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Objective Venues where people socialize, such as bars, play a significant role in HIV transmission risk. However, little research has been done that identifies characteristics of high-risk venues, to inform HIV prevention efforts. This study identified clusters of social venues in Uganda and their relationship with HIV vulnerability of young venue workers (15–24 years). We also assessed availability of HIV prevention services at the venues.Design and setting This was a secondary analysis of data from a larger cross-sectional survey of social venues in 25 districts of Uganda.Participants A total of 480 venues that employed young workers were included in this study.Analysis Hierarchical cluster and mixed-effects regression analyses were conducted.Results Four clusters were adopted: cluster 1 represented 127 venues (mainly alcohol-serving sex work venues with a provision of on-site sex); cluster 2 represented 80 venues (mainly alcohol-serving sex work venues without a provision of on-site sex); cluster 3 represented 113 venues (mainly alcohol-serving venues without sex work or on-site sex); and cluster 4 represented 160 venues (non-alcohol-serving venues). We found a positive correlation between venue clusters and HIV vulnerability. Workers who belonged to cluster 1 (alcohol-serving sex work venues with a provision of on-site sex) had a 0.15 increase in HIV vulnerability compared with those in alcohol-serving venues without sex work or a provision of on-site sex (cluster 3) (coefficient: 0.15, 95% CI: 0.030 to 0.287) after adjusting for age, sex and marital status. Thirty-seven per cent of cluster 1 venues reported any HIV prevention services in the past 12 months.Conclusion Alcohol-serving sex work venues with a provision of on-site sex (cluster 1) appeared to reinforce vulnerability to HIV in this study and should be targeted with HIV prevention interventions. Such venues can amplify HIV transmission by facilitating sexual partner coupling and on-site sex.

BackgroundKey Population size estimation (PSE) is instrumental for HIV/STI preventive, treatment and care services planning, implementation and delivery. The objective was to estimate the overall population of female sex workers (FSW) in all the 16 regions of Ghana using different PSE methods.MethodMapping of venues and complete enumeration of seaters was conducted at the formative stage prior to the bio-behavioral survey (BBS). Three PSE methods were used to derive the size estimates of FSW in the 16 regions. These include: Capture-recapture (CRC), service multiplier and three-source capture recapture (3SCRC) methods. The final choice of the estimation method used to estimate the roamer population was 3SCRC. This method was chosen because of its perfect record-linkage-hierarchic combination of three names that minimizes overmatching as well as the addition of an interaction term in the model which corrects for the dependencies in CRC.ResultsThe total population size estimate of the female sex workers in the country obtained for roamers using capture re-capture was 41,746 (95% CI: 41,488-41,932). Using the service multiplier, the total population for both the roamers and seaters was 41,153 (95% CI: 37,242-45,984). The 3-source capture re-capture yielded 55,686 roamers FSW (95% CI: 47,686-63,686). The seater population was 4,363 FSW based on census/complete enumeration. The total population size estimate of FSW (seaters and roamers) in Ghana was 60,049 when 3SCRC and census were added. This represents about 0.76% of all estimated adult females aged 15-49yrs in Ghana.ConclusionWe report population size estimates (PSE) for FSW in Ghana. These estimates are the results of 3SCRC. These findings provide a valid and reliable source of information that should be referenced by government officials and policymakers to plan, implement and provide HIV/STI preventive, treatment, and care services for FSW in Ghana.