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.
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.
Fonck
K
K
International Center for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Belgium.
Kaul
R
R
Kimani
J
J
Keli
F
F
MacDonald
K S
KS
Ronald
A R
AR
Plummer
F A
FA
Kirui
P
P
Bwayo
J J
JJ
Ngugi
E N
EN
Moses
S
S
Temmerman
M
M
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
D000900:Anti-Bacterial Agents; D017963:Azithromycin