Impact of Testing on Sexually Transmitted Infections among Female Brothel Sex Workers in Bangladesh: A Randomized Controlled Trial.

Past studies that have designed interventions to reduce the prevalence of sexually transmitted infections (STIs) have typically provided onsite treatment to sex workers who tested positive, which were expensive and difficult to implement. The purpose of this study was to examine the effect of an intervention which tested for STIs and provided information on the closest treatment facility on reducing the prevalence of STIs among female brothel-based sex workers (BSWs) in Bangladesh. The study adopted a pre-post interventional design as well as a randomized controlled study design. A baseline sample and follow-up urine sample were collected to evaluate the prevalence of STIs among participants in the treatment, but not control group. A baseline survey and interviews were also conducted for both the groups. The study found a nonsignificant reduction from baseline to follow-up in STI prevalence among intervention participants (adjusted odds ratio [aOR]: 0.74; 95% CI: 0.38, 1.45). However, the participants in the intervention group were significantly more likely to have a repeat client (aOR: 1.60; 95% CI: 1.12, 2.29) and nonsignificantly less likely to engage with a client suspected of having an STI (aOR: 0.62; 95% CI: 0.39, 1.00) than participants in the control group. The intervention testing of STIs and providing information to the positive cases about nearest treatment facilities were not effective in reducing the prevalence of STIs among BSWs. Further study of the clinical and behavioral impacts of such efforts to reduce STIs among BSWs is warranted.

Survey measures versus incentivized measures of risk preferences: Evidence from sex workers' risky sexual transactions.

Survey measures of risk attitudes are primarily used in the health literature, although incentivized measures of risk preferences are being increasingly used in other fields. We exploit the unique setting of commercial female sex workers in Bangladesh to investigate whether incentivized measures of risk preferences, or non-incentivized survey measures of risk preferences, best identify the risky commercial sex decisions that they make. The study uses survey data collected during February-April 2016, and October-November 2016 from eight brothels in Bangladesh. Wave 1 includes 1,332 female sex workers, Wave 2 includes 1,185 female sex workers. Our findings suggest that researchers can reliably use survey measures to elicit risk preferences on health.