Sheri A. Lippman|Magda Chinaglia|Angela Donini|Juan D??az|Arthur Reingold|Deanna Kerrigan
Findings From Encontros
San Francisco AIDS Foundation|University of California, San Francisco|University of California, Berkeley|Ministry of Health|University of California, Berkeley|Johns Hopkins University
brief background sexually transmitted infection stihiv prevention programs modify social structural contexts contribute risk stihiv may fail bring improvements health particularly among groups experience discrimination exclusion public life conducted multilevel intervention sex workers including improved clinical care communitymobilizing strategies modify social structural factors shape sexual behavior improve condom use reduce incident sti methods followed 420 sex workers participating encontros intervention corumb brazil 2003 2005 estimated effect intervention incident chlamydia gonorrhea infections condom use using generalized estimating equations inverse probability weighting comparing actively engaged intervention activities exposed less engaged unexposed also determined association participation reported social cohesion participation networks results exposed participants significantly higher odds reporting consistent condom use regular clients odds ratio 19 95 confidence interval1133 nonsignificantly increased odds new clients 16 0928 nonpaying partners 15 0915 odds incident sti nonsignificantly reduced exposed participants compared unexposed 046 0213 participation significantly associated increased perceived cohesion participation networks conclusion prospective study provides evidence multilevel interventions mobilizing strategies modify aspects social environment improve condom use reduce stis increase social cohesion participation networks among sex workers multilevel intervention brazilian sex workers demonstrated significant improvements condom use regular clients trends toward improved condom use partners reductions sexually transmitted infections