title: Changes in STI services following a community based STI-intervention project in Cambodia.
abstract: The aim of this study was to assess changes in sexually transmitted infections (STI) related care following a STI project with a particular focus on registered brothel-based (direct) female sex workers (DFSWs) in four border provinces of Cambodia. A survey of health care facilities providing STI care was undertaken and the results compared with a baseline survey done two years previously. The main components of the project were: renovation of the STI clinics, STI training, formation of mobile teams, provision of STI drugs, and the introduction of basic laboratory tests at STI clinics. Interviews were held with health care providers and STI patients and a manual check was made of the STI register and special forms for DFSWs. Clinical management of STI cases was assessed for DFSWs, women with vaginal discharge and men with urethral discharge. Advice given to clients about condom use, partner notification and STI education was assessed and availability of STI drugs was reviewed. STI clinic attendance by DFSWs each month increased from 72% (296/412) to 93% (459/496). The proportion of DFSWs diagnosed with presumed STIs decreased from 86.5% (256/296) to 25.5% (117/459) and cervicitis from 32.8% (135/412) to 12.6% (58/459). The percentage of men attending STI clinics decreased from 26.9% (251/933) to 9.4% (102/1,080). The proportion of presumed STI cases/all cases attending health centers decreased from 7.0% (934/13,177) to 4.3% (739/17,224). The introduction of laboratory tests coincided with a marked reduction in DFSWs diagnosed with cervicitis. Further validation studies are required to determine whether this reduction was accompanied by a real decrease in gonorrhea and chlamydia.
authors.affiliation: Pasteur Suite, Ealing Hospital, London, UK. nigel.ofarrell@eht.nhs.uk
authors.forename: Nigel
authors.initials: N
authors.lastname: O'Farrell
authors.forename: Phal
authors.initials: P
authors.lastname: Sano
authors.forename: Seng
authors.initials: S
authors.lastname: Sopheap
authors.forename: Lon Say
authors.initials: LS
authors.lastname: Heng
authors.forename: Ly Penh
authors.initials: LP
authors.lastname: Sun
authors.forename: Mean Chhi
authors.initials: MC
authors.lastname: Vun
authors.forename: Knut
authors.initials: K
authors.lastname: Fylkesnes
authors.forename: Peter
authors.initials: P
authors.lastname: Godwin
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D002160:Cambodia / Q000453:epidemiology; D003153:Community Health Services / Q000458:organization & administration*; D017280:Condoms / Q000706:statistics & numerical data; D019937:Diagnostic Techniques and Procedures; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008297:Male; D016730:Program Development; D015397:Program Evaluation; D034121:Reproductive Health Services / Q000458:organization & administration*; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents