Declines in risk behaviour and sexually transmitted infection prevalence following a community-led HIV preventive intervention among female sex workers in Mysore, India
Declines in risk behaviour and sexually transmitted infection prevalence following a community-led HIV preventive intervention among female sex workers in Mysore, India
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DOI：
10.1097/01.aids.0000343767.08197.18
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发表时间：
2008-12-01
期刊：
影响因子：
3.8
通讯作者：
Moses, Stephen
中科院分区：
文献类型：
--
作者：
Reza-Paul, Sushena;Beattie, Tara;Moses, Stephen
目的：调查旨在降低印度迈索尔女性性工作者 (FSW) 性风险的社区主导综合干预计划对性行为和性传播感染 (STI) 的影响。计划的关键组成部分是：社区动员和同行介导的外展活动；增加性健康服务的获取和利用；方法：在 2004 年和 2006 年，相隔 30 个月对 FSW 随机样本进行了两次横断面调查。结果：在迈索尔市 1000 多名卖淫妇女中，有 429 人参与了基线调查，425 人参与了后续调查。中位年龄为 30 岁，中位从事性工作的时间为 4 年，大多数人从事街头工作（88%）。基线调查和后续调查之间安全套使用率显着增加：上次与偶尔嫖客发生性行为时使用安全套的比例为 65% 与 90%，P < 0001；回头客分别为 53% 和 66%，P < 0.001；与固定伴侣的比例分别为 7% 和 30%，P < 0.001。 STI 患病率从基线到随访期间下降：梅毒 25% 对比 12%，P < 0.001；滴虫感染分别为 33% 和 14%，P < 0.001；衣原体感染 11% 与 5%，P = 0.001；淋病 50% 与 2%，P = 0.03。 HIV 感染率保持稳定（26% 与 24%），失谐分析测试表明近期 HIV 感染率有所下降。 结论：这项赋予 FSW 权力的全面 HIV 预防干预措施导致报告的安全套使用率显着增加，同时可治愈性传播感染的患病率也随之下降。这种模式应该在印度各地类似的城市环境中复制。
Objective: To investigate the impact on sexual behaviour and sexually transmitted infections (STI) of a comprehensive community-led intervention programme for reducing sexual risk among female sex workers (FSW) in Mysore, India. The key programme components were: community mobilization and peer-mediated outreach; increasing access to and utilization of sexual health services; and enhancing the enabling environment to support programme activities.Methods: Two cross-sectional surveys among random samples of FSW were conducted 30 months apart, in 2004 and 2006.Results: Of over 1000 women who sell sex in Mysore city, 429 participated in the survey at baseline and 425 at follow-up. The median age was 30 years, median duration in sex work 4 years, and the majority were street based (88%). Striking increases in condom use were seen between baseline and follow-up surveys: condom use at last sex with occasional clients was 65% versus 90%, P < 0001; with repeat clients 53% versus 66%, P < 0.001; and with regular partners 7% versus 30%., P < 0.001. STI prevalence declined from baseline to follow-up: syphilis 25% versus 12%, P < 0.001; trichomonas infection 33% versus 14%, P < 0.001; chlamydial infection 11% versus 5%, P = 0.001; gonorrhoea 50% versus 2%, P = 0.03. HIV prevalence remained stable (26% versus 24%), and detuned assay testing suggested a decline in recent HIV infections.Conclusion: This comprehensive HIV preventive intervention empowering FSW has resulted in striking increases in reported condom use and a concomitant reduction in the prevalence Of Curable STI. This model should be replicated in similar urban settings across India.