The Principal Investigator notes that many developing countries, especially in Latin America, rely on pharmacies for diagnosis and treatment of many illnesses, including STDs, and that improving pharmacists skills and delivery of STD and HIV prevention services could contribute to the prevention and control of the STDs and AIDS epidemic. Pharmacies far enough apart geographically to limit possible contamination will be selected and assigned at random to control or intervention conditions. Control pharmacists will be provided continuing education directed to control of diarrheal disease. Intervention pharmacists and an assistant will be trained to recognize probable STDs and AIDS risks, provide recommendations to see a physician, provide a packet of educational materials and condoms with advice to use condoms, and to provide the recommended medications for selected STDs. Mock sales persons will visit the businesses five times. The first will be during the three months of seminar training; additional visits will be one week after training, and at Months 3 and 6 follow-up. [Note, this is only four visits and does not make clear that a true baseline visit will be conducted.] At these visits the salesperson will collect a self-monitoring log of STD patients seen and services provided. Measures will include the proportion of pharmacists who attend seminars, student feedback regarding quality of training, proportion of visits by sales persons that are completed, and by the number of prevention packets dispensed per month. In addition, a standardized simulated patient will visit the intervention pharmacies at 1, 3, 6, and 12 months post training. These confederates will record the diagnosis, treatment offered, other recommendations including counseling, contact referral, compliance with treatment, and condom use. Confederates are to be blind to experimental conditions. Analyses will emphasize differences in proportions or two-sample t-tests.
