Prevalence and factors associated with hepatitis B and C virus infections among female Sex workers in Ethiopia: Results of the national biobehavioral Survey, 2020

• Published in: PloS one Vol. 17; no. 12; p. e0269510
• Main Authors: Bedassa, Birra Bejiga, Ebo, Gemechu Gudeta, Yimam, Jemal Ayalew, Tura, Jaleta Bulti, Wariso, Feyiso Bati, Lulseged, Sileshi, Eticha, Getachew Tollera, Wolde, Tsigereda Kifle, Abrahim, Saro Abdella
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 30.12.2022; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Age; AIDS; Biology and life sciences; Confidence intervals; Cross-Sectional Studies; Diagnosis; Distribution; Earth Sciences; Ethiopia - epidemiology; Female; Females; Health aspects; Hepacivirus; Hepatitis; Hepatitis B; Hepatitis B - epidemiology; Hepatitis B vaccine; Hepatitis B virus; Hepatitis C; Hepatitis C - epidemiology; Hepatitis C virus; HIV; HIV (Viruses); HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Immunization; Independent variables; Infections; International economic relations; Medicine and health sciences; People and Places; Prevalence; Prostitutes; Public health; Regression analysis; Risk analysis; Risk Factors; Risk taking; Sex industry; Sex oriented businesses; Sex Workers; Sexual behavior; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Social Sciences; Statistical analysis; STD; Surveys; Syphilis; Vaccination; Vaccines; Viruses; Ethiopia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0269510

Hepatitis B and C virus infections are endemic diseases in sub-Saharan Africa, the region with the highest prevalence of these infections in the world. Female sex workers are exposed to sexually transmitted infections, including hepatitis B and C, because of their high-risk sexual behavior and limited access to health services. There are no large-scale data on the prevalence of hepatitis B and C virus infections among female sex workers in Ethiopia, a critical gap in information this study aimed to fill. This was a cross-sectional, biobehavioral survey conducted from December 2019-April 2020 among 6085 female sex workers aged ≥15 years and residing in sixteen (16) regional capital cities and selected major towns of Ethiopia. Blood samples were collected from the participants for hepatitis B and C virus serological testing. The data were collected using an open data kits (ODK) software and imported into STATA version16 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize data on the study variables. Bivariable and multivariable logistic regression analyses were conducted to determine the strength of association between independent variables (risk factors) and the outcome (hepatitis B and C virus infection). Adjusted Odd ratio (AOR) was used to determine independent associations, 95% confidence interval to assess precision of the estimates, and a P value ≤ 0.05 to determine statistically significant. The prevalence of hepatitis B and C infections among the 6085 female sex workers was 2.6% [(95% CI (2.2,2.8)] and 0.5% [(95% CI (0.4,0.7)], respectively. Female sex workers who had 61-90 and ≥91 paying clients in the past six months [(AOR = 1.66; 95% CI, (0.99, 2.79); P = 0.054] and [(AOR = 1.66 95% CI, (1.11, 2.49); P = 0.013], respectively, age at first sex selling of 20-24 and >25 years [(AOR = 1.67; 95% CI, (1.14, 2.44); P = 0.009)] and [(AOR = 1.56; 95% CI (1.004, 2.43); P = 0.048)], respectively, known HIV positive status [(AOR = 1.64; 95% CI (1.03, 2.62); P = 0.036] were significantly associated with the prevalence of hepatitis B virus infection. Similarly, hepatitis C was significantly associated with, age at first sex ≤15 years and age 16-20 years [(AOR = 0.21; 95%CI (0.07,0.61); P = 0.005)] and [(AOR = 0.18; 95% CI (0.061, 0.53); P = 0.002)], respectively, known HIV positive status [(AOR = 2.85; 95%CI (1.10,7.37); P = 0.031)] and testing positive for syphilis [(AOR = 4.38; 95% CI (1.73,11.11); P = 0.002)], respectively. This analysis reveals an intermediate prevalence of hepatitis B and a low prevalence of hepatitis C infection among female sex workers in Ethiopia. It also suggests that population groups like female sex workers are highly vulnerable to hepatitis B, hepatitis C, and other sexually transmitted infections. There is a need for strengthening treatment and prevention interventions, including immunization services for hepatitis B vaccination, increasing HCV testing, and provision of treatment services.