14th International AIDS Conference Barcelona, Spain - July 7-12, 2002

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrD1152)

Ramos ER, Wi T, Steen R, Esguerra TA, Roces MC, Lim-Quizon MC, Dallabetta G, Neilsen G
Family Health International, Manila, Philippines

BACKGROUND: This intervention-linked research in Angeles City aimed to (a) rapidly reduce the prevalence of common curable STDs and (b) maintain STD reductions over time.

METHODOLOGY: A targeted strategy was employed with a single round of azithromycin presumptive treatment (PT) given to all sex workers (SW) reached during one month. Preventive and curative services were strengthened as were outreach efforts and peer education for freelance SWs. Cross-sectional measurements of N.gonorrhoea and C. trachomatis prevalence using urine polymerase chain reaction (PCR) were done prior to PT, one month post-PT and six months post-PT, and stratified by type of sex work.

RESULTS: A total of 1938 SW received PT and1651 were randomly selected for the assessment surveys during 3 evaluation rounds. PT coverage was 75% for brothel-based (BSW), 63% for street-based (SSW), 50% for registered (RSW) and 79% for guest relations officers (GRO). The prevalence of gonorrhea and/or chlamydial infections one month after PT declined 50% for BSW, 39% for SSW, 28% for RSW, and 73% for GRO. Sixth months after the PT, prevalence remained 56% lower than baseline for BSW, and 32% lower for SSW, but had returned to baseline levels for the other groups. Factors related to STD decreases at one month included PT coverage, while at six months, access to improved screening services was more important. Discussion: Significant reductions in prevalence of common curable STDs is possible when effective interventions reach core groups such as sex workers. In Angeles, a single round of presumptive antibiotic treatment had a short-term impact on STD prevalence that was proportional to coverage. Longer-term maintenance of STD control requires establishment of effective preventive and curative services .

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TuOrD1152

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