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We implemented population size estimation of female sex workers FSW and transgender women TGW in Sri Lanka in using several approaches geographical mapping, service and unique object multiplier and a modified Delphi method during the stakeholder consensus meeting.
Mapping was done in 49 randomly selected Divisional Secretariats, which provided a basis for extrapolation of size estimates to the national level. Doole tx housewives personals the multiplier method, we used data from services of non-governmental organisations that FSW and TGW were in contact with, and surveys based on respondent-driven sampling.
This study provided baseline estimates of 2, TGW in the country, with a plausible range of 2,—3, which is 0. The provide an important point for macro- and micro-level planning of HIV services, allocating programme resources and assessing programme coverage and quality. This is prostitute in columbus ga open access article distributed under the terms of the Creative Commons Attributionwhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
The funders had no role in study de, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Sri Lanka consists of nine provinces and 25 districts and has a population of An private asian escorts woodbury [—] adults 15 years and above were living with HIV in Sri Lanka at the end of [ 3 ]. They also include those working in restaurants, hotels, guest houses and boat-related tourism.
Knowing the size escort toronto KPs at higher risk best melbourne escort HIV is essential for intervention planning, resource allocation and for advocacy efforts. Measuring the size of KPs is, however, challenging since behaviours that put individuals at increased risk of HIV are often stigmatizing, which creates difficulties in reaching these prostitutes in evansville indiana. The size of KPs can be estimated using different methods, each having its strengths and weaknesses [ 45 ].
UNAIDS and WHO recommend that multiple methods are used in order to generate an estimate of a size of a KP for an area, given the variability in estimates produced by single studies [ 6 ].
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Methods to estimate the size of KPs can be broadly categorized into methods based on collection of data directly from a KP mapping, census and enumeration, multiplier, and capture—recaptureand methods whereby data are collected from a general population population-based surveys, network allensville pa milf personals [ 7 ]. The aim of this paper is to describe of the estimation of the population size of FSW and TGW in Sri Lanka using geographical mapping and the multiplier method.
The choice of the geographical mapping and the multiplier method was maryland personals based on experiences from other countries in Asia where these methods have been used, and applied to improve targeted HIV prevention and control programmes for KPs [ 9 — 13 ].
That round of IBBS did not include TGW as a separate category, a population that often faces social and legal exclusion, and is at an increased risk of experiencing violence and acquiring HIV [ 1415 ]. At the biological level, transgender women edmonton escort cost partners are males face a high HIV transmission probability via condomless anal sex.
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Data collection methods included geographical mapping and the multiplier methods and finally a stakeholder consensus meeting, which provided an opportunity to discuss and interpret the and agree on final KP size estimates. The Divisional Secretariat division DS division was selected as the unit area for mapping, as this is the smallest administrative division in Sri Lanka that has defined boundaries. DSs were also selected as unit areas for mapping in the first round of geographical mapping carried out in Sri Lanka in [ 8 ]. Higher-density DSs were purposively over-sampled based on the assumption that they contain a greater concentration of KPs.
Data looking for a little person altoona female collected through conducting Level 1 and Level 2 activities. Level 1 activities were used to collect information from secondary key informants KIs about locations where KPs socialize and about the minimum and maximum of KP individuals that can be found at those locations.
Private escorts in wollongong KIs include individuals who have close relationships with KPs, such as pimps, local food sellers, hotel staff, taxi drivers, and those that have professional knowledge about KPs such as health care staff, police and prostitute app wolverhampton of non-governmental organisations NGOs.
KP members can also be included as secondary KIs. To expedite field work, selected DSs were divided into smaller areas based on administrative boundaries. Field supervisors collated data from Level 1 questionnaires on a daily basis in williamsport escorts to create unique lists of hotspots and estimates of the KP size.
Level 2 activities richmond starr escort of visiting hotspots from lists generated during Level 1 activities to validate that these were locations were KPs congregate, and interviewing KP members also called primary KIs. During these interviews, information was collected about the minimum and boelus ne milf personals of KP members that socialize at those hotspots on a peak day escort in windsor a week and during an average month, typology of the hotspot public place, brothel, night club, etc and locations of other hotspots in the area.
KP individuals interviewed at hotspots during Level 2 activities were also asked about their mobility across spots in terms of how many hotspots on average they visit on a peak day.
Estimates about population size obtained during Level 2 activities were taken as the final chinese prostitute in coventry estimates. Questionnaires used to collect data during Level 1 and Level 2 activities were completed by trained field workers electronically, using tablets.
Data collection teams consisted of two interviewers representing non-KP and KP individuals to facilitate interaction with KIs, and a team co-ordinator. The following formula was used to adjust for mobility: where S 2 was the estimated of KP individuals adjusted for mobility, S 1 was the crude of KP individuals at a spot level obtained during Level 2 activities, p 1 was the proportion of KP individuals that visit more than one mature indian escorts in weston on a peak day, and m 1 was the mean of spots that KP members visit in a peak day.
Adjusted KP size estimates were calculated for each spot. As a first step, all reported straight male escorts uk and escort pune KP estimates were summed up to get a range of estimate for each spot, which were summed up into DS estimates. Further on, extrapolation was done to produce a point estimate and a range low and high estimate for the population size of FSW and TGW at a district, province and national level, using adjusted data. Firstly, a proportion of KP members among the total general population was kent wa escorts for each sampled DS.
Secondly, a relationship between the estimated of a KP and the general population was tested using the coefficient of determination R 2 to assess plausibility of estimates. The pooled proportion was applied to census data of each DS, district, province and national counts to calculate population size estimates at the district, province and national level.
The multiplier method relies on two data sources that overlap in a known way: 1 data from an institution or service that KPs were in contact with, and 2 an IBBS representative cheapest london escort a target population. We implemented the service and unique object multiplier method using four separate counts and the overlap of these counts with the IBBS.
The of unique objects distributed was determined by the of contacts the distributing outreach organisations anticipated reaching within one week. The of venues in the cities where the unique object distribution occurred ranged between 11— During administration of the survey questionnaires, all respondents were asked whether they received NGO services and vineland independent escort service by peer outreach workers during the specified time periods.
The choice of service multipliers was determined by the availability and quality of programme data. Eligibility criteria for the survey jessup md housewives personals consistent with those for NGO service utilization and for unique object distribution.
Service data were extracted from the egypt escorts logbooks of NGOs that have unique codes ased to individual clients and later on stored in an MS Excel file. Attention was paid that data are de-duplicated since these services could male escorts cancun obtained multiple times in a period of several months. During data analysis it emerged that data on the of clients escorted to STI clinics by NGO staff were of low quality and therefore could not be used. Methods and of the IBBS are described elsewhere [ 18 ].
Briefly, participants were recruited using respondent-driven sampling RDSwhich is a quasi probability-based peer recruitment sampling method [ 19 ]. Recruitment started with a pre-determined of seeds who were asked to recruit their peers from their personal social networks. Three separate multiplier estimates for each city and population were synthesised using the median value, with escort durham nc exception of data for Kandy [ 1022 ].
Find person india use of several multipliers enables to obtain several size estimates and lowers the influence of bias had only one multiplier been used. Final population size estimates were reviewed and agreed upon at the community and stakeholder consensus meeting held in June using a modified Delphi method [ 23 ].
The escorts harlow au of the consensus meeting was to interpret the and establish upper and lower plausibility bounds for the KP size estimates. These forms included questions on the estimated most likely, minimum lower bound and maximum escorte independant bound of KPs in Sri Lanka.
Median values of the most likely, minimum and maximum estimates were used for the consensus estimate.
If needed, adjustments to the estimates were escort el monte luxe and additional rounds of estimations were conducted. We also compared our estimates to the UNAIDS-recommended estimates for Asia and the Pacific, as a check on consistency of our estimates, and calculated the proportion of adult women and men in the general population who are FSW and TGW, respectively, using the census data [ 24 ]. The protocols for the population size estimation and IBBS were what is full service escort for the ethical approval to denver escorts outcall Medical Faculty of the University of Sri Jayewardenepura, and the approval was obtained in October Respondents provided an informed oral consent before participating in the study.
Oral consent was witnessed by a team member and documented in an informed consent form. For FSW, a total of spots were validated during Level 2 activities, and primary and secondary KIs were interviewed.
Mapping resulted in an estimate of cracker newcastle escort, FSW range from a tamil escorts in london of 2, to a maximum of 3, at hotspots during an average month. The average spot size is 6 FSW per spot.
At Adjustment for mobility gave an estimate of 2, range: 2,—3,while an additional adjustment for a hidden population an estimate of 6, 5,—7, In Kandy, it was not possible to calculate the service-based multiplier estimates because of poor quality of NGO data.
Higher estimates of FSW were obtained via mapping compared to the multiplier method: 3, 3,—4, of FSW in Colombo, 1, 1,—1, in Galle and 2, 1,—2, in Kandy. There were two rounds of Delphi estimations done to reach the consensus estimate for FSW at the national level. The group agreed on the national point estimate of 30, and acceptable lower and escorts and babes tamworth bounds of 20, and 35, FSW, respectively.
This translates to a population prevalence of 0. Fifty-five spots were TGW socialise and find partners were visited during mapping, and 78 KIs were interviewed 44 primary and 34 secondary KIs. These spots were described as streets Mapping yielded an fargo beach prostitutes estimate of range: — TGW. From IBBS data collected, At only two spots respondents reported that they visited more than one search free personals on a peak day, and that included a visit to only one other spot.
The final PSE reached after the first round of the Delphi process was 2, lower plausibility bound of 2, —higher plausibility bound of 3, of TGW at the national-level, which corresponds to 0. The provide an important point for macro- and micro-level planning of HIV services at national and local level, and for allocating programme resources, including determining the volume of services required, planning of outreach work at the community-level and assessing how to talk to a person you like coverage and quality.
Overall, the size estimate for FSWs in this study was considerably higher 30,; lower plausibility bound of 20,—upper plausibility bound of 35, than that found in the round of size estimation in 14,; lower plausibility bound of 12,—upper plausibility bound of 15, most escorts nw due to correction factors that we employed to avoid substantially under-counting FSW.