BACKGROUND: An HIV-preventive intervention targeting the sex work milieu and involving fully integrated components of structural interventions, communication for behavioral change and care for sexually transmitted infections (STIs), was implemented in Benin by a Canadian project from 1992 to 2006. It first covered Cotonou before being extended to other main cities from 2000. At the project end, the Beninese authorities took over the intervention, but structural interventions were interrupted and other intervention components were implemented separately. We estimated time trends in HIV/STI prevalence among female sex workers (FSWs) from 1993 to 2008 and assessed the impact of the change in intervention model on trends. METHODS: Six integrated biological and behavioral surveys were carried out among FSWs. Time trend analysis controlled for potential sociodemographic confounders using log-binomial regression. RESULTS: In Cotonou, from 1993 to 2008, there was a significant decrease in HIV (53.3%-30.4%), gonorrhea (43.2%-6.4%), and chlamydia (9.4%-2.8%) prevalence (all adjusted P = 0.0001). The decrease in HIV and gonorrhea prevalence was also significant in the other cities between 2002 and 2008. In 2002, gonorrhea prevalence was lower in Cotonou than elsewhere (prevalence ratio = 0.53, 95% confidence interval: 0.32 to 0.88). From 2005 to 2008, there was an increase in gonorrhea prevalence (prevalence ratio = 1.76, 95% confidence interval: 1.17 to 2.65) in all cities combined. CONCLUSIONS: Our results suggest a significant impact of this targeted preventive intervention on HIV/STI prevalence among FSWs. The recent increase in gonorrhea prevalence could be related to the lack of integration of the intervention components.
BACKGROUND: An HIV-preventive intervention targeting the sex work milieu and involving fully integrated components of structural interventions, communication for behavioral change and care for sexually transmitted infections (STIs), was implemented in Benin by a Canadian project from 1992 to 2006. It first covered Cotonou before being extended to other main cities from 2000. At the project end, the Beninese authorities took over the intervention, but structural interventions were interrupted and other intervention components were implemented separately. We estimated time trends in HIV/STI prevalence among female sex workers (FSWs) from 1993 to 2008 and assessed the impact of the change in intervention model on trends. METHODS: Six integrated biological and behavioral surveys were carried out among FSWs. Time trend analysis controlled for potential sociodemographic confounders using log-binomial regression. RESULTS: In Cotonou, from 1993 to 2008, there was a significant decrease in HIV (53.3%-30.4%), gonorrhea (43.2%-6.4%), and chlamydia (9.4%-2.8%) prevalence (all adjusted P = 0.0001). The decrease in HIV and gonorrhea prevalence was also significant in the other cities between 2002 and 2008. In 2002, gonorrhea prevalence was lower in Cotonou than elsewhere (prevalence ratio = 0.53, 95% confidence interval: 0.32 to 0.88). From 2005 to 2008, there was an increase in gonorrhea prevalence (prevalence ratio = 1.76, 95% confidence interval: 1.17 to 2.65) in all cities combined. CONCLUSIONS: Our results suggest a significant impact of this targeted preventive intervention on HIV/STI prevalence among FSWs. The recent increase in gonorrhea prevalence could be related to the lack of integration of the intervention components.
Authors: Stephen Moses; Banadakoppa M Ramesh; Nico J D Nagelkerke; Ajay Khera; Shajy Isac; Parinita Bhattacharjee; Vandana Gurnani; Reynold Washington; Kudur H Prakash; Banandur S Pradeep; James F Blanchard Journal: AIDS Date: 2008-12 Impact factor: 4.177
Authors: Robert L Cook; Shari L Hutchison; Lars Østergaard; R Scott Braithwaite; Roberta B Ness Journal: Ann Intern Med Date: 2005-06-07 Impact factor: 25.391
Authors: C M Lowndes; M Alary; A-C Labbé; C Gnintoungbè; M Belleau; L Mukenge; H Meda; M Ndour; S Anagonou; A Gbaguidi Journal: Sex Transm Infect Date: 2007-10-17 Impact factor: 3.519
Authors: C M Lowndes; M Alary; H Meda; C A B Gnintoungbé; L Mukenge-Tshibaka; C Adjovi; A Buvé; L Morison; M Laourou; L Kanhonou; S Anagonou Journal: Sex Transm Infect Date: 2002-04 Impact factor: 3.519
Authors: Sharmistha Mishra; Marie-Claude Boily; Sheree Schwartz; Chris Beyrer; James F Blanchard; Stephen Moses; Delivette Castor; Nancy Phaswana-Mafuya; Peter Vickerman; Fatou Drame; Michel Alary; Stefan D Baral Journal: Ann Epidemiol Date: 2016-06-15 Impact factor: 3.797
Authors: Andrea J Low; Issouf Konate; Nicolas Nagot; Helen A Weiss; David Mabey; Michel Segondy; Peter Vickerman; Nicolas Meda; Philippe van de Perre; Philippe Mayaud Journal: Sex Transm Infect Date: 2013-12-13 Impact factor: 3.519