Methods We cluster-randomised 24 low-income neighbourhoods in Lima, Peru, to one of four conditions: (1) Establishment of Community Centers focused on empowerment and promotion of HIV/ STI prevention messages for MSM; (2) Expedited Partner Therapy for bacterial STIs; (3) Both interventions combined or; (4) No intervention. To determine the effectiveness of the interventions, a cohort of participants from each neighbourhood was interviewed concerning sexual risk behaviours and tested for HIV, HSV-2, syphilis, chlamydia and gonorrhoea (pharyngeal and anal) at baseline and 9-and 18-months follow-up visits. We used Poisson regression adjusted for neighbourhood clustering to determine the association of intervention allocation with unprotected anal intercourse (UAI) and overall STI incidence. Results We enrolled 718 MSM and retained 571 (80%) at 18 months. At baseline there were no differences by intervention arm in either UAI or STI prevalence. The overall STI incidence was 19/100 person years with no difference in STI incidence by intervention allocation (all p > 0.05) ( Table 1). There was an 19% absolute reduction in reported UAI in all communities comparing baseline to 18 months. There was no difference in the probability of reporting UAI by intervention allocation at the second follow-up (all p > 0.05) ( Table 2). Conclusions There was no significant intervention effect on STI incidence or UAI. Further analyses to interpret the lack of intervention effectiveness are ongoing and should be considered in future efforts to conceptualise and study the relationship between structural and biomedical components of combination prevention.Abstract P4.122 Table 1 STI incidence during the 18 month follow-up by intervention component.

Nwuba et al.: Nocardiosis-an emerging complication in the clinical management of HIV infected patients. Retrovirology 2012 9(Suppl 1):P134.

Background Adolescents often lack basic reproductive health RH information, knowledge, and access to health services for RH. Many have less than favourable attitudes and do not feel comfortable to discuss RH with parents or other key adults. Objectives To assess RH knowledge, attitude and provider preference among adolescents of age 15 to 19 years. Methods A community-based cross-sectional study was conducted in Tirana Town, capital city of Albania from October 2012 to January 2013. A structured questionnaire was utilised to collect data from the sampled population.Adolescents aged between 15 to 19 years old were interviewed about their knowledge and attitudes regarding health services for RH. The data were entered into two different computers using SPSS for windows version 17.00. Descriptive analyses using t-test were employed to depict results. Results The majority of adolescents knew major health services for RH and the main health service providers of RH.The major sources of information for RH were internet radio 92% and television and radio for 61% school teachers for 35.9% and parents 28% of respondents. Conclusion The level of knowledge and attitude about health services for RH, source of information for these services and service provider centres is encouraging. However, the role of health professionals and families as the source of information for the adolescents seems to be low. This should be improved using a more integrated all stakeholders particularly adolescents' families and health professionals who have a vital role to ensure adequate knowledge and favourable attitudes for utilisation of the RH in the locality. Sexual Network aNd PractiSe of female Sex workerS iN Sikkim

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BackgroundDue to Lesotho's high adult HIV prevalence (23%), considerable resources have been allocated to the HIV/AIDS response, while resources for non-communicable diseases have lagged. Since November 2011, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has supported Lesotho Ministry of Health to roll out Family Health Days (FHDs), an innovative strategy to increase community access to integrated health services, with a focus on hard-to-reach areas where immunization coverage, HIV service uptake, and screening and treatment for chronic diseases are low.MethodsServices were provided at mobile service delivery points from 17th October to 25th November 2011. Delivery points located in rural setting were staffed by multi-disciplinary teams of doctors, nurses, community workers, nutritionists, AIDS officers, and pharmacists (30-40 health professionals present).ResultsDuring this campaign, 8,396 adults were tested for HIV (67.3% female; 32.6% male). In all, 588 (7%) tested HIV-positive (6.7% female; 7.1% male). Among those testing HIV-positive, 68.5% (403) received CD4 testing and 36.6% were enrolled into HIV care at their nearest clinics. A total of 324 ART defaulters were identified and linked back to care. Follow-up with referral facilities showed 100% of patients (defaulters and newly enrolled) linked to care were enrolled at a facility. Standard immunizations were administered to 990 children. 4,454 adults (24.7% male; 75.3% female) were screened for hypertension, and of those screened, 24.2% had elevated blood pressure and were linked to care centers. Addtitionally, 3,045 adults had blood sugar tests (27.0% males; 73.0% females); 3.1% had elevated blood sugar and were linked to care facilities.ConclusionOffering integrated services within hard-to-reach communities can increase access to a variety of critical health services, including those for non-communicable diseases, and can link ART clients lost to follow-up back to facilities. This approach will be scaled up throughout Lesotho as a strategy to reach all populations in the country.