Uptake of the hepatitis B vaccine among brothel-based female sex workers in Kampala, Uganda

Hepatitis B is a significant health problem worldwide, particularly among high-risk groups such as female sex workers (FSWs). In Uganda, it is highly recommended that FSWs receive the hepatitis B vaccine. However, there is limited evidence of the level of uptake of the hepatitis B vaccine and associated factors among FSWs in Uganda. This study aimed to assess hepatitis B vaccine uptake and associated factors among FSWs in Kampala district, Uganda.

We conducted a cross-sectional study using data from 400 FSWs in Kampala, Uganda. We utilized a researcher-developed digitized semi-structured questionnaire and employed multistage sampling to enroll participants. Data analysis was performed using STATA version 14.0. Continuous data were expressed as mean and standard deviation whereas categorical data were reported as frequencies and proportions. We employed Modified Poisson regression analysis to assess the relationship between predictor variables and the uptake of the hepatitis B vaccine.

A total of 400 respondents (98.5% response rate) were surveyed. Close to half, 49.8% of the respondents had ever heard about hepatitis B, and only 16.5% had received at least a hepatitis B vaccine dose. Individual factors significantly associated with hepatitis B vaccine uptake included spending more than four years in sex work (APR: 1.06, 95% CI: 1.01–1.12), previous screening for hepatitis B (APR: 1.49, 95% CI: 1.38–1.61), and having work conditions that allowed time to seek HBV services (APR: 1.13, 95% CI: 1.04–1.22). Health system factors significantly associated with vaccine uptake included the presence of hepatitis B outreach programs in residential areas (APR: 1.17, 95% CI: 1.03–1.33) and receiving information about hepatitis B from peers (APR: 1.07, 95% CI: 1.05–1.31).

The study revealed a low prevalence of hepatitis B vaccine uptake among FSWs, with less than a tenth completing the three-dose schedule. Therefore, enhancing screening programs, expanding outreach initiatives, and tailoring services to accommodate nontraditional work hours while leveraging peer networks can significantly improve vaccine uptake and reduce hepatitis B transmission in this high-risk population.