XI International Conference on AIDS|
July 7-12, 1996
Gangakhedkar R.R., Mehendale, S.M.,
Bentley, M., Rompalo, A.M., Shepherd, M.E.,
STD and HIV infection Among Female Non-Commercial Sex Workers (Non-CSWs) Attending STD Clinics in Pune, India
ObjectiveHigh HIV incidence has been previously reported among female commercial sex workers (CSWs) and male STD patients in Pune. Since an increasing HIV prevalence has also been reported in low-risk populations, we compared the prevalence of and risk factors for HIV and STDs in women who identified themselves as CSWs, and in women who did not report commercial sex work (non-CSWs) attending two STD clinics in Pune, India.
MethodsWomen attending STD clinics were prospectively enrolled for assessment of STDs and HIV. A questionnaire including demographic and behavioral information was collected, and a clinical exam was performed.
ResultsOf the 711 women enrolled over two years, 409 were CSWs and 302 were non-CSWs. 93% of non-CSWs were married compared to 36% of CSWs (p <0.01). The median ages were 22 and 25 in non-CSWs and CSWs, respectively (p <0.001). While 82% of CSWs reported recent condom use, only 6% of non-CSWs report using condoms in the past three months (p <0.001). Only 25% of non-CSWs reported ever hearing of AIDS. Non-CSWs reported significantly fewer partners in the last three months (median one partner vs. 180) in CSWs (p <0.001). However, the proportion of women having > or equal to one STD was similar in both groups. 21% of CSWs had GUDs compared to 44% in non-CSWs (p <0.001). HIV prevalence among CSWs and non-CSWs was 47% and 14%, respectively. HIV incidence was 24/100 PY in CSWs and 3.3/100 PY in non-CSWs (p <0.002). History of sexual contact to a partner with an STD was significantly associated with HIV in non-CSWs (p <0.005).
ConclusionsAlthough a high incident rate was documented in CSWs, an incident rate of 3.3% in non-CSWs suggests that HIV is rapidly increasing in women previously considered to be at low risk. Among non-CSWs a history of sexual contact with their only partner, who was infected with an STD, was the only risk factor found to be significantly associated with HIV infection. The high proportion of multiple STDs and significant HIV incidence among young non-CSWs coupled with low condom usage and low AIDS awareness necessitates the strengthening of appropriate partner notification strategies and counseling facilities in STD clinics in India.
Raman R. Gangakhedkar
|XI Int. Conference on AIDS abstracts...||
Created: July 16, 1996|
Last modified: July 17, 1996
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