Journal
AMERICAN JOURNAL OF PUBLIC HEALTH
Volume 96, Issue 1, Pages 120-125Publisher
AMER PUBLIC HEALTH ASSOC INC
DOI: 10.2105/AJPH.2004.042200
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Funding
- FOGARTY INTERNATIONAL CENTER [D43TW000010] Funding Source: NIH RePORTER
- FIC NIH HHS [D43 TW000010, 2D43TW000010-18] Funding Source: Medline
- NIMH NIH HHS [K01MH3491] Funding Source: Medline
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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% CI=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.
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