjusted). Results. Among Ouagadougou, Koudougou, and Ouahigouya FSWs, RDS-adjusted HIV prevalence was 13.5% (95% Confidence Interval [CI]: 9.6–18.7), 13.3% (95% CI: 7.6–22.4), and 13.0% (95% CI: 7.6–21.3), respectively, compared to 30.1% (95% CI: 25.5–35.1) among Bobo-Dioulasso FSWs. Factors associated with HIV infection were age (adjusted odds ratio [aOR] = 7.84 95% CI: 3.78–16.20), being married or cohabitating (aOR = 2.43, 95% CI: 1.31–4.49), and history of pregnancy (aOR = 5.24, 95% CI: 1.44–18.97). Conclusion. These results highlight the need to strengthen HIV prevention among FSWs, through behavior change strategies, and improve access to sexual and reproductive health services

Human immunodeficiency virus (HIV) among men who have sex with men: results of the first integrated biological and behavioral survey in Burkina Faso, West Africa

Abstract Background Many men who have sex with men (MSM) are at significant risk for HIV infection. The objective of this study was to determine the prevalence and correlates of HIV infection among MSM in Burkina Faso. Methods A cross-sectional biological and behavioral survey was conducted from January to August 2013 among MSM in Ouagadougou and Bobo-Dioulasso. MSM 18 years old and above were recruited using respondent driven sampling (RDS). A survey was administered to study participants followed by HIV testing. Population prevalence estimates and 95% confidence intervals (CI) adjusted for the RDS design were produced using the RDS Analysis Tool version 6.0.1 (RDS, Inc., Ithaca, NY). Results A total of 662 MSM were enrolled in Ouagadougou (n = 333) and Bobo-Dioulasso (n = 329). The majority were unmarried, with an average age of 22.1 ± 4.4 years old in Ouagadougou and 23.1 ± 4.7 years old in Bobo-Dioulasso. RDS-adjusted HIV prevalence was 1.7% (95% CI: 0.9–3.1) in Ouagadougou and 2.7% (95% CI: 1.6–4.6) in Bobo-Dioulasso. HIV prevalence among MSM under 25 years old was 1.3% (95% CI: 0.6–2.8) and 0.9% (95% CI: 0.4–2.5) respectively in Ouagadougou and Bobo-Dioulasso, compared to 5.4% (95% CI: 2.2–12.5) and 6.6% (95% CI: 3.4–12.3) among those 25 years old or older in these cities (p = 0.010 and p < 0.001). Conclusions Results from this first biological and behavioral survey among MSM in Burkina Faso suggest a need for programs to raise awareness among MSM and promote safer sex, particularly for young MSM to prevent HIV transmission. These programs would need support from donors for innovative actions such as promoting and providing pre-exposure prophylaxis, condoms and water-based lubricants, HIV counseling, testing, early treatment initiation and effective involvement of the MSM communities

Development and reliability of metrics to characterize types and sources of stigma among men who have sex with men and female sex workers in Togo and Burkina Faso

Abstract Background Stigma is a multifaceted concept that potentiates Human Immunodeficiency Virus and sexually transmitted infection acquisition and transmission risks among key populations, including men who have sex with men (MSM) and female sex workers (FSW). Despite extensive stigma literature, limited research has characterized the types and sources of stigma reported by key populations in Sub-Saharan Africa. Methods This study leveraged data collected from 1356 MSM and 1383 FSW in Togo and Burkina Faso, recruited via respondent-driven sampling. Participants completed a survey instrument including stigma items developed through systematic reviews and synthesis of existing metrics. Using exploratory factor analysis with promax oblique rotation, 16 items were retained in a stigma metric for MSM and 20 in an FSW stigma metric. To assess the measures’ convergent validity, their correlations with expected variables were examined through bivariate logistic regression models. Results One factor, experienced stigma, included actions that were carried out by multiple types of perpetrators and included being arrested, verbally harassed, blackmailed, physically abused, tortured, or forced to have sex. Other factors were differentiated by source of stigma including healthcare workers, family and friends, or police. Specifically, stigma from healthcare workers loaded on two factors: experienced healthcare stigma included being denied care, not treated well, or gossiped about by healthcare workers and anticipated healthcare stigma included fear of or avoiding seeking healthcare. Stigma from family and friends included feeling excluded from family gatherings, gossiped about by family, or rejected by friends. Stigma from police included being refused police protection and items related to police confiscation of condoms. The Cronbach’s alpha ranged from 0.71–0.82. Median stigma scores, created for each participant by summing the number of affirmative responses to each stigma item, among MSM were highest in Ouagadougou and among FSW were highest in both Ouagadougou and Bobo-Dioulasso. Validation analyses demonstrated higher stigma was generally significantly associated with suicidal ideation, disclosure of involvement in sex work or same-sex practices, and involvement in organizations for MSM or FSW. Conclusions Taken together, these data suggest promising reliability and validity of metrics for measuring stigma affecting MSM and FSW in multiple urban centers across West Africa

Prise en charge de la COVID-19 à domicile à Ouagadougou au Burkina Faso au début de la pandémie (Résultats préliminaires)

Introduction : Face au nombre croissant de cas de refus d’hospitalisation d’une part et à la faiblesse des capacités d’hospitalisation d’autre part, le Burkina Faso a opté pour un programme de suivi des patients à domicile que nous étudions.Méthodologie : Il s’est agi d’une étude transversale descriptive du 16 avril au 20 mai 2020, à Ouagadougou des patients COVID-19 confirmés par PCR et pris en charge à domicile.Résultats : Au total 222 patients avec une COVID-19 ont été recensés dont 30 patients (13,5%) pris en charge à domicile. Le nombre moyen de suivi était de 3,45 visites, l’âge moyen était de 36,1 ± 16,7 ans et les enfants ainsi que les sujets de plus de 60 ans représentaient chacun 10% des cas. Parmi les patients, 60% étaient des célibataires et 22% avaient une comorbidité dont les plus fréquentes étaient le diabète (13,2%) et l’hypertension artérielle (6,7%). Les principaux symptômes étaient la toux (30,0%), l’asthénie physique (26,7%) et les céphalées (16,7%). Au cours du suivi, 33% des patients n’ont pas respecté le confinement à domicile : certains étaient absents et d’autres à leurs occupations sans port de masque ; Dans 10% des cas, les patients ont été hospitalisés et un décès a été constaté.Conclusion : Cette nouvelle pratique de prise en charge, si elle respecte certains critères d’éligibilité permettra de désengorger les structures sanitaires et offrirait plus de confort et de sérénité aux patients. &nbsp; English title: Home Care of COVID-19 in Burkina Faso at the Start of the pandemic (Preliminary Results)Background : Faced with the growing number of cases of refusal of hospitalization on the one hand and the weakness of hospitalization capacity on the other hand, Burkina Faso has opted for a home patient monitoring program, which we study.Methodology : This was a descriptive cross-sectional study carried out on COVID-19 patients confirmed by polymerase chain reaction and cared for at home from April 16 to May 20, 2020, in the city of Ouagadougou. Results : A total of 223 patients were identified in Ouagadougou, including 30 patients (13.5%) who were cared for at home. The mean number of follow-ups was 3.45 visits, average age was 36.1±16.7 years, children and people over 60 years in 10.0% of each. Of the patients, 60.0% were single and 22.0% had a comorbidity; the most common of which were diabetes (13.2%) and hypertension (6.7%). The main symptoms were cough (30.0%), physical asthenia (26.7%), and headache (16.7%). During follow-up, 33.0% did not adhere to containment at home: some of them were absents or doing theirs work without masque. Ten percent of patients takecare at home were hospitalized, and one death was recorded.Conclusion : If this new practice of home care meets certain eligibility criteria, it will relieve congestion at healthcare facilities and offer more comfort and serenity to patients