bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S2.13 The impact of the 2010 Winter Olympic Games on sex work patterns, safety and sex worker vulnerability to HIV and sexually transmitted infections
Authors: Deering K , Chettiar J , Chan K , Taylor M , Montaner J , Shannon K 
Published: July 2011

BackgroundLarge-scale international sports events such as the 2010 Winter Olympics Games in Vancouver, Canada can have significant impacts on the vulnerability of sex workers (SWs) to HIV and sexually transmitted infections (STIs). SWs in Vancouver continue to face extreme vulnerabilities to violence and HIV/STIs. Despite significant focus on the social legacy of large-scale sports events, there is surprisingly limited research evaluating the impact of such events on sex work. This study therefore examined the impact of the 2010 Olympic time period on sex work patterns, safety and HIV/STI vulnerability of SWs in Vancouver.MethodsData were used from a screening questionnaire for a longitudinal cohort study of 230 SWs from January to July 2010. Bivariate and multivariable logistic regression was used to examine the impact of time period (pre/during-Olympics vs post-Olympics) on sex work patterns, safety and HIV/STI vulnerability in the last 30 days.ResultsOverall, the median age of respondents was 33 years (IQR—28–40), and 106 (51.2%) SWs were non-Caucasian. In multivariable analysis (after adjusting for social and environmental factors) in the pre/during-Olympics period compared to post-Olympics, we found significantly higher odds of respondents reporting more police stopping SWs without arrest (adjusted ORs[AOR]—3.95, 95% CIs 1.92 to 8.14), reporting a decrease in the numbers of clients available (AOR—1.97, 95% CI 1.11 to 3.48), reporting difficulty hooking up with clients due to road closures/construction (AOR 7.68, 95% CI 2.46 to 23.98) and a decrease in the numbers of clients available (AOR 3.59, 95% CI 1.79 to 7.19). We found no significantly increased odds in new/trafficked SWs in the Olympic time period.ConclusionsThere were significant changes in sex work patterns, safety and HIV/STI vulnerability of SWs immediately before and during the 2010 Winter Olympics compared to post-Olympics. Fears over an influx of new SWs or human trafficking appear to be unfounded. Displacement of SWs away from main streets/commercial areas has significant public health implications, since this previously has been shown to promote violence and coercive unprotected sex, and increase risk for HIV/STIs. Safer sex work spaces such as indoor brothels and policy reforms should be considered both in Canada and by other host countries of large-scale events to reduce the vulnerability of SWs to HIV from displacement and disruption.
P1-S2.14 Neisseria gonorrhoeaandChlamydia trachomatisRe-infection and associated risk factors among cohort of female sex workers in India
Authors: Risbud A R , Deshpande G R , Narayanan P , Parimi P , Das Anjana 
Published: July 2011

BackgroundNeisseria gonorrhoea(NG) andChlamydia trachomatis(CT) infections can be completely cured by appropriate medication. Syndromic STI management often fails to cover asymomatic NG/CT infections. Additionally, Female sex workers (FSWs), due to their risky behaviour are vulnerable to repeated infections. Frequency of repeated infections with these pathogens was studied in a cohort of FSWs.MethodsIn 6 months prospective cohort study, FSWs aged 18–40 years were recruited from three STI clinics in two states in India as a part of Bill & Melinda Gates Foundation funded operational research. Vaginal swab specimens were collected in all visits and were tested for NG/CT by Gen-Probe APTIMA Combo II assay. Presumptive treatment for gonorrhoea and chlamydia at the baseline visit and syndromic STI management at all subsequent visits was provided during the study period. Re-infection was defined as a laboratory confirmed NG/CT infection occurring after 30 days from an initial confirmed positive test result.ResultsOf 417 FSWs recruited during 2008–2009, 360 made at least 1-monthly follow-up visit. At baseline and during follow-up, 184 were NG infected and 210 were CT infected see Abstract P1-S2.14 Table 1. A total of 39 (11.8%) NG re-infections and 30 (8.3%) CT re-infections were identified at follow-up visits. Among the factors studied, alcohol consumption (OR=2.4, p=0.01); relatively new to commercial sex work (within 3 years) (OR=2.16, p=0.03); had STIs in the past (OR=3.85, p=0.00) were significantly associated with the NG, CT re-infection.Abstract P1-S2.14 Table 1Re-infection frequency among female sex workers Cohort in IndiaNG-Re-infectionVisit 1Visit 2Visit 3Visit 4Visit 5TotalNo re-infection/Negatives4173432882441751467Re-infected (31–330 days)0017461239Total4173602922501871506CT-Re-infectionNo re-infection/ Negatives4173462822501811476Re-infected (30–291 days)0014100630Total4173602922501871506ConclusionHigh frequency of NG and CT re-infection among FSWs highlights the need for regular screening for etiological diagnosis for effective treatment. New sex workers and those consuming alcohol need special attention in STI management.
P1-S2.15 Prevalence of condyloma acuminatum and certain sexually transmitted diseases among female sex workers (FSWs) in a cohort study at sexually transmitted diseases dispensary (DIST) in Cotonou, BÉnin
Authors: Nassirou N , Diabate S , Akakpo J , Tremblay C , Alary M 
Published: July 2011

BackgroundCondyloma acuminatum usually diagnosed among FSWs, represents an entrance for HIV infection. This study aimed to determine the prevalence of condyloma acuminatum and factors associated with its appearance among FSWs who attended this STI dispensary.MethodsFrom September 2008 to March 2010, each FSWs of the cohort at recruitment was probed with a questionnaire on her sexual behaviours, social and demographic characteristics, to provide a blood sample for HIV screening, vaginal and cervix samples for gonorrhoea and Chlamydia screening. Prevalence of condyloma acuminatum, HIV, gonorrhoea and Chlamydia were performed. Analysis unites and multivariates in logistic regression have been performed to estimate the influence of these factors in the appearance of condyloma acuminatum among FSWs in DIST.ResultsAmong the 403 FSWs enrolled, the prevalence of condyloma acuminatum was 5.2%. The one of HIV infection was 37%. Prevalence of gonorrhoea and Chlamydia were nil. This remark certifies the high level of condom use (87.3%) among FSWs. HIV infection was significantly associated with appearance of condyloma acuminatum in the cohort of FSWs attending the STI dispensary with an adjusted OR of 2.4 (95% CI= 0.90 to 6.43).ConclusionCondyloma acuminatum remains a way in HIV infection transmission. A meticulous check and treatment contributes to reduce HIV/AIDS risk.
P1-S2.17 Modelling the impact of rapid test syphilis screening among female sex workers in China
Authors: Mitchell Kate , Cox Andrew 
Published: July 2011

BackgroundIn China, female sex workers (FSWs) are hard to reach for public health interventions. STIs and syphilis (Tp) in particular, are now a major public health concern in China. Currently, diagnosis of active Tp requires laboratory tests, which have high sensitivity, are capable of diagnosing active Tp infection, but involve delays between testing and treatment. Such delays lead to a low proportion of FSWs returning for treatment. In contrast, rapid Tp tests can provide instant results, thereby offering the possibility of immediate treatment, but are generally lower sensitivity and cannot differentiate between active and previous Tp infection. In this study, we estimate the impact of using rapid tests to screen FSWs for Tp in a Chinese setting and compare the performance with lab-based diagnosis.MethodsA deterministic model of Tp transmission among FSWs and clients was parameterised and fitted to data from the medium prevalence setting (Kaiyuan City). Random sampling of parameter uncertainty ranges was used to find multiple fits. Model fits were used to explore the epidemiological impact of providing rapid Tp testing and treatment for FSW at different annual coverage levels for 3 years, in comparison to using a high sensitivity lab-based test. Because of evidence for Tp rebounding following treatment, the impact of the intervention after it has ended was evaluated.ResultsThe model projected the 3-year impact of annually screening 40% or 80% of FSWs with a rapid Tp test (sensitivity 87%) would result in a 46% (43–54%) or 69% (66–77%) relative reduction in Tp prevalence in this setting, respectively. The corresponding decrease in Tp prevalence among clients was estimated to be 2 to 3-fold less but more infections were averted among them. The Asbtract P1-S2.17 figure 1 shows that for a lab-based testing strategy to achieve the same impact as using a rapid test with 87% sensitivity would require a return rate of 92% or 98% if the delay in treatment was 1 or 2 weeks, respectively. After screening ceases, the model projects the percentage of infections averted would continue increasing for a number of years in this setting.Asbtract P1-S2.17 Figure 1Required return rate for lab-based gold standard test to have same impact as a rapid test for different delays in treatment. Different lines are for different delay periods between testing and treatment for the lab test - thick line, 0 weeks; dashed line, 1 week; dotted line, 2 weeks; narrow line, 4 weeks.ConclusionsIn a moderate Tp prevalence setting, a rapid test point of care intervention could have considerable impact on Tp transmission. Unless there is very low sensitivity for the rapid test and a very high return rate for the lab-based method of screening, the rapid test intervention will provide a greater relative reduction in Tp prevalence.
P1-S2.18 Syphilis prevalence and related risk factors among female workers at social venues in Liuzhou, China
Authors: Li J , Chen X S , Gandhi A , Suchindran C , Weir S 
Published: July 2011

BackgroundIn the context of rapid urbanisation and economic growth in China, places where social mixing intersects with commercial activities could play an important role in the formation of new partnerships and spread of sexually transmitted infections (STIs) including HIV. People who work at such venues may be at higher risk of STIs. A study was conducted from October 2009 through February 2010 in Liuzhou, China to estimate the prevalence of syphilis and related risk factors among females working at places where people go to meet new sexual partners.MethodsUsing a two-stage venue-based sampling method called PLACE, data were collected through interviews with 656 females nested within 36 venues with a minimum of five females per venue. A venue was classified as a “sex venue” if the manager or at least one of the females reported solicitation of commercial sex at the venue in the past 4 weeks. All respondents were screened for syphilis onsite using a rapid treponemal-specific test which represents lifetime syphilis infection acquired at anytime. Multi-level regression modelling was used to examine individual and venue correlates of syphilis infection and to account for clustering.Results23 of the 36 venues were classified as sex venues. Among all females, those working at sex venues and at venues with no report of sex work, the weighted lifetime syphilis prevalence was 5.8%, 16.3%, 0.5% respectively and the reported average number of new sexual partners in the past 4 weeks was 1.5, 4.4, 0.1 respectively. After adjusting for other individual characteristics and clustering, two venue-level factors, that is working at sex venues (AOR 24.0, 95% CI 2.5 to 227.6), working in venues located in rural counties (AOR 3.6, 95% CI 1.2 to 10.9), and two individual correlates, ie, self-report of sex work (AOR 2.3, 95% CI 1.0 to 5.3) and being in elder age groups (AOR 7.0, 95% CI 1.5 to 32.2) were significantly associated with risk of lifetime syphilis infection.ConclusionsFemales working at social venues had a high rate of new sexual partner acquisition and a high prevalence of lifetime syphilis infection. Females working at sex venues or venues located in rural counties were at relatively high risk of syphilis infection, despite whether they reported engaging in sex work. An intervention strategy focused on the places where social mixing occurs rather than risk group status may contribute to the prevention and control of HIV/STIs in China.
P1-S2.19 Unprotected fellatio and pharyngeal gonorrhoea in Sydney sex workers
Authors: Read P J , Wand H , Guy R , McNulty A , Donovan B 
Published: July 2011

BackgroundSex workers are a priority population in the WHO sexually transmitted infection (STI) global strategy. In Australia, condom use for vaginal sex has remained high over the past decade rates in sex workers with corresponding low rates of STIs. In recent years, there have been anecdotal reports of Sydney sex workers increasingly reporting unprotected fellatio with clients which has coincided with an increase in cases of pharyngeal gonorrhoea in these women. The aim of this study was to investigate the extent and predictors of inconsistent condom use for fellatio at work, and rates of pharyngeal gonorrhoea among sex workers attending a large sexual health clinic.MethodsAll female sex workers reporting fellatio at work seen at the Sydney Sexual Health Centre from May 2009 to January 2011 were included. Demographic data, risk behaviours and STI diagnoses were extracted from the clinic database. Pharyngeal gonorrhoea cultures were collected routinely. Multivariate logistic regression analysis was used to determine predictors of inconsistent condom use for fellatio at work.ResultsThere were 1539 sex workers seen during the study period—most (n=1142, 74%) worked in brothels and 24% reported inconsistent condom use for fellatio at work. Significant independent predictors of reporting inconsistent condom use for fellatio at work were being a new client at our clinic (compared to an existing client) (adjusted (AOR) 2.66, 95% CI 2.08 to 3.44), speaking a Mandarin or Cantonese language (AOR 3.01, 95% CI 1.67 to 5.42), inconsistent condom use for vaginal sex at work (AOR 12.54, 95% CI 7.32 to 21.48), and being older than 40 years (AOR 2.85, 95% CI 1.91 to 4.25). Thai language speakers were less likely to report inconsistent condom use for fellatio (AOR 0.44, 95% CI 0.23 to 0.83). No significant association was demonstrated for injection drug use or sexual practice outside of work. During the study period 17 of the 1539 sex workers (1.1%, 95% CI 0.6 to 1.8) were diagnosed with pharyngeal gonorrhoea.ConclusionsThese finding suggest interventions to promote condoms for fellatio by sex workers are needed. We could not determine if inconsistent condom use for fellatio at work was directly associated with pharyngeal gonorrhoea due to the low sample size of cases. Further research into the determinants of this behaviour, particularly among different language groups is warranted.
P1-S2.20 Factors influencing cervical infection among female sex workers in Benin
Authors: Diabaté S , Chamberland A , Géraldo N , Zannou M , Massinga-Loembé M , Anagonou S , CLabbé A , Tremblay C , Alary M 
Published: July 2011

BackgroundAs female sex workers (FSW) continue to play a key role in HIV-1 epidemic in sub-Saharan Africa, programs aiming at reducing sexually transmitted infections (STI) involved in HIV acquisition and transmission are still needed. The objective of this study was to determine factors influencing STI acquisition among FSW in Cotonou, Benin.MethodsThree hundred and eighty seven (387) FSW were recruited in a medical center dedicated to STI treatment among female sex workers and their clients. Cervical infections byNeisseria gonorrhoeae(NG) andChlamydia trachomatis(CT; SDA, BD Probe Tec®) were investigated at enrolment into the study. All infected FSW received adequate treatment for free. We used a multivariate logistic regression model to assess variables independently associated with cervical infection at enrolment (p value<0.05).ResultsThe FSW were essentially from Benin (39.5%) and neighbouring countries such as Nigeria (22.1%), Togo (21.8%) and Ghana (15.1%). One hundred and forty three subjects (143; 37.0%) were HIV-1 positive (52 were treated with antiretroviral therapy and 91 remained untreated because not yet meeting eligibility for treatment). Median age (IQR) and median duration (IQR) in the work were 33 (27—40) and 3 (1.2—5) years. Cervical infections by NG and CT were diagnosed in 4.4% and 3.9% cases, respectively. Only two women (0.5%) had both infections. Seventy seven per cent (77.1%) and 86.8% of the FSW reported, respectively, consistent condom use during the last 7 days of work and condom use at last sexual intercourse with a client. After adjustment for age and condom use, being HIV-1 infected [RR 3.04; 95% CI 1.25—to 7.40], not working in a brothel (RR 3.28; 95% CI 1.64—to 9.27), and being working for less than 12 months (RR 3.55; 95% CI 1.53—to 8.23) were independently associated with cervical infection in our study population.ConclusionOur results suggest that HIV-1 infection and cervical infection by NG and CT alter each other. Antiretroviral therapy in association with preventive programmes aiming at controlling STI should be encouraged among new FSW and also among those working outside brothels.
P1-S2.24 HIV and hepatitis C risk factors, infection status awareness and access to care among people who inject drugs - results from a national surveillance system, I-Track Phase 2 (2005–2008)
Authors: Tarasuk J , Frescura A M , Ogunnaike-Cooke S , Archibald C 
Published: July 2011

BackgroundHIV and hepatitis C (HCV) risk factors, infection status awareness and access to care among people who inject drugs (IDU) were compared across infection groups in a national enhanced surveillance sample.MethodsPhase 2 data collection for I-Track (Enhanced surveillance of HIV and HCV risk behaviours among IDU) was conducted from 2005 to 2008 in 10 Canada sites. Confidential face-to-face interviews collected data on demographics, drug-use and sexual risk behaviours, and HIV and HCV testing. Dried blood or oral fluid samples were collected for HIV and HCV antibody testing. Descriptive statistics for demographics, risk behaviours and access to care and treatment were compared across four exclusive infection groups—HIV-seropositive-only, HCV-seropositive-only, HIV-HCV seropositive and HIV-HCV seronegative individuals.ResultsOf 2969 IDU, 1.7% were HIV-seropositive-only, 57.5% were HCV-seropositive-only, 11.6% were HIV–HCV seropositive, and 29.2% were HIV–HCV seronegative. The proportion of IDU who were accurately aware of their negative or positive HIV infection status (based on concordance between self-report and laboratory result) was 85.7% among HIV-seropositive-only, 87.5% among HCV-seropositive-only, 78.7% among HIV–HCV seropositives and 77.5% among HIV–HCV seronegatives. The highest proportions reporting needle borrowing (past 6 months 24.2%) and high drug injecting frequency (69.4% > once or twice per week) were in the HCV-seropositive-only group. The highest proportions reporting multiple sex partners (past 6 months 44.9%) and no condom use at last sex (33.8%) were among HIV–HCV seronegative IDU; this group was also least likely to have been tested for HIV or HCV (85.1% and 80.6% respectively). Among those who were HIV-seropositive-only, 87.8% were under the recent care of a doctor and 74.2% were taking prescribed drugs for HIV. Among those HCV-seropositive-only, 45.5% were under the recent care of a doctor and 13.1% were taking prescribed drugs for HCV.ConclusionsInjecting and sexual risk behaviours were prevalent particularly among HCV-seropositive-only and seronegative IDU, respectively. Awareness of correct HIV infection status and frequency of HIV testing were lowest among seronegative IDU. These findings underscore the importance of routine and integrated HIV and HCV testing for at-risk IDU which may lead to higher levels of awareness for both HIV and HCV infections.
P1-S2.27 Response of troubled youth and STIs
Authors: Bhutta A Iqbal 
Published: July 2011

DescriptionPakistan, the second most populous Muslim nation in the world, has started to finally experience and confront the HIV/AIDS epidemic. The country had been relatively safe from any indigenous HIV cases for around 2 decades, with most of the infections being attributable to deported HIV positive migrants from the Gulf States. However, the virus finally seems to have found a home-base, as evidenced by the recent HIV outbreaks among the injection drug user community. Extremely high-risk behaviour has also been documented among youth (school going and out of school). The weak government response coupled with the extremely distressing social demographics of this South-Asian republic also helps to compound the problem. The time is ripe now to prepare in advance, to take the appropriate measures to curtail further spread of the disease. If this opportunity is not utilised right now, little if at all could be done later. Islamic charities provide health, education and social services to millions of people in Pakistan. But in Pakistan still sexuality is a taboo topic. Strong hold of religious leaders on socio cultural pattern of community (attitude with extremism). Prevailing concepts to talk about sex considered as act of vulgarity and immoral activity. Word STIs and HIV/AIDS conceived as symbol of sexual delinquencies.MethodThrough a Questionnaire data on knowledge, attitude, behaviour and practices related to STIs/HIV/AIDS was collected from 1200 male religious students and religious scholars from randomly selected Islamic religious centers. Baseline knowledge, attitude, acceptability of the concept were assessed.ResultsAccording to KABP study 70% students have friends of opposite sex and due to strong religious values and restriction 30% have no friendship with opposite sex. Regarding nature of sex, 40% had kissing and only 18% had intercourse. During intercourse only 3% used condoms. 42% consider that condom is used only for family planning purpose. 56% answered that during intercourse use of condoms reduce sexual pleasure and enjoyment. 32% youth use drugs and 38% did not know about STIs and HIV/AIDS. General discussions were also started with four Maderssas students and their teachers. These meetings addressed the sensitisation of religious scholars to the issue of HIV/AIDS and highlight the role of Maderssas in STIs and HIV prevention.ConclusionsTraining of adolescent as peer educators is recommended. Ours being an Islamic society, such information should be given to youth in a way that does not challenge local norms and values. Problem-based learning and participatory education for improving knowledge and condom use and community-based interventions should be considered for STIs/HIV/AIDS prevention.