Factors contributing to differences in uptake of antiretroviral treatment between female sex workers (FSWs) and non-sex workers (NSWs), Manicaland, Zimbabwe, 2009–2011
| Bivariate analysis | Socio-demographic | Socio-demographic sex work | Intermediate determinants | Intermediate determinants sex work | Full model | |||||||||
| n | % | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | |
| Female sex work | ||||||||||||||
| Sex work | ||||||||||||||
| NSWs | 138 | 75.4 | 1 | – | – | – | 1 | – | – | – | 1 | – | 1 | – |
| FSWs | 45 | 24.6 | 2.64 | 1.16 to 6.00 | – | – | 2.28 | 0.97 to 5.39 | – | – | 3.46 | 0.91 to 13.16 | 3.51 | 0.79 to 15.47 |
| Socio-demographic | ||||||||||||||
| Age | ||||||||||||||
| Age (continuous) | – | – | 1.53 | 1.14 to 2.06 | 1.62 | 1.19 to 2.22 | 1.57 | 1.14 to 2.15 | – | – | – | – | 1.63 | 1.03 to 2.57 |
| Age2 | – | – | 1 | 0.99 to 1.00 | 0.99 | 0.99 to 1.00 | 1 | 0.99 to 1.00 | – | – | – | – | 1 | 0.99 to 1.00 |
| Marital status | ||||||||||||||
| Never married | 2 | 1.1 | 0.33 | 0.04 to 2.57 | – | – | – | – | – | – | – | - | – | – |
| Married | 72 | 39.3 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Divorced/separated | 29 | 15.8 | 1.56 | 0.66 to 3.65 | – | – | – | – | – | – | – | – | – | – |
| Widowed | 80 | 43.7 | 1.41 | 0.73 to 2.74 | – | – | – | – | – | – | – | – | – | – |
| Church denomination | ||||||||||||||
| Christian churches | 100 | 54.6 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Spiritual churches | 59 | 32.2 | 0.62 | 0.35 to 1.12 | – | – | – | – | – | – | – | – | – | – |
| Other religion | 19 | 10.4 | 1.29 | 0.46 to 3.58 | – | – | – | – | – | – | – | – | – | – |
| No religion | 5 | 2.7 | 2 | 0.30 to 13.48 | – | – | – | – | – | – | – | – | – | – |
| Socioeconomic status | ||||||||||||||
| 1 (poorest) | 113 | 61.7 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| 2 | 47 | 25.7 | 1.21 | 0.63 to 2.34 | – | – | – | – | – | – | – | – | – | – |
| 3 | 20 | 10.9 | 2.3 | 0.82 to 6.44 | – | – | – | – | – | – | – | – | – | – |
| Residential area | ||||||||||||||
| Town | 62 | 33.9 | 1 | – | 1 | – | 1 | – | – | – | – | – | 1 | – |
| Agricultural estate | 54 | 29.5 | 1.1 | 0.52 to 2.35 | 1.27 | 0.58 to 2.76 | 1.37 | 0.62 to 3.01 | – | – | – | – | 2.53 | 0.77 to 8.29 |
| Roadside settlement | 35 | 19.1 | 0.48 | 0.23 to 1.01 | 0.54 | 0.26 to 1.15 | 0.6 | 0.28 to 1.28 | – | – | – | – | 0.87 | 0.29 to 2.61 |
| Subsistence farming village | 32 | 17.5 | 0.82 | 0.37 to 1.82 | 0.96 | 0.42 to 2.16 | 1.01 | 0.44 to 2.30 | – | – | – | – | 1.78 | 0.53 to 5.95 |
| Education | ||||||||||||||
| Primary or less | 86 | 47.0 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Secondary or higher | 97 | 53.0 | 1.09 | 0.58 to 2.07 | – | – | – | – | – | – | – | – | – | – |
| Children alive | ||||||||||||||
| 0 | 50 | 27.3 | 1 | – | 1.00 | – | 1 | – | – | – | – | – | 1 | – |
| 1 | 52 | 28.4 | 0.44 | 0.18 to 1.08 | 0.44 | 0.18 to 1.10 | 0.49 | 0.19 to 1.24 | – | – | – | – | 0.2 | 0.04 to 1.12 |
| 2 | 40 | 21.9 | 0.37 | 0.15 to 0.95 | 0.39 | 0.15 to 1.02 | 0.46 | 0.18 to 1.22 | – | – | – | – | 0.13 | 0.02 to 0.76 |
| 3 | 24 | 13.1 | 0.27 | 0.10 to 0.75 | 0.27 | 0.10 to 0.74 | 0.31 | 0.11 to 0.87 | – | – | – | – | 0.13 | 0.02 to 0.80 |
| 4 | 17 | 9.3 | 0.24 | 0.08 to 0.72 | 0.24 | 0.08 to 0.75 | 0.25 | 0.08 to 0.78 | – | – | – | – | 0.05 | 0.01 to 0.36 |
| Intermediate determinants | ||||||||||||||
| Knowledge about HIV risks | ||||||||||||||
| Good | 162 | 88.5 | 1.18 | 0.53 to 2.63 | – | – | – | – | – | – | – | – | – | – |
| Poor | 21 | 11.5 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Risk perception for HIV infection | ||||||||||||||
| Own high-risk behaviour | 37 | 20.2 | 1.1 | 0.38 to 3.16 | – | – | – | – | – | – | – | – | – | – |
| Partner(s)' high-risk behaviour | 92 | 50.3 | 1.06 | 0.42 to 2.68 | – | – | – | – | – | – | – | – | – | – |
| Other reasons | 36 | 19.7 | 0.81 | 0.29 to 2.26 | – | – | – | – | – | – | – | – | – | – |
| None | 18 | 9.8 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Peer influence | ||||||||||||||
| Relative(s) on ART | 72 | 39.3 | 9.12 | 4.25 to 19.58 | – | – | – | – | 1.95 | 0.70 to 5.42 | 1.83 | 0.66 to 5.06 | 1.79 | 0.61 to 5.20 |
| Friend(s) on ART | 91 | 49.7 | 16.38 | 7.22 to 37.20 | – | – | – | – | 3.04 | 1.03 to 8.93 | 2.52 | 0.85 to 7.46 | 2.19 | 0.69 to 6.97 |
| None | 20 | 10.9 | 1 | – | – | – | – | – | 1 | – | 1 | – | 1 | – |
| Sickness in last 12 months | ||||||||||||||
| HIV-related illness | 69 | 37.7 | 1.09 | 0.57 to 2.09 | – | – | – | – | – | – | – | – | – | – |
| Other illness | 42 | 23.0 | 0.69 | 0.35 to 1.35 | – | – | – | – | – | – | – | – | – | – |
| None | 72 | 39.3 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| STD symptoms in last 12 months | ||||||||||||||
| Yes | 51 | 27.9 | 1.03 | 0.56 to 1.89 | – | – | – | – | – | – | – | – | – | – |
| No | 132 | 72.1 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Psychological distress | ||||||||||||||
| Yes | 36 | 19.7 | 0.46 | 0.24 to 0.86 | – | – | – | – | 0.43 | 0.19 to 0.99 | 0.41 | 0.18 to 0.96 | 0.48 | 0.20 to 1.18 |
| No | 147 | 80.3 | 1 | – | – | – | – | – | 1 | – | 1 | – | 1 | – |
| Pregnancies in last 3 years | ||||||||||||||
| One or more | 28 | 15.3 | 0.86 | 0.41 to 1.80 | – | – | – | – | – | – | – | – | – | – |
| None | 155 | 84.7 | 1 | – | – | – | – | – | – | – | – | – | – | – |
| Travel time to ART service * | ||||||||||||||
| <30 min | 43 | 23.5 | 1 | – | – | – | – | – | 1 | – | 1 | – | 1 | – |
| 30–59 min | 42 | 23.0 | 0.27 | 0.08 to 0.86 | – | – | – | – | 0.27 | 0.08 to 0.89 | 0.34 | 0.10 to 1.15 | 0.41 | 0.11 to 1.58 |
| 60–89 min | 34 | 18.6 | 0.32 | 0.09 to 1.18 | – | – | – | – | 0.37 | 0.10 to 1.40 | 0.42 | 0.11 to 1.62 | 0.34 | 0.07 to 1.67 |
| 90 min | 63 | 34.4 | 0.37 | 0.12 to 1.16 | – | – | – | – | 0.46 | 0.14 to 1.46 | 0.51 | 0.15 to 1.65 | 0.65 | 0.17 to 2.49 |
| Uncertain | 1 | 0.5 | – | – | – | – | – | – | – | – | – | – | – | – |
| Stigma and discrimination (in the community) | ||||||||||||||
| Yes | 38 | 20.8 | 1.3 | 0.64 to 2.64 | – | – | – | – | – | – | – | – | – | – |
| No | 145 | 79.2 | 1 | – | – | – | – | – | – | – | – | – | – | – |
*Includes women not aware of HIV testing and ART services to prevent exclusion of these participants from the multivariable analysis. ORs were not interpreted for this group as they are not comparable with the reference category.
AOR, adjusted OR; ART, antiretroviral treatment; STD, sexually transmitted diseases.