Number of cases of STDs reported by PREVEN Network.

<p>The number of cases of urethral discharge, vaginal discharge, genital ulcer disease, and pelvic inflammatory disease reported by the PREVEN Network of pharmacies or boticas for 2004, 2005, and 2006 was substantially higher than the numbers reported by Network physicians and midwives, especially for urethral discharge, less so for suspected PID.</p

Results of evaluations by Simulated Patients.

<p>Evaluations to pharmacy workers at baseline both at intervention and control cities showed no significant differences in STD management or referral, or in recommendations for use of condoms or partner treatment. Subsequent evaluations at three, six and 18 months showed significantly better performance for all measures in intervention cities.</p

Baseline census and training of pharmacy/botica workers, physicians and midwives in private practice in the 10 intervention cities.

*<p>Certification required attendance at all four seminars and passing the peer evaluation test and at least 60% correct answers to the written test.</p>**<p>Certification required attendance at two seminars, completion of homework and at least 60% correct answers to the written test.</p

Follow up of PREVEN Network members in 10 intervention cities, (2003–2006).

*<p>Percent in relation to 2003 PREVEN Network participants from each category.</p

Reaching the Unreachable: Providing STI Control Services to Female Sex Workers via Mobile Team Outreach

<div><p>Background</p><p>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. </p> <p>Methods</p><p>Throughout 20 two-month cycles, MTs provided counseling; condoms; screening and specific treatment for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and vaginal <i>Trichomonas vaginalis</i> (TV) infections; and periodic presumptive metronidazole treatment for vaginal infections. </p> <p>Results</p><p>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). </p> <p>Conclusions</p><p>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.</p> </div

Prevalences of <i>C. trachomatis</i> and <i>T. vaginalis</i> infections among female sex workers.

<p>The 95% confidence intervals are shown for Cycle 1 (when the number of encounters was smallest). Reductions in prevalences are significant for <i>C. trachomatis</i> (p <0·001) and for <i>T. vaginalis</i> (p <0·001).</p

Proportion of female sex workers new to Mobile Teams at each intervention cycle.

<p>For each cycle, the number of encounters decreases from top to bottom of the figure; participants with greatest number of Mobile Team encounters are depicted at the top, those with lowest (i.e., new participants) at the bottom.</p

Numbers of female sex workers and commercial sex venues reached by Mobile Teams.

<p>The numbers of female sex workers and the numbers of commercial sex venues reached by mobile teams during the 20 eight-week intervention cycles is represented here. The numbers of sex work venues reached per cycle increased steadily from the first intervention cycle to the fifth cycle, then leveled off. Data from cycles 15 and 20 can’t be disaggregated from data for the 2005 and 2006 surveys of random samples of FSW in the ten cities, and therefore are not presented here.</p