Impact of Testing on Sexually Transmitted Infections among Female Brothel Sex Workers in Bangladesh: A Randomized Controlled Trial

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  • 1 Department of Economics, Monash University, Melbourne, Australia;
  • 2 Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California;
  • 3 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia

Past studies that have designed interventions to reduce the prevalence of sexually transmitted infections (STIs) have typically provided onsite treatment to sex workers who tested positive, which were expensive and difficult to implement. The purpose of this study was to examine the effect of an intervention which tested for STIs and provided information on the closest treatment facility on reducing the prevalence of STIs among female brothel-based sex workers (BSWs) in Bangladesh. The study adopted a pre–post interventional design as well as a randomized controlled study design. A baseline sample and follow-up urine sample were collected to evaluate the prevalence of STIs among participants in the treatment, but not control group. A baseline survey and interviews were also conducted for both the groups. The study found a nonsignificant reduction from baseline to follow-up in STI prevalence among intervention participants (adjusted odds ratio [aOR]: 0.74; 95% CI: 0.38, 1.45). However, the participants in the intervention group were significantly more likely to have a repeat client (aOR: 1.60; 95% CI: 1.12, 2.29) and nonsignificantly less likely to engage with a client suspected of having an STI (aOR: 0.62; 95% CI: 0.39, 1.00) than participants in the control group. The intervention testing of STIs and providing information to the positive cases about nearest treatment facilities were not effective in reducing the prevalence of STIs among BSWs. Further study of the clinical and behavioral impacts of such efforts to reduce STIs among BSWs is warranted.

Author Notes

Address correspondence to Md Golam Hasnain, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. E-mail: mdgolam.hasnain@uon.edu.au

Disclosure: Any errors are ours.

Financial support: This study received financial support from Monash University, GDRI in Bangladesh, and National Institutes of Health.

Authors’ addresses: Asad Islam, HongQi Alexis Tan, Russell Smyth, and Liang Choon Wang, Department of Economics, Monash University, Melbourne, Australia, E-mails: asadul.islam@monash.edu, tan_hongqi@hotmail.com, russel.smith@monash.edu, and liang.c.wang@monash.edu. Claire C. Bristow, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, E-mail: cbristow@ucsd.edu. Md Golam Hasnain, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia, E-mail: mdgolam.hasnain@uon.edu.au.

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