Lessons learned from research

with HIV+ female sex workers in

Kibera, a large informal

settlement in Nairobi, Kenya

Kimberly Sharpe1, Cecilia Benoit1, Helga Hallgrimsdottir1 ,Mikael Jansson1, Elizabeth Ngugi2, and Eric Abella Roth1

1Centre for Addictions Research of British Columbia, University of Victoria, BC, Canada

2 Centre for HIV Prevention and Research, University of Nairobi, Nairobi, Kenya,

THE STUDY SITE: KIBERA

3

Methodology - Sampling

Descriptive Sample Statistics VARIABLE

(MEAN VALUES)

FEMALE SEX

WORKERS

(N= 161)

KIBERA

WORKING

WOMEN (N=159)

PROBABILITY

AGE

30.4 29.3 0.21

CHILDREN

EVER BORN 3.5 3.4 0.74

AGE

AT LAST

CONTACT MALE

GUARDIAN

14.6

17.1

<0.001

AGE AT LAST

CONTACT

FEMALE

GUARDIAN

16.8

18.1

0.009

NUMBER OF

FAMILY SEEN

REGULARLY

NOW

2.7

3.9

0.015

FSW: Clients and Partners

VARIABLE (M)

Female Sex

Workers with

intimate partners

n=70

Female Sex

Workers without

current intimate

partner

n=91

Number of

people had sex

with last week

3.1

6.6

Number of those

used condoms

2.2

4.4

Number of those

did not use

condoms

0.9

2.2 7

Negative Binomial Regression # Of Clients

8

PARAMETER

DF

COEFFICIENT

STANDARD

ERROR

PROBABILITY

INTERCEPT 1 1.9021 0.1981 <0.001

HIV STATUS

Positive vs.

Negative or

Unknown

1

-0.1901

0.2049

0.3535

ROMANTIC

PARTNER

Present vs. Absent

1

-0.8260

0.1814

<0.0001

EDUCATION

No Formal

Education vs.

Some Education

1

0.0712

0.1085

0.5119

BEER

Drink Beer

Daily vs. Drink

Less Frequently

1

-0.2809

0.1796

0.1178

FAMILY NOW

Continuous

Variable

1

0.0126

0.0247

0.6102

Potential for Intervention?

0

2

4

6

8

10

12

14

16

18

20

HIV+ SEX WORK

Number of Women Who Informed Their Partners of Their HIV Status and Sex Work

Involvement

Yes

No

Lessons Learned:

1)HIV Normalized

Partners knew about the woman’s HIV+ status

before the relationship began:

Interviewer: Did it affect your relationship with

him?

Violet (Age 35): No, because he’s also HIV +.

Interviewer: So to him, he didn’t feel like

affected or…

Violet: Yeah, actually met him there, at the

hospital,

Lessons Learned:

2) Sex Work Stigmatized

Others worried about losing economic

support if their partner found out:

–Janiel, age 39: “She says she didn’t

tell him because she’s afraid. If she

tells, the guy will pack off and maybe

she wouldn’t have any source of

income, even after she has told him.”

Sex workers marchingin Nairobi – March 2012 – International Sex Workers Rights Day

ACKNOWLEDGEMENTS This research was funded by the National Institutes of Health (RD

HD056799-01): A Kenya free of AIDS: Harnessing interdisciplinary science for HIV prevention

Principal Investigators: Dr. Elizabeth Ngugi, University of Nairobi and Dr.

Martina Morris, University of Washington

All research instruments were approved by the Kenyan, American and Canadian ethics offices and translated into English and Kiswahili

We are grateful for the efforts and mentorship provided by our Kenyan Field Assistants: Ann Gikuni, Veronica Kamau, Mary Pere, Beth Njeri, Jackie Gitahi, Caroline Gitahi, Dennis Njogu, Isaiah Gitonga, and Deborah David

We remain indebted to the people of Kibera who shared so much of their life histories with us.

ericroth@uvic.ca