Prevalence of HIV and syphilis among sex workers in the Haute Matsiatra region of Madagascar

Aims: In 2019, the prevalences of syphilis and HIV in Madagascar at the level of the general population from 15 to 49 years were respectively 3.8% and 1%. In Madagascar, key populations, including sex workers (SWs), are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the serological status of SWs related to HIV and  

syphilis infection and their risky behaviours for these infection. Methods: we conducted a cross-sectional study in September 2021 targeting SWs  in Haute Matsiatra region. Among participant who consented, we collected blood samples for syphilis and HIV serological testing and structured questionnaire was used. Results: In total, 96 participants were included. Their mean age was 24 years old with extremes of 14 and 52 years old, sex-ratio was 0.02. SWs were single in 63.54% of cases, participants were heterosexual in 97.92% of cases. All SWs (100%) acknowledged having already been informed about HIV or syphilis. Regarding SWs’s knowledge about HIV and syphilis, sexual and blood transmission routes were the most cited in 97.92% and 96.88% of cases respectively. Twenty three percent of SWs reported not using condoms during sexual relations with their clients. All 96 SWs surveyed wanted to be tested for HIV. The prevalence of syphilis was 20.83%. Out of the 96 participants, 3.13% were HIV positive.

Conclusion: This study showed that the prevalence of syphilis and HIV among SWs were high compared to general population. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.