Patterns of Sex Worker–Client Contacts and Their Implications for the Persistence of Sexually Transmitted Infections (original) (raw)
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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.
2014
Female sex workers (FSWs) bear a disproportionately large burden of HIV infection worldwide. Despite decades of research and programme activity, the epidemiology of HIV and the role that structural determinants have in mitigating or potentiating HIV epidemics and access to care for FSWs is poorly understood. We reviewed available published data for HIV prevalence and incidence, condom use, and structural determinants among this group. Only 87 (43%) of 204 unique studies reviewed explicitly examined structural determinants of HIV. Most studies were from Asia, with few from areas with a heavy burden of HIV such as sub-Saharan Africa, Russia, and eastern Europe. To further explore the potential eff ect of structural determinants on the course of epidemics, we used a deterministic transmission model to simulate potential HIV infections averted through structural changes in regions with concentrated and generalised epidemics, and high HIV prevalence among FSWs. This modelling suggested t...
Little is known as to why some populations develop generalized herpes simplex virus 2 (HSV-2) epidemics. Sexual network-level factors, such as the proportion of partnerships that run concurrently, are plausible explanations. In this ecological analysis, we used Spearman's correlation coefficients to assess if there is an association between population prevalence of point-concurrency and HSV-2 in a number of national and subnational populations. We found that there is an association between prevalence of point-concurrency and female HSV-2 prevalence between different countries (Spearman's rho ¼ 0.715; P ¼ 0.020), and within different races and ethnic groups within countries. In addition, there was a strong association between peak HIV and HSV-2 prevalence in 40 -44-year-old women at an international level (Spearman's rho ¼ 0.720; P ¼ 0.0001). This could be indicative of populations with high HIV and HSV-2 prevalence rates having extensively connected sexual networks which puts them at increased risk of spread by both these sexually transmitted infections (STIs). No country with an HSV-2 prevalence of under 20% in their 20 -24-year-old women had a generalized HIV epidemic. Thus, HSV-2 prevalence in adolescents may be a useful marker of how risky a local sexual network is for STI spread and may provide a useful early indicator of the success or failure of behavior change initiatives.
Determinants of generalized herpes simplex virus-2 epidemics- the role of sexual partner concurrency
Little is known as to why some populations develop generalized herpes simplex virus 2 (HSV-2) epidemics. Sexual network-level factors, such as the proportion of partnerships that run concurrently, are plausible explanations. In this ecological analysis, we used Spearman's correlation coefficients to assess if there is an association between population prevalence of point-concurrency and HSV-2 in a number of national and subnational populations. We found that there is an association between prevalence of point-concurrency and female HSV-2 prevalence between different countries (Spearman's rho ¼ 0.715; P ¼ 0.020), and within different races and ethnic groups within countries. In addition, there was a strong association between peak HIV and HSV-2 prevalence in 40 -44-year-old women at an international level (Spearman's rho ¼ 0.720; P ¼ 0.0001). This could be indicative of populations with high HIV and HSV-2 prevalence rates having extensively connected sexual networks which puts them at increased risk of spread by both these sexually transmitted infections (STIs). No country with an HSV-2 prevalence of under 20% in their 20 -24-year-old women had a generalized HIV epidemic. Thus, HSV-2 prevalence in adolescents may be a useful marker of how risky a local sexual network is for STI spread and may provide a useful early indicator of the success or failure of behaviour change initiatives.
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Israel Journal of Health Policy Research
The ongoing rise of sexually transmitted infections (STIs) poses a global public health challenge and the risk of acquiring one of these infections depends upon sexual practices, the number of sexual encounters and the location of that individual within the sexual network. Commercial sex workers (CSWs) have potentially a pivotal role in the transmission of STIs; however, a new study presented in this journal describes markers of risk but no increase in infections amongst men who pay for sex (MPS). This commentary highlights some of the growing evidence regarding STI prevention and the value of using these tools to protect CSWs, their clients and by extension the sexual partners of MPS.
Effect of Concurrent Partnerships and Sex-Act Rate on Gonorrhea Prevalence
SIMULATION, 1998
The disease gonorrhea (GC) is a major public health problem in the United States, and the dynamics of the spread of GC through popula tions are complicated and not well understood. Studies have drawn attention to the effect of concurrent sexual partnerships as an influen tial factor for determining disease prevalence. However, little has been done to date to quantify the combined effects of concurrency and within-partnership sex-act rates on the prevalence of GC. This simulation study examines this issue with a simplified model of GC transmission in closed human populations that include concurrent partnerships. Two models of within-partnership sex-act rate are compared; one is a fixed sex-act rate per partnership, and the other is perhaps more realistic in that the rate depends on the number of concurrent partners. After controlling for total number of sex acts, pseudo-equilibrium prevalence is higher with the fixed sex-act rate than under the concurrency-adjusted rate in all the mo...