Here we describe changes in sexual behaviours among young FSW across Zimbabwe between and , and risk factors for prevalent HIV in and We collected data on socio-demographics and sexual behaviour and offered HIV testing. Characteristics of young FSW aged 18β24 were described, stratified by age. Logistic regression was used to assess difference in sexual behaviours by reported HIV status between and , and to explore associations with prevalent HIV in and Characteristics of young FSW were similar across both surveys.
Strategies to identify young FSW when they first start selling and refer them into services that address their economic, social and sexual vulnerabilities are critical. In addition to the physiological, emotional and social vulnerabilities faced by AGYW as they transition into adulthood, young FSW face added challenges related to stigma, discrimination and criminalisation [ 2 , 3 ], and reduced ability to negotiate condom use with sexual partners [ 4 ].
As a consequence, young FSW are a particularly important group for comprehensive prevention interventions [ 5 , 6 ]. Despite their increased risk of HIV, STIs and unplanned pregnancies, young FSW are poorly engaged with sexual health and HIV prevention and care programmes, in part because of fear of stigma and discrimination from healthcare providers, older FSW, families and friends, and the possible legal repercussions of visiting healthcare services and disclosing their engagement in sex work [ 5 , 7 , 8 ].
Data on socio-economic characteristics and HIV risk behaviours among young FSW remain sparse in Africa, including in Zimbabwe, due to their lack of engagement in health services [ 7 ] and difficulty in reaching them for research.
We investigated trends in sexual risk behaviours over this time period to better interpret any future changes in behaviour following the introduction of DREAMS in Zimbabwe. We investigated whether these behaviours were associated with prevalent HIV in and [ 9 ]. Our hypothesis was that HIV prevalence would be higher among women reporting more years of sex work, and sexual risk behaviours would become less risky over time and differ by age.
