title: A randomized, placebo-controlled trial of monthly azithromycin prophylaxis to prevent sexually transmitted infections and HIV-1 in Kenyan sex workers: study design and baseline findings.
abstract: Our objectives were to describe the baseline findings of a trial of antibiotic prophylaxis to prevent sexually transmitted infections (STIs) and HIV-1 in a cohort of Nairobi female sex workers (FSWs). A questionnaire was administered and a medical examination was performed. HIV-negative women were randomly assigned to either one gram azithromycin or placebo monthly. Mean age of the 318 women was 32 years, mean duration of sex work 7 years and mean number of clients was 4 per day. High-risk behaviour was frequent: 14% practised anal intercourse, 23% sex during menses, and 3% used intravenous drugs. While 20% reported condom use with all clients, 37% never use condoms. However, STI prevalence was relatively low: HIV-1 27%, bacterial vaginosis 46%, Trichomonas vaginalis 13%, Neisseria gonorrhoeae 8%, Chlamydia trachomatis 7%, syphilis 6% and cervical intraepithelial neoplasia (CIN) 3%. It appears feasible to access a population of high-risk FSWs in Nairobi with prevention programmes, including a proposed trial of HIV prevention through STI chemoprophylaxis.
authors.affiliation: International Center for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Fonck
authors.forename: R
authors.initials: R
authors.lastname: Kaul
authors.forename: J
authors.initials: J
authors.lastname: Kimani
authors.forename: F
authors.initials: F
authors.lastname: Keli
authors.forename: K S
authors.initials: KS
authors.lastname: MacDonald
authors.forename: A R
authors.initials: AR
authors.lastname: Ronald
authors.forename: F A
authors.initials: FA
authors.lastname: Plummer
authors.forename: P
authors.initials: P
authors.lastname: Kirui
authors.forename: J J
authors.initials: JJ
authors.lastname: Bwayo
authors.forename: E N
authors.initials: EN
authors.lastname: Ngugi
authors.forename: S
authors.initials: S
authors.lastname: Moses
authors.forename: M
authors.initials: M
authors.lastname: Temmerman
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000382:microbiology / Q000517:prevention & control*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012309:Risk-Taking; D011477:Sex Work; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D016585:Vaginosis, Bacterial / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin