Proven prevention tools for addressing STI epidemics (original) (raw)
Related papers
Reproductive health matters, 2003
Sex workers have high rates of sexually transmitted infections (STIs), many of them easily curable with antibiotics. STIs as co-factors and frequent unprotected exposure put sex workers at high risk of acquiring HIV and transmitting STIs and HIV to clients and other partners. Eliminating STIs reduces the efficiency of HIV transmission in the highest-risk commercial sex contacts--those where condoms are not used. This paper reviews two STI treatment strategies that have proven effective with female sex workers and their clients. 1) Clinical services with regular screening have reported increases in condom use and reductions in STI and HIV prevalence. Such services include a strong peer education and empowerment component, emphasize consistent condom use, provide effective treatment for both symptomatic and asymptomatic STIs, and begin to address larger social, economic and human rights issues that increase vulnerability and risk. 2) Presumptive treatment of sex workers, a form of epi...
Sexually Transmitted Infections, 2011
P1-S2.07 Table 1 Association between selected risk factors and being "STI positive" (testing positive for Chlamydia, Gonorrhoea, Syphilis and/or Trichomoniasis) among female sex workers attending STI testing sites in Germany, 2010 (N¼1142) STI positive (Chlamydia, Gonorrhoea, Syphilis and/or Trichomoniasis), N[233 N Total N Positive OR (95% CI) p Value German language Fluent (R) 437 59 1 Medium 301 34 0.82 (0.52 to 1.30) 0.376 Very poor / None 375 135 3.60 (2.55 to 5.10) 0.000 Age Range 15e77 years 1142 233 0.95 (0.93 to 0.97) 0.000 Health insurance No (R) 450 138 1 Yes 648 87 0.35 (0.26 to 0.47) 0.000 Meet clients on the street No (R) 995 173 1 Yes 101 43 3.52 (2.30 to 5.40) 0.000 Meet clients through internet or adds No (R) 908 195 1 0.002 Yes 188 21 0.46 (0.28 to 0.74) Number of clients per week Range 1e75 270 37 1.02 (1.00 to 1.04) 0.028 Explanatory factor included as continuous variable in logistic regression. (R), Reference group.
Sex workers and the control of sexually transmitted disease
Genitourinary medicine, 1997
Objectives: To describe and assess measures to control sexually transmitted diseases (STDs) among sex workers and their partners. Methods: A review of medical, historical and social literature, focusing on selected cases. Results: Measures to control disease in sex ...
Periodic presumptive treatment of curable sexually transmitted infections among sex workers
AIDS, 2012
Background: Unprotected sex work remains a major driver of HIV/sexually transmitted infection (STI) epidemics in many countries. STI treatment can lower disease burden, complications and prevalence of HIV cofactors. Periodic presumptive treatment (PPT) has been used with sex workers to reduce their high burden of largely asymptomatic STIs. The objective of this review is to assess benefits and harms of PPT among female sex workers.
The Journal of Infectious Diseases, 2005
Sex workers (SWs) and their clients are often identified as being central in transmission of sexually transmitted infections (STIs). Little is known about how patterns of contact between SWs and their clients influence the persistence of STIs. We developed an individual-based simulation model to explore how variation in number of client contacts per SW, whether clients repeatedly visited the same SW, and the relative sizes of the SW and client populations influence the endemic prevalence of gonorrhea and herpes simplex virus type 2 infection. Persistence of either infection was more likely if clients visited many different SWs, regardless of variation in the SW-client contact rate, and also resulted in a higher endemic prevalence in both populations and a greater likelihood of persistence of infection at lower levels in the general population. The size of the SW population (relative to the total population) was found to be most important in determining the overall prevalence of infection.
PLOS ONE, 2015
Background and Overview High rates of partner change in sex work-whether in professional, 'transactional' or other context-disproportionately drive transmission of HIV and other sexually transmitted infections. Several countries in Asia have demonstrated that reducing transmission in sex work can reverse established epidemics among sex workers, their clients and the general population. Experience and emerging research from Africa reaffirms unprotected sex work to be a key driver of sexual transmission in different contexts and regardless of stage or classification of HIV epidemic. This validation of the epidemiology behind sexual transmission carries an urgent imperative to realign prevention resources and scale up effective targeted interventions in sex work settings, and, given declining HIV resources, to do so efficiently. Eighteen articles in this issue highlight the importance and feasibility of such interventions under four themes: 1) epidemiology, data needs and modelling of sex work in generalised epidemics; 2) implementation science addressing practical aspects of intervention scaleup; 3) community mobilisation and 4) the treatment cascade for sex workers living with HIV. Conclusion Decades of empirical evidence, extended by analyses in this collection, argue that protecting sex work is, without exception, feasible and necessary for controlling HIV/STI epidemics. In addition, the disproportionate burden of HIV borne by sex workers calls for facilitated access to ART, care and support. The imperative for Africa is rapid scale-up of targeted prevention and treatment, facilitated by policies and action to improve conditions where sex work takes place. The opportunity is a wealth of accumulated experience working with sex workers in diverse settings, which can be tapped to make up for lost time. Elsewhere, even
Journal of the International AIDS Society, 2014
Introduction: The objective of this article is to present the rationale and baseline results for a randomized controlled pilot trial using economic incentives to reduce HIV and sexually transmitted infection (STI) risk among male sex workers (MSWs) in Mexico City. Methods: Participants (n0267) were tested and treated for STIs (chlamydia, gonorrhoea, syphilis and HIV) and viral hepatitis (hepatitis B and C), received HIV and STI prevention education and were randomized into four groups: (1) control, (2) medium conditional incentive ($50/six months), (3) high conditional incentive ($75/six months) and (4) unconditional incentive ($50/six months). In the conditional arms, incentives were contingent upon testing free of new curable STIs (chlamydia, gonorrhoea and syphilis) at follow-up assessments. Results: Participants' mean age was 25 years; 8% were homeless or lived in a shelter, 16% were unemployed and 21% lived in Mexico City less than 5 years. At baseline, 38% were living with HIV, and 32% tested positive for viral hepatitis or at least one STI (other than HIV). Participants had a mean of five male clients in the previous week; 18% reported condomless sex with their last client. For 37%, sex work was their main occupation and was conducted mainly on the streets (51%) or in bars/discotheques (24%) and hotels (24%). The average price for a sex transaction was $25 with a 35% higher payment for condomless sex. Conclusions: The findings suggest that economic incentives are a relevant approach for HIV prevention among MSWs, given the market-based inducements for unprotected sex. This type of targeted intervention seems to be justified and should continue to be explored in the context of combination prevention efforts.