title: Sexually Transmitted Infections and Associated Risk Factors Among Street-Based and Residence-Based Female Sex Workers in Dhaka, Bangladesh.
abstract: Female sex workers (FSWs) in Bangladesh remain at elevated risk of sexually transmitted infections (STIs) although the human immunodeficiency virus (HIV) prevalence among them is low. Recent information on the burden and etiological diagnosis of STIs among them has been lacking. This study examines prevalence and risk behaviors of selected STIs among FSWs in Dhaka in 2014.
  
  
  
  Between August and October 2014, a cross-sectional study was conducted among street-based and residence-based FSWs receiving HIV prevention services at 24 drop in centers in Dhaka. Participants underwent behavioral interview, clinical examination, and laboratory testing for selected STIs using cervical swabs and blood.
  
  
  
  The sample consisted of 371 streets and 329 residence FSWs. Prevalence of gonorrhea, chlamydia, and active syphilis were 5.1%, 4.6%, 1.3% in street FSWs and were 5.8%, 8.2%, and 0.6% for residence FSWs which are lower compared with the previously reported rates. The following factors were associated with having any STI: being ≤5 years in sex trade (odds ratio, 2.2; 95% confidence interval, 1.2-3.9; P < 0.01), and having a cervical discharge (odds ratio, 2.6, 95% confidence interval, 1.5-4.6; P < 0.01). Resistance to cefixime and azithromycin was observed for 1 and 3 Neisseria gonorrhoeae strains, respectively.
  
  
  
  Despite receiving HIV/STI prevention services, bacterial STIs remain prevalent among FSWs suggesting the need for more effective management of STIs. The guidelines for management of STIs need revision in view of the emerging resistance.
authors.affiliation: From the *Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; †International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; ‡Clinical Microbiology Laboratory, Laboratory Sciences and Services Division, §Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka; ¶Save the Children in Bangladesh; **Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; and ††Fenway Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Rasheda
authors.initials: R
authors.lastname: Khanam
authors.forename: Masud
authors.initials: M
authors.lastname: Reza
authors.forename: Dilruba
authors.initials: D
authors.lastname: Ahmed
authors.forename: Mustafizur
authors.initials: M
authors.lastname: Rahman
authors.forename: M Shah
authors.initials: MS
authors.lastname: Alam
authors.forename: Salima
authors.initials: S
authors.lastname: Sultana
authors.forename: Anadil
authors.initials: A
authors.lastname: Alam
authors.forename: Sharful I
authors.initials: SI
authors.lastname: Khan
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Tasnim
authors.initials: T
authors.lastname: Azim
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult