Analysis of STI and condom use trends among female sex workers in Honduras, 2006 - 2008, impact of an HIV prevention intervention
F. Tinajeros1, W. Miller2, N. Artiles1, M. Urquía3, F. Flores1, S. Mendoza3, G. Paz-Bailey2
1Tephinet, HIV/AIDS, Tegucigalpa, Honduras, 2Universidad del Valle de Guatemala, HIV/AIDS, Guatemala, Guatemala, 3National AIDS Program Honduras, STI/HIV/AIDS, Tegucigalpa, Honduras
Background: A program for commercial sex workers was implemented in three cities in Honduras (Tegucigalpa, San Pedro Sula and La Ceiba) in 2006. It included: standardizing STI services, strengthening laboratory for STI diagnosis, promoting condom use and setting up a sentinel surveillance system to monitor progress.
Methods: Sex workers attending STI clinics in the three cities underwent a gynecologic examination. Blood and vaginal specimens were collected for laboratory tests (Determine and oraquick for HIV, RPR and TPPA for syphilis, Pace II for chlamydia and gonorrhea and wet mount for trichomoniasis) at each visit. Information on condom use with clients was collected through a standardized form at each visit. Data was entered and analyzed in Epinfo. Chi square for trends was used to assess the significance of the prevalence changes by year.
Results: From 2006 to 2008, 1217 female sex workers were evaluated in the three cities. 931, 547 and 370 FSW were attended in 2006, 2007 and 2008, respectively. Upon comparing the first to the third visit, there was a significant decline of syphilis (2.3%, 1.8%, 0.0%; p=0.05) and Chlamydia trachomatis (6.1%, 2.3%, 3.3%; p= 0.01) prevalence while HIV (2.5%, 1.4%, 3.1%; p= NS) trichomoniasis (5.4%, 5.4%, 4.0%; p=NS) and Gonorrhea (2.3%, 1.2%, 2.0% p=NS) did not change significantly. Reports of consistent condom use with clients increased significantly (93.9%, 96.9%, 98.9% p< 0.001).
Conclusions: The implementation of the VICITS strategy for FSW has increased condom use with clients. The program has only been in place for 3 years and changes in STI prevalence and HIV have yet to be achieved. The intervention should be strengthened to increase condom use with regular partners.
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