Alary M, Mukenge - Tshibaka L, Anagonou S, Lafia E, Baganizi E, Ouedraogo LH, Guedeme A, Bernier F, Joly JR; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePpC1315.

M. Alary, Epidemiology Research Group, Hopital du St-Sacrement du CHA, 1050 Chemin Sainte-Foy, Quebec G1S 4L8, Canada, Tel.: +1 418 682 73 87, Fax: +1 418 682 79 49, E-mail: malary@gre.ulaval.ca

Background: Within an ongoing (since 1993) HIV/STD prevention project aimed at female prostitutes (FP) in Cotonou, Benin, we evaluated time trends in HIV and STD prevalences. The intervention includes condom promotion and syndromic STD management. Given the changing demographic characteristics of FP over time and the fact that most FP in Cotonou are foreigners, it is essential to control for these factors in this trend analysis. Methods: Serial cross-sectional studies in 1993 (n = 366), 1995-96 (n = 350) and 1998-99 (n = 445). A questionnaire was administered and blood drawn for HIV (double-EIA) and syphilis (RPR and TPHA) serology. Endocervical samples were used for gonorrhea and chlamydia testing using PCR (Amplicor, Roche Diagnostics). Results: The prevalence of HIV and all STDs studied decreased significantly (all p > 0.01, chi-square for trend) from 93 to 95-96 and 98-99: HIV 53%, 49% and 41%; gonorrhea: 43%, 31% and 21%; chlamydia: 9%, 7%, 4%; syphilis (both RPR+ and TPHA+): 9%, 7%, 1%. However, median age of FP has decreased over time, from 30 years in 93 to 28 in 95-96 and 27 in 98-99. In addition, the distribution of country of origin has varied substantially over time: 93: Ghana (G) 66%, Nigeria (N) 11%, Togo (T) 20%, Benin (B) 2%; 95-96: G 38%, N 38%, T 13%, B 10%; 98-99: G 24%, N 39%, T 14%, B 19%. In a logistic regression model controlling for age and country of origin, the downward trend was still present but not significant for HIV (p = 0.60) and chlamydia (p = 0.18), whereas it remained highly significant for both gonorrhea (p = 0.0005) and syphilis (p = 0.008). Conclusions: These data suggest that the intervention has been effective in reducing the prevalence of gonorrhea and syphilis among FP in Cotonou. In addition, the leveling of HIV prevalence, independently of sociodemographic changes, is encouraging. Indeed, among FP from other cities in Benin where no targeted intervention has been carried out, HIV prevalence has increased from 36% in 1993 to 52% in 1996 (data from the National AIDS Program). Preventive interventions that include STD care and are aimed at FP should be highly prioritized.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Advertising as Topic
• Benin
• Condoms
• Cross-Sectional Studies
• Female
• Ghana
• Gonorrhea
• HIV Infections
• HIV Seropositivity
• Nigeria
• Prevalence
• Prostitution
• Sexually Transmitted Diseases
• Syphilis
• Togo
• methods
• therapy

Other ID:

• GWAIDS0003046

UI: 102240540

From Meeting Abstracts