XI International Conference on AIDS|
July 7-12, 1996
Kilmarx, Peter H., Louis M.E.,
Limpakarnjanarat K., Kaewkungwal J.,
Mastro T.D., Uthaivoravit W., Young N.
Declining Prevalence of Gonorrhoea (GC) and Chlamydia (CT) in Female Sex Workers (FSW) Chiang Rai, Thailand, 1991-94
ObjectiveTo assess the Thai government condom-promotion HIV-prevention campaign, we investigated risk factors for and temporal trends in prevalent GC and CT in a defined cohort of FSW in Thailand using accurate laboratory methods.
MethodsFrom 1991 to 1994, FSW were enrolled and evaluated with interview, physical exam, and GC and CT Gen-probeTM of cervical secretions. Prevalence in women enrolling in 1991-93 was compared to that in women enrolling in 1994.
ResultsGC infection was present in 15.4% of FSW at enrollment; 73 (17.5%) of 416 enrolled 1991-93, and 3 (3.8%) of 79 in 1994 (odds ratio [OR] 0.19 [for enrollment in 1994 vs. 1991-93]; 95% confidence interval [CI] 0.06-0.53). CT was present in 20.2%; 93 (22.4%) of 416 enrolled 1991-93, and 7 (8.9%) of 79 in 1994 (OR 0.33; 95% CI 0.16-0.71). FSW enrolling in 1994 were less likely to be higher-risk brothel-based FSW, and were more likely to report 100% condom use and to have < 2 customers per working day. In stratified analysis, GC and CT prevalence declined significantly (p<0.05) in 1994 in both high and lower risk groups. In multivariable analysis, GC was less prevalent in FSW reporting use of depo-medroxyprogesterone (DMPA) (adjusted OR [AOR] 0.28; 95% CI 0.09-0.87), < 2 customers per working day (AOR 0.30; 95% CI 0.12-0.77), or 100% condom use (AOR 0.59; 95% CI 0.33-1.0), or enrolling in 1994 (AOR 0.34; 95% CI 0.10-1.2). CT was associated with £2 years as a FSW (AOR 2.4; 95% CI 1.4-4.0) and age £21 (AOR 1.8; 95% CI 1.0-3.0); enrolling in 1994 was protective (AOR 0.42; 95% CI 0.17-1.0).
ConclusionsThe prevalence of GC and CT in FSW was lower in 1994 than in 1991-93. While this decrease was associated with less high-risk behaviour, the decrease remained in analyses controlling for behaviour, suggesting a decline in community prevalence. This supports Thai government STD surveillance data suggesting that the national HIV-control program has been effective.
Peter H. Kilmarx
|XI Int. Conference on AIDS abstracts...||
Created: July 16, 1996|
Last modified: July 17, 1996
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