Mujer Mas Segura(Safer Women): a combination prevention intervention to reduce sexual and injection risks among female sex workers who inject drugs

BMC Public Health

Study Protocol

M Gudelia Rangel¹  Alicia Vera²  Daniela Abramovitz²  Steffanie A Strathdee³  Thomas L Patterson⁴  Remedios Lozada⁵  Gustavo Martinez⁶  Hugo Staines⁷ 

[1] Colegio de la Frontera Norte, Baja California, Frontera, Norte, México;Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0507, 92093-0507, La Jolla, CA, USA;Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0507, 92093-0507, La Jolla, CA, USA;University of California, San Diego, Institute of the Americas, 9400 Gilman Drive MC 0507, 92093-0507, La Jolla, CA, USA;Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive # 0680, 92093-0680, La Jolla, CA, USA;Instituto de Servicios de Salud Publica, Secretaria de Salud de Baja California, Calle Circuito de las Misiones Oriente 188, Parque Industrial Las Californias, 2139, Mexicali, BC, Mexico;Salud y desarrollo Comunitario de cuidad Juarez, Ave. Malecon e Ing. M Cardona, No. 788 Zona Centro, 32000, Cd Juarez, Chih, Mexico;Universidad Autonoma de Ciudad Juarez, Pedro Rosales de Leon #7510-117 Colonia Las Fuentes, 32500, Cd Juarez, Chih, Mexico;

关键词: Sexually Transmitted Infection;    Motivational Interview;    Bacterial Vaginosis;    Gonorrhea;    Sterile Syringe;   

DOI  :  10.1186/1471-2458-12-653

 received in 2012-05-03, accepted in 2012-07-27,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundFemale sex workers who inject drugs (FSW-IDUs) are at risk of acquiring HIV, sexually transmitted infections (STI) and blood-borne infections through unprotected sex and sharing injection equipment. We conducted a 2×2 factorial randomized controlled trial to evaluate combination interventions to simultaneously reduce sexual and injection risks among FSW-IDUs in Tijuana and Ciudad Juarez, Mexico.Methods/designFSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month were randomized to one of four conditions based on an a priori randomization schedule, blinding interviewer/counselors to assignment. Due to the extreme vulnerability of this population, we did not include a control group that would deny some women access to preventive information. All women received similar information regardless of group allocation; the difference was in the way the information was delivered and the extent to which women had an interactive role. Each condition was a single 60-minute session, including either an interactive or didactic version of an injection risk intervention and sexual risk intervention. Women underwent interviewer-administered surveys and testing for HIV, syphilis, gonorrhea, Chlamydia, and Trichomonas at baseline and quarterly for 12 months. Combined HIV/STI incidence will be the primary outcome. Secondary outcomes are proportionate reductions in sharing of injection equipment and unprotected sex with clients.DiscussionOf 1,132 women, 548 (48.4%) were excluded (88.9% were ineligible; 11.1% refused to participate or did not return); 584 eligible women enrolled (284 in Tijuana; 300 in Ciudad Juarez). All 584 participants completed the baseline interview, provided biological samples and were randomized to one of the four groups. During follow-up, 17 participants (2.9%) were lost to follow-up, of whom 10 (58.8%) had died, leaving 567 participants for analysis. This study appears to be the first intervention to attempt to simultaneously reduce injection and sexual risk behaviors among FSW-IDUs. The factorial design will permit analysis to determine whether the combination of the two interactive interventions and/or its respective components are effective in reducing injection and/or sexual risks, which will have direct, tangible policy implications for Mexico and potentially other resource-poor countries.Trial registrationNCT00840658

【 授权许可】

Unknown   
© Vera et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.