Prevention of Sexually Transmitted Diseases (STDs) in Female Sex Workers

Sánchez, Jorge; Campos, Pablo E.; Courtois, B; Gutiérrez, L. Reina; Carrillo, Carlos; Alarcón, Jorge; Gotuzzo, Eduardo; Hughes, Jim R.; Watts, Douglas M.; Hillier, Sharon L.; Buchanan, Kelvin C.; Holmes, King K.

doi:10.1097/00007435-200304000-00001

Cited by 46 publications

(13 citation statements)

References 18 publications

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“…Our estimate of 9% syphilis seroprevalence is comparable with an 11% estimate from the mid-1990s [4], but higher than the 3.3% reported earlier that decade [2] and 4.1% identified among primarily registered sex workers [30]. Our study reports no evidence of recent syphilis, consistent with an interpretation of low frequency of transmission.…”

Section: Discussionsupporting

confidence: 87%

Genital Tract Infections, Bacterial Vaginosis, HIV, and Reproductive Health Issues among Lima-Based Clandestine Female Sex Workers

Perla

Ghee

Sánchez

et al. 2012

Infectious Diseases in Obstetrics and Gynecology

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Sociodemographic and behavioral characteristics of 212 Peruvian female sex workers (FSWs) were analyzed. The association between genital tract infections (GTIs) and risk factors by multivariate analysis was evaluated. Eighty-eight percent of FSWs were diagnosed with at least one GTI (HSV-2 80.1%, BV 44.8%, candidiasis 9.9%, syphilis seropositivity 9.4%,Trichomonas vaginalis2.4%, HIV seropositivity 2.4%). Reported condom use with clients was nearly universal (98.3%), but infrequent with husband/regular partners (7.3%). In multivariate analysis BV was negatively associated with more consistent condom use (PRR=0.63, 95% CI, 0.42–0.96). Many had not visited a Sexually Transmitted Infection (STI) clinic or been tested for HIV in the past year (40.6%, 47.1%, resp.). Nonclient contraceptive use was low (57%) and induced abortion was common (68%). High GTI burden and abortions suggest that a services-access gap persists among marginalized FSWs. Continued health outreach programs and integrating family planning and reproductive health services into existing STI clinic services are recommended.

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Section: Discussionsupporting

confidence: 87%

Genital Tract Infections, Bacterial Vaginosis, HIV, and Reproductive Health Issues among Lima-Based Clandestine Female Sex Workers

Perla

Ghee

Sánchez

et al. 2012

Infectious Diseases in Obstetrics and Gynecology

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“…The intervention group underwent a 6-month program of educational videos, small group discussions, educational materials, received free condoms, and it found incidences of 0.04 compared to 0.12 per person-year of follow-up among intervention and control women, respectively [15]. The second reported that long-term consistent condom use had protective effect for anti-HBc positivity among FSW participating in a control program in Peru [34]. However, two additional studies carried out in other populations found conflicting results.…”

Section: Discussionmentioning

confidence: 99%

HBV Infection in Relation to Consistent Condom Use: A Population-Based Study in Peru

et al. 2011

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BackgroundData on hepatitis B virus (HBV) prevalence are limited in developing countries. There is also limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use.Methods and FindingsData from two different surveys performed in 28 mid-sized Peruvian cities were analyzed. Participants aged 18–29 years were selected using a multistage cluster sampling. Information was collected through a validated two-part questionnaire. The first part (face-to-face) concerned demographic data, while the second part (self-administered using handheld computers) concerned sexual behavior. Hepatitis B core antibody (anti-HBc) was tested in 7,000 blood samples. Prevalences and associations were adjusted for sample strata, primary sampling units and population weights. Anti-HBc prevalence was 5.0% (95%CI 4.1%–5.9%), with the highest prevalence among jungle cities: 16.3% (95%CI 13.8%–19.1%). In the multivariable analysis, Anti-HBc positivity was directly associated with geographic region (highlands OR = 2.05; 95%CI 1.28–3.27, and jungle OR = 4.86; 95%CI 3.05–7.74; compared to coastal region); and inversely associated with age at sexual debut (OR = 0.90; 95%CI 0.85–0.97). Consistent condom use, evaluated in about 40% of participants, was associated with reduced prevalence (OR = 0.34; 95%CI 0.15–0.79) after adjusting for gender, geographic region, education level, lifetime number of sex partners, age at sexual debut and year of survey.ConclusionResidence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences. Consistent condom use was associated with decreased risk of anti-HBc. Findings from this study emphasize the need of primary prevention programs (vaccination) especially in the jungle population, and imply that condom use promotion might be a potential strategy to prevent HBV infection.

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“…Although there is response to antibiotics in many women, persistence or recurrence of the condition occurs in 11%–29% of women at 1 month [104, 108, 109]. Moreover, long-term recurrence rates have been shown to be greater than 70% [19, 110, 111]. Marrazzo et al [63] investigated several risk factors for BV persistence one month after treatment, including the detection of key vaginal bacteria by species-specific PCR.…”

Section: Molecular Studies In the Vaginal Niche: A Critical Examinmentioning

confidence: 99%

The Human Vaginal Bacterial Biota and Bacterial Vaginosis

Srinivasan

Fredricks

2008

Interdisciplinary Perspectives on Infectious Diseases

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198

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The bacterial biota of the human vagina can have a profound impact on the health of women and their neonates. Changes in the vaginal microbiota have been associated with several adverse health outcomes including premature birth, pelvic inflammatory disease, and acquisition of HIV infection. Cultivation-independent molecular methods have provided new insights regarding bacterial diversity in this important niche, particularly in women with the common condition bacterial vaginosis (BV). PCR methods have shown that women with BV have complex communities of vaginal bacteria that include many fastidious species, particularly from the phyla Bacteroidetes and Actinobacteria. Healthy women are mostly colonized with lactobacilli such as Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus iners, though a variety of other bacteria may be present. The microbiology of BV is heterogeneous. The presence of Gardnerella vaginalis and Atopobium vaginae coating the vaginal epithelium in some subjects with BV suggests that biofilms may contribute to this condition.

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Prevention of Sexually Transmitted Diseases (STDs) in Female Sex Workers

Abstract: Strengthened periodic screening for and treatment of confirmed STD, in addition to condom promotion and provision, represent feasible, effective interventions in commercial sex, and time series analyses can provide a useful approach to evaluating new interventions.

Cited by 46 publications

References 18 publications

Genital Tract Infections, Bacterial Vaginosis, HIV, and Reproductive Health Issues among Lima-Based Clandestine Female Sex Workers

Genital Tract Infections, Bacterial Vaginosis, HIV, and Reproductive Health Issues among Lima-Based Clandestine Female Sex Workers

HBV Infection in Relation to Consistent Condom Use: A Population-Based Study in Peru

The Human Vaginal Bacterial Biota and Bacterial Vaginosis

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