Article type
Year
Abstract
Background: The purpose of this study was to compare sexually transmitted disease (STD) prevalence in cohorts of women with and without access to female condoms.
Methods: Six matched pairs of communities were identified from tea, coffee and flower plantations. One community within each pair was randomly selected to receive the female condom intervention. Approximately 160 eligible women were enrolled at each site. The six female condom communities received an intensive educational intervention, along with female and male condoms available to all residents. Control communities received male condoms and a similar educational program on male condoms. Clinicians were trained in STD syndromic management, and a steady drug supply was assured. At baseline, women were tested for gonorrhea and chlamydia using ligase chain reaction with urine, and vaginal trichomoniasis using InPouchTM culture, to be repeated at 6 and 12 months.
Results: Participants at intervention and control sites (N=1929) were similar. Mean age was 33 years, 78% had never used MC, 19% reported a history of STD, and 9% reported >1 sexual partner in the three months before the study. Baseline prevalences of gonorrhea, chlamydia and trichomoniasis were 2.6%, 3.2% and 20.4% respectively (23.9% overall), and were similar at intervention and control sites. At the 3 sites with follow-up data, the overall STD prevalence decreased from 24.6% at baseline to 17.1% at 6 months and 18.4%. There was no difference in STD reduction between the intervention and control sites. Reported male condom use increased substantially, and male condom distribution was higher at some control sites, suggesting that female condom use may have substituted for male condom use at intervention sites. Female condoms were used half the time or more by 31% and 28% of women at first follow-up and second follow-up respectively. Among women who had used both, more preferred the female than the male condoms.
Conclusions: Condom use increased, and STD prevalence fell. From these results we can conclude that the female condom does not seem to offer additional protection against STDs for these rural community based women.
Methods: Six matched pairs of communities were identified from tea, coffee and flower plantations. One community within each pair was randomly selected to receive the female condom intervention. Approximately 160 eligible women were enrolled at each site. The six female condom communities received an intensive educational intervention, along with female and male condoms available to all residents. Control communities received male condoms and a similar educational program on male condoms. Clinicians were trained in STD syndromic management, and a steady drug supply was assured. At baseline, women were tested for gonorrhea and chlamydia using ligase chain reaction with urine, and vaginal trichomoniasis using InPouchTM culture, to be repeated at 6 and 12 months.
Results: Participants at intervention and control sites (N=1929) were similar. Mean age was 33 years, 78% had never used MC, 19% reported a history of STD, and 9% reported >1 sexual partner in the three months before the study. Baseline prevalences of gonorrhea, chlamydia and trichomoniasis were 2.6%, 3.2% and 20.4% respectively (23.9% overall), and were similar at intervention and control sites. At the 3 sites with follow-up data, the overall STD prevalence decreased from 24.6% at baseline to 17.1% at 6 months and 18.4%. There was no difference in STD reduction between the intervention and control sites. Reported male condom use increased substantially, and male condom distribution was higher at some control sites, suggesting that female condom use may have substituted for male condom use at intervention sites. Female condoms were used half the time or more by 31% and 28% of women at first follow-up and second follow-up respectively. Among women who had used both, more preferred the female than the male condoms.
Conclusions: Condom use increased, and STD prevalence fell. From these results we can conclude that the female condom does not seem to offer additional protection against STDs for these rural community based women.