13th International AIDS Conference Durban, South Africa - July 9-July 14, 2000

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC660)

Ettiegne Traore V, Ghys PD, Diallo MO, Vuylsteke B, Anoma C, Hoyi Y, Kadjo JC, Van Damme L, Sanogo A, Roels TH, Laga M
V. Ettiegne Traore, Projet Retro - CI, 01 BP 1712, Abidjan 01, Cote D'ivoire, Tel.: +225 212 541 11, Fax: +225 212 429 69, E-mail: vae4@cdc.gov

INTRODUCTION: Safe and effective female controlled methods of protection against HIV are needed. Abidjan is one of the trial sites of an UNAIDS-sponsored randomized double-blind study investigating the potential effectiveness of a vaginal microbicide gel that contains nonoxynol-9.

OBJECTIVES: To assess socio-demographic and behavioral determinants for participating in the microbicide trial, and to describe the safe sex practices of participants during the trial.

METHODS: From June 1998 to May 1999, FSWs attending a confidential clinic for the first time were interviewed and screened for STD/HIV. One to 3 weeks later, they were invited to participate in the intervention trial. At each monthly follow-up visit, participants were asked about condom and gel use and received preventive messages, advice, condoms and gel supplies.

RESULTS: On 429 FSWs presenting for the first time to the clinic, 16% were enrolled. Participants were older and had a higher schooling level than those not participating. Participation was not associated with duration of sex work, condom use or HIV status. From the first to tenth follow-up visit (total 769 visits), consistent use of condoms with clients during the last working day increased from 82% to 97%, use of the gel increased from 71% to 90% and use of both methods increased from 64.5% to 85% (all p > 0.001). These trends were independent of loss-to-follow up. With the regular partner of FSWs, consistent condom use was reported only by 25% of the women, compared to 41% who reported consisted gel use (p > 0.001), and no trend was observed during follow-up visits. HIV infected women were more likely to use condoms with their regular partners then were HIV-women (45% vs. 24%, p = 0.04).

CONCLUSION: Condom use with clients was high among FSWs in Abidjan, and can be sustained and even increased with continuous prevention messages and counseling. However, safe sex behavior with regular partners remains low. A microbicide gel, if it is proven effective, is an acceptable alternative in this setting.

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