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206 A field trial to assess the effectiveness of setting up model outreach sti/hiv clinics for female sex workers in delhi
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  1. Jitendra Kumar Meena1,2,
  2. Suneela Garg2
  1. 1Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
  2. 2Maulana Azad Medical College, New Delhi, India

Abstract

Introduction Sexually transmitted infections (STI) are associated with increased risk of HIV infection and represent a major public health problem in developing countries. The UNAIDS global guidance on HIV and sex work (2010) recommends comprehensive, accessible, acceptable, user friendly STI/HIV prevention and treatment based on local context and individual needs of female sex workers (FSWs).

Methods A field trial conducted to assess the effectiveness of specialised STI/HIV outreach clinic for FSWs. Pre and post intervention data were collected using semi-structured questionnaires (Cronbach´s a=0.74) with health counselling (safe sex, condom promotion). Data obtained on demographic characteristics, knowledge, practices, morbidity profile and clinical treatment outcomes. The study done at sentinel STI/HIV clinic near to brothels for easy accessibility. Participant’s baseline assessment and management done coupled with a counselling session. Participants were followed up after 7 days and 3 months and data analysed using Mc Nemars test.

Result Out of 200 participants 156 followed up in the study. The mean age was 28.6±5.2 years and 58.2% were illiterate. 48.0% participant’s reported pathological discharge suggestive of STI. On lab testing, 18 subjects were HIV seropositive and referred to ART centre. Partner management for STIs done in only 35.4% cases due to noncompliance. In pre-intervention phase majority 76.0% were aware of but only 41.0% knew transmission routes correctly. 78% had ever undergone HIV testing and only 36% used condoms regularly. Significant clinical improvement and behaviour change reported in 84.3% (p=0.003) and 82.2% (p=0.01) cases respectively. There was an improved coverage, satisfaction for STI/HIV diagnostic and management services. The coverage of condom usage and voluntary HIV testing escalated to 71.0% (p≤0.01) and 96.0% (p=0.034) respectively.

Discussion Creation of outreach clinics providing quality diagnostic and treatment aided by counselling services is an effective strategy for prevention and management of STI/HIV among high risk groups (FSWs).

  • Female sex workers
  • STI
  • HIV

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