Background and objectives . Within an ongoing HIV/STD prevention project (condom promotion and syndromic management of STDs) aimed at female sex workers (FSW) in Cotonou, Benin, we evaluated time trends in HIV and STD prevalences from 1993 to 1999. We also evaluated the practical utility of the syndromic diagnosis for cervicitis with Neisseria gonorrhoeae or Chlamydia trachomatis in comparison with a strategy based on laboratory tests in FSW and the diagnostic performance of the Roche Amplicor CT/NG PCR test for the detection of N. gonorrhoeae infection in female urine.
Methods . Three cross-sectional surveys were conducted among FSW from Cotonou in 1993 (n = 365), 1995-96 (n = 374), and 1998-99 (n = 591). The subjects were screened for HIV/STDs. In 1998-99, the validity of the syndromic diagnosis for cervicitis was compared with that of laboratory tests in Cotonou (culture for N. gonorrhoeae and Elisa for C. trachomatis ) using a standard including PCR results on endocervical specimens. The women were asked to return within 10 days for their laboratory results and to receive an appropriate treatment when necessary. In the 1998-99 survey, 342 women also provided a urine sample for detection of N. gonorrhoeae infection using the Amplicor PCR.