Syndromic and biological screening for sexually transmitted infections in female sex workers in Côte d’Ivoire: the ANRS 12381 PRINCESSE cohort study
NOUAMAN, Marcellin N’zebo
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
Global Health in the Global South [GHiGS]
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
Global Health in the Global South [GHiGS]
COFFIE, Patrick Ahuatchi
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
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Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
NOUAMAN, Marcellin N’zebo
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
Global Health in the Global South [GHiGS]
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
Global Health in the Global South [GHiGS]
COFFIE, Patrick Ahuatchi
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
Programme PAC-CI
Université Félix Houphouët-Boigny [Abidjan, Côte d'Ivoire] [UFHB]
BECQUET, Valentine
Institut national d'études démographiques [INED]
Centre Population et Développement [Ceped - UMR 196]
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Institut national d'études démographiques [INED]
Centre Population et Développement [Ceped - UMR 196]
Langue
EN
Article de revue
Ce document a été publié dans
Frontiers in Public Health. 2025-03-12, vol. 13
Résumé en anglais
Background Female sex workers (FSWs) are at high risk of contracting STIs, in particular in Sub-Saharan Africa. The implementation of oral HIV pre-exposure prophylaxis provided an opportunity to draw attention to the sexual ...Lire la suite >
Background Female sex workers (FSWs) are at high risk of contracting STIs, in particular in Sub-Saharan Africa. The implementation of oral HIV pre-exposure prophylaxis provided an opportunity to draw attention to the sexual health needs of FSWs. Innovative strategies to screen for and reduce the burden of STIs is thus a priority. This study describes STI screening among FSWs enrolled in the PRINCESSE project in Côte d’Ivoire. Methods The PRINCESSE project (2019–2023) was an interventional cohort of FSWs ≥18 years, evaluating a comprehensive, community-based sexual and reproductive health care package, including the management of STIs, offered through mobile clinics operating on prostitution sites in San Pedro area. HIV testing and syndromic STI testing were offered at baseline and every 3 months. Biological testing of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) was offered annually. Clinical forms included sociodemographic, behavioral and sex-work-related characteristics. We describe baseline characteristics, coverage of clinical examination, and vaginal, anal swab collection. Social, behavioral and sex work-related factors associated with an STI syndromic diagnosis were explored. A multivariable logistic regression model was used to identify factors associated with diagnosing a symptomatic STI. Results 489 FSWs were included in the PRINCESSE cohort. Median age was 29 years (24–35 years), 28.6% had had sex without a condom in the last 7 days. The prevalence of HIV at baseline was 10.5%. Only one case of HIV seroconversion was observed during the project. The most frequent symptom was ano-vaginal discharge (19.1%). The prevalence of STI based on clinical symptoms was 26.6%. The proportion of vaginal swab samples for which the PCR result was positive was 8.0% for CT and 4.0% for NG. Only age remained significantly associated with diagnosing a symptomatic STI in the multivariable analysis. Conclusion This study revealed a high prevalence of HIV and STIs, similar to national estimates among FSWs enrolled in a sexual health cohort. Screening for these generically asymptomatic bacterial STIs must be combined with the syndromic approach used in key populations, especially with the introduction of new PrEP programs, to reduce the exposure of individuals in these populations to STIs.< Réduire
Mots clés en anglais
Sub-Saharan Africa
Biological Stis Screening
Female Sex Workers
Key Population
Sexually Transmitted Infections
Syndromic STI
Unités de recherche