Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex wor...Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.展开更多
Background: The overall HIV prevalence and incidence in Rwanda have decreased significantly in the past decade. However, opposite trends are seen among key populations (KP). The HIV prevalence among sex workers is as ...Background: The overall HIV prevalence and incidence in Rwanda have decreased significantly in the past decade. However, opposite trends are seen among key populations (KP). The HIV prevalence among sex workers is as high as 51% and continues to rise. While the HIV prevalence among KP remains high, their adherence to treatment is low. Healthcare providers play a vital role in KP’s access and adherence to HIV treatment. This study aimed to explore the perspectives of healthcare providers on providing HIV services to key populations in Rwanda. Methods: An exploratory qualitative study was conducted with nurses, doctors, social workers, and psychologists who provide HIV services to KP in public health facilities in Rwanda. In-depth interviews were conducted using a semi-structured interview guide. All data were analyzed thematically using Dedoose. Results: Interviews were conducted with 18 healthcare providers. Three overarching themes emerged from the interviews: healthcare providers’ intrinsic feelings affect the ways they provide HIV services to key populations, key populations face a multitude of challenges related to accessing treatment and preventing the spread of HIV, and a more comprehensive and sensitive approach should be used to improve HIV services for key populations. Conclusion: Healthcare providers expressed difficulties in providing services to key populations and identified a lack of adherence to treatment and prevention guidelines, structural barriers, KP’s lack of trust in the healthcare system, and the discrimination and abuse KP face as challenges to effective HIV prevention and treatment. More comprehensive services including clinical, financial, and psychosocial support from trusted sources are needed. Some important policy changes are essential to facilitate access to HIV services for KP.展开更多
Objective To study gonorrhoea among sex workers in China as to prevalence, risk factors, and resistance to antibiotics Subjects & Methods From March 1998 to October 1999, 966 sex workers from Guangzhou were rec...Objective To study gonorrhoea among sex workers in China as to prevalence, risk factors, and resistance to antibiotics Subjects & Methods From March 1998 to October 1999, 966 sex workers from Guangzhou were recruited into a sexually transmitted diseases (STD) care and prevention programme through various outreach activities. Data collection was standardized. Cervical samples were tested for the presence of Neisseria (N.) gonorrhoea by culture. The agar dilution method was performed to determine susceptibilities of 85 isolates to penicillin, ciprofloxacin, spectinomycin and ceftriaxone. The production of B-lactamase was determined by paper acidometric testing. Results The prevalence of gonorrhoea was 9%. Independent predictors for the disease were inconsistent condom use, lack of regular salary, absence of a previous STD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamydial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent discharge at genital examination were also independently associated with gonorrhoea. Of the 85 N. gonorrhoea isolates, 3.5% was penicillinase producing (PPNG) and 7% plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% was insensitive to penicillin, while 52% and 47% were resistant or less susceptible to ciprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriaxone. All strains were susceptible to spectinomycin. Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, but strains were sensitive to ceftriaxone and spectinomycin. Several personal or medical characteristics were independently associated with the presence of gonorrhoea. Women diagnosed with gonorrhoea should receive concurrent treatment for chlamydial infection.展开更多
Background: Prevention against human immunodeficiency virus (HIV) includes natural resistance in the population;mainly frequency of cysteine-cysteine chemokine receptor type-5 (CCR5-delta 32 mutation). By knowing the ...Background: Prevention against human immunodeficiency virus (HIV) includes natural resistance in the population;mainly frequency of cysteine-cysteine chemokine receptor type-5 (CCR5-delta 32 mutation). By knowing the frequency of this resistance in the community, the proportion of the population susceptible to infection can be determined. This study aimed to detect for the first time the rate of CCR5-delta 32 mutation in Sudanese individuals with HIV and sex workers. Methods: Cross-sectional study was followed in the parade from 2019 through 2021, study groups were Sudanese with HIV and sex workers. Sero-negativity of sex workers was confirmed by a rapid immunochromatography test (ICT). A blood sample was targeted for DNA isolation. PCR amplification was accomplished for CCR5 wild type and CCR5-delta 32 mutation genes using specific primers. Result: Among HIV patients, males, basic education level and ages below 60 years were commonly recorded while ages below 40 years, secondary education level and single marital status were predominated in sex workers. All HIV patients were positive for CCR5 wild type and negative for CCR5-delta 32 genotype. The sex workers group showed a frequency of 3.5% (97/200) for homozygous CCR5-delta 32 mutation. Conclusion: The rating of homozygous CCR5-delta 32 genotype in studied Sudanese sex workers was relatively more than other results obtained from African countries, and the mutation was significantly detected among sex workers group (P value = 0.008) when compared to the studied HIV group.展开更多
文摘Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.
文摘Background: The overall HIV prevalence and incidence in Rwanda have decreased significantly in the past decade. However, opposite trends are seen among key populations (KP). The HIV prevalence among sex workers is as high as 51% and continues to rise. While the HIV prevalence among KP remains high, their adherence to treatment is low. Healthcare providers play a vital role in KP’s access and adherence to HIV treatment. This study aimed to explore the perspectives of healthcare providers on providing HIV services to key populations in Rwanda. Methods: An exploratory qualitative study was conducted with nurses, doctors, social workers, and psychologists who provide HIV services to KP in public health facilities in Rwanda. In-depth interviews were conducted using a semi-structured interview guide. All data were analyzed thematically using Dedoose. Results: Interviews were conducted with 18 healthcare providers. Three overarching themes emerged from the interviews: healthcare providers’ intrinsic feelings affect the ways they provide HIV services to key populations, key populations face a multitude of challenges related to accessing treatment and preventing the spread of HIV, and a more comprehensive and sensitive approach should be used to improve HIV services for key populations. Conclusion: Healthcare providers expressed difficulties in providing services to key populations and identified a lack of adherence to treatment and prevention guidelines, structural barriers, KP’s lack of trust in the healthcare system, and the discrimination and abuse KP face as challenges to effective HIV prevention and treatment. More comprehensive services including clinical, financial, and psychosocial support from trusted sources are needed. Some important policy changes are essential to facilitate access to HIV services for KP.
基金This work was supported by UNAIDSand the World AIDS Foundation
文摘Objective To study gonorrhoea among sex workers in China as to prevalence, risk factors, and resistance to antibiotics Subjects & Methods From March 1998 to October 1999, 966 sex workers from Guangzhou were recruited into a sexually transmitted diseases (STD) care and prevention programme through various outreach activities. Data collection was standardized. Cervical samples were tested for the presence of Neisseria (N.) gonorrhoea by culture. The agar dilution method was performed to determine susceptibilities of 85 isolates to penicillin, ciprofloxacin, spectinomycin and ceftriaxone. The production of B-lactamase was determined by paper acidometric testing. Results The prevalence of gonorrhoea was 9%. Independent predictors for the disease were inconsistent condom use, lack of regular salary, absence of a previous STD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamydial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent discharge at genital examination were also independently associated with gonorrhoea. Of the 85 N. gonorrhoea isolates, 3.5% was penicillinase producing (PPNG) and 7% plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% was insensitive to penicillin, while 52% and 47% were resistant or less susceptible to ciprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriaxone. All strains were susceptible to spectinomycin. Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, but strains were sensitive to ceftriaxone and spectinomycin. Several personal or medical characteristics were independently associated with the presence of gonorrhoea. Women diagnosed with gonorrhoea should receive concurrent treatment for chlamydial infection.
文摘Background: Prevention against human immunodeficiency virus (HIV) includes natural resistance in the population;mainly frequency of cysteine-cysteine chemokine receptor type-5 (CCR5-delta 32 mutation). By knowing the frequency of this resistance in the community, the proportion of the population susceptible to infection can be determined. This study aimed to detect for the first time the rate of CCR5-delta 32 mutation in Sudanese individuals with HIV and sex workers. Methods: Cross-sectional study was followed in the parade from 2019 through 2021, study groups were Sudanese with HIV and sex workers. Sero-negativity of sex workers was confirmed by a rapid immunochromatography test (ICT). A blood sample was targeted for DNA isolation. PCR amplification was accomplished for CCR5 wild type and CCR5-delta 32 mutation genes using specific primers. Result: Among HIV patients, males, basic education level and ages below 60 years were commonly recorded while ages below 40 years, secondary education level and single marital status were predominated in sex workers. All HIV patients were positive for CCR5 wild type and negative for CCR5-delta 32 genotype. The sex workers group showed a frequency of 3.5% (97/200) for homozygous CCR5-delta 32 mutation. Conclusion: The rating of homozygous CCR5-delta 32 genotype in studied Sudanese sex workers was relatively more than other results obtained from African countries, and the mutation was significantly detected among sex workers group (P value = 0.008) when compared to the studied HIV group.
