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Recruitment of Caribbean female commercial sex workers at high risk of HIV infection

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Multivariable logistic regression models were used to evaluate the association of sexual behaviors, alcohol and drug use, participant demographics, and partner characteristics Table 1 with HIV prevalence and expressed willingness to participate in a future HIV vaccine trial.

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Clinical trials to assess the efficacy of a vaccine must be conducted in the populations that ultimately would benefit from vaccination.

Site was not a significant factor, but given the differences between subpopulations, sites were also analyzed individually. For DR, no significant factors were Prostitutes Tamra. This study reviews sociodemographic and epidemiologic data among Caribbean CSWs and factors associated with previously undiagnosed prevalent HIV infection and recruitment strategies and risk behaviors Prostitutes Tamra with high HIV-1 prevalence.

For women enrolled in the longitudinal cohort, willingness Prostitutes Tamra participate in a future HIV vaccine trial was evaluated. Prevalence of undiagnosed HIV infection in this study was 3.

These rates are based on HIV testing results at the screening stage in this study. Those who self-reported HIV infections were Prostitutes Tamra tested.

Therefore, the prevalence in the targeted subgroups may be higher than reported here. The prevalence in these CSW cohorts is higher than that of the general population in each country; for example, over Prostitutes Tamra times that of the general population in Haiti and 4 times that in DR 17 Risk for sexual acquisition of HIV infection depends on the behavior of a subgroup population and the HIV prevalence in the population 17 In this study, these factors differed among the cohort of women at each of the sites.

Crack cocaine use was a statistically significant predictor of HIV prevalence but was found primarily among the PR cohort; this could explain the risk for PR women, who had fewer total clients but were more likely to have a main IDU partner.

Having sex with clients on the street, more Prostitutes Tamra reported in Haiti, appeared to enhance HIV infection risk and Prostitutes Tamra be Prostitutes Tamra to Prostitutes Tamra condom use or other high-risk behavior. The eligibility criteria for women in the step study included exchanging sex for money or drugs, crack cocaine use, or having unprotected sex with an HIV-infected or IDU male partner.

By focusing on the enrollment of CSW, our cohort has a higher percentage of women engaging in Prostitutes Tamra that put them at risk for HIV infection. Data were not collected on the risk practices of their male partners in Prostitutes Tamra other studies.

Site-specific strategies accounting for local epidemiologic, demographic, and social factors should be considered to inform recruitment of high-risk women for future HIV vaccine trials.

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The DR site used CSW peer educators to recruit CSWs who were not members of Modemu a group from which participants were recruited for previous studies and who worked within or in close proximity to jails. PR identified areas Prostitutes Tamra drugs are illegally sold or Prostitutes Tamra, injection drugs are shared, there are high crime rates, and CSWs were located. Prescreening and screening were part of the recruitment Prostitutes Tamra used Prostitutes Tamra all sites. The strategies appear to be effective for identifying a population at higher risk of HIV infection as prevalence observed at screening was higher than that of the general population.

High HIV prevalence at screening, however, may not be indicative of high incidence during a longitudinal study, a necessity for HIV vaccine efficacy trials. Most CSWs in this study were probably or definitely willing to participate in future vaccine studies.

These results are promising.

Abstract Objective To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean.

There are limitations, however, on how well cohort study data translate to actual willingness to enroll in a vaccine study Expressing willingness to a hypothetical situation may be more likely than actual willingness to join an HIV vaccine trial.

In addition, participants Prostitutes Tamra enroll in a cohort study may not represent an equivalent population as those who enroll in a vaccine study. Despite these difficulties, having a good Prostitutes Tamra of these factors and the local Prostitutes Tamra and working effectively with CBOs who understand these subpopulations resulted in relatively low screening to enrollment ratios.

Further analysis is needed to evaluate behavior changes that may occur as a result of risk reduction counseling and how these Prostitutes Tamra other factors may affect HIV prevalence and incidence rates in subgroups.

We thank the trial participants, clinic staff, and CBOs who made this study possible and Tracey Day and Adi Ferrara for manuscript editing. Conflicts Prostitutes Tamra interest.

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National Center for Biotechnology InformationU. Rev Panam Salud Publica. Author manuscript; available in PMC May 2. Marie Marcelle Deschamps1 Carmen D. Zorrilla Prostitutes Tamra, 2 Cecilia A. Carmen D. Cecilia A. Author information Copyright and License information Prostitutes Tamra. Send correspondence to: Marie Marcelle Deschamps, gro. Copyright notice. See other articles in PMC that cite the published article.

Abstract Objective To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. Methods A prospective cohort study was conducted in — among female commercial sex workers in the Dominican Republic, Haiti, and Puerto Rico.

Results HIV prevalence at screening Prostitutes Tamra 4. Conclusions This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial. Study eligibility Eligibility requirements included being an at-risk Prostitutes Tamra uninfected female, ages 18—45 Prostitutes Tamra is the legal lower limit for PRwilling to receive HIV test results and risk reduction counseling, not pregnant or intending to become pregnant for 18 months, Prostitutes Tamra deemed medically and psychologically capable of participation.

Study recruitment Prostitutes Tamra site developed recruitment methods for their local populations based on local epidemiologic data, lessons from previous studies, and information from community members and community-based Prostitutes Tamra CBOs. Statistical analysis Site differences in demographics, risk behaviors, and partner characteristics were assessed with chi-square tests for categorical items and Kruskal—Wallis tests for continuous data items.

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Behaviors are with regard to the six months before the screening visit unless otherwise noted. Enrolled No. Screening-to-enrollment ratio Tested No. Infected b No. In Haiti, for screening to enrollment ratios and prevalence, all but Prostitutes Tamra women one by social service agency Prostitutes Tamra and two by referral were recruited by street outreach and one or more other methods.

Acknowledgments We thank the trial participants, clinic staff, and CBOs who made this study possible and Tracey Day and Adi Ferrara for manuscript editing. Footnotes Conflicts of interest. References 1. Efficacy assessment of a cell-mediated Prostitutes Tamra HIV-1 vaccine the Step Study : a double-blind, randomised, placebo-controlled, test-of-concept trial. Migration, ethnicity and environment: Prostitutes Tamra risk factors for women on the sugar cane plantations of the Dominican Republic.

Centers for Disease Control and Prevention. Atlanta, Georgia: CDC; Report no. Lessons drawn from recent HIV vaccine efficacy trials. Acquir Immune Defc Syndr. Are US populations appropriate for trials of human immunodeficiency virus vaccine? Am J Epidemiol. J Aquir Immune Defc Syndr. Efficacy assessment of a cell-mediated immunity HIV-1 vaccine the step Prostitutes Tamra : a double-blind, randomised, placebo-controlled, test-of-concept trial.

Changes in risk behaviors with risk reduction counseling among volunteers involved in efficacy HIV vaccine trial in Haiti.

Prostitutes Tamra, Where find a hookers in Tamra (IL): Zorrilla , 2 Cecilia A. Clinical trials to assess the efficacy of a vaccine must be conducted in the populations that ultimately would benefit from vaccination.

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