[health menu] XI International Conference on AIDS
July 7-12, 1996

Gangakhedkar R.R., Mehendale, S.M.,
Thilakavathi, S.M., Gadkari, D.A.,
NARI, Pune, India

Bentley, M., Rompalo, A.M., Shepherd, M.E.,
Amin, A., Bollinger, R.C., Quinn, T.C.*
Johns Hopkins, Baltimore
*NIAID, Bethesda, MD, USA

Mo.C.226

STD and HIV infection Among Female Non-Commercial Sex Workers (Non-CSWs) Attending STD Clinics in Pune, India

Objective

High 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.

Methods

Women 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.

Results

Of 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).

Conclusions

Although 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
Division of Infectious Diseases
Johns Hopkins University
720 Rutland Ave., Ross 1159
Baltimore, MD 21205-2196
Tel: 410-614-0936; Fax: 410-955-7889
E-mail: rrg@welchlink.welch.jhu.edu

XI Int. Conference on AIDS abstracts... [health menu] [main menu]
Created: July 16, 1996
Last modified: July 17, 1996
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