Periodical Antibiotic Treatment for the Control of Gonococcal and Chlamydial Infections Among Sex Workers in Benin and Ghana

Labbé, Annie‐Claude; Pépin, Jacques; Khonde, Nzambi; Dzokoto, Agnes; Meda, Honoré A.; Asamoah-Adu, Comfort; Mayaud, Philippe; Mabey, David; Demers, Éric; Alary, Michel

doi:10.1097/olq.0b013e318244aaa0

Cited by 13 publications

(20 citation statements)

References 20 publications

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“…Women who engaged in occasional sex work, but who depended primarily on other means of income generation [45-51] and other ‘high-risk women’ [52-55] were also prioritised by several projects, demonstrating understanding of the broad spectrum of transactional sex that characterises many African settings. Male partners of FSWs [40,48,56-66] and (potential) male clients [67-69] – including truck drivers [70,71], mine workers [72] or military personnel [73,74] – were frequently targeted in HIV prevention interventions alongside FSWs.…”

Section: Resultsmentioning

confidence: 99%

“…Although a wide range of outreach activities was undertaken across all the projects, again most appeared to be geared towards HIV and STI prevention through individual behaviour change. Thus outreach services most frequently encompassed STI and HIV prevention education, condom distribution and promotion and recruitment for STI screening [40,48,56-66,83,99,110-121], often via a referral card system [52,55,140,141]. Most projects encouraged FSWs to ‘drop in’ to a clinic to collect free condoms; however we identified only three projects (in Ghana, Mombasa Kenya, and The Sex Worker Education and Advocacy Taskforce (SWEAT) in Cape Town South Africa) which had established an actual community drop-in centre that could serve as a meeting place and central hub for distribution of condoms and information, education and communication (IEC) materials [41,60,75-80,142-147].…”

Section: Resultsmentioning

confidence: 99%

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Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review

et al. 2014

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BackgroundFemale sex workers (FSWs) experience high levels of sexual and reproductive health (SRH) morbidity, violence and discrimination. Successful SRH interventions for FSWs in India and elsewhere have long prioritised community mobilisation and structural interventions, yet little is known about similar approaches in African settings. We systematically reviewed community empowerment processes within FSW SRH projects in Africa, and assessed them using a framework developed by Ashodaya, an Indian sex worker organisation.MethodsIn November 2012 we searched Medline and Web of Science for studies of FSW health services in Africa, and consulted experts and websites of international organisations. Titles and abstracts were screened to identify studies describing relevant services, using a broad definition of empowerment. Data were extracted on service-delivery models and degree of FSW involvement, and analysed with reference to a four-stage framework developed by Ashodaya. This conceptualises community empowerment as progressing from (1) initial engagement with the sex worker community, to (2) community involvement in targeted activities, to (3) ownership, and finally, (4) sustainability of action beyond the community.ResultsOf 5413 articles screened, 129 were included, describing 42 projects. Targeted services in FSW ‘hotspots’ were generally isolated and limited in coverage and scope, mostly offering only free condoms and STI treatment. Many services were provided as part of research activities and offered via a clinic with associated community outreach. Empowerment processes were usually limited to peer-education (stage 2 of framework). Community mobilisation as an activity in its own right was rarely documented and while most projects successfully engaged communities, few progressed to involvement, community ownership or sustainability. Only a few interventions had evolved to facilitate collective action through formal democratic structures (stage 3). These reported improved sexual negotiating power and community solidarity, and positive behavioural and clinical outcomes. Sustainability of many projects was weakened by disunity within transient communities, variable commitment of programmers, low human resource capacity and general resource limitations.ConclusionsMost FSW SRH projects in Africa implemented participatory processes consistent with only the earliest stages of community empowerment, although isolated projects demonstrate proof of concept for successful empowerment interventions in African settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review

et al. 2014

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“…In west Africa, FSW carry a significant burden of HIV disease and are identified as a high-prevalence and incidence core group [18,19]. In selected cities in Ghana, Benin and Togo, 32–84% of prevalent cases among men had been attributed to sexual contact with FSW [1,18,20]. The percentage of HIV in the general women population that can be attributed to female sex work is estimated at 18% [21].…”

Section: Concentrated Epidemicsmentioning

confidence: 99%

“…A meta-analysis of FSW studies in low to middle-income countries indicated that FSW in sub-Saharan Africa had 12.4 times the odds of HIV compared with all women of reproductive age [15 ▪▪ ]. HIV prevalence in FSW varies within and across west African settings, with reported estimates over the past 5 years of 15.9% in The Gambia [22], 20% in Nigeria [23], 20.1% in Senegal [21], 25.7% in Bobo-Dioulasso, Burkina Faso [24], 26.6% in Côte d’Ivoire [17], 30.4% in Cotonou, Benin [25], 45.4% in Lome, Togo [20] and up to 68.6% in a study in Ghana and Benin [18] (Table 1). Although data are scarce for male and transgender sex workers, a study conducted among male sex workers in Côte d’Ivoire identified an HIV prevalence of 50% [7].…”

Section: Concentrated Epidemicsmentioning

confidence: 99%

“…FSW studies from Côte d’Ivoire, Ghana, Benin and Nigeria documented an elevated prevalence of curable bacterial STIs, denoting a higher risk for HIV infection among these FSW [17,18,26]. Structural factors that elevate risk among FSW include extreme poverty, concomitant lack of familial and social support, gender inequality, stigma, discrimination, physical and sexual violence and legal and regulatory policies penalizing sex work [15 ▪▪ ,37].…”

Section: Concentrated Epidemicsmentioning

confidence: 99%

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HIV epidemic among key populations in west Africa

Djomand

Quaye²,

Sullivan

2014

Current Opinion in HIV and AIDS

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Purpose of review Globally, HIV infection remains a significant issue for key populations such as men who have sex with men (MSM) and female sex workers. A review of recent articles was conducted for west African countries to assess the burden of disease among female sex workers and MSM, access to services and identify barriers to implementation of services for key populations. Recent findings In west Africa, key populations engage in high-risk practices for the acquisition of HIV and other sexually transmitted infections. Available HIV prevalence data fluctuate across and within countries for both MSM and female sex workers and may be five to ten times as high as that of the general population. HIV prevalence varied from 15.9% in The Gambia to 68% in Benin among female sex workers, whereas it ranged from 9.8% in The Gambia to 34.9% in Nigeria for MSM. Yet, important data gaps exist, including key populations size estimations in several countries as well as HIV prevalence, incidence and other biomarkers of HIV risk. Because of sociocultural, legal, political and economic challenges, exacerbated by a poor health system infrastructure, the HIV response is not strategically directed toward programs for key populations in countries with concentrated epidemics. Noteworthy is the low coverage of prevention care and treatment interventions offered to key populations. Summary Sufficient planning and political will with legal and structural frameworks that reconcile public health and human rights are needed to prioritize HIV prevention, care and treatment programming for key populations programs in west Africa.

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Structural and community-level interventions for increasing condom use to prevent the transmission of HIV and other sexually transmitted infections

Moreno

Nababan

Ota

et al. 2014

Cochrane Database of Systematic Reviews

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Periodical Antibiotic Treatment for the Control of Gonococcal and Chlamydial Infections Among Sex Workers in Benin and Ghana

Cited by 13 publications

References 20 publications

Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review

Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review

HIV epidemic among key populations in west Africa

Structural and community-level interventions for increasing condom use to prevent the transmission of HIV and other sexually transmitted infections

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