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Peer Reviewed

Title: Biological Validation of Self-Reported Condom Use Among Sex Workers in Guinea.
Author: Aho J; Koushik A; Diakite SL; Loua KM; Nguyen VK; Rashed S
Source: AIDS and Behavior. 2009 Aug 13;
Abstract: Self-reported condom use may be prone to social desirability bias. Our aim was to assess the validity of self-reported condom use in a population of female sex workers using prostate specific antigen (PSA) as a gold standard biomarker of recent unprotected vaginal intercourse. We collected data on 223 sex-workers in Conakry, Guinea in order to assess the sensitivity and specificity of self-reported condom use as well as to examine the predictors of discordance between self-report and PSA presence. PSA was detected in 38.4% of samples. Sensitivity of self-reported condom use was 14.6% and its specificity was 94.7%. Self-perceived high risk of HIV infection was the only significant independent predictor of misreported condom use. PSA could be useful to validate self-reported condom use in surveys and to allow a better understanding of factors associated with social desirability in sexual behaviour reporting.
Language: English
Keywords:
GUINEA | RESEARCH REPORT | STATISTICAL REGRESSION | SEX WORKERS | CONDOM USE | BIAS | DATA REPORTING | VALIDITY | VAGINA | SEMEN | ANTIGENS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Data Analysis | Research Methodology | Sex Behavior | Behavior | Risk Reduction Behavior | Error Sources | Measurement | Data Collection | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Seminal Vesicles | Genitalia, Male | Immunologic Factors | Immunity | Immune System | Reproductive Tract Infections | Infections | Diseases
Document Number: 342486

Title: Human papillomavirus typing and soluble interleukin-2 receptor levels in female sex workers with a negative cervical smear result.
Author: Arioz DT; Altindis M; Tokyol C; Kalayci R; Saylan A; Yilmazer M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV. METHOD: A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed. RESULTS: Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001). CONCLUSION: High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CONTROL GROUPS | SEX WORKERS | HPV | CERVICAL CANCER | RISK FACTORS | CYTOLOGIC EFFECTS | SCREENING | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Sex Behavior | Behavior | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341451

Peer Reviewed

Title: Talking the talk, walking the walk: Social network norms, communication patterns, and condom use among the male partners of female sex workers in La Romana, Dominican Republic.
Author: Barrington C; Latkin C; Sweat MD; Moreno L; Ellen J; Kerrigan D
Source: Social Science and Medicine. 2009 Jun;68(11):2037-2044.
Abstract: Male partners of female sex workers are rarely targeted by HIV prevention interventions in the commercial sex industry, despite recognition of their central role and power in condom use negotiation. Social networks offer a naturally existing social structure to increase male participation in preventing HIV. The purpose of this study was to explore the relationship between social network norms and condom use among male partners of female sex workers in La Romana, Dominican Republic. Male partners (N =318) were recruited from 36 sex establishments to participate in a personal network survey. Measures of social network norms included 1) perceived condom use by male social network members and 2) encouragement to use condoms from social network members. Other social network characteristics included composition, density, social support, and communication. The primary behavioral outcome was consistent condom use by male partners with their most recent female sex worker partner during the last 3 months. In general, men reported small, dense networks with high levels of communication about condoms and consistent condom use. Multivariate logistic regression revealed consistent condom use was significantly more likely among male partners who perceived that some or all of their male social network members used condoms consistently. Perceived condom use was, in turn, significantly associated with dense networks, expressing dislike for condoms, and encouragement to use condoms from social network members. Findings suggest that the tight social networks of male partners may help to explain the high level of condom use and could provide an entry point for HIV prevention efforts with men. Such efforts should tap into existing social dynamics and patterns of communication to promote pro-condom norms and reduce HIV-related vulnerability among men and their sexual partners.
Language: English
Keywords:
DOMINICAN REPUBLIC | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | SOCIAL NETWORKS | SEX WORKERS | WOMEN IN DEVELOPMENT | SEXUAL PARTNERS | MEN | CONDOM USE | HIV PREVENTION | PEER PRESSURE | PERCEPTION | MALE ROLE | MEN'S INVOLVEMENT | Developing Countries | Caribbean | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Friends and Relatives | Family and Household | Sociocultural Factors | Sex Behavior | Behavior | Economic Development | Economic Factors | Demographic Factors | Population | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Psychosocial Factors | Psychological Factors | Social Behavior | Programs | Organization and Administration
Document Number: 331004

Title: Sexual practices, drug use behaviors, and prevalence of HIV, syphilis, hepatitis B and C, and HTLV-1/2 in immigrant and non-immigrant female sex workers in Argentina.
Author: Bautista CT; Pando MA; Reynaga E; Marone R; Sateren WB; Montano SM; Sanchez JL; Avila MM
Source: Journal of Immigrant and Minority Health. 2009 Apr;11(2):99-104.
Abstract: OBJECTIVE: To study socio-demographics, sexual practices, drug use behaviors, and prevalences of HIV, syphilis, hepatitis B and C, HTLV-1 and HTLV-2 in immigrant (foreigner) and non-immigrant (local/native) female sex workers (FSW). DESIGN: This was a cross-sectional study in immigrant and non-immigrant FSW living in Buenos Aires, Argentina. Participants were interviewed using a standardized questionnaire. RESULTS: A total of 625 FSW were enrolled, of whom 169 (27%) were immigrant FSW from Paraguay, the Dominican Republic, Brazil, Peru, and Uruguay. The prevalence of syphilis and hepatitis C was significantly higher among Argentinean FSW than among immigrant FSW. However, hepatitis B prevalence was higher among immigrant FSW. Adjusted risk factor analysis comparing immigrant FSW with Argentinean FSW indicated that marital status (single), occupation (none), fee per sex act (Language: English
Keywords:
ARGENTINA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | COMPARATIVE STUDIES | EPIDEMIOLOGIC METHODS | SEX WORKERS | WOMEN IN DEVELOPMENT | IMMIGRANTS | HEPATITIS | SYPHILIS | PREVALENCE | DRUG USE AND ABUSE | HIV INFECTIONS | SEX BEHAVIOR | South America, Southern | South America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Economic Development | Economic Factors | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement
Document Number: 331118

Peer Reviewed

Title: Can sex workers regulate police? Learning from an HIV prevention project for sex workers in southern India.
Author: Biradavolu MR; Burris S; George A; Jena A; Blankenship KM
Source: Social Science and Medicine. 2009 Apr;68(8):1541-7.
Abstract: There is an argument that policing practices exacerbate HIV risk, particularly for female sex workers. Interventions that mobilize sex workers to seek changes in laws and law enforcement practices have been prominent in India and have received considerable scholarly attention. Yet, there are few studies on the strategies sex worker advocates use to modify police behavior or the struggles they face in challenging state institutions. This paper draws upon contemporary theories of governance and non-state regulation to analyze the evolving strategies of an HIV prevention non-governmental organization (NGO) and female sex worker community-based organizations (CBOs) to reform police practices in southern India. Using detailed ethnographic observations of NGO and CBO activities over a two year period, and key informant interviews with various actors in the sex trade, this paper shows how a powerless group of marginalized and stigmatized women were able to leverage the combined forces of community empowerment, collective action and network-based governance to regulate a powerful state actor, and considers the impact of the advocacy strategies on sex worker well-being.
Language: English
Keywords:
INDIA | RESEARCH REPORT | NONGOVERNMENTAL ORGANIZATIONS | POLICE | SEX WORKERS | HIV PREVENTION | INTERVENTIONS | ADVOCACY | POWER | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Corrections Officers | Government | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Communication | Data Collection | Research Methodology
Document Number: 341691

Peer Reviewed

Title: Political feasibility of scaling-up five evidence-informed HIV interventions in Pakistan: a policy analysis.
Author: Buse K; Lalji N; Mayhew SH; Imran M; Hawkes SJ
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 2):ii37-ii42.
Abstract: Background: Drawing on policy theories, an assessment was made of the perceived political feasibility of scaling-up five evidence-based interventions to curb Pakistan's HIV epidemic: needle and syringe exchange programmes; targeted behaviour change communication; sexual health care for male and transgender sex workers; sexual and reproductive health care for female sex workers; and promoting and protecting the rights of those at greatest risk. Method: A questionnaire was emailed to 40 stakeholders and completed by 22. They expressed their level of agreement with 15 statements for each intervention (related to variables associated with policy success). Semi-structured interviews were conducted with 12 respondents. Results: The interventions represent considerable change from the status quo, but are perceived to respond to widely acknowledged problems. These perceptions, held by the HIV policy elite, need to be set in the context of the prevailing view that the AIDS response is not warranted given the small and concentrated nature of the epidemic and that the interventions do not resonate closely with values held by society. The interventions were perceived to be evidence-based, supported by at least one donor and subject to little resistance from frontline staff as they will be implemented by contracted non-government organisations. The results were mixed in terms of other factors determining political feasibility, including the extent to which interventions are easy to explain, exhibit simple technical features, require few additional funds, are supported and not opposed by powerful stakeholders. Conclusion: The interventions stand a good chance of being implemented although they depend on donor support. The prospects for scaling them would be improved by ongoing policy analysis and strengthening of domestic constituencies among the target groups.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | THEORETICAL MODELS | KAP SURVEYS | POLICYMAKERS | IV DRUG USERS | SEX WORKERS | HIV PREVENTION | BEHAVIOR CHANGE COMMUNICATION | POLICY DEVELOPMENT | HEALTH POLICY | INTERVENTIONS | CAPACITY BUILDING | SEXUALLY TRANSMITTED DISEASE PREVENTION | SYRINGE | NEEDLE SHARING | SOCIAL POLICY | Developing Countries | Asia, Southern | Asia | Research Methodology | Surveys | Sampling Studies | Studies | Administrative Personnel | Organization and Administration | Drug Use and Abuse | Behavior | Sex Behavior | HIV Infections | Viral Diseases | Diseases | Communication Programs | Communication | Behavior Change | Planning | Policy | Political Factors | Sociocultural Factors | Programs | Program Sustainability | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Behavior
Document Number: 340114

10.

Peer Reviewed

Title: Understanding the context of male and transgender sex work using peer ethnography.
Author: Collumbien M; Quereshi AA; Mayhew SH; Rizvi N; Rabbani A; Rolfe B; Verma RK; Rehman H; Naveed-i-Rahat
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 2):ii3-ii7.
Abstract: Objectives: To distinguish between three distinct groups of male and transgender sex workers in Pakistan and to demonstrate how members of these stigmatised groups need to be engaged in the research process to go beyond stated norms of behaviour. Methods: A peer ethnography study was undertaken in a major city in Pakistan. 15 male and 15 transgender sex workers were trained as peer researchers to each interview three peers in their network. Analysis was based on interviews with peer researchers as well as observation of dynamics during training and analysis workshops. Results: The research process revealed that, within the epidemiological category of biological males who sell sex, there are three sociologically different sexual identities: khusras (transgender), khotkis (feminised males) and banthas (mainstream male identity). Both khusras and khotkis are organised in strong social structures based on a shared identity. While these networks provide emotional and material support, they also come with rigid group norms based on expected "feminine" behaviours. In everyday reality, sex workers showed fluidity in both behaviour and identity according to the situational context, transgressing both wider societal and group norms. The informal observational component in peer ethnography was crucial for the accurate interpretation of interview data. Participant accounts of behaviour and relationships are shaped by the research contexts including who interviews them, at what stage of familiarity and who may overhear the conversation. Conclusions: To avoid imposing a "false clarity" on categorisation of identity and assumed behaviour, it is necessary to go beyond verbal accounts to document the fluidity of everyday reality.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | KAP SURVEYS | EPIDEMIOLOGIC METHODS | QUALITATIVE RESEARCH | MEN | SOCIAL NETWORKS | HOMOSEXUALS | SEX WORKERS | PEER GROUPS | ANTHROPOLOGY, CULTURAL | STIGMA | WORKSHOPS | VALUE ORIENTATION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Sex Behavior | Behavior | Knowledge Sources | Communication | Anthropology | Social Sciences | Science | Social Problems | Education | Psychological Factors
Document Number: 340119

11.

Peer Reviewed

Title: High-risk status of HIV-1 infection in the very low epidemic country, Mongolia, 2007.
Author: Davaalkham J; Unenchimeg P; Baigalmaa Ch; Oyunbileg B; Tsuchiya K; Hachiya A; Gatanaga H; Nyamkhuu D; Oka S
Source: International Journal of STD and AIDS. 2009 Jun;20(6):391-4.
Abstract: Thirty-six HIV-1 cases had been reported by December 2007 in Mongolia. Therefore, Mongolia has been regarded as a very low HIV-1 epidemic country, although the surveillance system is not fully developed. The aim of this study was to evaluate the risk status of HIV-1 infection in Mongolia. A total of 1415 blood samples from high-risk populations including female sex workers, men who have sex with men, mobile men, tuberculosis patients and male sexually transmitted infection (STI) clinic clients and 1050 samples from healthy controls were collected. The seroprevalences of anti-HIV-1/2, anti-Treponema pallidum, hepatitis B surface antigen (HBs Ag), anti-hepatitis C virus and hepatitis B surface antibody in the high-risk populations were 0%, 23.1%, 15.5%, 8.0% and 48.2%, and those in the controls were 0%, 3.1%, 14.7%, 4.4% and 44.4%, respectively. HIV-1 prevalence is currently low. However, according to the high prevalence of STIs in the high-risk populations, the risk status for HIV-1 infection is estimated to be high.
Language: English
Keywords:
MONGOLIA | RESEARCH REPORT | CONTROL GROUPS | SEX WORKERS | MEN HAVING SEX WITH MEN | MIGRANT WORKERS | CLIENTS | SEXUALLY TRANSMITTED DISEASES | TUBERCULOSIS | RISK FACTORS | HIV INFECTIONS | HEPATITIS | PREVALENCE | Developing Countries | Asia, Northern | Asia | Research Methodology | Sex Behavior | Behavior | Labor Force | Human Resources | Economic Factors | Program Activities | Programs | Organization and Administration | Reproductive Tract Infections | Infections | Diseases | Health | Viral Diseases | Measurement
Document Number: 342444

12.

13.

Peer Reviewed

Title: Ethical Considerations in HIV/AIDS Biobehavioral Surveys That Use Respondent-Driven Sampling: Illustrations From Lebanon.
Author: Dejong J; Mahfoud Z; Khoury D; Barbir F; Afifi RA
Source: American Journal of Public Health. 2009 Jul 16;
Abstract: Respondent-driven sampling is especially useful for reaching hidden populations and is increasingly used internationally in public health research, particularly on HIV. Respondent-driven sampling involves peer recruitment and has a dual-incentive structure: both recruiters and their peer recruits are paid. Recent literature focusing on the ethical dimensions of this method in the US context has identified integral safeguards that protect against ethical violations. We analyzed a study of 3 groups in Lebanon who are at risk for HIV (injection drug users, men who have sex with men, female sex workers) and the ethical issues that arose. More explicit attention should be given to ethical issues involved in research implementing respondent-driven sampling of at-risk populations in developing countries, where ethical review mechanisms may be weak.
Language: English
Keywords:
LEBANON | SUMMARY REPORT | RECRUITMENT ACTIVITIES | RESPONDENTS | IV DRUG USERS | MEN HAVING SEX WITH MEN | SEX WORKERS | PUBLIC HEALTH | HIV INFECTIONS | AIDS | ETHICS | INFORMED CONSENT | Middle East | Developing Countries | Program Activities | Programs | Organization and Administration | Surveys | Sampling Studies | Studies | Research Methodology | Drug Use and Abuse | Behavior | Sex Behavior | Health | Viral Diseases | Diseases | Sociocultural Factors | Health Services | Delivery of Health Care
Document Number: 342038

14.
Peer Reviewed

Title: Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana.
Author: Fiscian VS; Obeng EK; Goldstein K; Shea JA; Turner BJ
Source: AIDS Education and Prevention. 2009;21(1):67-79.
Abstract: A U.S. HIV prevention program was adapted to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection. (author's)
Language: English
Keywords:
GHANA | UNITED STATES OF AMERICA | EVALUATION REPORT | THEORETICAL MODELS | KAP SURVEYS | ADOLESCENTS, FEMALE | WOMEN IN DEVELOPMENT | SEX WORKERS | HIV PREVENTION | SEX EDUCATION | KNOWLEDGE | COMPUTER PROGRAMS AND PROGRAMMING | SELF ESTEEM | RISK BEHAVIOR | PARTNER COMMUNICATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Evaluation | Research Methodology | Surveys | Sampling Studies | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Education | Sociocultural Factors | Information Processing | Information | Psychological Factors | Interpersonal Relations
Document Number: 325287

15.

Peer Reviewed

Title: Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana.
Author: Fiscian VS; Obeng EK; Goldstein K; Shea JA; Turner BJ
Source: AIDS Education and Prevention. 2009 Feb;21(1):67-79.
Abstract: We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection.
Language: English
Keywords:
UNITED STATES OF AMERICA | GHANA | EVALUATION REPORT | THEORETICAL MODELS | ADOLESCENTS, FEMALE | SUGAR DADDIES | SEX WORKERS | FAITH-BASED ORGANIZATION | HEALTH EDUCATION | SEX EDUCATION | HIV PREVENTION | CULTURE | COMPUTER PROGRAMS AND PROGRAMMING | ABSTINENCE | BEHAVIOR CHANGE COMMUNICATION | Developed Countries | North America | Americas | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Organizations | Political Factors | Sociocultural Factors | Education | HIV Infections | Viral Diseases | Diseases | Information Processing | Information | Family Planning, Behavioral Methods | Family Planning | Communication Programs | Communication | Behavior Change
Document Number: 331081

16.

Peer Reviewed

Title: How much could a microbicide's sexually transmitted infection efficacy contribute to reducing HIV risk and the level of condom use needed to lower risk? Model estimates.
Author: Foss AM; Vickerman PT; Alary M; Watts CH
Source: Sexually Transmitted Infections. 2009 Aug;85(4):276-82.
Abstract: OBJECTIVE: This study explores the potential contribution of a microbicide's sexually transmitted infection (STI) efficacy in reducing a female sex worker's (FSW) risk of STI and HIV infection. The study then investigates whether the threshold for the reduction in condom use following microbicide introduction that can be tolerated without increasing HIV risk is affected by STI efficacy. METHODS: A dynamic model describing the transmission of a bacterial STI between FSW and their clients was coupled with a static HIV model. The model uses data from Cotonou, Benin (1998-9), for illustration, to estimate the change in risk following the introduction of 50% HIV efficacious microbicides of different STI efficacies, used in 50% of sex acts when a condom is not used. The condom migration thresholds were estimated. The degree to which the findings are influenced by STI prevalence was explored. RESULTS: For highly transmissible STI, there is a non-monotonic relationship between STI prevalence and microbicide impact on HIV with the relative reduction in HIV risk first increasing, due to the proportion of HIV risk attributable to the STI increasing, but then decreasing at high prevalences as the STI becomes harder to control. A less transmissible STI can still be impacted upon with a moderate/high STI efficacy microbicide even at high STI prevalences. This relationship is also reflected in the condom migration thresholds. CONCLUSIONS: A microbicide's STI efficacy may have a substantial impact on STI and HIV incidence among high-risk groups. The variation in the condom migration thresholds for different STI efficacies and STI prevalences may be difficult to measure accurately.
Language: English
Keywords:
BENIN | RESEARCH REPORT | PREVALENCE | SEX WORKERS | WOMEN | MICROBICIDES | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV INFECTIONS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Sex Behavior | Behavior | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Viral Diseases
Document Number: 342720

17.

Peer Reviewed

Title: Prevalence of needle sharing, commercial sex behaviors and associated factors in Chinese male and female injecting drug user populations.
Author: Gu J; Wang R; Chen H; Lau JT; Zhang L; Hu X; Lei Z; Li Z; Cai H; Wang T; Tsui H
Source: AIDS Care. 2009 Jan;21(1):31-41.
Abstract: The objective of this study is to investigate prevalence and associated factors of commercial sex behaviors and condom use at commercial sex, as well as prevalence of needle sharing among injecting drug users (IDUs) in China. In this study, 162 IDUs were recruited by peer workers in Dazhou, Sichuan and were anonymously interviewed by using a structured questionnaire. Univariate and multivariate logistic regression analyses were performed and interaction between gender and the studied independent variables were tested for significance. The results of this study showed that the male and female respondents, respectively 11.7 and 16.9% were HIV positive; 34.0 and 40.7% engaged in commercial sex and 23.3 and 11.9% shared needles with others in the last six months. Percent using a condom in the last episode of commercial sex was 30.3% for males and 76.2% for females. The multivariate analyses showed that higher drug dosage (OR=0.3, 95% CI: 0.1-0.9) and reduced sexual drive (OR=0.3, 95% CI: 0.1-0.9) were associated with lower likelihood for commercial sex among male IDUs while higher drug dosage (OR=9.1, 95% CI: 1.0-86.0), perceived difficulty in finding a job (OR=5.1, 95% CI: 1.3-20.1) and lack of family support (OR=4.0, 95% CI: 1.1-15.4) were associated with commercial sex among female IDUs. Similarly, unknown HIV status (OR=8.2, 95% CI: 1.7-9.2) and having a regular sex partner (OR=3.7, 95% CI: 1.3-10.9) was associated with needle sharing. It is concluded that male and female IDUs were sexually active and often engaged in commercial sex. Drug dosage and reduced sexual drive were relevant but did not stop commercial sex behaviors. More supportive social environment is required to prevent female IDUs to enter sex work.
Language: English
Keywords:
CHINA | RESEARCH REPORT | PREVALENCE | MEN | WOMEN | IV DRUG USERS | SEX WORKERS | SEX BEHAVIOR | NEEDLE SHARING | Asia, Eastern | Asia | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Drug Use and Abuse | Behavior | Risk Behavior
Document Number: 331213

18.
Title: Knowledge about AIDS/HIV infection among women attending obstetrics and gynaecology clinic at a university hospital.
Author: Haider G; Zohra N; Nisar N; Munir AA
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Feb;59(2):95-8.
Abstract: OBJECTIVE: To determine the level of awareness about Human Immune-deficiency Virus Infection and Auto Immune Deficiency Syndrome (HIV/AIDS) among women attending obstetrics and gynaecology clinic. METHODS: A descriptive cross-sectional study was conducted in the obstetric and gynaecology clinic at Isra University Hospital Hyderabad Pakistan from April to June 2007. A total of 189 women attending the obstetric and gynaecology clinic between ages 20 and 50 years were included. Informed consent was taken and information was collected by a pre-designed questionnaire to assess the level of awareness about HIV/AIDS. Data analysis was done by computer software, SPSS version 11. RESULTS: Out of the total, 86.8% women had heard about HIV/AIDS. A large majority of women knew that it is transmitted by close sexual relationship, through infected blood, can be transmitted from mother to baby and knew that it is transmitted by reuse of infected needles while only 40.7% knew that it can be transmitted during delivery. The respondents had the knowledge that multiple sexual partners (79.4%), prostitutes and homosexual males (49.7%), drug addicts (49.7%) were high risk groups. Regarding prevention of AIDS, 70.9% mentioned avoiding homosexuality, 58.7% knew the use of condoms and 74.7% women knew that screening of blood in laboratories before transfusion can prevent AIDS. CONCLUSION: The level of awareness regarding HIV/AIDS transmission and prevention was satisfactory among women attending the out-patient department of a gynaecology and obstetrics department. However, number of misconceptions needs to be corrected.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | MEN HAVING SEX WITH MEN | SEX WORKERS | MULTIPLE PARTNERS | KNOWLEDGE | HIV TRANSMISSION | SEX BEHAVIOR | RISK BEHAVIOR | BLOOD TRANSFUSION | MOTHER-TO-CHILD TRANSMISSION | CHILDBIRTH | NEEDLE SHARING | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Behavior | Sexual Partners | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Transmission | Infections | Pregnancy Outcomes | Pregnancy | Reproduction
Document Number: 330906

19.

Peer Reviewed

Title: HIV and other sexually transmitted infections among men, transgenders and women selling sex in two cities in Pakistan: a cross-sectional prevalence survey.
Author: Hawkes S; Collumbien M; Platt L; Lalji N; Andreasen A; Chow J; Muzaffar R; ur-Rehman H; Siddiqui N; Hasan S; Bokhari A
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 2):ii8-ii16.
Abstract: Objectives: The extent and possibilities of spread of the HIV epidemic are not fully understood in Pakistan. A survey was conducted among men, women and transgender populations selling sex in Rawalpindi (Punjab) and Abbottabad (North West Frontier Province) in order to inform evidence-based programme planning. Methods: A cross-sectional survey was performed with participants recruited through respondent-driven sampling. Male and transgender sex workers were analysed in three gender groups; women were analysed as one group. Behavioural surveys were conducted and clinical specimens collected. Laboratory tests looked for evidence of acute infection (gonorrhoea, Chlamydia, syphilis, Trichomonas) and infection over the lifetime (HIV, herpes simplex virus-2, syphilis). Predictors of infection were explored using univariable and multivariable logistic regression. Results: The prevalence of HIV was low in 917 male and transgender sex workers and absent in 533 female sex workers in the study. High levels of current sexually transmitted infections were found, predominantly among transgender sex workers. Risk behaviours were common and knowledge of HIV was extremely low. Multivariable analysis found a large number of factors associated with higher levels of infection, including experience of forced first sex. Protection against risk was low, but those sex workers who reported using condoms at last sex had lower rates of infection. Conclusions: The HIV epidemic is currently in its early stages among people who sell sex, but there may be potential for a much greater spread given the levels of other sexually transmitted infections found and the concomitant low levels of both protective knowledge and risk-reducing behaviours. Action is needed now to avert an epidemic. Framing interventions by upholding the recognition and protection of human rights is vital.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | KAP SURVEYS | MULTIVARIATE ANALYSIS | SEX WORKERS | PREVALENCE | PROGRAM DESIGN | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASES | SEX FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | KNOWLEDGE | Developing Countries | Asia, Southern | Asia | Research Methodology | Surveys | Sampling Studies | Studies | Data Analysis | Behavior | Measurement | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Population Characteristics | Demographic Factors | Population | Sociocultural Factors
Document Number: 340118

20.

Peer Reviewed

Title: Good performance of rapid prostate-specific antigen test for detection of semen exposure in women: implications for qualitative research.
Author: Hobbs MM; Steiner MJ; Rich KD; Gallo MF; Alam A; Rahman M; Menezes P; Chipato T; Warner L; Macaluso M
Source: Sexually Transmitted Diseases. 2009 Aug;36(8):501-6.
Abstract: BACKGROUND: Prostate-specific antigen (PSA) is a valid biomarker of semen exposure in women and has been used to assess reliability of self-reported sexual behavior as well as serve as a proxy measure for condom efficacy. Quantitative PSA tests are expensive and require specialized equipment. A simple, rapid, and inexpensive test for PSA would facilitate semen biomarker evaluation in a variety of research settings. This study evaluated the performance of a rapid PSA test compared with a quantitative assay to identify semen in vaginal swab specimens. METHODS: We tested 581 vaginal swabs collected from 492 women participating in 2 separate research studies in Bangladesh and Zimbabwe. PSA in vaginal secretions was detected using the quantitative IMx (Abbott Laboratories) assay and the ABAcard p30 (Abacus Diagnostics) rapid immunochromatographic strip test. RESULTS: The ABAcard test was 100% sensitive (95% confidence interval [CI], 98%-100%) and 96% specific (95% CI, 93%-97%) compared with the quantitative test in detecting >1.0 ng PSA/mL vaginal swab eluate. Rapid PSA results were semiquantitative and correlated well with PSA concentrations (kappa = 0.88; 95% CI, 0.85-0.90). CONCLUSION: Rapid PSA detection requires no instrumentation and can be performed easily and economically. Having rapid PSA results available immediately following interview provides opportunities to explore discrepancies between the objective marker of recent semen exposure and self-reported behaviors.
Language: English
Keywords:
BANGLADESH | ZIMBABWE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | SEX WORKERS | SEX BEHAVIOR | SEMEN | PROSTATE | ANTIGENS | TESTING | RELIABILITY | Developing Countries | Asia, Southern | Asia | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Behavior | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Immunologic Factors | Immunity | Immune System | Measurement
Document Number: 342948

21.

Peer Reviewed

Title: HIV/AIDS behavioral interventions in China: a literature review and recommendation for future research.
Author: Hong Y; Li X
Source: AIDS and Behavior. 2009 Jun;13(3):603-13.
Abstract: In the past two decades, China has witnessed an alarming increase of HIV/AIDS epidemic. Meanwhile, a number of HIV prevention interventions have been conducted. This study reviews existing studies in literature on behavioral interventions on HIV/AIDS in China. Of 25 studies we identified, most have been concentrated in South and South-West China, mainly targeting injection drug users and female sex workers. The most commonly used intervention strategy was individual-oriented HIV-related knowledge education and behavioral skill training. All studies reported positive intervention effects including improved HIV-related knowledge, increased condom use, reduced needle sharing, and reduced STI. Literature also suggests a lack of intervention among other at-risk populations such as MSM, migrant workers, and non-injecting drug users, lack of studies with rigorous evaluation design, inadequate follow-up, limited outcome measurement, and lack of multi-faceted structural interventions. The existing intervention studies document strong evidence of controlling HIV/AIDS epidemic through effective behavioral intervention. More efforts are needed to control the growing HIV/AIDS epidemic in China. Future studies need to employ more rigorous methodology and incorporate environmental or structural factors for different populations at risk of HIV infection in China.
Language: English
Keywords:
CHINA | LITERATURE REVIEW | IV DRUG USERS | SEX WORKERS | EPIDEMICS | HIV PREVENTION | AIDS PREVENTION | INTERVENTIONS | HEALTH EDUCATION | KNOWLEDGE | RISK REDUCTION BEHAVIOR | Asia, Eastern | Asia | Developing Countries | Drug Use and Abuse | Behavior | Sex Behavior | Diseases | HIV Infections | Viral Diseases | AIDS | Programs | Organization and Administration | Education | Sociocultural Factors
Document Number: 342110

22.

Peer Reviewed

Title: HIV/AIDS-related sexual risks and migratory status among female sex workers in a rural Chinese county.
Author: Hong Y; Li X; Yang H; Fang X; Zhao R
Source: AIDS Care. 2009 Feb;21(2):212-20.
Abstract: Currently, there are millions of female sex workers (FSWs) in China and these women play a critical role in the escalating HIV epidemic in the country. Existing studies revealed high mobility of this population, but data on the relationship of FSWs' migratory status and their HIV/AIDS-related sexual risks are limited. A cross-sectional survey was administered among 454 FSWs in a rural county of Guangxi, China. Sexual risks and current infections of sexually transmitted disease (STD) were compared among local FSWs (i.e. those who were the county residents or from other parts of Guangxi) and those FSWs who migrated from outside Guangxi. Data reveal that local FSWs were younger, less educated and newer to the sex industry, and had more sexual risks and higher rates of STDs compared to migrant FSWs. This relationship remains significant after controlling for potential confounders. A higher level of sexual risks and STDs among local FSWs than migrant FSWs in the rural Chinese county suggests the need to examine the relationship between migratory status and HIV/AIDS-related risks within specific social and cultural contexts. The data also underscore an urgent need for culturally appropriate HIV/AIDS-prevention intervention efforts among FSWs in rural or less developed areas in China.
Language: English
Keywords:
CHINA | RESEARCH REPORT | RURAL AREAS | SEX WORKERS | WOMEN | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | SEX BEHAVIOR | RISK BEHAVIOR | MIGRANT WORKERS | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Behavior | Demographic Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Labor Force | Human Resources | Economic Factors
Document Number: 330805

23.

Peer Reviewed

Title: Sex work in Mexico: vulnerability of male, travesti, transgender and transsexual sex workers.
Author: Infante C; Sosa-Rubi SG; Cuadra SM
Source: Culture, Health and Sexuality. 2009 Feb;11(2):125-37.
Abstract: In Mexico, male sex workers (MSW) and travesti, transgender and transsexual (TTT) sex workers are among the groups most affected by HIV. They suffer from stigma and discrimination, yet are often absent from the design of programmes and HIV prevention campaigns. The objective of this study was to provide an account of the social context in which MSW and TTT sex workers live, by focusing on their sexual identities, sexual practices and vulnerability to HIV. Data collection took place in Mexico City and involved observational work together with 36 in-depth interviews. Findings reveal a differentiation of vulnerability by sub-group. In general, vulnerability is influenced by the social context, stigma related to homosexuality and sex work, as well as sex workers' access to scarce social capital and the lack of response in terms of social and health programmes. In order to diminish the vulnerability of MSW and TTT sex workers and reduce their risk of HIV infection, preventive measures are needed which take into account their specific health and social needs, promote meaningful participation and the encourage respect for human rights.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | DATA COLLECTION | INTERVIEWS | MEN | HOMOSEXUALS | SEX WORKERS | LIFE STYLE | STIGMA | SOCIAL DISCRIMINATION | RISK FACTORS | North America | Americas | Developing Countries | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Social Problems | Sociocultural Factors | Health
Document Number: 341619

24.

Title: The Thai Government's Repatriation and Reintegration Programmes: responding to trafficked female commercial sex workers from the Greater Mekong Subregion.
Author: Jayagupta R
Source: International Migration. 2009 Jun;47(2):227-253.
Abstract: Since the 1990s, trafficked women and girls from neighbouring countries in the Greater Mekong Subregion (GMS), including Myanmar, Lao People's Democratic Republic (Laos), Cambodia, Viet Nam, and Yunnan province in southern China, have increasingly migrated to Thailand and worked in the country's thriving commercial sex industry. In response, the Thai government has launched a range of programmes to supplement its earlier programmes designed primarily to combat internal trafficking. This paper concentrates on one component of the Thai government's response: repatriation and reintegration. The paper is organized as follows: First, a definition of human trafficking, particularly as it relates to women and children, is provided. Second, a succinct discussion of the history of the domestic trafficking of women and girls into commercial sex work in Thailand, focusing especially on the Thai government's broad response to this dilemma, is given. Third, the dynamics of the relatively recent surge of trafficked women and girls from neighbouring GMS countries working in Thailand's commercial sex industry and the Thai government's efforts to combat this are discussed. Finally, the paper focuses on repatriation and reintegration in Thailand; by briefly discussing the situation that trafficked women and girls confront in this process, and by defining repatriation, reintegration, and reintegration assistance. The Thai government's repatriation and reintegration programmes are then described and critically reviewed, focusing particularly on the Kredtrakarn Protection and Occupational Development Centre. Recommendations on how to improve existing repatriation and reintegration programmes are provided. Above all, greater collaboration must take place in order to effectively and efficiently implement policies, plans, and projects to more successfully reintegrate trafficked women and girls back into neighbouring GMS countries, in particular at the local level.
Language: English
Keywords:
THAILAND | CRITIQUE | SEX WORKERS | HUMAN TRAFFICKING | SEXUAL EXPLOITATION | GOVERNMENT PROGRAMS | LEGISLATION | SOCIAL PROTECTION | POLICY | Developing Countries | Asia, Southeastern | Asia | Sex Behavior | Behavior | Crime | Social Problems | Sociocultural Factors | Programs | Organization and Administration | Political Factors
Document Number: 341297

25.

Peer Reviewed

Title: Association Between Testing for Human Immunodeficiency Virus and Changes in Risk Behaviors Among Injecting Drug Users in Southern China.
Author: Jin X; Smith K; Sun Y; Ding G; Yao Y; Xu J; Chang D; Wang G; Zhu Y; Wang N
Source: Sexually Transmitted Diseases. 2009 May 18;
Abstract: BACKGROUND:: There is growing need for research in China regarding posttest risk behavior differences among injecting drug users that explores the effect of various testing modes (nonvoluntary vs. voluntary) and other related factors on changes in posttest risk behaviors. METHODS:: One hundred seventy-two study subjects self-reported human immunodeficiency virus (HIV)-related personal risk behaviors including condom use rates and needle-sharing habits. Fisher exact test and multivariate regression analysis compared the impact of HIV testing mode on ongoing risk behaviors for HIV transmission. RESULTS:: The study found that those who received positive test results were 5.37 times more likely to increase condom use with regular sexual partners, that men were 8.8 times more likely than women to increase posttest condom use in commercial sexual activities. Needle-sharing behavior was significantly lower for subjects who tested HIV-positive (odds ratio [OR]: 4.5), who notified sexual partners of test results (OR: 0.03), and who had tested voluntarily (OR: 0.04). CONCLUSION:: Based on the study results this report concludes that voluntary HIV testing and encouragement of partner notification of test results should be incorporated into China's national testing strategy.
Language: English
Keywords:
CHINA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | IV DRUG USERS | SEX WORKERS | HIV TESTING | RISK REDUCTION BEHAVIOR | HIV TRANSMISSION | CONDOM USE | NEEDLE SHARING | SEX FACTORS | VOLUNTARY COUNSELING AND TESTING | NOTIFICATION | PARTNER COMMUNICATION | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Drug Use and Abuse | Behavior | Sex Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Risk Behavior | Population Characteristics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Interpersonal Relations
Document Number: 341498

26.

27.
Title: Care seeking for STI symptoms in Pakistan.
Author: Khan AA; Naghma-e-Rehan; Qayyum K; Khan A
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Sep;59(9):628-30.
Abstract: OBJECTIVE: To estimate the frequency of Sexually Transmitted Infections (STIs) among sex workers and drug users in Pakistan. METHODS: Interviews were conducted on 3640 sex workers, injection drug users and truckers about STI symptoms within the past year and currently and the care they sought for them. RESULTS: Nearly half (46%) reported STI symptoms in the past 12 months and 55% went for treatment. Most of the care sought was from the private sector and more by IDUs and female sex workers. Increasing age or having a genital ulcer predicted care seeking. CONCLUSIONS: The results suggest the need to understand the factors determining care seeking among members of high risk groups; and emphasizing the role of the private health care providers in treatment and control of STIs.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | INTERVIEWS | SEX WORKERS | WOMEN | IV DRUG USERS | TRUCK DRIVERS | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | TREATMENT | Developing Countries | Asia, Southern | Asia | Data Collection | Research Methodology | Sex Behavior | Behavior | Demographic Factors | Population | Drug Use and Abuse | Labor Force | Human Resources | Economic Factors | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342954

28.

Peer Reviewed

Title: Unmet need for contraception among sex workers in Madagascar.
Author: Khan MR; Turner AN; Pettifor A; Van Damme K; Rabenja NL; Ravelomanana N; Swezey T; Williams D; Jamieson D; Behets F
Source: Contraception. 2009 Mar;79(3):221-7.
Abstract: BACKGROUND: The study was conducted to investigate past and future pregnancy preferences and contraceptive need among Malagasy sex workers. STUDY DESIGN: We analyzed data on pregnancy and contraceptive use collected during the baseline visit of a randomized, prospective formative trial which assessed diaphragm and microbicide acceptability among sex workers. To be eligible, women could not be pregnant or planning pregnancy for the next 2 months. RESULTS: Women (N=192) from four cities (Antananarivo, Antsiranana, Mahajanga and Toamasina) reported a median of 10 sex acts per week. Fifty-two percent reported a prior unwanted pregnancy, 45% at least one induced abortion and 86% that preventing future pregnancy was moderately to very important. During the last sex act, 24% used a hormonal method, 36% used a male condom, 2% used a traditional method and 38% used no method. Nearly 30% of participants reported that pregnancy prevention was moderately or very important but used no contraception at last sex; these women were categorized as having "unmet need" for contraception. In multivariable binomial regression analyses, factors associated with unmet need included low knowledge of contraceptive effectiveness [age- and site-adjusted prevalence ratio (PR): 2.1; 95% confidence interval (CI): 1.4-3.0] and low self-efficacy to negotiate condom use (age- and site-adjusted PR: 2.0; 95% CI: 1.4-3.0). CONCLUSIONS: Among these women, prior unwanted pregnancy and induced abortion were common and preventing future pregnancy was important, yet gaps in contraceptive use were substantial. Contraceptive knowledge and self-efficacy should be improved to promote contraceptive use by sex workers.
Language: English
Keywords:
MADAGASCAR | RESEARCH REPORT | KAP SURVEYS | PROSPECTIVE STUDIES | MULTIVARIATE ANALYSIS | SEX WORKERS | WOMEN IN DEVELOPMENT | FERTILITY PREFERENCES | CONTRACEPTIVE USAGE | NEEDS ASSESSMENT | PREGNANCY, UNWANTED | ABORTION RATE | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | KNOWLEDGE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Sex Behavior | Behavior | Economic Development | Economic Factors | Fertility | Population Dynamics | Demographic Factors | Population | Contraception | Family Planning | Evaluation | Reproductive Behavior | Fertility Control, Postconception | Sociocultural Factors
Document Number: 330055 Notification

29.

Peer Reviewed

Title: Changes in Condom Use Behaviors Among Clients of Female Sex Workers in China.
Author: Lau J; Wan S; Yu X; Cheng F; Zhang Y; Wang N; Zhang L; Zhang J
Source: Sexually Transmitted Infections. 2009 Jun 3;
Abstract: BACKGROUND: Clients of female sex workers (CFSWs) are at-risk for HIV transmission; relevant surveillance and interventions for this vulnerable group are scare. The China-UK HIV/AIDS Prevention and Care Project launched an enhanced intervention program involving peer education, seminars, testing services and social gatherings etc., and two behavioral surveillance studies (BSS) targeting CFSWs in Suining, Sichuan. METHODS: Two cross-sectional BSS (a baseline survey and an evaluative survey) were conducted in September 2005 and May 2006, respectively 356 and 372 respondents who patronized some low-end sex-services were interviewed by peer interviewers. Another triangulation condom audit exercise was conducted in June 2006. RESULTS: Prevalence of respondents utilizing at least one prevention services increased from 50.3% in 2005 to 68.5% in 2006 (adjusted OR=2.2). Respondents of the evaluative survey, as compared to their counterparts of the baseline survey, had lower prevalence of inconsistent condom users in the last 6 months (44.1% versus 77.0%, adjusted OR=0.2) and higher prevalence of condom use in the last episode of commercial sex (78.0% verus 41.5%, adjusted OR=4.9). The triangulation audit showed that condoms were used by 73.8% of CFSWs. The multivariate analysis shows that year of study (OR=0.3), self-reported STD symptoms (OR=2.9), utilization of face-to-face counseling services (OR=0.5) etc. were significantly associated with inconsistent condom use during commercial sex in the last 6 months. CONCLUSIONS: Condom use and service utilization behaviors changed in the study population over a time period, when an enhanced intervention program was implemented. Such effective programs may be applied to other locations in China.
Language: English
Keywords:
CHINA | RESEARCH REPORT | WOMEN | SEX WORKERS | CONDOM USE | CHANGES | RISK BEHAVIOR | HIV | INTERVENTIONS | EVALUATION | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Sex Behavior | Behavior | Risk Reduction Behavior | Social Change | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Delivery of Health Care | Health
Document Number: 341565

30.