Introduction

In recognition of the public health significance of sexually transmitted diseases (STD), governments and health organizations around the world have begun to step up their efforts to prevent and control the spread of these infections. In epidemiologic terms, the aim of such STD control programs is to reduce the incidence (the number of new infections over x time period) of STDs in the susceptible population. This is accomplished by significantly reducing the number of new infections produced in the population by persons who are already infected, specifically by reducing either one or all of the following: (1) the rate of sexual partner change, (2) the probability of infection with each sexual contact, and (3) the duration of infectivity. Following this logic, targeting "core groups" of individuals who have above average rates of sexual partner change and STD infection(including commercial sex workers (SW) and their clients(is central to overall STD prevention and control efforts in a given population.

The research plan presented in this manual represents an important initial step in designing or improving interventions that will have an impact on STD rates in these core high risk behavior groups. It is essentially intended to help program planners better understand and, in turn, programmatically respond to prevalent STD related illness perceptions and treatment behaviors among sex workers and their clients.