20th International AIDS Conference - Melbourne, Australia


WEPDC0105 - Poster Discussion Abstract

If you aren't counted, you don't count: estimating the number of female sex workers in Mandalay and Yangon, Myanmar

Presented by Si Thu Thein (Myanmar).

S.T. Thein1, T. Aung1, H.M. Kyaw1, A. Lancelot1, W. Mcfarland2

1Population Services International/Myanmar, Strategic Information, Yangon, Myanmar, 2San Francisco Department of Public Health, San Francisco, United States

Background: Estimates of the size of key affected populations, including female sex workers (FSW), are necessary for advocacy and for planning, implementation, and evaluation of HIV prevention and care programs. However, these populations are usually hidden and hard to reach. This study aims to provide population size estimates (PSE) of FSW in two most populous cities of Myanmar (Yangon and Mandalay) using multiple methods.
Methods: The study was conducted in Yangon and Mandalay from October to December 2013. Time-location cluster sampling was used to recruit 450 FSW in Yangon and 328 in Mandalay using probability proportionate to size of clusters. Four PSE methods were applied, including unique object, unique event and service multipliers, and wisdom of the crowd, to calculate estimates for each city. Adjusted and unadjusted estimates were used for the multiplier methods and compared. Estimated proportion of FSW among adult female population in each region was calculated and compared with the published literature in the region.
Results: Estimates from the methods were consistent with each other, with medians of ~5000 in Yangon (Range: 3500-7000); and ~3000 in Mandalay (Range: 1600-4400). Adjusted proportions produced slightly higher estimates, by ~200-500. The estimated proportion of FSW among the adult female population (15-49 years) was 0.45% (0.27-0.63%) in Yangon and 0.51% (0.25-0.76%) in Mandalay, falling within published estimates in Asia region. These estimates are plausible and have immediate applications for establishing the reach of current programs and the need for scale up of services for FSW in Myanmar.

PSE from various multiplier methods
[PSE from various multiplier methods]

Conclusions: PSE methods, when applied properly, could produce plausible size estimates of hidden, hard to reach populations. Triangulation of data from various sources could produce more reliable results. These results could provide background data for various HIV prevention and control activities, especially for hidden populations for which conventional population data is scarce.

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