title: Decreasing STD incidence and increasing condom use among Chinese sex workers following a short term intervention: a prospective cohort study.
abstract: OBJECTIVE
  To describe the impact of a repeating behavioural intervention focused on preventive education and provision of STD testing and treatment services to female sex workers.
  
  
  METHODS
  A prospective cohort study of 966 sex workers (first of its kind in China) was conducted in Guangzhou from March 1998 to October 1999. At each visit information was collected on sexual behaviour, condom use and knowledge about HIV transmission and condom use, education was given, STD were diagnosed, and treatment was provided free of charge. We evaluated trends in condom use, knowledge about HIV transmission and condom use, and STD incidences. Generalised estimating equations were applied to control for repeated measurements.
  
  
  RESULTS
  The proportion of consistent condom use increased from the intake through the third follow up visit (from 30% to 81%), as well as the proportion of having good knowledge on HIV transmission (4.3% to 98.6%) and condom use (23.6% to 79.3%). The incidence of gonorrhoea, trichomoniasis, and chlamydia decreased over each follow up visit; from 17.5/100 person years (PY), 22.4/100PY, 65.9/100PY at the first follow up visit to 5.1/100PY, 3.0/100PY, 16.1/100PY at the third follow up visit, for each STD respectively.
  
  
  CONCLUSIONS
  STD care and prevention programmes targeting sex workers are feasible in China and, more importantly, intervention consisting of prevention education and STD care is likely to reduce unprotected sexual behaviour and STD incidence in this group at high risk for HIV and other STD infection.
authors.affiliation: Cluster Infectious Diseases, Municipal Health Service, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Ma
authors.forename: N H T M
authors.initials: NH
authors.lastname: Dukers
authors.forename: A
authors.initials: A
authors.lastname: van den Hoek
authors.forename: F
authors.initials: F
authors.lastname: Yuliang
authors.forename: C
authors.initials: C
authors.lastname: Zhiheng
authors.forename: F
authors.initials: F
authors.lastname: Jiangting
authors.forename: Z
authors.initials: Z
authors.lastname: Lina
authors.forename: Z
authors.initials: Z
authors.lastname: Xiuxing
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D011477:Sex Work / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control