Table 3.

Findings on personal-level risk factors, including behavioral, interpersonal, and psychosocial factors

Author Year Country	Time in bar work	Sex work and type of clients	HIV risk awareness and willingness to test	Condom use	HIV risk magnifiers
Nagot 2002 Burkina Faso [9]	Median of 6 years, with wide range	Mean of 3.3 clients per week	Self-assessment of acquiring HIV in the future. Yes: 31%; No: 31%; Don’t know: 37%	12% of sex acts condomless	–
Van Blerk 2007 Ethiopia [24]	Timespan worked in bars often short	SW venue: back rooms of bars; Mean of 1 client per night most nights	High HIV risk awareness	High condom use with clients almost never with boyfriends	Alcohol consumption among FBWs lowers their control over condom negotiation
Van Blerk 2008 Ethiopia [23]	–	–	High risk awareness but feeling powerless to insist on condom use Many afraid to test for HIV	Forced condomless sex or condom cutting common	Several reports of client violence against FBWs
Van Blerk 2011 Ethiopia [25]	–	SW venue: varies by bar: luxury hotel rooms to backrooms and corridors; Regular clients can become boyfriends		Forced condomless sex, sometimes cutting of condoms	Expected to drink alcohol; Socially isolated if friends & family know occupation
Sori 2012 Ethiopia [3]	Mean of several years; Frequent bar changes	Expectation that low/no wages supplemented by SW; SW venue: back room of bars		Condom use occasional with new clients, rare for regulars
Messersmith 2014 Ghana [6]	–	Few admitted doing transactional sex; widespread agreement that sex work is done by FBW	High HIV knowledge; 64% FBWs think they are at risk of HIV, most due to partner infidelity 64% had ever tested for HIV	–	Low levels of alcohol use reported; client alcohol use seen as risky; violence largely IPV, not at bars
Kishindo 1995a Malawi [26]	Mean 3 years	Expected to make money from SW not BW; mean of 11 clients per week; SW venue: back rooms of bars	Low HIV risk awareness	23% lifetime condom use	Willing to not use condoms with clients if enough money paid Stigmatized because they are perceived to spread HIV
Kishindo 1995b Malawi [8]	All consider BW a temporary occupation;	SW venue: in back room, or elsewhere post- shift; 40% report regular clients.	High awareness that multiple partners risky; low HIV risk self-perception	30% lifetime condom use	–
Mhalu 1991 Tanzania [27]	–	–	–	Unmarried and longer term FBWs with access to counseling had condom use rates of around 65%	–
Mnyika 1995 Tanzania [28]	–	92% of FBWs are aware of the importance of condom use	–	47% lifetime condom use; 44% always have condoms available; 28% regularly insist on condom use with clients	–
Talle 1995 Tanzania [7]	–	All FBWs engage in SW; often have clients & boyfriends	High awareness, low perceived self-risk for HIV	Condom use rare	Reports of violence if refuse client’s demanded sexual practices Asking clients to use condoms raises stigma
Talle 1998 Tanzania [10]	All working in Namanga < 1 year	Number of clients answered imprecisely & perhaps underreported	–	–	–
Mgalla 1997 Tanzania [29]	–	Almost all have both casual & regular clients	High but imperfect HIV awareness	Some condom use with casual clients, none with regulars;	Low negotiation power
Riedner 2003 Tanzania [30]	–	75% of FBWs´ relationships involve money	–	Condom use ~ 50% ever with both, regular & casual partners	–
Akarro 2009 Tanzania [1]	–	–	High HIV risk awareness	90% report more money for condomless sex	96.7% regularly drink alcohol
Beckham 2013 Tanzania [31]	–	–	High HIV risk awareness Reports of FBWs unveiling their occupation in front of doctors to receive appropriate care	Condom decisions often left to client; condomless sex better paid	Stigmatized if reveal their profession to HCW; often assumed HIV-positive & referred to ART clinic
Ostermannn 2015 Tanzania [32]	–	FBWs have twice as many lifetime sexual partners as non-FBW peers	FBWs willing to test for HIV when tests are required by officials	–	FBWs less willing than others use home-based HIV testing, more concern re. disclosure
Gysels 2002 Uganda [2]	–	Women have both casual & regular clients Some claim to enjoy work: can make money & avoid demands for sex from local men; some do well through SW, others still struggling	High HIV risk awareness	Condom use acceptable with casual, but taboo for regular clients	Alcohol use leads to rape; 82% have been subject to violence, 44% to forced sex. Majority of rape prior to starting bar work
Ntozi 2003 Uganda [33]	–	Both types of casual & regular clients; prefer casual because they pay higher and mostly cash	High HIV risk awareness High stated willingness to test for HIV, but no past testing Barriers to HIV testing: cost & no facility	Increased condom use in recent years	Alcohol claimed as reason for multiple partners & low condom use