1. Regular sex partners to sex workers:- “a forgotten population" In STI/HIV Control Maureen Akolo 1, Kimani J 1,2, Nyamiobo F 1, Lipesa S 1, Musyimi A 1, Mbaji R 1, Chemutai J 1, Nadupoi J 1 Weru V 1, Njunguna R 1, Festus K 1, Kariri T 1, Kamau K 1, Onyango R 1, Magothe L 1, Gelmon L 1,2 1.University of Nairobi 2. University of Manitoba

2. Background University of Manitoba and Nairobi Collaborative HIV/STI research group has been involved with HIV prevention activities targeting sex workers since early 1980’s With PEPFAR support additional clinics were opened in 2008 creating 7 sex workers dedicated facilities, while two were opened to take care of the children, clients and family members of the sex workers. In Feb 2013 under the community positive health dignity and prevention (PHDP), “ushirikiano” (cooperation) intervention was initiated and targeted regular partners of the sex workers Regular partners of sex workers are hard to reach besides being at high risk of HIV acquisition

3. Methods A cross sectional study was conducted between April and Sept 2013 Prevention officers routinely visit sex workers at hotspot in Nairobi Mobilized sex workers are offered a minimum prevention package at the hotspot- “ushirikiano” under the PHDP initiative Issued referral cards for their regular partners Clinic-baseline questionnaire administered to partners Risk reduction counseling offered and routine HIV/STI screening Treatment offered for those who tested postive

4. Demographics Demographic Characteristics (n=732) Percentage Age Group 18-2936.6% 30-3932.5% 40-4922.0% 50+8.9% Marital StatusMarried and living together Married and living apart 1.4% Single 25.7% Widowed 0.8% Divorced 5.3%

5. Sexual Practices Percentage Type of sex Practiced Anal<1% Anal+ Vaginal +Oral<1% Vaginal93.9% Vaginal +Oral1.8% Anal+Vaginal1.8% Condom use with Casual Partner (n=139) Never24.5% Some (<50%)21.6% Most (>50%)17.3% Always36.7% Condom use with Regular Partner (n= 239) Never49.0% Some (<50%)25.1% Most (>50%)13.4% Always12.6% *Only 2.2% of the clients were able to properly demonstrate how to use a condom

6. Sexual Practices 2 Percentage Last time you had sex who did you have sex with Girlfriend17.70% Casual Partner11.50% Spouse52.70% Regular Partner18.10% Did you use a condom No77.40% Yes22.60% Ever paid to have sex No58.20% Yes41.80% Sex with Man No99.20% Yes<1%

7. HIV and STI Testing HIV testing Positive4.90% Total719 RPR Positive1.70% Total688 GC Culture Positive15.10% Total688

8. GC Infection by Age Group

9. Percentage Last time you had sex who did you have sex with* Girlfriend15.3% Casual Partner25.3% Spouse27.0% Regular Partner32.4% Did you use a condomNo80.2% Yes19.8% Ever paid to have sexNo42.3% Yes57.7% Ever been treated for STINo65.8% Yes34.2% Ever been tested for HIVNo77.5% Yes22.5% Sexual Practices of those with STI

10. Conclusions / Recommendations Majority of regular partners of sex workers are married They also have multiple partners and therefore at high risk for STI acquisition and transmission Have low rates of HIV testing and efforts to target them with prevention interventions needed Also more work on condoms and social determinants of risks required as they serve as a bridging population Ushirikiano as part of PHDP should be scaled up to help control STI/HIV among regular partners of sex workers

11. Acknowledgement University of Nairobi University of Manitoba NASCOP – MOH Kenya CDC-Kenya PEPFAR- Kenya CAPT-N All clinic staff and clients AIDS 2014