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Background: A 2006 study of female sex workers (FSW) in Honduras found HIV prevalence rates of 5.5% in Tegucigalpa (TG), 4.6% in San Pedro Sula (SPS), and 1.9% in La Ceiba (LC), and identified sexual violence as an HIV risk factor. This report focuses on sexual violence and HIV among FSW in those three cities.
Methods: Respondent driven sampling was used to recruit FSW who received a face-to-face computer-assisted survey and were tested for HIV (Determine and ELISA, plus Western Blot if discordant). RDSAT 7.1.38 and STATA 12.0 were used for statistical analyses.
Results: HIV prevalence (and 95% CI) was 3.5% (1.3-5.8) among 584 FSW in TG, 6.6% (4.1-9.3) among 588 in SPS, and 15.6% (7.7-23.8) among 189 in LC. Prevalence (and 95% CI) of sexual violence (ever forced sex) was 37.5% (32.1-43.5) in TG, 39.0% (34.3-45.1) in SPS, and 38.1% (28.9-48.7) in LC. Rates of sexual violence were higher (p < .005) among FSF who started sex work at an older age (≥18 vs. <18): 85.8% vs. 14.2%; 76.5% vs. 23.5%; 67.9% vs. 32.1%. Rates were also higher (p < .005) among FSW who had engaged in sex work longer (> vs. < 1 year): 85.8% vs. 14.2%; 74.9% vs. 25.1%; 80.8% vs. 19.2%).
Conclusions: HIV prevalence rates were similar to those reported in 2006, except for noticeably higher rates in LC. Rates of sexual violence were high in all three cities and consistently associated with older age at initiation and more than 1 year of sex work. Violence sex among FSW is a complex issue in Honduras. It is recommended that public health interventions to reduce sexual violence among sex workers are reinforced with the support of other sectors such as the economy, political leadership and gender inequality in Honduras.