|
Résumé :
|
[BDSP. Notice produite par INIST-CNRS R0xbtSiO. Diffusion soumise à autorisation]. Objectives. We assessed the effectiveness of 2 environmental-structural interventions in reducing risks of HIV and sexually transmitted infections (STIs) among female sex workers in the Dominican Republic. Methods. Two intervention models were implemented over a 1-year period : community solidarity in Santo Domingo and solidarity combined with government policy in Puerto Plata. Both were evaluated via preintervention-postintervention cross-sectional behavioral surveys, STI testing and participant observations, and serial cross-sectional STI screenings. Results. Significant increases in condom use with new clients (75.3% - 93.8% ; odds ratio [OR]=4.21 ; 95% confidence interval [CI]=1.55,11.43) were documented in Santo Domingo. In Puerto Plata, significant increases in condom use with regular partners (13.0% - 28.8% ; OR=2.97 ; 95% CI=1.33,6.66) and reductions in STI prevalence (28.8% - 16.3% ; OR=0.50 ; 95% CI=0.32,0.78) were documented, as were significant increases in sex workers'verbal rejections of unsafe sex (50.0% - 79.4% ; OR=3.86 ; 95% CI=1.96,7.58) and participating sex establishments'ability to achieve the goal of no STIs in routine monthly screenings of sex workers (OR=1.17 ; 95% Cl=1.12,1.22). Conclusions. Interventions that combine community solidarity and government policy show positive initial effects on HIV and STI risk reduction among female sex workers.
|
