The complex vaginal flora of West African women with bacterial vaginosis.

Background: The spectrum of bacteria associated with bacterial vaginosis (BV) has recently expanded through taxonomic changes and the use of molecular methods. These methods have yet to be used in large-scale epidemiological studies in Africa where BV is highly prevalent.

Methods: An analysis of samples obtained during a clinical trial of the management of vaginal discharge in four West African countries.

A tale of two countries: HIV among core groups in Togo.

Objective: To describe the epidemiology of HIV among core groups in Togo.

Methods: We enumerated sex workers (SWs) and conducted cross-sectional surveys of SWs and their clients in 2003 in Lomé and in 2005 in the whole country.

Results: Sex work was concentrated in Lomé, which comprised 15% of the population, but 52% of the 5397 SWs enumerated in Togo in 2005 and 68% of the estimated 101,376 men who had bought sex in the year before the 2005 survey.

Satisfaction with health services for STIs, HIV, AIDS among a high-risk population in West Africa.

The goal of this study was to develop an instrument and assess the degree of satisfaction regarding HIV/STIs services for women working in, associated with, or living in or nearby, prostitution environments. This study took place in seven West-African countries (Benin, Burkina Faso, Ghana, Mali, Niger, Senegal, Togo) participating in the West Africa Aids Program (AIDS3). A validated six-dimension questionnaire was used to interview 698 women.

The syndromic management of vaginal discharge using single-dose treatments: a randomized controlled trial in West Africa.

Objective: To evaluate whether single-dose treatments are as effective as standard therapy in the syndromic management of vaginal discharge.

Methods: A randomized controlled effectiveness trial compared single-dose tinidazole plus fluconazole (TF) with treatment for 7 days with metronidazole plus 3 days of treatment with vaginal clotrimazole (MC) among 1570 women presenting with vaginal discharge at primary health care institutions in Ghana, Guinea, Mali and Togo. Participants were randomly allocated to one of the two treatments by research nurses or physicians using precoded envelopes.

Improving second-generation surveillance: the biological measure of unprotected intercourse using prostate-specific antigen in vaginal secretions of West African women.

Background: Second-generation surveillance for HIV includes measures of high-risk behaviors among the general adult population and sex workers (SW). Questionnaires are prone to social desirability biases because individuals minimize the frequency of behaviors not expected from them.

Objective: Determine whether the prostate-specific antigen (PSA) could be used as a biological marker of unprotected intercourse.