Universidad Peruana Cayetano Heredia

Prevention of sexually transmitted infections in urban communities (Peru PREVEN): A multicomponent community-randomised controlled trial

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dc.contributor.author Garcia Funegra, Patricia Jannet
dc.contributor.author Holmes, K.K.
dc.contributor.author Cárcamo Cavagnaro, César Paul Eugenio
dc.contributor.author Garnett, G.P.
dc.contributor.author Hughes, J.P.
dc.contributor.author Campos, P.E.
dc.contributor.author Whittington, W.L.H.
dc.date.accessioned 2022-01-18T19:26:48Z
dc.date.available 2022-01-18T19:26:48Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/10899
dc.description.abstract Background: Previous community-randomised trials of interventions to control sexually transmitted infections (STIs) have involved rural settings, were rarely multicomponent, and had varying results. We aimed to assess the effect of a multicomponent intervention on curable STIs in urban young adults and female sex workers (FSWs). Methods: In this community-randomised trial, baseline STI screening was done between August, and November, 2002, in random household samples of young adults (aged 18-29 years) and in FSWs in Peruvian cities with more than 50 000 inhabitants. Geographically separate cities were selected, matched into pairs, and randomly allocated to intervention or control groups with an S-PLUS program. Follow-up surveys of random samples were done after 2 years and 3 years. The intervention comprised four modalities: strengthened STI syndromic management by pharmacy workers and clinicians; mobile-team outreach to FSWs for STI screening and pathogen-specific treatment; periodic presumptive treatment of FSWs for trichomoniasis; and condom promotion for FSWs and the general population. Individuals in control cities received standard care. The composite primary endpoint was infection of young adults with Chlamydia trachomatis, Trichomonas vaginalis, or Neisseria gonorrhoeae, or syphilis seroreactivity. Laboratory workers and the data analyst were masked, but fieldworkers, the Peruvian study team, and participants in the outcome surveys were not. All analyses were done by intention to treat. This trial is registered, ISRCTN43722548. Findings: We did baseline surveys of 15 261 young adults in 24 Peruvian cities. Of those, 20 geographically separate cities were matched into pairs, in each of which one city was assigned to intervention and the other to standard of care. In the 2006 follow-up survey, data for the composite primary outcome were available for 12 930 young adults. We report a non-significant reduction in prevalence of STIs in young adults, adjusted for baseline prevalence, in intervention cities compared with control cities (relative risk 0.84, 95 CI 0.69-1.02; p=0.096). In subgroup analyses, significant reductions were noted in intervention cities in young adult women and FSWs. Interpretation: Syndromic management of STIs, mobile-team outreach to FSWs, presumptive treatment for trichomoniasis in FSWs, and condom promotion might reduce the composite prevalence of any of the four curable STIs investigated in this trial. Funding: Wellcome Trust and Burroughs Wellcome Fund, National Institutes of Health, Center for AIDS Research, CIPRA, and USAID-Peru. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Lancet
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Controlled Study en_US
dc.subject Major Clinical Study|Human Immunodeficiency Virus Infection en_US
dc.subject Prostitution en_US
dc.subject Sexually Transmitted Disease en_US
dc.subject Condom en_US
dc.subject Syphilis en_US
dc.subject Follow Up en_US
dc.subject Urban Population en_US
dc.subject Infection Prevention en_US
dc.subject Randomized Controlled Trial en_US
dc.subject Ciprofloxacin en_US
dc.subject Azithromycin en_US
dc.subject Metronidazole en_US
dc.subject Chlamydiasis en_US
dc.subject Gonorrhea en_US
dc.subject Health Care Quality en_US
dc.subject Trichomonas Vaginalis en_US
dc.subject Neisseria Gonorrhoeae en_US
dc.subject Trichomoniasis en_US
dc.subject Chlamydia Trachomatis en_US
dc.subject Multiple Cycle Treatment en_US
dc.subject Vaginitis en_US
dc.title Prevention of sexually transmitted infections in urban communities (Peru PREVEN): A multicomponent community-randomised controlled trial en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/S0140-6736(11)61846-1
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1474-547X


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