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For willingness, perceived personal benefit Prostitutes Tamra an HIV vaccine and level of concern Prostitutes Tamra participation in an HIV vaccine trial coded as high, medium, or low were also assessed. Overall, the study met enrollment targets, enrolling women from May to July The screening to enrollment ratio was highest for Haiti, 3. The ratio for street outreach was 3. Screening to enrollment ratios and HIV prevalence by site and recruitment strategy a. Haiti had the youngest cohort median 23 years and PR had the oldest median 30 years.

Most women Prostitutes Tamra all sites did not live with a main Prostitutes Tamra. Early initiation of sexual contact with clients was reported at all sites medians 17—19 years old. In Haiti, prevalence was 5. Numbers of male sexual partners, numbers of clients, having a casual partner, or having a main partner were nonsignificant factors.

Site was not a significant factor, but given the differences between subpopulations, sites were also analyzed individually.

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For DR, no significant factors were identified. This study reviews sociodemographic and epidemiologic data among Caribbean CSWs and factors associated with previously undiagnosed prevalent HIV Prostitutes Tamra and recruitment Prostitutes Tamra and risk behaviors associated with high HIV-1 prevalence. For women enrolled in the longitudinal cohort, willingness to participate in a future HIV vaccine trial was evaluated.

Prevalence of undiagnosed HIV infection in this study was 3. These rates are based on HIV testing results at the screening stage in this study. Prostitutes Tamra who self-reported HIV infections were not tested.

Prostitutes Tamra, the prevalence in the targeted subgroups may be higher than reported here.

The prevalence in these CSW cohorts is higher than that of the general population in each country; for example, over 2 times that of the general population in Haiti and Prostitutes Tamra times that in DR 17 Risk for sexual acquisition of HIV infection depends on the behavior of a subgroup population and the HIV prevalence in the population 17 In this study, these factors differed among the cohort of women at each of the sites. Crack cocaine use was a statistically significant predictor of HIV prevalence but was found primarily among the PR cohort; this could explain the risk for PR women, Prostitutes Tamra had fewer total clients but were more likely to have a Prostitutes Tamra IDU partner.

Having sex with clients on the street, more frequently reported in Haiti, appeared Prostitutes Tamra enhance HIV infection risk and may be related to less condom use or other Prostitutes Tamra behavior.

The eligibility criteria for women in the step study included exchanging sex for money or drugs, crack cocaine use, or having unprotected sex with an HIV-infected or IDU male partner. By focusing on the enrollment of CSW, our cohort has a higher percentage of women engaging in behaviors that put them at risk for HIV infection. Data were not collected on the risk practices Prostitutes Tamra their male partners in the other studies.

Site-specific strategies accounting for local epidemiologic, demographic, and social factors should be considered to inform recruitment of high-risk women for future HIV vaccine trials.

The DR site used CSW Prostitutes Tamra educators to recruit CSWs who were not members of Modemu a group from which participants were recruited for previous studies and who worked within or in close proximity to jails.

PR identified areas where drugs are illegally sold or distributed, injection drugs are shared, there Prostitutes Tamra high crime rates, and CSWs were located.

Prescreening and screening were part of the recruitment strategies used at all sites. The strategies appear to be effective for Prostitutes Tamra a population at higher risk of HIV infection as Prostitutes Tamra observed at screening was Prostitutes Tamra than that of the general population. High HIV prevalence at screening, however, may not be indicative of high incidence during a longitudinal study, a necessity for HIV vaccine efficacy trials.

Most CSWs in this study were probably or definitely willing to participate in future vaccine studies. These results are promising. There are limitations, however, on how well cohort study data translate to actual willingness to enroll in a vaccine study Expressing willingness to a hypothetical situation may be more likely than actual willingness to join Prostitutes Tamra HIV vaccine trial.

In addition, participants who enroll in a cohort study may not represent an equivalent population Prostitutes Tamra those who enroll in a vaccine study. Prostitutes Tamra these difficulties, having a good understanding of these factors and the local epidemic and working effectively Prostitutes Tamra CBOs who understand these subpopulations resulted in relatively low screening to enrollment ratios.

Further analysis is needed to evaluate behavior changes that may occur as a result of risk reduction counseling and how these and other factors may affect HIV prevalence and incidence rates in subgroups.

We thank the trial participants, clinic staff, and CBOs who made this study possible and Tracey Day and Adi Ferrara for manuscript editing. Conflicts of interest.

National Center for Biotechnology InformationU. Rev Panam Salud Publica. Author manuscript; available in PMC May 2. Marie Prostitutes Tamra Deschamps1 Carmen D. Zorrilla2 Cecilia A. Carmen D. Cecilia A. Author Prostitutes Tamra Copyright and License information Disclaimer.

Send correspondence to: Marie Marcelle Deschamps, gro. Copyright notice. See other articles in PMC that cite the published article.

Recruitment of Caribbean female commercial sex workers at high risk of HIV infection

Abstract Objective To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. Methods A prospective cohort Prostitutes Tamra was conducted in — among female Prostitutes Tamra sex workers in the Dominican Republic, Haiti, and Puerto Rico. Results HIV prevalence at screening was 4.

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Conclusions This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial. Study eligibility Eligibility requirements included being an at-risk HIV uninfected female, ages 18—45 21 is the legal lower limit for PRwilling to receive HIV test results and risk reduction counseling, not pregnant or intending to become pregnant for 18 months, and deemed medically and psychologically capable of participation.

Study recruitment Prostitutes Tamra site developed recruitment methods for their local populations based on local epidemiologic data, lessons from previous studies, and information from community members and community-based organizations CBOs.

Statistical analysis Site Prostitutes Tamra in demographics, risk behaviors, and partner characteristics were assessed with chi-square tests for categorical items and Kruskal—Wallis Prostitutes Tamra for continuous data items.

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Behaviors are with regard to the six months before Prostitutes Tamra screening visit unless otherwise noted. Enrolled No. Screening-to-enrollment ratio Tested No. Infected b No. In Haiti, for screening to enrollment ratios and prevalence, all but three women one by social Prostitutes Tamra agency outreach and two by referral were recruited by street outreach and one or more other methods. Acknowledgments We thank the trial participants, clinic staff, and CBOs who made this study possible and Tracey Day and Adi Ferrara for manuscript editing.

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Footnotes Conflicts of interest. References 1. Efficacy assessment of a cell-mediated immunity HIV-1 vaccine the Step Study : Prostitutes Tamra double-blind, randomised, placebo-controlled, test-of-concept trial.