Environmental-Structural Interventions to Reduce HIV/STI Risk among Female Sex Workers in the Dominican Republic
Journal Article
Kerrigan, Deanna
Moreno, Luis
Rosario, Santo
Gomez, Bayardo
Jerez, Hector
Barrington, Clare
Weiss, Ellen
Sweat, Michael D.
2006
American Journal of Public Health
96
1
120-5
10.2105/AJPH.2004.042200
PMC1470438
3778
OBJECTIVES: We assessed the effectiveness of 2 environmental-structural interventions in reducing risks of HIV and sexually transmitted infections (STIs) among female sex workers in the Dominican Republic. METHODS: Two intervention models were implemented over a 1-year period: community solidarity in Santo Domingo and solidarity combined with government policy in Puerto Plata. Both were evaluated via preintervention-postintervention cross-sectional behavioral surveys, STI testing and participant observations, and serial cross-sectional STI screenings. RESULTS: Significant increases in condom use with new clients (75.3%-93.8%; odds ratio [OR]=4.21; 95% confidence interval [CI]=1.55, 11.43) were documented in Santo Domingo. In Puerto Plata, significant increases in condom use with regular partners (13.0%-28.8%; OR=2.97; 95% CI=1.33, 6.66) and reductions in STI prevalence (28.8%-16.3%; OR = 0.50; 95% CI = 0.32, 0.78) were documented, as were significant increases in sex workers' verbal rejections of unsafe sex (50.0%-79.4%; OR=3.86; 95% CI=1.96, 7.58) and participating sex establishments' ability to achieve the goal of no STIs in routine monthly screenings of sex workers (OR=1.17; 95% CI=1.12, 1.22). CONCLUSIONS: Interventions that combine community solidarity and government policy show positive initial effects on HIV and STI risk reduction among female sex workers.
Sexual Behavior, Contraceptive Use, and Reproductive Health
Biological and Social Interactions
Place, Space, and Health
Population and Health Policies and Programs
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