HIV prevention and care services for female sex workers: efficacy of a targeted community-based intervention in Burkina Faso.

Autor: Traore IT; Department of Clinical Research, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa; tiandiogo2002@yahoo.fr., Meda N; Department of Clinical Research, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa.; Department of Public Health, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa., Hema NM; Centre of International Research for Health, University of Ouagadougou, Ouagadougou, Burkina Faso, West Africa., Ouedraogo D; Centre of International Research for Health, University of Ouagadougou, Ouagadougou, Burkina Faso, West Africa., Some F; Centre of International Research for Health, University of Ouagadougou, Ouagadougou, Burkina Faso, West Africa., Some R; Centre of International Research for Health, University of Ouagadougou, Ouagadougou, Burkina Faso, West Africa., Niessougou J; Centre of International Research for Health, University of Ouagadougou, Ouagadougou, Burkina Faso, West Africa., Sanon A; Department of Clinical Research, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa., Konate I; Department of Clinical Research, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa., Van De Perre P; UMR 1058, INSERM/University of Montpellier/EFS, Montpellier, France.; CHRU Montpellier, Montpellier, France., Mayaud P; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK., Nagot N; UMR 1058, INSERM/University of Montpellier/EFS, Montpellier, France.; CHRU Montpellier, Montpellier, France.
Jazyk: angličtina
Zdroj: Journal of the International AIDS Society [J Int AIDS Soc] 2015 Sep 14; Vol. 18, pp. 20088. Date of Electronic Publication: 2015 Sep 14 (Print Publication: 2015).
DOI: 10.7448/IAS.18.1.20088
Abstrakt: Introduction: Although interventions to control HIV among high-risk groups such as female sex workers (FSW) are highly recommended in Africa, the contents and efficacy of these interventions are unclear. We therefore designed a comprehensive dedicated intervention targeting young FSW and assessed its impact on HIV incidence in Burkina Faso.
Methods: Between September 2009 and September 2011 we conducted a prospective, interventional cohort study of FSW aged 18 to 25 years in Ouagadougou, with quarterly follow-up for a maximum of 21 months. The intervention combined prevention and care within the same setting, consisting of peer-led education sessions, psychological support, sexually transmitted infections and HIV care, general routine health care and reproductive health services. At each visit, behavioural characteristics were collected and HIV, HSV-2 and pregnancy were tested. We compared the cohort HIV incidence with a modelled expected incidence in the study population in the absence of intervention, using data collected at the same time from FSW clients.
Results: The 321 HIV-uninfected FSW enrolled in the cohort completed 409 person-years of follow-up. No participant seroconverted for HIV during the study (0/409 person-years), whereas the expected modelled number of HIV infections were 5.05/409 person-years (95% CI, 5.01-5.08) or 1.23 infections per 100 person-years (p=0.005). This null incidence was related to a reduction in the number of regular partners and regular clients, and by an increase in consistent condom use with casual clients (adjusted odds ratio (aOR)=2.19; 95% CI, 1.16-4.14, p=0.01) and with regular clients (aOR=2.18; 95% CI, 1.26-3.76, p=0.005).
Conclusions: Combining peer-based prevention and care within the same setting markedly reduced the HIV incidence among young FSW in Burkina Faso, through reduced risky behaviours.
Databáze: MEDLINE
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