Concurrent sexual and substance-use risk behaviours among female sex workers in Kenya's Coast Province: findings from a behavioural monitoring survey.

While many studies confirm the association between HIV, alcohol and injecting drug use by female sex workers (FSWs), little is known about their use of marijuana, khat and other substances and the association of these substances with HIV, risky sexual behaviour, and sexual violence. To better understand this association, data were analysed from a cross-sectional, behavioural survey of 297 FSWs in Mombasa, a well-known tourist destination and the second largest port in Africa and capital city of the Coast Province in Kenya. Among the FSWs, lifetime use of different substances was reported by 91% for alcohol, 71% for khat, 34% for marijuana, and 6% for heroin, cocaine, glue or petrol. The majority (79%) used more than one substance, and multiple-substance use was reported by all respondents who ever used marijuana, heroin, cocaine, glue and petrol. The risk of HIV acquisition was perceived as medium to high by 41% of respondents, 75% of whom attributed this risk to multiple partners. Sexual violence was reported by 48% of respondents, and 30% indicated that this happened several times. Despite HIV prevention programmes targeting FSWs in Mombasa, most of them continue to engage in risky sexual behaviours. This suggests that harm reduction strategies for substance use should be coupled with efforts to promote consistent condom use and partner reduction.

An evaluation of the "Entre Nous Jeunes" peer-educator program for adolescents in Cameroon.

A quasi-experimental design is used in this study to evaluate the "Entre Nous Jeunes" peer-educator program to promote STI/HIV-preventive behaviors in Nkongsamba, Cameroon. The main objective of the study is to assess whether the young people exposed to a peer educator gained greater knowledge and practiced more protective behaviors than did those in the control community and those who were not exposed. During the 18-month intervention period, the peer educators were able to reach a large number of young people, specifically those who were sexually experienced and in need of reproductive health information. Multivariate analyses indicate that contact with a peer educator is statistically significantly associated with greater spontaneous knowledge of modern contraception, the symptoms of sexually transmitted infections, and greater use of modern contraceptives, including the condom. In the absence of a peer-education program, current contraceptive use in the intervention community would have been significantly lower.