Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda.
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
BMC Health Serv Res. 2021 May 7;21(1):436. doi: 10.1186/s12913-021-06461-w.
BACKGROUND: Globally, female sex workers (FSW) are disproportionately affected by HIV and other sexually transmitted infections (STIs). However, uptake of STI and HIV testing services among FSW in sub-Saharan Africa remains low. We aimed to assess the effect of FSW-led peer education and text message reminders on 3-monthly syphilis and HIV testing among FSW in Uganda. METHODS: Between September 2019 and February 2020, we implemented weekly peer education sessions and bi-monthly SMS reminders for FSW in Mbarara (intervention city). Peer education sessions were implemented by 20 FSW, who received five days of basic training as peer educators. We held monthly meetings with peer educators throughout the six-month implementation period. FSW in Mbale (control city) continued to receive standard of care consisting of HIV testing outreach campaigns, and facility-based testing. Using a quasi-experimental design in one intervention city, and one control city, we conducted pre- and post- questionnaire-based surveys on recent syphilis and HIV testing behavior among FSW in July-October 2018, and March 2020. We compared proportions and prevalence ratios at baseline and follow-up using chi-square tests and negative binomial regression. RESULTS: We conducted 436 interviews (200 before/236 after) with FSW. At baseline similar proportions reported taking an HIV test (57 % vs. 54 %; p = 0.72), and a syphilis serology test (35 % vs. 39 %; p = 0.67) in the intervention and control cities, respectively, in the prior three months. After the intervention, this proportion increased to 82 % (95 % confidence interval [CI] 74.0-88.2) for HIV, and 81 % (95 % CI: 73.0-87.0) for syphilis in the intervention city. Relative to baseline in the control city, the proportion testing for HIV was unchanged (52 %) but decreased for syphilis (26 %). CONCLUSIONS: Bi-monthly text message reminders with weekly peer education sessions increased uptake of 3-monthly syphilis and HIV testing in a Ugandan female sex work population and could help increase sex worker engagement in HIV/STI services in line with World Health Organization recommendations.
背景：在全球范围内，女性性工作者（FSW）受到艾滋病毒和其他性传播感染（STI）的影响不成比例。然而，撒哈拉以南非洲的 FSW 接受性传播感染和艾滋病毒检测服务的比例仍然很低。我们旨在评估 FSW 主导的同伴教育和短信提醒对乌干达 FSW 每三个月进行梅毒和艾滋病毒检测的效果。
方法：在 2019 年 9 月至 2020 年 2 月期间，我们在姆巴拉拉（干预城市）为 FSW 实施了每周同伴教育课程和每两个月的短信提醒。20 名 FSW 实施了同伴教育课程，他们接受了五天的基本培训作为同伴教育者。我们在整个六个月的实施期间与同伴教育者每月举行一次会议。姆巴莱（对照城市）的 FSW 继续接受包括艾滋病毒检测外展运动和基于设施的检测在内的标准护理。我们在一个干预城市和一个对照城市使用准实验设计，在 2018 年 7 月至 10 月和 2020 年 3 月，对 FSW 最近的梅毒和艾滋病毒检测行为进行了基于问卷的预和随访调查。我们使用卡方检验和负二项回归比较了基线和随访时的比例和患病率比。
结果：我们对 436 名 FSW 进行了采访（200 名在干预前/236 名在干预后）。在基线时，干预和对照城市中分别有类似比例的 FSW 在过去三个月内报告接受过艾滋病毒检测（57% vs. 54%；p=0.72）和梅毒血清学检测（35% vs. 39%；p=0.67）。在干预后，干预城市中艾滋病毒检测比例增加到 82%（95%置信区间[CI]：74.0-88.2），梅毒检测比例增加到 81%（95% CI：73.0-87.0）。与对照城市的基线相比，艾滋病毒检测的比例保持不变（52%），但梅毒检测的比例下降（26%）。
结论：每月两次的短信提醒与每周的同伴教育课程相结合，增加了乌干达性工作者群体中每三个月进行梅毒和艾滋病毒检测的比例，并有助于按照世界卫生组织的建议增加性工作者对艾滋病毒/性传播感染服务的参与。
AIDS Res Ther. 2020-8-1
Medicine (Baltimore). 2018-5
Rev Esp Salud Publica. 2025-2-18
Can Commun Dis Rep. 2022-2-24
BMC Infect Dis. 2020-5-12
AIDS Behav. 2019-4
Zotero 插件