@article{fdi:010093340,
  title = {{S}yndromic and biological screening for sexually transmitted infections in female sex workers in {C}{\^o}te d'{I}voire : the {ANRS} 12381 {PRINCESSE} cohort study},
  author = {{N}ouaman, {M}. {N}. and {C}offie, {P}. {A}. and {A}goua, {A}. {A}. and {Z}ebago, {C}. and {D}ao, {H}. {Z}. and {K}issi, {E}. and {L}enaud, {S}. and {A}natole, {M}. and {B}ecquet, {V}alentine and {P}lazy, {M}. and {D}abis, {F}. and {E}holie, {S}. and {L}armarange, {J}oseph and {ANRS} 12381 {P}rincesse {S}tudy {G}roup,},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {F}emale sex workers ({FSW}s) are at high risk of contracting {STI}s, in particular in {S}ub-{S}aharan {A}frica. {T}he implementation of oral {HIV} pre-exposure prophylaxis provided an opportunity to draw attention to the sexual health needs of {FSW}s. {I}nnovative strategies to screen for and reduce the burden of {STI}s is thus a priority. {T}his study describes {STI} screening among {FSW}s enrolled in the {PRINCESSE} project in {C}{\^o}te d'{I}voire.{M}ethods {T}he {PRINCESSE} project (2019-2023) was an interventional cohort of {FSW}s >= 18 years, evaluating a comprehensive, community-based sexual and reproductive health care package, including the management of {STI}s, offered through mobile clinics operating on prostitution sites in {S}an {P}edro area. {HIV} testing and syndromic {STI} testing were offered at baseline and every 3 months. {B}iological testing of {C}hlamydia trachomatis ({CT}) and {N}eisseria gonorrhoeae ({NG}) was offered annually. {C}linical forms included sociodemographic, behavioral and sex-work-related characteristics. {W}e describe baseline characteristics, coverage of clinical examination, and vaginal, anal swab collection. {S}ocial, behavioral and sex work-related factors associated with an {STI} syndromic diagnosis were explored. {A} multivariable logistic regression model was used to identify factors associated with diagnosing a symptomatic {STI}.{R}esults 489 {FSW}s were included in the {PRINCESSE} cohort. {M}edian age was 29 years (24-35 years), 28.6% had had sex without a condom in the last 7 days. {T}he prevalence of {HIV} at baseline was 10.5%. {O}nly one case of {HIV} seroconversion was observed during the project. {T}he most frequent symptom was ano-vaginal discharge (19.1%). {T}he prevalence of {STI} based on clinical symptoms was 26.6%. {T}he proportion of vaginal swab samples for which the {PCR} result was positive was 8.0% for {CT} and 4.0% for {NG}. {O}nly age remained significantly associated with diagnosing a symptomatic {STI} in the multivariable analysis.{C}onclusion {T}his study revealed a high prevalence of {HIV} and {STI}s, similar to national estimates among {FSW}s enrolled in a sexual health cohort. {S}creening for these generically asymptomatic bacterial {STI}s must be combined with the syndromic approach used in key populations, especially with the introduction of new {P}r{EP} programs, to reduce the exposure of individuals in these populations to {STI}s.},
  keywords = {sexually transmitted infections ; female sex workers ; key population ; syndromic {STI} ; biological {STI}s screening ; {S}ub-{S}aharan {A}frica ; {COTE} {D}'{IVOIRE} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{F}rontiers in {P}ublic {H}ealth},
  volume = {13},
  numero = {},
  pages = {1535122 [11 p.]},
  year = {2025},
  DOI = {10.3389/fpubh.2025.1535122},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093340},
}