Levine W C, Revollo R, Kaune V, Vega J, Tinajeros F, Garnica M, Estenssoro M, Lewis J S, Higueras G, Zurita R, Wright-De Agüero L, Pareja R, Miranda P, Ransom R L, Zaidi A A, Melgar M L, Kuritsky J N
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
AIDS. 1998 Oct 1;12(14):1899-906. doi: 10.1097/00002030-199814000-00022.
To implement an HIV prevention intervention among female commercial sex workers (CSW), and to monitor key outcomes using routinely collected clinical and laboratory data.
Cross-sectional and longitudinal analysis of data from an open-enrollment cohort.
One public sexually transmitted disease (STD) clinic and about 25 brothels in La Paz, Bolivia.
A total of 508 female CSW who work at brothels and attend a public STD clinic.
Improved STD clinical care, supported by periodic laboratory testing, and behavioral interventions performed by a local non-governmental organization.
Prevalence of gonorrhea, syphilis (reactive plasma reagin titer > or = 1 : 16), genital ulcer disease, chlamydial infection, and trichomoniasis; self-reported condom use in the previous month; and HIV seroprevalence.
From 1992 through 1995, prevalence of gonorrhea among CSW declined from 25.8 to 9.9% (P < 0.001), syphilis from 14.9 to 8.7% (P = 0.02), and genital ulcer disease from 5.7 to 1.3% (P = 0.006); trends in prevalence of chlamydial infection and trichomoniasis were not significant. Self-reported condom use during vaginal sex in the past month increased from 36.3 to 72.5% (P < 0.001). In a multivariate analysis, condom use was inversely associated with gonorrhea [odds ratio (OR), 0.63; 95% confidence interval (Cl), 0.41-0.97], syphilis (OR, 0.39; 95% Cl, 0.23-0.64), and trichomoniasis (OR, 0.44; 95% Cl, 0.32-0.71). In 1995, HIV seroprevalence among CSW was 0.1%.
Effective prevention interventions for female CSW can be implemented through public services and non-governmental organizations while HIV rates are still low, and key outcomes can be monitored using data obtained from periodic screening examinations.
在女性商业性工作者中实施一项艾滋病预防干预措施，并利用常规收集的临床和实验室数据监测关键结果。
对一个开放入组队列的数据进行横断面和纵向分析。
玻利维亚拉巴斯的一家公共性传播疾病（STD）诊所和约25家妓院。
共有508名在妓院工作且前往公共STD诊所就诊的女性商业性工作者。
在定期实验室检测的支持下改善STD临床护理，并由当地一个非政府组织开展行为干预。
淋病、梅毒（反应素血浆滴度>或=1:16）、生殖器溃疡疾病、衣原体感染和滴虫病的患病率；前一个月自我报告的避孕套使用情况；以及HIV血清阳性率。
从1992年到1995年，商业性工作者中淋病患病率从25.8%降至9.9%（P<0.001），梅毒患病率从14.9%降至8.7%（P=0.02），生殖器溃疡疾病患病率从5.7%降至1.3%（P=0.006）；衣原体感染和滴虫病患病率的趋势不显著。过去一个月中阴道性交时自我报告的避孕套使用率从36.3%升至72.5%（P<0.001）。在多变量分析中，避孕套使用与淋病[比值比（OR），0.63；95%置信区间（Cl），0.41 - 0.97]、梅毒（OR，0.39；95% Cl，0.23 - 0.64）和滴虫病（OR，0.44；95% Cl，0.32 - 0.71）呈负相关。1995年，商业性工作者中的HIV血清阳性率为0.1%。
在HIV感染率仍然较低时，可通过公共服务和非政府组织对女性商业性工作者实施有效的预防干预措施，并且可利用定期筛查检查获得的数据监测关键结果。
