Prevalence of hepatitis B virus infection and associated factors among female sex workers in Dar es Salaam, Tanzania

Abstract

Background: Hepatitis B virus (HBV) infection is a serious public health problem in sub-Saharan Africa among the most at risk groups such as Female sex workers (FSW). The modes of transmission are mainly by skin or mucosal exposure to infected blood and various body fluids including saliva, menstrual blood, vaginal and seminal fluid. Prevalence and associated factors for HBV infection among FSW in Dar es Salaam is not well established. Objective: The study aimed to determine the prevalence of Hepatitis B Virus infection and associated factors among FSW in Dar es Salaam, Tanzania. Methodology: A cross-sectional integrated biological and behavioral survey among FSW was conducted between September and December 2017 in Dar es Salaam. The survey utilized a Respondent Driven Sampling (RDS) approach to recruit FSW. Data on socio-demographic characteristics, risky sexual behaviors practices were collected using a structured questionnaire and blood was collected and tested for Hepatitis B surface Antigen (HBsAg). Data was analyzed using Respondent Driven Analysis Tool (RDSAT) together with STATA version 13 for windows. Logistic regression models were used to identify independent risk factors associated with HBV infection. All analyses were two – tailed, significance level was set at 5% level and adjusted for clustering. Results: A total of 950 FSW with median age of 26 years and interquartile range 22-32 years were recruited. Prevalence of HBV was estimated at 2.9 % [95% CI: (1.9-4.4)]. Independent risk factors for HBV were age 35 years and above [AOR, 5.3, 95%CI: (1.4, 19.7)], having no alternative source of income besides sex work [AOR, 3.7, 95%CI: (1.2- 11.7)], obtaining clients through telephone or internet or agent [AOR, 11.3, 95%CI: (1.5-82.3)]; and meeting in Pub/ bar or nightclub or Guest house/ Hotel [AOR, 6.5, 95%CI: (1.2-34.1)]. Conclusion: Prevalence of HBV infection among FSW in Dar es Salaam was found to be 2.9%. Old age 35 years and above, having no alternative source of income besides sex work, negotiating sex through telephone or internet or agent, and meeting clients in Pub/bar /nightclubs/Guest house/Hotel were significantly associated with HBV infection.