Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. Commentary
Identifieur interne : 000108 ( PascalFrancis/Corpus ); précédent : 000107; suivant : 000109Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. Commentary
Auteurs : Anne-Marie Cote ; Francois Schola ; Agnes Dzokoto ; Khonde Nzambi ; Comfort Asamoah-Adu ; Annie-Claude Labbe ; Benoit Masse ; Joyce Mensah ; Eric Frost ; Jacques Pepin ; Michel Alary ; Catherine M. LowndesSource :
- AIDS : (London) [ 0269-9370 ] ; 2004.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Objective: To delineate the population attributable fraction (PAF) of transactional sex in prevalent cases of HIV infection in the male adult population of Accra, Ghana. Design and methods: Cross-sectional study of clients who visited a sex worker (SW), of boyfriends of SW and of male personnel in prostitution venues. A questionnaire was administered and urine obtained for detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was calculated using a combination of data from this survey of clients, from on-going SW surveys, the national HIV surveillance system and the national census. Results HIV prevalence was 4.9% (8/162) among clients of mobile SW, 15.8% (53/ 335) among clients of home-based SW, 17.5% (10/57) among personnel and 32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses, according to clients. Non-use of a condom was clustered in selected locations and independently associated with older age of client, frequency of intercourse with SW in the last year and current urethritis. Among the male population of Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to transactional sex. A sensitivity analysis showed that under various assumptions PAF varied between 47% and 100%. Conclusions: In Accra, approximately four-fifths of prevalent cases of HIV in adult males were acquired from SW. Comprehensive interventions providing education, condoms and treatment for sexually transmitted diseases for SW and their clients should be approached as other public health priorities and provided in all cities, large and small, of West Africa.
Notice en format standard (ISO 2709)
Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 04-0562064 INIST |
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ET : | Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. Commentary |
AU : | COTE (Anne-Marie); SCHOLA (Francois); DZOKOTO (Agnes); NZAMBI (Khonde); ASAMOAH-ADU (Comfort); LABBE (Annie-Claude); MASSE (Benoit); MENSAH (Joyce); FROST (Eric); PEPIN (Jacques); ALARY (Michel); LOWNDES (Catherine M.) |
AF : | Centre for International Health, University of Sherbrooke/Canada (1 aut., 2 aut., 4 aut., 10 aut.); West Africa Project to Combat AIDS/Accra/Ghana (2 aut., 4 aut., 5 aut., 8 aut.); STD/AIDS Regional Co-ordination Unit for the Greater Accra Region, Ministry of Health/Accra/Ghana (3 aut., 5 aut., 8 aut.); Department of Microbiology, Hospital Maisonneuve-Rosemont/Montreal/Canada (6 aut.); Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center/Seattle, Washington/Etats-Unis (7 aut.); Department of Microbiology and Infectious Diseases, University of Sherbrooke/Canada (9 aut., 10 aut.); Population Health Research Unit, Centre Hospital affiliated with the Universities of Québec and Laval/Québec/Canada (11 aut.); Health Protection Agency, Communicable Disease Surveillance Centre/London/Royaume-Uni (12 aut.) |
DT : | Publication en série; Article; Commentaire; Niveau analytique |
SO : | AIDS : (London); ISSN 0269-9370; Etats-Unis; Da. 2004; Vol. 18; No. 6; 917-925,945-947 [12 p.]; Bibl. 26 ref. |
LA : | Anglais |
EA : | Objective: To delineate the population attributable fraction (PAF) of transactional sex in prevalent cases of HIV infection in the male adult population of Accra, Ghana. Design and methods: Cross-sectional study of clients who visited a sex worker (SW), of boyfriends of SW and of male personnel in prostitution venues. A questionnaire was administered and urine obtained for detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was calculated using a combination of data from this survey of clients, from on-going SW surveys, the national HIV surveillance system and the national census. Results HIV prevalence was 4.9% (8/162) among clients of mobile SW, 15.8% (53/ 335) among clients of home-based SW, 17.5% (10/57) among personnel and 32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses, according to clients. Non-use of a condom was clustered in selected locations and independently associated with older age of client, frequency of intercourse with SW in the last year and current urethritis. Among the male population of Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to transactional sex. A sensitivity analysis showed that under various assumptions PAF varied between 47% and 100%. Conclusions: In Accra, approximately four-fifths of prevalent cases of HIV in adult males were acquired from SW. Comprehensive interventions providing education, condoms and treatment for sexually transmitted diseases for SW and their clients should be approached as other public health priorities and provided in all cities, large and small, of West Africa. |
CC : | 002B05C02D; 002B05B02H |
FD : | SIDA; Urétrite; Maladie sexuellement transmissible; Sexe; Ghana; Prostitution; Virus immunodéficience humaine; Mâle; Adulte; Conception; Méthode; Etude transversale; Questionnaire; Urine; Anticorps; Enquête; Surveillance; Prévalence |
FG : | Virose; Infection; Afrique; Lentivirus; Retroviridae; Virus; Homme; Immunopathologie; Immunodéficit; Epidémiologie; Appareil génital mâle pathologie; Appareil urinaire pathologie; Voie urinaire pathologie; Urètre pathologie |
ED : | AIDS; Urethritis; Sexually transmitted disease; Sex; Ghana; Prostitution; Human immunodeficiency virus; Male; Adult; Design; Method; Cross sectional study; Questionnaire; Urine; Antibody; Survey; Surveillance; Prevalence |
EG : | Viral disease; Infection; Africa; Lentivirus; Retroviridae; Virus; Human; Immunopathology; Immune deficiency; Epidemiology; Male genital diseases; Urinary system disease; Urinary tract disease; Urethral disease |
SD : | SIDA; Uretritis; Enfermedad de transmisión sexual; Sexo; Ghana; Prostitución; Human immunodeficiency virus; Macho; Adulto; Diseño; Método; Estudio transversal; Cuestionario; Orina; Anticuerpo; Encuesta; Vigilancia; Prevalencia |
LO : | INIST-22094.354000111580610090 |
ID : | 04-0562064 |
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Pascal:04-0562064Le document en format XML
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<term>Ghana</term>
<term>Human immunodeficiency virus</term>
<term>Male</term>
<term>Method</term>
<term>Prevalence</term>
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<term>Maladie sexuellement transmissible</term>
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<term>Prostitution</term>
<term>Virus immunodéficience humaine</term>
<term>Mâle</term>
<term>Adulte</term>
<term>Conception</term>
<term>Méthode</term>
<term>Etude transversale</term>
<term>Questionnaire</term>
<term>Urine</term>
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<front><div type="abstract" xml:lang="en">Objective: To delineate the population attributable fraction (PAF) of transactional sex in prevalent cases of HIV infection in the male adult population of Accra, Ghana. Design and methods: Cross-sectional study of clients who visited a sex worker (SW), of boyfriends of SW and of male personnel in prostitution venues. A questionnaire was administered and urine obtained for detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was calculated using a combination of data from this survey of clients, from on-going SW surveys, the national HIV surveillance system and the national census. Results HIV prevalence was 4.9% (8/162) among clients of mobile SW, 15.8% (53/ 335) among clients of home-based SW, 17.5% (10/57) among personnel and 32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses, according to clients. Non-use of a condom was clustered in selected locations and independently associated with older age of client, frequency of intercourse with SW in the last year and current urethritis. Among the male population of Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to transactional sex. A sensitivity analysis showed that under various assumptions PAF varied between 47% and 100%. Conclusions: In Accra, approximately four-fifths of prevalent cases of HIV in adult males were acquired from SW. Comprehensive interventions providing education, condoms and treatment for sexually transmitted diseases for SW and their clients should be approached as other public health priorities and provided in all cities, large and small, of West Africa.</div>
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<fA06><s2>6</s2>
</fA06>
<fA08 i1="01" i2="1" l="ENG"><s1>Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. Commentary</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>COTE (Anne-Marie)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>SCHOLA (Francois)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>DZOKOTO (Agnes)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>NZAMBI (Khonde)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>ASAMOAH-ADU (Comfort)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>LABBE (Annie-Claude)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>MASSE (Benoit)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>MENSAH (Joyce)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>FROST (Eric)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>PEPIN (Jacques)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>ALARY (Michel)</s1>
<s9>comment.</s9>
</fA11>
<fA11 i1="12" i2="1"><s1>LOWNDES (Catherine M.)</s1>
<s9>comment.</s9>
</fA11>
<fA14 i1="01"><s1>Centre for International Health, University of Sherbrooke</s1>
<s3>CAN</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>West Africa Project to Combat AIDS</s1>
<s2>Accra</s2>
<s3>GHA</s3>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>STD/AIDS Regional Co-ordination Unit for the Greater Accra Region, Ministry of Health</s1>
<s2>Accra</s2>
<s3>GHA</s3>
<sZ>3 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department of Microbiology, Hospital Maisonneuve-Rosemont</s1>
<s2>Montreal</s2>
<s3>CAN</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center</s1>
<s2>Seattle, Washington</s2>
<s3>USA</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Department of Microbiology and Infectious Diseases, University of Sherbrooke</s1>
<s3>CAN</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Population Health Research Unit, Centre Hospital affiliated with the Universities of Québec and Laval</s1>
<s2>Québec</s2>
<s3>CAN</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Health Protection Agency, Communicable Disease Surveillance Centre</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA20><s2>917-925,945-947 [12 p.]</s2>
</fA20>
<fA21><s1>2004</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>22094</s2>
<s5>354000111580610090</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2004 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>26 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>04-0562064</s0>
</fA47>
<fA60><s1>P</s1>
<s3>AR</s3>
<s3>CT</s3>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>AIDS : (London)</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Objective: To delineate the population attributable fraction (PAF) of transactional sex in prevalent cases of HIV infection in the male adult population of Accra, Ghana. Design and methods: Cross-sectional study of clients who visited a sex worker (SW), of boyfriends of SW and of male personnel in prostitution venues. A questionnaire was administered and urine obtained for detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was calculated using a combination of data from this survey of clients, from on-going SW surveys, the national HIV surveillance system and the national census. Results HIV prevalence was 4.9% (8/162) among clients of mobile SW, 15.8% (53/ 335) among clients of home-based SW, 17.5% (10/57) among personnel and 32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses, according to clients. Non-use of a condom was clustered in selected locations and independently associated with older age of client, frequency of intercourse with SW in the last year and current urethritis. Among the male population of Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to transactional sex. A sensitivity analysis showed that under various assumptions PAF varied between 47% and 100%. Conclusions: In Accra, approximately four-fifths of prevalent cases of HIV in adult males were acquired from SW. Comprehensive interventions providing education, condoms and treatment for sexually transmitted diseases for SW and their clients should be approached as other public health priorities and provided in all cities, large and small, of West Africa.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B05C02D</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B05B02H</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>SIDA</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>AIDS</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>SIDA</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Urétrite</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Urethritis</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Uretritis</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Maladie sexuellement transmissible</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Sexually transmitted disease</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Enfermedad de transmisión sexual</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Sexe</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Sex</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Sexo</s0>
<s5>07</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Ghana</s0>
<s2>NG</s2>
<s5>08</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Ghana</s0>
<s2>NG</s2>
<s5>08</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Ghana</s0>
<s2>NG</s2>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Prostitution</s0>
<s5>09</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Prostitution</s0>
<s5>09</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Prostitución</s0>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Virus immunodéficience humaine</s0>
<s2>NW</s2>
<s5>10</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Human immunodeficiency virus</s0>
<s2>NW</s2>
<s5>10</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Human immunodeficiency virus</s0>
<s2>NW</s2>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Mâle</s0>
<s5>14</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Male</s0>
<s5>14</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Macho</s0>
<s5>14</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Adulte</s0>
<s5>15</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Adult</s0>
<s5>15</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Adulto</s0>
<s5>15</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Conception</s0>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Design</s0>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Diseño</s0>
<s5>17</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Méthode</s0>
<s5>18</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Method</s0>
<s5>18</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Método</s0>
<s5>18</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE"><s0>Etude transversale</s0>
<s5>19</s5>
</fC03>
<fC03 i1="12" i2="X" l="ENG"><s0>Cross sectional study</s0>
<s5>19</s5>
</fC03>
<fC03 i1="12" i2="X" l="SPA"><s0>Estudio transversal</s0>
<s5>19</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE"><s0>Questionnaire</s0>
<s5>20</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG"><s0>Questionnaire</s0>
<s5>20</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA"><s0>Cuestionario</s0>
<s5>20</s5>
</fC03>
<fC03 i1="14" i2="X" l="FRE"><s0>Urine</s0>
<s5>21</s5>
</fC03>
<fC03 i1="14" i2="X" l="ENG"><s0>Urine</s0>
<s5>21</s5>
</fC03>
<fC03 i1="14" i2="X" l="SPA"><s0>Orina</s0>
<s5>21</s5>
</fC03>
<fC03 i1="15" i2="X" l="FRE"><s0>Anticorps</s0>
<s5>22</s5>
</fC03>
<fC03 i1="15" i2="X" l="ENG"><s0>Antibody</s0>
<s5>22</s5>
</fC03>
<fC03 i1="15" i2="X" l="SPA"><s0>Anticuerpo</s0>
<s5>22</s5>
</fC03>
<fC03 i1="16" i2="X" l="FRE"><s0>Enquête</s0>
<s5>23</s5>
</fC03>
<fC03 i1="16" i2="X" l="ENG"><s0>Survey</s0>
<s5>23</s5>
</fC03>
<fC03 i1="16" i2="X" l="SPA"><s0>Encuesta</s0>
<s5>23</s5>
</fC03>
<fC03 i1="17" i2="X" l="FRE"><s0>Surveillance</s0>
<s5>24</s5>
</fC03>
<fC03 i1="17" i2="X" l="ENG"><s0>Surveillance</s0>
<s5>24</s5>
</fC03>
<fC03 i1="17" i2="X" l="SPA"><s0>Vigilancia</s0>
<s5>24</s5>
</fC03>
<fC03 i1="18" i2="X" l="FRE"><s0>Prévalence</s0>
<s5>35</s5>
</fC03>
<fC03 i1="18" i2="X" l="ENG"><s0>Prevalence</s0>
<s5>35</s5>
</fC03>
<fC03 i1="18" i2="X" l="SPA"><s0>Prevalencia</s0>
<s5>35</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Virose</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Viral disease</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Virosis</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Infection</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Infection</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Infección</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Afrique</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Africa</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Africa</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Homme</s0>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Human</s0>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Hombre</s0>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Immunopathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Immunopathology</s0>
<s5>37</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA"><s0>Inmunopatología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE"><s0>Immunodéficit</s0>
<s5>38</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG"><s0>Immune deficiency</s0>
<s5>38</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA"><s0>Inmunodeficiencia</s0>
<s5>38</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE"><s0>Epidémiologie</s0>
<s5>40</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG"><s0>Epidemiology</s0>
<s5>40</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA"><s0>Epidemiología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="11" i2="X" l="FRE"><s0>Appareil génital mâle pathologie</s0>
<s5>41</s5>
</fC07>
<fC07 i1="11" i2="X" l="ENG"><s0>Male genital diseases</s0>
<s5>41</s5>
</fC07>
<fC07 i1="11" i2="X" l="SPA"><s0>Aparato genital macho patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="12" i2="X" l="FRE"><s0>Appareil urinaire pathologie</s0>
<s5>42</s5>
</fC07>
<fC07 i1="12" i2="X" l="ENG"><s0>Urinary system disease</s0>
<s5>42</s5>
</fC07>
<fC07 i1="12" i2="X" l="SPA"><s0>Aparato urinario patología</s0>
<s5>42</s5>
</fC07>
<fC07 i1="13" i2="X" l="FRE"><s0>Voie urinaire pathologie</s0>
<s5>44</s5>
</fC07>
<fC07 i1="13" i2="X" l="ENG"><s0>Urinary tract disease</s0>
<s5>44</s5>
</fC07>
<fC07 i1="13" i2="X" l="SPA"><s0>Vía urinaria patología</s0>
<s5>44</s5>
</fC07>
<fC07 i1="14" i2="X" l="FRE"><s0>Urètre pathologie</s0>
<s5>45</s5>
</fC07>
<fC07 i1="14" i2="X" l="ENG"><s0>Urethral disease</s0>
<s5>45</s5>
</fC07>
<fC07 i1="14" i2="X" l="SPA"><s0>Uretra patología</s0>
<s5>45</s5>
</fC07>
<fN21><s1>320</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
<server><NO>PASCAL 04-0562064 INIST</NO>
<ET>Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. Commentary</ET>
<AU>COTE (Anne-Marie); SCHOLA (Francois); DZOKOTO (Agnes); NZAMBI (Khonde); ASAMOAH-ADU (Comfort); LABBE (Annie-Claude); MASSE (Benoit); MENSAH (Joyce); FROST (Eric); PEPIN (Jacques); ALARY (Michel); LOWNDES (Catherine M.)</AU>
<AF>Centre for International Health, University of Sherbrooke/Canada (1 aut., 2 aut., 4 aut., 10 aut.); West Africa Project to Combat AIDS/Accra/Ghana (2 aut., 4 aut., 5 aut., 8 aut.); STD/AIDS Regional Co-ordination Unit for the Greater Accra Region, Ministry of Health/Accra/Ghana (3 aut., 5 aut., 8 aut.); Department of Microbiology, Hospital Maisonneuve-Rosemont/Montreal/Canada (6 aut.); Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center/Seattle, Washington/Etats-Unis (7 aut.); Department of Microbiology and Infectious Diseases, University of Sherbrooke/Canada (9 aut., 10 aut.); Population Health Research Unit, Centre Hospital affiliated with the Universities of Québec and Laval/Québec/Canada (11 aut.); Health Protection Agency, Communicable Disease Surveillance Centre/London/Royaume-Uni (12 aut.)</AF>
<DT>Publication en série; Article; Commentaire; Niveau analytique</DT>
<SO>AIDS : (London); ISSN 0269-9370; Etats-Unis; Da. 2004; Vol. 18; No. 6; 917-925,945-947 [12 p.]; Bibl. 26 ref.</SO>
<LA>Anglais</LA>
<EA>Objective: To delineate the population attributable fraction (PAF) of transactional sex in prevalent cases of HIV infection in the male adult population of Accra, Ghana. Design and methods: Cross-sectional study of clients who visited a sex worker (SW), of boyfriends of SW and of male personnel in prostitution venues. A questionnaire was administered and urine obtained for detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was calculated using a combination of data from this survey of clients, from on-going SW surveys, the national HIV surveillance system and the national census. Results HIV prevalence was 4.9% (8/162) among clients of mobile SW, 15.8% (53/ 335) among clients of home-based SW, 17.5% (10/57) among personnel and 32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses, according to clients. Non-use of a condom was clustered in selected locations and independently associated with older age of client, frequency of intercourse with SW in the last year and current urethritis. Among the male population of Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to transactional sex. A sensitivity analysis showed that under various assumptions PAF varied between 47% and 100%. Conclusions: In Accra, approximately four-fifths of prevalent cases of HIV in adult males were acquired from SW. Comprehensive interventions providing education, condoms and treatment for sexually transmitted diseases for SW and their clients should be approached as other public health priorities and provided in all cities, large and small, of West Africa.</EA>
<CC>002B05C02D; 002B05B02H</CC>
<FD>SIDA; Urétrite; Maladie sexuellement transmissible; Sexe; Ghana; Prostitution; Virus immunodéficience humaine; Mâle; Adulte; Conception; Méthode; Etude transversale; Questionnaire; Urine; Anticorps; Enquête; Surveillance; Prévalence</FD>
<FG>Virose; Infection; Afrique; Lentivirus; Retroviridae; Virus; Homme; Immunopathologie; Immunodéficit; Epidémiologie; Appareil génital mâle pathologie; Appareil urinaire pathologie; Voie urinaire pathologie; Urètre pathologie</FG>
<ED>AIDS; Urethritis; Sexually transmitted disease; Sex; Ghana; Prostitution; Human immunodeficiency virus; Male; Adult; Design; Method; Cross sectional study; Questionnaire; Urine; Antibody; Survey; Surveillance; Prevalence</ED>
<EG>Viral disease; Infection; Africa; Lentivirus; Retroviridae; Virus; Human; Immunopathology; Immune deficiency; Epidemiology; Male genital diseases; Urinary system disease; Urinary tract disease; Urethral disease</EG>
<SD>SIDA; Uretritis; Enfermedad de transmisión sexual; Sexo; Ghana; Prostitución; Human immunodeficiency virus; Macho; Adulto; Diseño; Método; Estudio transversal; Cuestionario; Orina; Anticuerpo; Encuesta; Vigilancia; Prevalencia</SD>
<LO>INIST-22094.354000111580610090</LO>
<ID>04-0562064</ID>
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