HIV prevention in female sex workers: results of social interventions at Central American borders
R. Leyva1, F. Melchor2, F. Quintino2
1Instituto Nacional de Salud Pública, Centro de Investigación en Sistemas de Salud, Cuernavaca, Mexico, 2National Institute of Public Health of Mexico, Cuernavaca, Mexico
Background: In Central America, female sex workers (FSW) are a mobile group in the region. Their usual clients include other mobile groups such as truck drivers, sailors, seasonal farm workers, and migrants in transit to Mexico or the US. The majority has and irregular immigration status, their work is illegal in almost every country, and they suffer from stigma and discrimination. This context creates important barriers to the exercise of their sexual and human rights and to access health care services. Social and governmental organizations in Central America have developed a comprehensive HIV prevention and care project directed to mobile groups, which is supported by the Global Fond, 2005-2010. Its goal is to increase the access to comprehensive care to STIs and HIV focused on the most vulnerable groups such as FSW.
Methods: A cuasi-experimental study was carried out between August-September 2009 to evaluate the results of the interventions (condom use, access to HIV rapid tests, and basic information on sexual and reproductive rights). 424 FSW were interviewed (60% with intervention). The analysis included a logistic regression model to estimate the effect of the interventions on condom use.
Results: Both groups (with and without intervention) have similar socio-demographic characteristics (age, years of formal education, marital status, economic dependants, number of children). FSW that received the intervention had 2.3 times higher possibilities to use condoms with their last client (p=0.048, IC95%; 1.0071-5.5285) in comparison with those that did not receive the intervention. This result was adjusted by the following variables: new or regular client, work place (street, bars, table dance, brothels), and carnet for STIs control.
Conclusions: Comprehensive health care interventions focused to FSW demonstrated to increase condom use at a context of high population mobility.
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