Recruitment of Caribbean female commercial sex workers at high risk of HIV infection/Captacion de mujeres profesionales del sexo con alto riesgo de infeccion por VIH en el Caribe

Objective. To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. Methods. A prospective cohort study was conducted in 2009-2012 among 799 female commercial sex workers in the Dominican Republic, Haiti, and Puerto Rico. Minimum eligibility criteria included exchange of sex for goods, services, or money in the previous 6 months and unprotected vaginal or anal sex with a man during the same period. Sites used local epidemiology to develop more stringent eligibility criteria and recruitment strategies. Participants were asked questions about HIV/AIDS and their level of concern about participating in an HIV vaccine trial. Logistic regression modeling was used to assess predictors of prevalent HIV infection and willingness to participate in a future HIV vaccine study. Results. HIV prevalence at screening was 4.6%. Crack cocaine use [odds ratio (OR) = 4.2, 95% confidence interval (CI) (1.8-9.0)] was associated with and having sex with clients in a hotel or motel [OR = 0.5, CI (0.3-1.0)] was inversely associated with HIV infection. A total of 88.9% of enrolled women were definitely or probably willing to participate in a future HIV vaccine trial. Conclusions. This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial. Key words HIV infections; acquired immunodeficiency syndrome; AIDS vaccines; sex workers; Caribbean region; Dominican Republic, Haiti, Puerto Rico. Objetivo. Evaluar nuevos criterios de seleccion y metodos extrainstitucionales encaminados a detectar y captar a las mujeres con alto riesgo de contraer la infeccion por virus de la inmunodeficiencia humana (VIH) en el Caribe. Metodos. Del 2009 al 2012, se llevo a cabo un estudio prospectivo de cohortes de 799 mujeres profesionales del sexo en la Republica Dominicana, Haiti y Puerto Rico. Los requisitos minimos de seleccion fueron el intercambio de relaciones sexuales por bienes, servicios o dinero en los ultimos 6 meses y las relaciones sexuales vaginales o anales sin proteccion con un hombre durante el mismo periodo. En cada centro se aplicaron criterios de seleccion y estrategias de captacion mas restrictivos, en funcion de las caracteristicas epidemiologicas locales. Se formularon a las participantes preguntas acerca de la infecci