|dc.description.abstract||Background: Standard programmatic mapping involves identifying locations where key
populations meet, profiling of these locations (hotspots) and estimating the key population size.
Information gained from this method has been used for HIV programming – resource allocation,
program planning, service delivery, and monitoring and evaluation – for people who inject drugs,
men who has sex with men, and female sex workers (FSW). With an increasing focus on
adolescent girls and young women (AGYW) as a priority population for HIV prevention,
programs need to know where and how to effectively reach individuals that are at increased risk
for HIV but were conventionally considered part of the general population. We hypothesize that
AGYW who engage in transactional and casual sex also congregate at sex work hotspots to meet
sex partners. Therefore, we adapted the standard programmatic mapping approach to understand
the geographic distribution and population size of AGYW in Mombasa County, Kenya.
Objectives: The objectives are several-fold: (1) to detail and compare the modified programmatic
mapping approach used in this study to the standard approach; (2) to estimate the number of
young FSW; (3) to estimate the number of AGYW who congregate in sex work hotspots to meet
sex partners other than clients; (4) to estimate the overlap in sexual network in hotspots; (5) to
describe the distribution of sex work hotspots across Mombasa and its four sub-counties; and (6)
to compare the distribution of hotspots that were known to the local HIV prevention program
prior to this study and those newly identified.
Methods: The standard programmatic mapping approach was modified to estimate the population
of young women aged 14-24 years who visit sex work hotspots in Mombasa to meet partners for
commercial, transactional and casual sex.
Results: We estimated that there were 11,777 FSW (range 9,265-14,290) in Mombasa in 2014;
among whom, 6,127 (52.0%) were 14-24 years old. The population estimate for women aged 14-
24 years who engaged in transactional and casual sex and congregated at the hotspots were 5,348
(range 4,185-6,510) and 4,160 (range 3,194-5,125), respectively. Of the 1,025 validated sex work
hotspots, 856 (83.5%) were locations also visited by women engaged in both transactional and
casual sex. Only 48 (4.7%) hotspots were exclusive sex work locations. The geographic and
typological distribution of hotspots were significantly different between the four sub-counties (P
< .001). Of the 1,025 hotspots, 419 (40.9%) were already known to the local HIV prevention
program and 606 (59.1%) were newly identified.Conclusions: Using the adapted programmatic mapping approach detailed in this study, our
results show that HIV prevention programs tailored to AGYW can focus delivery of their
interventions to traditional sex work hotspots to reach subgroups that may be at increased risk for