摘要:

ObjectiveTo study the prevalence and risk factors for HIV infection among sex workers of Addis Ababa, Ethiopia.Design and methodsCross-sectional survey on socio-demographic characteristics, behaviours, and HIV serological status of sex workers attending two health centres of Addis Ababa.ResultsHIV prevalence among sex workers was 274 of 372 (73.7%). Several factors were significantly associated with an increased risk of being HIV-infected [among others, working in ‘shared rooms', high number of clients, use of injectable hormones, and positiveTreponema pallidumparticle agglutination (TPPA) serology], and others with a decreased risk (being born in Addis Ababa, high level of education, peer education on sex work, condom use, use of oral pill, and use of condoms for contraception). Of interest, sex workers who were using condoms for contraception were, compared with others, more likely to use condoms consistently (65 versus 24%, respectively;P< 0.001), and less likely to be HIV-infected (55 versus 86%, respectively;P< 0.001). In multivariate analysis [log-binomial model, giving estimates of the prevalence ratio (PR)], being born in Addis Ababa (PR = 0.74; 95% confidence interval (CI), 0.61–0.91), using condoms for contraception (PR = 0.73; 95% CI, 0.64–0.85), and a positive TPPA serology (PR = 1.21; 95% CI, 1.09–1.36), remained significantly associated with HIV infection.ConclusionsHIV prevalence was remarkably high among sex workers of Addis Ababa. Condom use was higher, and HIV prevalence lower, in sex workers using condoms not only for prevention of HIV and sexually transmitted diseases, but also for contraceptive purpose. This finding is of particular interest for its implications for prevention strategies among sex workers in the developing world.

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectivesTo estimate HIV-1 prevalence among women attending an antenatal clinic in the Gulu District (North Uganda) and, based on these data, among the district's female population.MethodsAnonymous HIV-1 screening was performed for 8555 antenatal clinic attendees aged 15–39 years in the period 1993–1997. The results were used to estimate the prevalence among the district's female population, accounting for differences in fertility rates by HIV-1 serostatus.ResultsAmong antenatal clinic attendees, HIV-1 prevalence showed a significant linear decrease (P< 0.001), from 26.0% in 1993 [95% confidence Interval (CI), 23.2–29.0%] to 16.1% in 1997 (95% CI, 14.8–17.5%). This decrease was mostly due to a marked decrease until 1995 (14.3%; 95% CI, 12.7–16.0%) and was more pronounced among women aged under 30 years (P< 0.001), from both urban and rural areas (P< 0.001). The risk of being infected was higher among women from urban areas (Gulu Municipality), both over the entire period (adjusted prevalence proportion ratio = 1.54; 95% CI, 1.40–1.68) and by individual year. The estimated prevalence for the 15–39-year-old female population, standardized by age and area of residence, decreased from 25.4% in 1993–1994 to 17.8% in 1996–1997; these rates were 1.22 and 1.28 times higher, respectively, than those among antenatal clinic attendees.ConclusionsThe trend of decrease among young women, for whom changes in HIV-1 prevalence more closely reflect incidence, could be partially due to a reduction in risk behaviour and a consequent decreasing incidence. Differences in fertility rates by HIV-1 serostatus should be addressed when using antenatal clinic data to estimate prevalence among the general female population.

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo determine whether cervical mucosal shedding of HIV-1 RNA and HIV-1 infected cells decreases following successful treatment of cervicitis.DesignProspective interventional study.SettingSexually Transmitted Infections Clinic, Coast Provincial General Hospital, Mombasa, Kenya.ParticipantsThirty-six HIV-1 seropositive women with cervicitis: 16 withNeisseria gonorrhoeae,seven withChlamydia trachomatis,and 13 with non-specific cervicitis.InterventionsTreatment of cervicitis.Main outcome measuresLevels of total (cell-free and cell-associated) HIV-1 RNA and presence of HIV-1 DNA (a marker for infected cells) in cervical secretions before and after resolution of cervicitis.ResultsAfter treatment of cervicitis, the median HIV-1 RNA concentration in cervical secretions was reduced from 4.05 to 3.24 log10copies/swab (P= 0.001). Significant decreases in cervical HIV-1 RNA occurred in the subgroups withN. gonorrhoeae(3.94 to 3.28 log10copies/swab;P= 0.02) andC. trachomatis(4.21 to 3.19 log10copies/swab;P= 0.02). Overall, the prevalence of HIV-1 infected cells in cervical secretions also decreased after treatment, from 67% to 42% (odds ratio, 2.8; 95% confidence interval, 1.3–6.0;P= 0.009). Detection of infected cells was associated with higher mean HIV-1 RNA levels (4.04 versus 2.99 log10copies/swab;P< 0.0001).ConclusionsEffective treatment of cervicitis resulted in significant decreases in shedding of HIV-1 virus and infected cells in cervical secretions. Treatment of sexually transmitted diseases may be an important means of decreasing the infectivity of HIV-1 seropositive women by reducing exposure to HIV-1 in genital secretions.

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectivesTo develop methods to maximize the accuracy of reporting HIV risk behaviours in a general population survey. We assessed the feasibility of using a computer-assisted self-completion interview (CASI) in comparison with pen-and-paper self-completion interview (PAPI).DesignA probability sample survey of residents aged 16–44 years in Britain, with alternate assignment of addresses to interview by CASI (462) or PAPI (439).MethodsPersonal interviews exploring demographic and sexual behaviour variables. Principal outcome measures were the impact of CASI in relation to PAPI on data quality and rates of reporting a range of behaviours.ResultsA total of 901 interviews were completed; 829 individuals were eligible for and accepted the self-completion module. Internal consistency of data items was greater with CASI than PAPI and item non-response was lower. Overall, there was no significant difference in rates of reporting between CASI and PAPI. The main effect for CASI compared with PAPI in a generalized estimating equation (GEE) analysis was an OR (95% CI) of 1.04 (0.92–1.17). Variables were also examined individually, including homosexual partnership (adjusted OR 1.26 95% CI 0.69–2.29), payment for sex (adjusted OR 0.68 95% CI 0.29–1.59), masturbation (adjusted OR 0.89 95% CI 0.66–1.22) and five or more partners in the past 5 years (OR 0.85 95% CI 0.61–1.19).ConclusionWe found no evidence of a consistent effect of CASI on rates of reporting sexual HIV risk behaviours in this sample. CASI resulted in improvement in internal consistency and a reduction in missed questions.

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID