Publications

Background: In sub-Saharan Africa, cervical cancer is the leading cancer among women. The causative role of different human papillomavirus (HPV) types in cervical cancer is established, but the distribution of HPV types within this region is largely unknown. Goal: The goal was to study the distribution of HPV among family planning clinic attendees in Nairobi, Kenya. Study Design: This was a cross-sectional study of persons attending a family planning center in Nairobi, Kenya.

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BACKGROUND: Data from sentinel serosurveillance are useful to estimate HIV infection in populations but may not be representative of the general population. General population-based surveys attempt to avoid selection bias and are the most appropriate for tracking changes in exposure to risk of HIV infection over time and assessing changes in behavior following prevention campaigns.

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In sub-Saharan Africa, female sex workers (FSWs) are a vulnerable high risk group for the acquisition and transmission of sexually transmitted infections (STI) and HIV. Objectives: To study parameters of sexual behaviour and knowledge of STI and HIV, to describe health seeking

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BACKGROUND: In sub-Saharan Africa, female sex workers (FSWs) are a vulnerable high risk group for the acquisition and transmission of sexually transmitted infections (STI) and HIV. OBJECTIVES: To study parameters of sexual behaviour and knowledge of STI and HIV, to describe health seeking behaviour related to STI, and to measure the prevalence of gonorrhoea, chlamydia, syphilis, and HIV-1, to provide baseline data for targeted STI and HIV prevention interventions.

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There is an urgent need in sub-Saharan Africa to develop more effective methods of HIV prevention, including improved strategies of sexually transmitted infection (STI) prevention or an HIV vaccine. The efficacy of these strategies may be tested through clinical trials within cohorts at high risk for STI and HIV, such as female commercial sex workers. For ethical reasons, standard HIV prevention services, including access to free condoms, risk-reduction counseling, and STI therapy, will generally be offered to all study subjects.

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There is an urgent need in sub-Saharan Africa to develop more effective methods of HIV prevention, including improved strategies of sexually transmitted infection (STI) prevention or an HIV vaccine. The efficacy of these strategies may be tested through clinical trials within cohorts at high risk for STI and HIV, such as female commercial sex workers. For ethical reasons, standard HIV prevention services, including access to free condoms, risk-reduction counseling, and STI therapy, will generally be offered to all study subjects.

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After discussing advantages and risks, only a third of the 290 HIV-infected women included in an intervention study to reduce mother-to-child transmission of HIV in Mombasa, Kenya, informed their partners of their results. Despite careful counselling, 10% subsequently experienced violence or disruption of their relationship. To increase the uptake of interventions to reduce perinatal HIV transmission safely, we recommend the involvement of partners in HIV testing. In addition, the counselling of women has to address methods and skills to deal with violence

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BACKGROUND: Health-seeking and sexual behaviors are important elements in the control of sexually transmitted infections (STIs). GOAL: To examine patterns of health-seeking behavior and related sexual behavior relevant to improved prevention and care among patients attending primary healthcare (PHC) clinics. STUDY DESIGN: A questionnaire covering social, demographic, and healthcare-seeking and sexual behavior information was administered to 555 patients attending three primary healthcare clinics in low socioeconomic areas of Nairobi, Kenya.

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OBJECTIVES: To determine the effect of the HIV epidemic on invasive cervical cancer in Kenya. METHODS: Of the 3902 women who were diagnosed with reproductive tract malignancies at Kenyatta National Hospital (KNH) from 1989 to 1998, 85% had invasive cervical cancer. Age at presentation and severity of cervical cancer were studied for a 9-year period when national HIV prevalence went from 5% to 5-10%, to 10-15%. RESULTS: There was no significant change in either age at presentation or severity of cervical cancer. Of the 118 (5%) women who were tested for HIV, 36 (31%) were seropositive.

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Dr. Karoline Fonck defended her PhD thesis in 2002, entitled: STI prevention and control, Sexually transmitted infections in Nairobi, Kenya: clinical, epidemiological and public health aspects.

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