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Abduction of women and rape were punishable under Japanese military law. Continue Reading. This environment, combined with poverty, is directly responsible for their weak power in negotiating condom use [ 9 ], low access to sexual and reproductive health SRH care services [ Prostitutes Meda ] and low exposure to safer sex education.

We enrolled FSW in the cohort Figure 2. Flow chart of participants from screening to the month follow-up visit in Ouagadougou. The latter were also Prostitutes Meda likely to have an earlier age of sex work debut Table 1. Baseline participant characteristics and comparison with potentially eligible female sex workers who missed Prostitutes Meda enrolment visit in Ouagadougou. At enrolment, the median age of participants was 21 years [interquartile range IQR 19—23], the median number of clients Prostitutes Meda week before the enrolment visit was 2 IQR, 1—3 and the median numbers of regular clients and regular partners during the month prior to enrolment were 1 IQR, 0—2 and 1 IQR, 1—1respectively.

Among FSW who completed at least one follow-up visit and who were included in the incidence analysis, the median follow-up time was No participant seroconverted during the person-years of follow-up, whereas 5. In the sensitivity analyses, the expected number of HIV infections in the absence of the intervention ranged between 0. Model parameters and sensitivity analyses for the expected number of Prostitutes Meda infections in the absence of the intervention among female sex workers in Ouagadougou.

Predictors of consistent condom use with casual clients during follow-up of female sex workers in Ouagadougou. Our findings suggest that our Prostitutes Meda of intervention, integrating prevention and care in the same setting with a strong involvement of the community, had a significant impact on the HIV incidence of young FSW in the capital city of Burkina Faso.

Even though this impact was not statistically significant in the extreme and most detrimental scenario, the observed null HIV infection contrasted with the expected number of HIV infections. The good quality of the data collected in the general population and among clients of FSW at the same time allowed a robust estimation of the HIV incidence expected in the study population in the absence of any Prostitutes Meda intervention.

However, our group and others have reported that such women, barmaids for example, had a risk Prostitutes Meda HIV infection similar to that of professionals [ 36 ].

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Prostitutes Meda screening, the HIV prevalence among young sex workers 7. Similarly, their HSV-2 prevalence was also much higher [ 37 ], highlighting their risky sexual behaviours. Therefore, Prostitutes Meda null HIV incidence is likely due to our intervention and not to a selection bias of women with low exposure. This impact on HIV incidence was likely driven by a reduction in most risky sexual behaviours during the intervention period.

The number of sexual partners decreased over time with a Prostitutes Meda increase in condom use with casual and regular clients during the intervention.

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However, the Prostitutes Meda could not markedly increase consistent condom use with regular partners. The HIV risk is probably high among these men who, in the local context, have many sex worker girlfriends with whom condom use is seldom used. Despite specific sensitization modules on this topic, young FSW are unable to improve their condom negotiation with these partners, most likely because of their vulnerability and willingness to get married.

Similarly, the independent negative association between previous Prostitutes Meda and Prostitutes Meda condom use with casual clients is probably explained by a reduced condom negotiation power of FSW having dependent children. Our model of intervention combines prevention and care activities within the same setting, with peers playing a pivotal role in service delivery. We strongly believe that the continuum of care proposed in our intervention was crucial to get a high adherence level of FSW to the intervention, as highlighted by the high rate of follow-up for this Prostitutes Meda and hard to reach population.

In addition, the peer organization provided some support for non-medical issues which are of Prostitutes Meda importance for FSW, such as children schooling, administrative measures and nutritional assistance.

Adapted services to the special needs of each study participant, dedicated to prevention and care in general not only HIVin a Prostitutes Meda and empathetic setting to Prostitutes Meda confidence and empowerment of FSW, including their self-esteem, are certainly pivotal in the success of interventions targeting FSW. Our study had a number of limitations.

The community involvement Prostitutes Meda was not included in our impact evaluation [ 19 ]. In the absence of a control group, the calculation of the expected incidence Prostitutes Meda intervention is prone to imprecision and information bias on self-report of sexual behaviours in the general population study [ 41 ].

Our sensitivity analyses addressed these points and the true HIV incidence likely lies between the ranges of calculated values.

The data used Prostitutes Meda the calculation were collected at the same time as the cohort initiation. We cannot exclude a desirability bias in the self-report of sexual behaviours [ 41 ]. However, the FSW did not hesitate to report poor condom use with regular partners, even after specific risk-reduction sessions. We reported previously that the same intervention could achieve high rates of follow-up and virological success among FSW [ Prostitutes Meda ], which induced a marked reduction in infectiousness [ 15 ].

In this study in Ouagadougou, we showed that this intervention can also markedly have an impact on HIV incidence within a similar but younger population. Our study group reported that this combined intervention is not more expensive than either treating HIV in the general population [ 42 ] or funding local NGOs to implement prevention activities.

Prostitutes Meda a model could also be appropriate for other parts of Africa where sex workers share similar discrimination and limited access to prevention and care [ 18 ].

In light of our results, the Burkina Faso Prostitutes Meda and HIV authorities are scaling up this integrated peer-administered package of interventions at the country level.

A proper evaluation of this programme will inform on its cost-effectiveness and relevance when implemented widely in Prostitutes Meda. This impact was driven by a reduction Prostitutes Meda the number of regular partners and by increased condom use with clients. They acknowledge all the women who participated in this study and the non-governmental associations that facilitated the study as well as their involvement in the community Prostitutes Meda boards: the Ministry of Health and the National Program for AIDS control.

Isidore T Traore contributed to designing the study, and the acquisition, analysis and interpretation of the data. He also wrote the draft manuscript. Nicolas Nagot contributed to designing the study, and the acquisition, analysis and interpretation of the data.

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He Prostitutes Meda wrote the manuscript Prostitutes Meda supervised its development. Nicolas Meda, Philippe Van De Perre and Philippe Mayaud contributed to designing the study, interpretation of the data and critically reviewed the manuscript.

Noelie M. All authors have read and approved the final version. National Center for Biotechnology InformationU. Published online Sep Author information Article notes Copyright and License information Disclaimer. This is an open-access article distributed under the terms of the Creative Prostitutes Meda Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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This article has been cited by other articles in PMC. Abstract Prostitutes Meda Although interventions to control HIV among high-risk groups such as female sex workers FSW are highly recommended in Africa, the contents and efficacy of these interventions are unclear. Methods Between September and September we conducted a prospective, interventional cohort study of FSW aged 18 to 25 years in Ouagadougou, with Prostitutes Meda follow-up for a maximum of 21 months.

Conclusions Combining peer-based prevention and care within the same setting markedly reduced the HIV incidence among young FSW in Burkina Faso, through reduced risky behaviours.

Keywords: female sex Prostitutes Meda, HIV, incidence, Africa. Methods Study design From towe conducted a prospective, interventional Prostitutes Meda among HIV-uninfected Prostitutes Meda in Ouagadougou, with quarterly follow-up for a maximum of 21 months. Study population Women who declared receiving money or goods in exchange for sexual services [ 2021 ], were born in Burkina Faso, were aged between 18 and 25 years, had at least three sexual contacts per week Prostitutes Meda three different sexual partners during the last three months were eligible for this cohort.

Procedures and follow-up During the formative research, sex work venues were geo-mapped using geographic information system. Study outcomes The primary outcome was HIV incidence. Open in a separate window. Figure 1.

Number of unprotected sexual acts during follow-up, Prostitutes Meda to HIV, ART and disease-stage status of FSW sexual partners N1—N5 We multiplied the number of sexual intercourses with casual clients during the previous week as reported by FSW at baselineby the total number of person-weeks Prostitutes Meda by the rate of non-condom use with casual clients estimated at screening visit. Estimation of the impact of the intervention To estimate the expected number of HIV Prostitutes Meda without intervention during the Prostitutes Meda follow-up time, we included in the Bernoulli-weighted model the average rates of the per-act male-to-female risk, the HIV prevalence among male partners Prostitutes Meda the scores related to Prostitutes Meda increasing infectivity of sexual partners and susceptibility of FSW [ 26 ].

Model validation In the Prostitutes Meda of incidence data in a control group, we also used HIV prevalence at screening among young FSW who participated in sex work for less than one year, to estimate HIV incidence in the absence of the intervention [ 3132 ]. High-risk behaviours overtime The number of sexual partners was categorized as above or below the third quartile value of the number of casual clients at baseline, and as none or any for regular clients and regular partners.

Figure 2. Table 1 Baseline participant characteristics and comparison with potentially eligible female Prostitutes Meda workers who missed their enrolment visit in Ouagadougou.

Observed and expected HIV incidence Among FSW who completed at least one Prostitutes Meda visit and Prostitutes Meda were included in the incidence analysis, the median follow-up time was Table 2 Model parameters and sensitivity analyses for the expected number of HIV infections in the absence of the intervention among female sex workers in Ouagadougou. Table 3 Predictors of consistent condom use with casual clients during follow-up of female sex workers in Ouagadougou.

Table 4 Predictors of consistent condom use with regular clients during follow-up. Discussion Our findings suggest that our model of intervention, integrating prevention and care in the same setting with a strong involvement of Prostitutes Meda community, had a significant impact on the HIV incidence of young FSW in the capital city of Burkina Faso.

Competing interests All authors have no competing interest to declare. Authors' contributions Isidore T Traore contributed to designing the study, and Prostitutes Meda acquisition, analysis and interpretation of the data.

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References 1. AIDS Care. Prevalence of HIV and other sexually transmitted infections, and risk behaviours in unregistered sex workers in Dakar, Senegal. Alary M, Lowndes CM. The Prostitutes Meda role of clients of female sex workers in the dynamics of heterosexual HIV transmission in sub-Saharan Africa.

Male clients of brothel prostitutes as a bridge for HIV infection between high risk and low risk groups of women in Senegal. Sex Transm Infect. Is sexually transmitted infection Prostitutes Meda among sex workers still able to mitigate the spread of HIV infection in West Africa?

J Acquir Immune Defic Syndr. Spectrum of commercial sex activity in Burkina Faso: classification model and Prostitutes Meda of exposure Prostitutes Meda HIV. BMC Public Health. Scale-up of combination prevention and antiretroviral therapy for female sex workers in West Africa: time for action.

Part time female sex workers in a Prostitutes Meda community in Kenya: a vulnerable hidden population. Prevention of HIV-1 infection with early antiretroviral therapy. In our study, the Prostitutes Meda of cases of active syphilis was low, which limited the ability to further identify factors associated with the Prostitutes Meda infection through multivariate analysis.

We instead used syphilis serological markers for analysis purposes. Furthermore, Prostitutes Meda sexual behavior in a context of social stigmatization of and discrimination toward FSW may have led to social desirability bias; however, this did not have impact on the prevalence of syphilis, as this was evaluated through syphilis serological markers.

Our study provides updated data on syphilis serological markers in Burkina Faso. This study provided updated epidemiological data on syphilis based on rapid diagnostic testing in situ among sex workers in Burkina Faso.

We found Prostitutes Meda syphilis prevalence among FSW was relatively high and requires targeted preventive measures. Screening with rapid diagnostic tests followed by a single-dose administration of penicillin could be an effective approach to control syphilis among FSW and thus contribute to the prevention of HIV transmission.

Safer sex and HIV prevention activities for FSW offer an opportunity to integrate screening and early treatment of syphilis. They are grateful to all the study participants. The authors declare that there are no conflicts Prostitutes Meda interest regarding the publication of this article.

Prostitutes Meda, S. Kouanda, H. Ouedraogo, O. Ky-Zerbo, and A. Grosso conceptualized the study and contributed to study design, implementation, and manuscript writing; I. Meda and I. Zongo assisted in manuscript writing; B. Samadoulougou and G. Tarnagda helped in study implementation, data cleaning, and manuscript review; K. Sondo, N.

Sawadogo, Y. Traore, and Nicolas Barro conducted the manuscript review. National Center for Prostitutes Meda InformationU. Journal List Int J Microbiol v. Int J Microbiol. Published online Nov 8. Author information Article notes Copyright and License information Disclaimer.

Corresponding author. Henri Gautier Ouedraogo: fb. This is an open access article distributed under the Creative Prostitutes Meda Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Associated Data Data Availability Statement The datasets used during the current study are available from the corresponding author on reasonable request.

Abstract Background Syphilis among female sex workers FSW remains a public health concern due to its potential impact on their health and the possibility of transmission to their clients, partners, and children.

Results A total of FSW Prostitutes Meda screened for syphilis. Conclusion The Prostitutes Meda of syphilis markers was high during this study among FSW. Background Syphilis is Prostitutes Meda sexually transmitted disease STD due to Treponema palliduma spirochete bacteria belonging to the Spirochaetaceae family [ 12 ].

Methods 2. Setting The study was conducted in five cities of Burkina Faso: Ouagadougou the capital city in the centreBobo-Dioulasso in the Hauts-Bassins regionKoudougou in the middle westOuahigouya in the northand Tenkodogo in the middle east. Syphilis Prostitutes Meda Figure Prostitutes Meda shows the flowchart of the syphilis screening among study participants.

Open in a separate window. Figure 1. FSW Characteristics The mean age of the study population was Table Prostitutes Meda Characteristics of female sex workers in Burkina Faso.

No Prevalence of Syphilis Prostitutes Meda Markers The prevalence of syphilis serological markers was 5. Table 2 Active syphilis and syphilis serological markers prevalence among female sex workers by city. Table 3 Prevalence of syphilis serological markers and of active syphilis among female sex workers in Burkina Faso.

Factors Associated with Syphilis Serological Markers The factors associated with the syphilis serological markers among FSW in bivariate and Prostitutes Meda analyses are presented in Table 4. Table 4 Factors associated with syphilis serological markers among female sex workers in Burkina Faso. Multivariate Analysis In multivariate Prostitutes Meda, after adjustment for age, education level, marital status, number of clients per week, history of pregnancy, use of condoms, and the study city, the number of Prostitutes Meda and education level were independently associated Prostitutes Meda syphilis serological marker carriage.

Discussion This study found that the prevalence of syphilis serological markers and active syphilis were, respectively, 5.

Limitations In our study, the number of cases of active syphilis was low, which limited the ability to further identify factors associated with the acute infection through multivariate Prostitutes Meda. Conclusion This study provided updated epidemiological data on Prostitutes Meda based on rapid diagnostic testing in situ among sex workers in Burkina Faso.

We compared the cohort HIV incidence with a modelled expected incidence in the study population in the absence of intervention, using data collected at the same time from FSW clients.

Data Prostitutes Meda The datasets used during the current study are available from the corresponding author on reasonable request. Conflicts of Interest The authors Prostitutes Meda that there are no conflicts of interest regarding the publication of this article.

Authors' Contributions S. References 1. Hook E. The Lancet. Singh A. Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clinical Microbiology Reviews. Greenblatt R. Genital ulceration as a risk factor for human immunodeficiency virus infection. Salado-Rasmussen K. Syphilis and HIV co-infection. Epidemiology, treatment and molecular typing of Treponema pallidum. Danish Medical Journal. Stevenson J. Syphilis and HIV infection: an update.

Dermatologic Prostitutes Meda. Zetola Prostitutes Meda. Clinical Infectious Diseases. World Health Prostitutes Meda.

Geneva, Switzerland: World Health Organization; Kang D. Commercial sex venues, syphilis and methamphetamine use among female sex workers. AIDS Care. Zhou C. High prevalence of HIV and syphilis and associated factors among low-fee female sex workers in mainland China: Prostitutes Meda cross-sectional study.

BMC Infectious Diseases. Tao X. High prevalence of syphilis among street-based female sex workers in Nanchang, China. Indian Dermatology Online Journal. Kakchapati S. Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal. Halatoko W. Prevalence of syphilis among female sex workers and their clients in Togo in BMC Prostitutes Meda Health.

Elhadi M. Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, Sexually Transmitted Infections. Ramjee G. Sexually Transmitted Prostitutes Meda. Nicolas S. Scorgie F. Wanyenze R. Kim H.

Stigma as a barrier to health care utilization among female sex workers and men who have sex Prostitutes Meda men in Burkina Faso. Annals of Epidemiology. Davis A. Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China. International Journal for Equity in Health.

Lafort Y. Barriers to HIV and sexual and reproductive health care for female sex workers in Tete, Mozambique: results from a cross-sectional survey and focus group discussions. Wahed T. Barriers to sexual and reproductive healthcare Prostitutes Meda as experienced by female sex workers and service Prostitutes Meda in Dhaka city, Bangladesh. PLoS One. Baral S. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis.

The Lancet Infectious Diseases. Kaushic C. Increased prevalence of sexually transmitted viral Prostitutes Meda in women: the role of female sex hormones in regulating susceptibility and immune responses. Journal of Reproductive Immunology. Heckathorn Douglas D. Respondent-driven sampling: a new approach to the study of hidden populations. Social Problems. Ouedraogo H. The Use of Rapid Syphilis Test.

Bocoum F. Evaluation of the diagnostic performance and operational Prostitutes Meda of four rapid immunochromatographic syphilis tests in Burkina Faso. African Health Sciences.