Factors Associated With Uptake Of Hiv And Aids Combination Prevention Strategies Among Female Sex Workers In Nakuru County, Kenya

The fight against HIV and AIDS in Kenya has been intensified to reduce the prevalence of HIV and AIDS across all populations. The National adult HIV prevalence rate in Kenya is 4.4%, with prevalence higher among women (5.7%) compared to that of men (3.1%). The prevalence among female sex workers (FSWs) is highest at 29.3% compared to all other populations, This implies that there is low uptake of HIV combination prevention strategies (HACPS) which are  the recommended prevention intervention for FSWs due to their risk of exposure. This study aimed to determine factors associated with uptake of HACPS among FSWs in Nakuru County. The specific objectives were to establish the level of uptake of HACPS among FSWs, to establish the level of knowledge, attitude and practice of HACPS among the FSWs, to determine the perceptions of FSWs associated with uptake of HACPS and to establish the demographic characteristics associated with uptake of HACPS among the FSWs in Nakuru County. The study adopted a descriptive cross-sectional research design. Data were collected using questionnaires from 336 FSWs reached through snowballing. Focus group discussion was done with six purposefully selected participants. Data were analyzed using SPSS version 21 to produce percentages and frequencies, presented in tables and charts. The study found out that uptake of HACPS among FSWs in Nakuru County was low at 32.4%.The level of knowledge of HIV risk and that of HACPS was 61.3%  and 45.9%respectively The perceptions associated with uptake of HACPS were low perceived barriers(p: 0.000)and low motivational drive towards uptake (p: 0.001).The demographic characteristics associated with uptake of HACPS were long duration in sex work for more than five years (p: 0.000),level of education beyond primary school ( p: 0.003). The conclusion from the study was that the level of uptake of HACPS was very low at 32.4 % which put the FSWs at risk of acquisition and transmission of HIV and AIDS. There was little knowledge on HACPS at 45.9%despite moderate knowledge on HIV risk (61.3 %). FSWs with negative beliefs, negative behavior and low motivational drive were less likely to take up HACPS. Education below secondary school and duration of sex work above five years was associated with uptake of HACPS .The recommendations from this study is that Nakuru County department of Health and implementing partners working with FSWs in the county to work on measures that will help to scale up the low uptake of HACPS among FSWs, through education and  sensitization  of FSWs on HACPS . The Sensitization should target all FSWs especially those with negative perceived barriers low motivational drive, education level below secondary school and duration of sex work below five years.