There are a number of limitations in this study: firstly, our sample is by no means representative of all sex workers in Hong Kong but rather restricted to those who are willing to engage with an NGO. Since its establishment in 1996, Ziteng has developed very good relationships with the FSW, gaining

their trust over the years. In addition, as this group has become more health conscious through their engagement with the outreach service, the actual STI infection rates in other sex worker populations Autophagy activity could possibly be higher than we have found in our sample. We did not actively pursue the eight non-responders as it was thought that reliable information would be difficult to obtain from them in such a setting. Ziteng approached their clients from their old records, those they met on the street, and through the snowball method. Due to the sensitive nature of their work, this method of sample collection is common, as seen in several recently published articles.22,23 Certain

STI (including HIV) were common in our targeted population and many FSW might not be aware of the symptoms and hence often went untreated. Our results indicate that it is important, in the interests of public health, to consider including important STI into a continuous serial surveillance program among FSW in the community, ie, to continue the current study on a long-term basis, rather than relying on the sentinel surveillance undertaken check details at SHC. Since much evidence suggests an association between various risk factors and adverse reproductive health outcomes and the high prevalence of STI/HIV, medical professionals and public health specialists should address such issues through education and prevention activities beyond the traditional models of consistent condom use and STI/HIV risk awareness. When it comes to protective behaviors such as use of condoms, education alone is unlikely to be sufficient as people often find it difficult to translate knowledge into action.24,25 Other contextual factors such as socio-economic status may have

important roles to play.26,27 We thank the Research Fund for the Control of Infectious Disease of the Health, Welfare and Food Metformin manufacturer Bureau, Hong Kong SAR Government for funding this project. We are indebted to Liu Yan for running the outreach clinic and for her input on data entry and analyses. Finally, we extend our sincerest gratitude to all the sex workers involved in this project and hope this piece of work will generate a small step towards understanding some of the problems they have to go through. The authors state they have no conflicts of interest to declare. “
“Shigella bacteremias are uncommon in immune-competent adults. We report two cases of Shigella flexneri bacteremia that occurred in healthy young travelers, who recovered.