Sexually transmitted infection control with sex workers: Regular screening and presumptive treatment augment efforts to reduce risk and vulnerability
Sexually transmitted infection control with sex workers: Regular screening and presumptive treatment augment efforts to reduce risk and vulnerability
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DOI：
10.1016/s0968-8080(03)02295-x
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发表时间：
2003-11-01
影响因子：
--
通讯作者：
Dallabetta, G
中科院分区：
文献类型：
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作者：
Steen, R;Dallabetta, G
性工作者的性传播感染率很高，其中许多很容易用抗生素治愈。性传播感染作为辅助因素，加上经常无保护地接触艾滋病毒，使性工作者面临感染艾滋病毒和将性传播感染和艾滋病毒传染给客户和其他伙伴的高风险。消除性传播感染可降低艾滋病毒在最高风险的商业性接触-即不使用避孕套的接触-中的传播效率。本文回顾了两种性传播感染治疗策略，已被证明有效的女性性工作者和他们的客户。1)定期筛查的临床服务机构报告说，避孕套的使用率有所提高，性传播感染和艾滋病毒的流行率有所下降。这些服务包括一个强有力的同伴教育和增强能力的组成部分，强调坚持使用避孕套，为有症状和无症状的性传播感染提供有效治疗，并开始处理增加脆弱性和风险的更大的社会、经济和人权问题。2)对性工作者的假定治疗是一种流行病学治疗，可以是迅速降低性传播感染率的有效短期措施。然而，一旦流行率下降，就需要采取其他长期战略。为性工作者提供有效的性传播感染预防和治疗服务，是控制包括艾滋病毒在内的性传播感染的关键，并与其他艾滋病毒预防工作高度协同。(C)2003年生殖健康问题。All rights reserved.
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 hove 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 osymptomatic 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 epidemiologic treatment, can be an effective short-term measure to rapidly reduce STI rates. Once prevalence rates are brought down, however, other longer-term strategies are required. Effective preventive and curative STI services for sex workers are key to the control of sexually transmitted infections, including HIV, and are highly synergistic with other HIV prevention efforts. (C) 2003 Reproductive Health Matters. All rights reserved.