The Effectiveness and Costs of Two Methods for the Systematic Prevention and Control of STIs, among Female Sex Workers in Dhaka, Bangladesh

Bangladesh is threatened by an HIV epidemic. It is important to identify the best way to achieve rapid reductions in sexually transmitted infections (STI) as an effective approach to HIV prevention. Periodic presumptive treatment (PPT) is suggested as a method for STI control; however, it is considered a short-term solution as the epidemiological justification of this approach is weaker as the STI prevalence declines. Enhanced syndromic management (ESM) is an alternative approach that aims to reduce STI prevalence rapidly, through a single round of presumptive treatment of cervicitis, plus, subsequent monthly clinical care through an ESM protocol based on a risk assessment and laboratory tests.