Assessing high-risk sexual practices associated with human immunodeficiency virus infection among young female sex workers in Lubumbashi, Democratic Republic of the Congo: a cross-sectional study

Introduction: Young female sex workers (YFSWs) face a higher risk of HIV infection compared to older workers, but there is a lack of comprehensive data on their sexual practices and HIV infection risks, which may present unique challenges and vulnerabilities. The study aimed to identify high-risk sexual practices associated with HIV infection among YFSWs in Lubumbashi.

Methods: We conducted an analytical cross-sectional study and used a comprehensive sample of all YFSWs who presented to the HIV/Sexually Transmitted Infections Screening and Treatment Center in Lubumbashi between April 2016 and December 2017. We collected data on socio-demographic characteristics and behavioral risk factors of female sex workers were collected using a structured questionnaire. Using STATA version 16, multivariate logistic regression was fitted and the results were presented as adjusted odds ratios (aORs) with their 95% confidence intervals (95% CIs).

Results: A total of 572 YFSWs were included in the study, 19 of whom were HIV-positive (3.3%; 95% CI: 2.1-5.1%). Participants who were forced to have sex (aOR = 12.2; 95% CI: 3.2-46.4; p < 0.0001), those who did not use condoms systematically (aOR = 4.1; 95% CI: 1.3-13.0; p = 0.018), and those who had anal sex (aOR = 23.8; 95% CI: 6.9-82.4; p < 0.0001) were more likely to be HIV-positive.

Conclusion: The study reveals a concerning trend of higher hospital HIV prevalence among YFSWs compared to the general Congolese population. It also highlights a significant link between high-risk sexual practices and HIV infection, highlighting the need for urgent interventions.