Sexually Transmitted Infections among Sex Workers and Their Clients in Cotonou (Benin) in 2015: Prevalence and Risk Factors
Introduction: In the spread of sexually transmitted infections (STIs), the most vulnerable populations are sex workers (SWs). The objective of our study was to determine the prevalence and risk factors of STIs for SWs and their clients in a hospital in Cotonou, Benin.
Methods: A cross-sectional and prospective survey was conducted at the STI clinic in Cotonou, from November 2014 to April 2015. SWs and their clients who consulted in the clinic were included after informed consent. The diagnosis of STI was essentially based on the syndromic approach.
Results: At least one STI was diagnosed in 231 SWs out of 346 and 45 out of 49 clients, which ranks to a prevalence rate of 66.8% and 91.8% respectively; P=0.00064. The prevalence of STIs was higher among trader SWs, aged 25-44 (p=0.05), with at most a primary school level (p=0.02) and with traders or civil servant clients, aged 25-34 years old with secondary school level (p=0.02). STIs were distributed among the SWs and their clients in STI without flow:
54.1% against 32.6%, STI with outflow: 38.7% against 54.7% and STI with ulceration: 7.2% against 12.8%. In the absence of condom protection, the prevalence of STIs was higher among SWs (91%) and their clients (97.8%); 0.0005 ≤ p ≤ 0.0003. Anal penetration was associated with a high prevalence of STIs in both SWs (90%) and their clients (100%); 0.0002 ≤ p ≤ 0.005.
Conclusion: The high prevalence of STIs / HIV in SWs and their clients was mainly due to the low socioeconomic level of SWs, sexual behaviors such as the non-constant use of condom and anal penetration.