Reaching the Unreachable: Providing STI Control Services to Female Sex Workers via Mobile Team OutreachReportar como inadecuado

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As part of a community-randomized trial of a multicomponent intervention to prevent sexually transmitted infections, we created Mobile Teams MTs in ten intervention cities across Peru to improve outreach to female sex workers FSW for strengthened STI prevention services.


Throughout 20 two-month cycles, MTs provided counseling; condoms; screening and specific treatment for Neisseria gonorrhoeae NG, Chlamydia trachomatis CT, and vaginal Trichomonas vaginalis TV infections; and periodic presumptive metronidazole treatment for vaginal infections.


MTs had 48,207 separate encounters with 24,814 FSW; numbers of sex work venues and of FSW reached increased steadily over several cycles. Approximately 50% of FSW reached per cycle were new. Reported condom use with last client increased from 73% to 93%. Presumptive metronidazole treatment was accepted 83% of times offered. Over 38 months, CT prevalence declined from 15·4% to 8·2%, and TV prevalence from 7·3% to 2·6%. Among participants in ≥9 cycles, CT prevalence decreased from 12·9% to 6·0% p <0·001; TV from 4·6% to 1·5% p <0·001; and NG from 0·8% to 0·4% p =0·07.


Mobile outreach to FSW reached many FSW not utilizing government clinics. Self-reported condom use substantially increased; CT and TV prevalences declined significantly. The community-randomized trial, reported separately, demonstrated significantly greater reductions in composite prevalence of CT, NG, TV, or high-titer syphilis serology in FSW in these ten intervention cities than in ten matched control cities.

Autor: Pablo E. Campos, Anne L. Buffardi, César P. Cárcamo, Patricia J. García , Clara Buendia, Marina Chiappe, Geoff P. Garnett, Ana



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