HIV-1 seroconversion rates among female commercial sex workers, Chiang Mai, Thailand: a multi cross-sectional study
Sawanpanyalert, P.; Ungchusak, K.; Thanprasertsuk, S.; Akarasewi, P.
Aids 8(6): 825-829
1994
ISSN/ISBN: 0269-9370 PMID: 8086142 Document Number: 285345
In Thailand, health workers interviewed and drew blood samples from 518 female prostitutes working out of 38 brothels in Chiang Mai in December, 1989. They revisited the brothels, which were all still operating, and surveyed 431 and 320 female commercial sex workers in March and July, 1990, respectively. Researchers aimed for this 3-round multi cross- sectional study to determine HIV seroconversion rates among female prostitutes. HIV seroprevalence rates were 35.7%, 37.8%, and 42.6% in December, 1989, and March and July, 1990, respectively. 48.5% and 52.5% of prostitutes available on the 2nd and 3rd rounds, respectively, were new recruits. Newly recruited workers had much lower HIV seroprevalence rates than those previously working in the brothels (between 1st and 2nd round, 25.4% vs. 49.5% and between 2nd and 3rd round, 37.7% vs. 48%; p .05). The estimated HIV seroconversion rates in the December-March interval was 5.2% and 3.6% for the March-July interval. Around 90% of the workers used contraception, particularly oral contraceptives. Most (60.2-64.4%) were no more than 20 years old and were of Thai origin. Most workers (71.6-77%) had a history of sexually transmitted diseases (STDs), especially gonorrhea (45.6-63.4%) and genital ulcers (45.3- 47.2%). Positive cervical and urethral cultures for gonococcus were high (11.2-12.3% and 8.8-11.4%, respectively). Most (85.8-91.8%) used condoms for last night sex services. The high HIV seroconversion rates and high STD rates, despite high condom use, coupled with a high turnover rate suggest the need for more aggressive education programs aiming for 100% condom use rate to control the transmission of HIV and other STDs among commercial sex workers in Thailand.