Sustained changes in sexual behavior by female sex workers after completion of a randomized HIV prevention trial
Sustained changes in sexual behavior by female sex workers after completion of a randomized HIV prevention trial
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DOI：
10.1097/qai.0b013e3180f616db
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发表时间：
2007-08-15
影响因子：
3.6
通讯作者：
Kaul, Rupert
中科院分区：
文献类型：
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作者：
Ngugi, Elizabeth N.;Chakkalackal, Michelle;Kaul, Rupert
前言：对女性性工作者(FSWs)的行为干预与性行为的改变和性传播感染(STI)和HIV感染率的降低有关。我们研究了这种干预的可持续性。方法：对未感染HIV的肯尼亚FSWs进行临床试验，提供免费避孕套、基于社区和诊所的咨询以及STI管理。在试验完成后，缩减的基于社区的资源仍然存在。一年多后，女性被邀请完成后续行为问卷，并接受STI/HIV咨询和检测。通过配对分析评估个体性行为的变化。结果：172名女性参与了试验终止1.2年后的重新调查。客户数量增加了(配对t检验，P<；0.001)，但避孕套的使用量也增加了(P<；0.00 1)；两者都比注册时低很多。在无保护措施的性接触中，固定伴侣所占比例更大(35%vs.10%；P<；0.001)。172名妇女中只有9人(5.2%)有常规性传播感染，随访的HIV发病率为1.6/100人年(Pys)，与试验期间的3.7/100人年(3.7/100 Pys)相似。结论：在临床试验终止后，以社区为基础的减少风险服务的强度较低，这可能有助于高危暗娼持续减少性传播感染和艾滋病毒感染。
Introduction: Behavioral interventions in female sex workers (FSWs) are associated with changes in sexual behavior and reduced rates of sexually transmitted infections (STIs) and HIV We examined the sustainability of such interventions.Methods: HIV-uninfected Kenyan FSWs were enrolled in a clinical trial that provided free inale condoms, community and clinic-based counseling, and STI management. After trial completion, scaled-back community-based resources remained in place. More than a year later, women were invited to complete a follow-up behavioral questionnaire and to undergo STI/HIV counseling and testing. Individual changes in sexual behavior were assessed by paired analysis.Results: One hundred seventy-two women participated in the resurvey 1.2 years after trial termination. Client numbers had risen (paired t test, P < 0.001), but condom use had also increased (P < 0.00 1); both remained substantially lower than at enrollment. Regular partners accounted for a greater proportion of unprotected FSW sexual encounters (35% vs. 10%; P < 0.001). Only 9 (5.2%) of 172 women had a conventional STI, and the follow-up HIV incidence of 1.6 per 100 person-years (PYs) was similar to that during the trial period (3.7 per 100 PYs). Incident STIs and HIV were associated with the frequency of unprotected sex and younger age.Conclusions: Less intensive community-based risk reduction services after clinical trial termination may support ongoing reductions in STIs and HIV among high-risk FSWs.