Background Evidence suggests that the presence of untreated sexually transmitted infections (STIs) increases the chance of HIV transmission during unprotected sex. In the Ethiopian context, many female sex workers live in poor conditions in rented slums and are not typically known or recognised by local authorities, making them unable to access health facilities.
Methods Data were obtained from a register of female sex workers recorded for purpose of service provision at confidential STI clinics in Mekelle and Adigrat, Ethiopia, from May 2010 to August 2015 and from May 2011 to August 2015, respectively. A simple descriptive analysis of services delivered to patients was performed.
Results Among the 6288 patients included in this study, the prevalence of STIs was 23.4%. Of these, 12.9% (814/6288) of patients presented with vaginal discharge, 7.9% (490/6288) with genital ulcers and 2.3% (158/6288) with lower abdominal pain (as per the WHO syndromic approach to STIs). Moreover, 180 cases of genital ulcer were tested for syphilis with the VDRL test; 36 (20%) tested positive for active infection. The HIV prevalence declined from 10% in 2010 to 1.1% in 2015. The frequency of STIs amongst repeat patients was considerably lower than that in new presentations.
Conclusions HIV prevalence declined from 10% in 2010 to 1.1% in 2015. Compared to new cases, the frequency of STIs among repeat clients was extremely low, suggesting that the cumulative effect of peer promotion and preventative sexual health education is effective in reducing the rates of STIs among vulnerable populations. Clinic and workplace geography, hours of clinic operation, confidentiality and peer outreach are important factors in the prevention and control of STI/HIV infection in key sex worker populations. A comprehensive clinic intervention enhances early diagnosis and treatment of STIs and increases the proportion of sex workers accessing HIV treatment services.
Disclosure No significant relationships.
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