The UALE project : a cross-sectional approach for trends in HIV/STI prevalence among key populations attending STI clinics in Guatemala
García, Juan Ignacio (Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya - CEEISCAT)
Sabidó Espin, Meritxell (Universitat de Girona)
Nikiforov, Mikhail (Hospital Nacional de Escuintla, Guatemala)
Smith, Adriana (Hospital Nacional de Escuintla, Guatemala)
Hernández, Gabriela (Hospital Nacional de Escuintla, Guatemala)
Ortiz, Rudy (Hospital Nacional de Escuintla, Guatemala)
Ardani, Luis (Hospital Nacional de Escuintla, Guatemala)
Cajas, Alba (Hospital Nacional de Escuintla, Guatemala)
Camey, Elsy (Hospital Nacional de Escuintla, Guatemala)
Torrelles, Jordi B. (Texas Biomedical Research Institute, Texas, USA)
Wang, Shu-Hua (Division of Infectious Diseases. The Ohio State University, USA)
Campbell, Colin N. J. (Public Health England, London, UK)
Folch, Cinta (Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya - CEEISCAT)
Casabona-Barbarà, Jordi (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)

Data:	2018
Resum:	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. 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. 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%. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	BMJ open, Vol. 8 (september 2018) , ISSN 2044-6055

DOI: 10.1136/bmjopen-2018-022632
PMID: 30232112

9 p, 246.7 KB

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