Informing HIV prevention programs for adolescent girls and young women: a modified approach to programmatic mapping and key population size estimation
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Type
Journal Article
Abstract
Background: Standard programmatic mapping involves identifying locations where key populations meet, profiling of these locations (hotspots), and estimating the key population size. Information gained from this method has been used for HIV programming—resource allocation, program planning, service delivery, and monitoring and evaluation—for people who inject drugs, men who have sex with men, and female sex workers (FSWs). With an increasing focus on adolescent girls and young women (AGYW) as a priority population for HIV prevention, programs need to know the location of and how to effectively reach individuals who are at increased risk for HIV but were conventionally considered part of the general population. We hypothesize that AGYW who engage in transactional and casual sex also congregate at sex work hotspots to meet sex partners. Therefore, we adapted the standard programmatic mapping approach to understand the geographic distribution and population size of AGYW at increased HIV risk in Mombasa County, Kenya. Objectives: The objectives are several-fold: (1) detail and compare the modified programmatic mapping approach used in this study to the standard approach, (2) estimate the number of young FSWs, (3) estimate the number of AGYW who congregate in sex work hotspots to meet sex partners other than clients, (4) estimate the overlap in sexual network in hotspots, (5) describe the distribution of sex work hotspots across Mombasa and its four subcounties, and (6) compare the distribution of hotspots that were known to the local HIV prevention program prior to this study and those newly identified. Methods: The standard programmatic mapping approach was modified to estimate the population of young women aged 14 to 24 years who visit sex work hotspots in Mombasa to meet partners for commercial, transactional, and casual sex. Results: We estimated that there were 11,777 FSWs (range 9265 to 14,290) in Mombasa in 2014 among whom 6127 (52.02%) were 14 to 24 years old. The population estimates for women aged 14 to 24 years who engaged in transactional and casual sex and congregated at the hotspots were 5348 (range 4185 to 6510) and 4160 (range 3194 to 5125), respectively. Of the 1025 validated sex work hotspots, 870 (84.88%) were locations also visited by women engaged in transactional and casual sex. Only 47 (4.58%) hotspots were exclusive sex work locations. The geographic and typological distribution of hotspots were significantly different between the four subcounties (P<.001). Of the 1025 hotspots, 419 (40.88%) were already known to the local HIV prevention program and 606 (59.12%) were newly identified. Conclusions: Using the adapted programmatic mapping approach detailed in this study, our results show that HIV prevention programs tailored to AGYW can focus delivery of their interventions to sex work hotspots to reach subgroups that may be at increased risk for HIV.
Date Issued
2019-04-01
Online Publication Date
2020-09-29T12:16:44Z
Date Acceptance
2019-01-25
ISSN
2369-2960
Publisher
JMIR Publications
Start Page
242
End Page
255
Journal / Book Title
JMIR Public Health and Surveillance
Volume
5
Issue
2
Copyright Statement
©Eve Cheuk, Shajy Isac, Helgar Musyoki, Michael Pickles, Parinita Bhattacharjee, Peter Gichangi, Robert Lorway, Sharmistha
Mishra, James Blanchard, Marissa Becker. Originally published in JMIR Public Health and Surveillance
(http://publichealth.jmir.org), 01.04.2019. This is an open-access article distributed under the terms of the Creative Commons
Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction
in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete
bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license
information must be included.
Mishra, James Blanchard, Marissa Becker. Originally published in JMIR Public Health and Surveillance
(http://publichealth.jmir.org), 01.04.2019. This is an open-access article distributed under the terms of the Creative Commons
Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction
in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete
bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license
information must be included.
License URI
Identifier
https://publichealth.jmir.org/2019/2/e11196/
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000526816400018&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
programmatic mapping
key population size estimation
female sex workers
adolescent girls and young women
sex work
transactional sex
casual sex
HIV prevention
FEMALE SEX WORKERS
INTERVENTION
AFRICA
INCOME
HIV prevention
adolescent girls and young women
casual sex
female sex workers
key population size estimation
programmatic mapping
sex work
transactional sex
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
programmatic mapping
key population size estimation
female sex workers
adolescent girls and young women
sex work
transactional sex
casual sex
HIV prevention
FEMALE SEX WORKERS
INTERVENTION
AFRICA
INCOME
Publication Status
Published
Article Number
UNSP e11196
Date Publish Online
2019-04-01