JOURNAL ARTICLE

Findings from Encontros: a multilevel STI/HIV intervention to increase condom use, reduce STI, and change the social environment among sex workers in Brazil

Sheri A Lippman, Magda Chinaglia, Angela A Donini, Juan Diaz, Arthur Reingold, Deanna L Kerrigan
Sexually Transmitted Diseases 2012, 39 (3): 209-16
22337108

BACKGROUND: Sexually transmitted infection (STI)/HIV prevention programs, which do not modify social structural contexts that contribute to risk of STI/HIV may fail to bring about improvements in health, particularly among groups who experience discrimination and exclusion from public life. We conducted a multilevel intervention with sex workers, including improved clinical care and community-mobilizing strategies to modify social structural factors that shape sexual behavior, to improve condom use and reduce incident STI.

METHODS: We followed 420 sex workers participating in the Encontros intervention in Corumbá, Brazil, between 2003 and 2005. We estimated the effect of the intervention on incident chlamydia and gonorrhea infections and condom use using generalized estimating equations and inverse probability weighting by comparing those who actively engaged in the intervention activities (exposed) with those who were less engaged (unexposed). We also determined the association of participation on reported social cohesion and participation in networks.

RESULTS: Exposed participants had significantly higher odds of reporting consistent condom use with regular clients (odds ratio [OR]: 1.9, 95% confidence interval:1.1-3.3) and nonsignificantly increased odds with both new clients (OR: 1.6, 0.9-2.8) and nonpaying partners (OR: 1.5, 0.9-1.5). The odds of an incident STI were nonsignificantly reduced for exposed participants compared with unexposed (OR: 0.46, 0.2-1.3). Participation was significantly associated with increased perceived cohesion and participation in networks.

CONCLUSION: This prospective study provides evidence that multilevel interventions with mobilizing strategies to modify aspects of the social environment can improve condom use, reduce STIs, and increase social cohesion and participation in networks among sex workers.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
22337108
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"