TY - JOUR
T1 - The UALE project
T2 - a cross-sectional approach for trends in HIV/STI prevalence among key populations attending STI clinics in Guatemala
AU - the UALE Study Group
AU - García, Juan Ignacio
AU - Sabidó, Meritxell
AU - Nikiforov, Mikhail
AU - Smith, Adriana
AU - Hernández, Gabriela
AU - Ortiz, Rudy
AU - Ardani, Luis
AU - Cajas, Alba
AU - Camey, Elsy
AU - Torrelles, Jordi B.
AU - Wang, Shu Hua
AU - Campbell, Colin N.J.
AU - Folch, Cinta
AU - Casabona, Jordi
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018
Y1 - 2018
N2 - Objective To describe and compare trends in prevalence, sexual behaviour and HIV transmission knowledge data related to sexually transmitted infections (STI) and HIV in patients attending three STI clinics over an 8-year period in Escuintla Department, Guatemala. Methods STI clinic attendees were classified into transmission groups as follows: female sex workers (FSW), men who have sex with men (MSM) and ‘high-risk heterosexuals’ (HRH). Annual cross-sectional analysis and multivariable Poisson regression adjusted for sociodemographic variables were used for prevalence comparisons and adjusted prevalence trends for HIV/STI outcomes and used for adjusted trends in proportions in sexual behaviour and HIV transmission knowledge outcomes. Endocervical swabs were obtained to detect trichomonas, chlamydia and neisseria infections. Serologies for syphilis and HIV were performed using rapid tests. For reactive HIV samples, positivity was confirmed by an ELISA. All reactive syphilis samples were further confirmed for diagnosis of active syphilis disease. results From a total of 4027 clinic attendees, 3213 (79.78%) were FSW, 229 (5.69%) were MSM and 585 (14.53%) were HRH. The proportion of FSW, MSM and HRH who had a single visit was 56.42%, 57.23% and 91.10%, respectively. Overall, HIV prevalence was 2.10% in FSW, 8.17% in MSM and 4.12% in HRH. Prevalence trends in HIV and syphilis decreased in FSW. Prevalence trends in gonorrhoea did not decrease over time neither in FSW nor in HRH. Chlamydia and trichomonas infections in HRH showed an increase prevalence trend. In FSW, trends in condom use in last sexual intercourse with regular and occasional clients were above 93%. Conclusions FSW show a decreasing trend in HIV, syphilis and chlamydia prevalence. Gonorrhoea prevalence in FSW and HRH did not decrease over time. HRH is a hard to engage population with low follow-up rates and high potential to act as a bridge population.
AB - Objective To describe and compare trends in prevalence, sexual behaviour and HIV transmission knowledge data related to sexually transmitted infections (STI) and HIV in patients attending three STI clinics over an 8-year period in Escuintla Department, Guatemala. Methods STI clinic attendees were classified into transmission groups as follows: female sex workers (FSW), men who have sex with men (MSM) and ‘high-risk heterosexuals’ (HRH). Annual cross-sectional analysis and multivariable Poisson regression adjusted for sociodemographic variables were used for prevalence comparisons and adjusted prevalence trends for HIV/STI outcomes and used for adjusted trends in proportions in sexual behaviour and HIV transmission knowledge outcomes. Endocervical swabs were obtained to detect trichomonas, chlamydia and neisseria infections. Serologies for syphilis and HIV were performed using rapid tests. For reactive HIV samples, positivity was confirmed by an ELISA. All reactive syphilis samples were further confirmed for diagnosis of active syphilis disease. results From a total of 4027 clinic attendees, 3213 (79.78%) were FSW, 229 (5.69%) were MSM and 585 (14.53%) were HRH. The proportion of FSW, MSM and HRH who had a single visit was 56.42%, 57.23% and 91.10%, respectively. Overall, HIV prevalence was 2.10% in FSW, 8.17% in MSM and 4.12% in HRH. Prevalence trends in HIV and syphilis decreased in FSW. Prevalence trends in gonorrhoea did not decrease over time neither in FSW nor in HRH. Chlamydia and trichomonas infections in HRH showed an increase prevalence trend. In FSW, trends in condom use in last sexual intercourse with regular and occasional clients were above 93%. Conclusions FSW show a decreasing trend in HIV, syphilis and chlamydia prevalence. Gonorrhoea prevalence in FSW and HRH did not decrease over time. HRH is a hard to engage population with low follow-up rates and high potential to act as a bridge population.
UR - http://www.scopus.com/inward/record.url?scp=85065857153&partnerID=8YFLogxK
U2 - 10.1136/BMJOPEN-2018-022632
DO - 10.1136/BMJOPEN-2018-022632
M3 - Article
C2 - 30232112
AN - SCOPUS:85065857153
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e022632
ER -
