Abstract
Objectives: To describe the development, characteristics, and follow up of a high risk cohort of women in Tanzania. Differences in social background and sexual behaviour of women working in traditional and modern alcohol selling workplaces are shown.
Methods: Data from questionnaires four months before the enrolment of the cohort, at enrolment, and at 32 months were compared. Key informant interviews, social mapping exercises, and focus group discussions were held before the start of the cohort.
Results: In the absence of organised prostitution, two different groups of women with high risk exposure were identified during the baseline survey: female workers in modern alcohol selling places such as bars, guesthouses, and restaurants (barmaids) and in traditional places (local brew sellers). Overall, the population had a mean age of 27.7 years with barmaids tending to be younger (24.3 years) than local brew sellers (34.2 years). The main duration of stay in the current workplace was 2.1 years (barmaids 0.9 years; local brew sellers 4.1 years). Barmaids were more likely to have paying casual sex partners than local brew sellers and used condoms more regularly. Local brew sellers tend to be more stable with only 10% lost to follow up after 32 months compared with 24.4% of the bar workers.
Conclusions: Preliminary work revealed major differences in characteristics and behaviour between women working in modern and traditional alcohol selling outlets. Thorough preparation of the study, close monitoring of the cohort, and provision of selected benefits resulted in high retention rates over a 32 month project in a highly mobile population.
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- Ahmed H. J., Omar K., Adan S. Y., Guled A. M., Grillner L., Bygdeman S. Syphilis and human immunodeficiency virus seroconversion during a 6-month follow-up of female prostitutes in Mogadishu, Somalia. Int J STD AIDS. 1991 Mar-Apr;2(2):119–123. doi: 10.1177/095646249100200209. [DOI] [PubMed] [Google Scholar]
- Aklilu M., Messele T., Tsegaye A., Biru T., Mariam D. H., van Benthem B., Coutinho R., Rinke de Wit T., Fontanet A. Factors associated with HIV-1 infection among sex workers of Addis Ababa, Ethiopia. AIDS. 2001 Jan 5;15(1):87–96. doi: 10.1097/00002030-200101050-00013. [DOI] [PubMed] [Google Scholar]
- Baeten J. M., Richardson B. A., Martin H. L., Jr, Nyange P. M., Lavreys L., Ngugi E. N., Mandaliya K., Ndinya-Achola J. O., Bwayo J. J., Kreiss J. K. Trends in HIV-1 incidence in a cohort of prostitutes in Kenya: implications for HIV-1 vaccine efficacy trials. J Acquir Immune Defic Syndr. 2000 Aug 15;24(5):458–464. doi: 10.1097/00126334-200008150-00011. [DOI] [PubMed] [Google Scholar]
- Bakari M., Lyamuya E., Mugusi F., Aris E., Chale S., Magao P., Jossiah R., Janabi M., Swai A., Pallangyo N. The prevalence and incidence of HIV-1 infection and syphilis in a cohort of police officers in Dar es Salaam, Tanzania: a potential population for HIV vaccine trials. AIDS. 2000 Feb 18;14(3):313–320. doi: 10.1097/00002030-200002180-00014. [DOI] [PubMed] [Google Scholar]
- Beyrer C., Brookmeyer R., Natpratan C., Kunawararak P., Niraroot V., Palapunya P., Khamboonruang C., Celentano D. D., Nelson K. E. Measuring HIV-1 incidence in northern Thailand: prospective cohort results and estimates based on early diagnostic tests. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Aug 15;12(5):495–499. doi: 10.1097/00042560-199608150-00009. [DOI] [PubMed] [Google Scholar]
- Connolly Catherine A., Ramjee Gita, Sturm Adriann W., Abdool Karim Salim S. Incidence of Sexually Transmitted Infections among HIV-positive sex workers in KwaZulu-Natal, South Africa. Sex Transm Dis. 2002 Nov;29(11):721–724. doi: 10.1097/00007435-200211000-00017. [DOI] [PubMed] [Google Scholar]
- Fowke K. R., Nagelkerke N. J., Kimani J., Simonsen J. N., Anzala A. O., Bwayo J. J., MacDonald K. S., Ngugi E. N., Plummer F. A. Resistance to HIV-1 infection among persistently seronegative prostitutes in Nairobi, Kenya. Lancet. 1996 Nov 16;348(9038):1347–1351. doi: 10.1016/S0140-6736(95)12269-2. [DOI] [PubMed] [Google Scholar]
- Ghys P. D., Diallo M. O., Ettiègne-Traoré V., Yeboué K. M., Gnaoré E., Lorougnon F., Kalé K., Van Dyck E., Brettegaard K., Hoyi Y. M. Genital ulcers associated with human immunodeficiency virus-related immunosuppression in female sex workers in Abidjan, Ivory Coast. J Infect Dis. 1995 Nov;172(5):1371–1374. doi: 10.1093/infdis/172.5.1371. [DOI] [PubMed] [Google Scholar]
- Kaul R., Kimani J., Nagelkerke N. J., Plummer F. A., Bwayo J. J., Brunham R. C., Ngugi E. N., Ronald A. Risk factors for genital ulcerations in Kenyan sex workers. The role of human immunodeficiency virus type 1 infection. Sex Transm Dis. 1997 Aug;24(7):387–392. doi: 10.1097/00007435-199708000-00001. [DOI] [PubMed] [Google Scholar]
- Kaul Rupert, Kimani Joshua, Nagelkerke Nico J., Fonck Karoline, Ngugi Elizabeth N., Keli Florence, MacDonald Kelly S., Maclean Ian W., Bwayo Job J., Temmerman Marleen. Monthly antibiotic chemoprophylaxis and incidence of sexually transmitted infections and HIV-1 infection in Kenyan sex workers: a randomized controlled trial. JAMA. 2004 Jun 2;291(21):2555–2562. doi: 10.1001/jama.291.21.2555. [DOI] [PubMed] [Google Scholar]
- Lowndes C. M., Alary M., Meda H., Gnintoungbé C. A. B., Mukenge-Tshibaka L., Adjovi C., Buvé A., Morison L., Laourou M., Kanhonou L. Role of core and bridging groups in the transmission dynamics of HIV and STIs in Cotonou, Benin, West Africa. Sex Transm Infect. 2002 Apr;78 (Suppl 1):i69–i77. doi: 10.1136/sti.78.suppl_1.i69. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mulder D., Nunn A., Kamali A., Kengeya-Kayondo J. Decreasing HIV-1 seroprevalence in young adults in a rural Ugandan cohort. BMJ. 1995 Sep 30;311(7009):833–836. doi: 10.1136/bmj.311.7009.833. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nkya W. M., Gillespie S. H., Howlett W., Elford J., Nyamuryekunge C., Assenga C., Nyombi B. Sexually transmitted diseases in prostitutes in Moshi and Arusha, Northern Tanzania. Int J STD AIDS. 1991 Nov-Dec;2(6):432–435. doi: 10.1177/095646249100200608. [DOI] [PubMed] [Google Scholar]
- Piot P., Laga M. Prostitutes: a high risk group for HIV infection? Soz Praventivmed. 1988;33(7):336–339. doi: 10.1007/BF02084300. [DOI] [PubMed] [Google Scholar]
- Plummer F. A., Nagelkerke N. J., Moses S., Ndinya-Achola J. O., Bwayo J., Ngugi E. The importance of core groups in the epidemiology and control of HIV-1 infection. AIDS. 1991;5 (Suppl 1):S169–S176. [PubMed] [Google Scholar]
- Ramjee G., Karim S. S., Sturm A. W. Sexually transmitted infections among sex workers in KwaZulu-Natal, South Africa. Sex Transm Dis. 1998 Aug;25(7):346–349. doi: 10.1097/00007435-199808000-00004. [DOI] [PubMed] [Google Scholar]
- Wawer M. J., Sewankambo N. K., Berkley S., Serwadda D., Musgrave S. D., Gray R. H., Musagara M., Stallings R. Y., Konde-Lule J. K. Incidence of HIV-1 infection in a rural region of Uganda. BMJ. 1994 Jan 15;308(6922):171–173. doi: 10.1136/bmj.308.6922.171. [DOI] [PMC free article] [PubMed] [Google Scholar]