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PubMed1995

Validity of self-reported sexually transmitted diseases in a cohort of drug-using prostitutes in Amsterdam: trends from 1986 to 1992.

BACKGROUND: Rates of self-reported sexually transmitted diseases (STD) among drug-using prostitutes in Amsterdam have been shown to be declining. However, self reports may provide biased estimates. METHODS: We determined the prevalence of risk indicators for and time trends in incorrect self-reported STD in a cohort of drug-using prostitutes. Rates of self-reported STD were validated with diagnosed STD from a special STD clinic for drug-using prostitutes. RESULTS: Between 1986 and 1992, 314 STD were diagnosed in 85 (65%) of 131 studied prostitutes. Overall, 34% of diagnosed STD was not reported in the cohort, referred to as underreporting. For 40% of reported STD, no diagnosis was obtained ('overreporting'). In spite of these misclassifications, absolute numbers of reported and diagnosed STD practically balanced. Underreporting was independently associated with longer residence in Amsterdam (OR = 2.34 per 5 years), more than six clinic visits between two cohort visits (OR = 0.31), daily use of non-parenteral drug (OR = 8.45) and mainly injecting heroin (OR = 6.93); overreporting was independently associated only with a lower frequency of clinic visits. Multivariate analyses showed that trends in underreporting and overreporting were in part explained by a higher number of visits in the cohort and by lower numbers of clinic visits between two cohort visits. CONCLUSIONS: Self-reporting of STD in our cohort is unreliable and misclassification prevalent; risk factors for and associates of self-reported STD are biased. Inferences drawn from self reports are potentially misleading and therefore such data need to be validated. Trends in misclassification can be interpreted as recall errors and as a study participation effect. For monitoring of STD prevalences in relation to trends in sexual risk behaviours, diagnosed STD should be used in preference to self reports.

Adult↗
PubMed1996

Understanding the social needs of streetwalking prostitutes.

The social dynamics of prostitution render prostitutes unable at times to meet basic human needs, vulnerable to violence, and at risk for sexually transmitted disease. Since April 1989 a mobile van from a private foundation has been contacting prostitutes throughout the five boroughs of New York City to provide HIV testing and counseling and to distribute condoms, bleach kits for cleaning needles, and HIV prevention information. Data collected from 1,963 female prostitutes are discussed in this article. Information is provided on demographics, family and living arrangements, sex and drug practices, HIV status and risk reduction practices, and health history. Methods are discussed for social workers to develop creative ways to provide outreach and develop relationships with a vulnerable population that invests much effort in remaining concealed.

AIDS Serodiagnosis↗
PubMed1993

Human T lymphotropic virus type II (HTLV-II) infection among female prostitutes in Yucatan, Mexico.

The antibodies to human T-lymphotropic virus type I/II (HTLV-I/II) were determined in non-intravenous drug-using female prostitutes from Merida Yucatan, Mexico. Serum specimens from 282 female prostitutes collected during 1990 were tested initially by enzyme immunoassay and further confirmed by western blot assays. Of these, 5 (1.8%, 95% confidence interval 0.2 to 3.3) were shown to be HTLV-I/II positive (reactivity to p24gag and gp68/r21eenv). All five specimens were shown to be infected with HTLV-II by immunoassays using type-specific synthetic peptides and recombinant proteins. Long-term cell lines developed from two individuals demonstrated active viral replication and were of CD8 phenotype. Polymerase chain reaction analysis from four of these five prostitutes demonstrated HTLV-II-specific amplification of all four specimens, of which one was subtype a (HTLV-IIa) and three were subtype b (HTLV-IIb). These data show that HTLV-II is the predominant HTLV type among female prostitutes from the Yucatan.

Adolescent↗
PubMedDate not supplied

Prevalence of anti-hepatitis C virus antibodies in positive FTA-ABS non-drug abusing female prostitutes in Spain.

The prevalence of antibodies against Hepatitis C Virus (anti-HCV antibodies) and its association with the presence of treponemal antibodies (FTA-ABS) was studied in 227 non-drug abusing female prostitutes. The overall anti-HCV antibody prevalence was 8.8%, and a significantly higher prevalence of anti-HCV antibodies was found in prostitutes testing positive for FTA-ABS (19.4%) than in prostitutes testing negative for FTA-ABS (3.9%) (PR = 5.023, P less than 0.001). No statistical association was found between patient age or the duration of prostitution and the presence of anti-HCV antibodies.

Adult↗
PubMed1976

Prostitution in Sheffield.

Prostitution in Sheffield, a city with over half a million population, has been reviewed in its legal, social work, and medical aspects. The years studied were 1960-73. The medical studies were confined to the years 1968-72. Prosecutions for soliciting increased steadily during the study period. The trend was more marked locally than nationally and was associated both with increased police activity and, more recently, with the pursuit of a socially-aware sentencing, probationary, and social work policy. During the 5-year medical study, sixty prostitutes were seen. Using gonorrhoea as an index they were found to hazard the health of both themselves and others. Recurrent infection was the rule amongst them and 40 per cent. suffered salpingitis. In epidemiological terms our findings show that the vector role of prostitutes continues undiminished. The alleged decline in their role is relative only and not real. They accounted for one in six of locally acquired gonococcal infections in heterosexual men. The study indicates the need for the regular monitoring of the social phenomenon or prostitution and for the detailed study of all its aspects on a national basis.

England↗
PubMed1985

Hepatitis B virus markers in prostitutes in Singapore.

The prevalence of hepatitis B virus markers in 121 men and 239 women prostitutes was studied. Of 33 (9.7%) with hepatitis B surface antigen (HBsAg), nine (27.3%) also had hepatitis Be antigen, which was more prevalent in men than women. Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in about 71% of men and women prostitutes. Hepatitis B virus markers were more prevalent in men than in women prostitutes. Compared with other people, prostitutes had a significantly greater prevalence of hepatitis B virus markers. This study strongly suggested the importance of sexual transmission of infection with hepatitis B virus in a country where infection is endemic.

Antibodies, Viral↗
PubMed1991

A survey of female prostitutes at risk of HIV infection and other sexually transmissible diseases.

OBJECTIVE: To determine risk factors for the transmission of human immunodeficiency virus (HIV), including injecting drug use (IDU), sexual behaviour and other sexually transmissible diseases (STDs), in female prostitutes who attended the Sydney Sexual Health (previously STD) Centre. DESIGN: We surveyed by questionnaire 231 (47%) of 491 female prostitutes who visited the Centre over a 19 month period from 1986 to 1988. All were tested for HIV antibody. MAIN OUTCOME: All the women were seronegative for HIV but a number of major risk factors for infection were identified. RESULTS: Seventeen of 26 (65%) current injecting drug users had shared needles in the previous 6 months. Nineteen per cent of those surveyed had bisexual non-paying partners and 21% had partners who injected drugs. Sixty nine per cent always used condoms for vaginal intercourse with paying clients, but they were rarely used with non-paying partners. Condom use was also rare for anal intercourse with clients and/or partners by those (18%) who practised it. Seventeen per cent used condoms alone for contraception and 48% relied on oral contraceptives. We found a reduction in gonorrhoea, herpes and trichomoniasis when compared with a 1985 study conducted at the same Centre. However, there was an increase in reported abnormal cervical cytology. CONCLUSION: In spite of behaviour change by some, there are still many women working as prostitutes in Sydney who remain seriously at risk of HIV infection. We recommend more widespread use of barrier methods of contraception, intensified efforts to prevent the sharing of intravenous needles, closer monitoring of the health of prostitutes, and scientific study of their paying and non-paying sexual partners.

Adolescent↗
PubMed2003

Prevalence of STDs among prostitutes in Czech border areas with Germany in 1997-2001 assessed in project "Jana".

BACKGROUND: The STD problem emerged in the Czech Republic as a result of geopolitical and social and economic changes in the state. Prostitution is concentrated mainly around border areas with Austria and Germany, contributing to the increase in STDs. The Czech-German project "Jana," based on a project umbrella network of the WHO, was organised. OBJECTIVES: To prevent STDs, including HIV/AIDS, and assessment of STD prevalence in the target group. METHODS: Prostitutes working in night clubs and in the streets and roads of three districts in the West Bohemian Region of the Czech Republic bordering on Germany were studied. Interactions included street work, venereology check up, psychology and sociology counselling, psychological preparation on possible treatment, and continuous and regular contact. RESULTS: The number of "love clubs" involved in project "Jana" increased from 46 in 1997 to 72 in 2000. Of 561 street girls registered in the project during 1997-2001, there was one HIV positive, every 11th prostitute had syphilis, and one in 93 women had gonorrhoea, whereas incidence of syphilis in the Czech Republic was 10.2/100000 and that of gonorrhoea 9.5/100000 inhabitants in 2001, 31 women had Chlamydia trachomatis urinary tract and genital infection, and 25 were HBsAg positives. STD frequency revealed in project participants significantly exceeds numbers of STDs in the other inhabitants of the Czech Republic. The majority of prostitutes were foreigners, mostly Ukrainians and Russians. CONCLUSION: The situation in the border areas is alarming. The priority must be to concentrate efforts on prevention of spread of venereal diseases in borders of economically disparate states.

Condoms↗
PubMed2002

Exploitation of children and young people through prostitution.

The numbers of children in contemporary society involved in prostitution is still largely unknown. However, there are multiple factors which leave children vulnerable and involved in prostitution. This article aims to explore the historical context of child prostitution, factors which may predispose an adolescent engaging in prostitution, and the role that professionals within the healthcare settings can offer.

Adolescent↗
PubMedDate not supplied

Child prostitution: reaching out to children who sell sex to survive.

Childhood prostitution is an area that most health-care workers do not come into direct contact with other than through media coverage. It is difficult to obtain a national picture of the scale of the problems associated with childhood prostitution as research has been sparse, fragmented and mainly localized Health and social care professionals need to be aware of the factors that influence routes into prostitution such as childhood abuse, poverty and breakdowns in family relationships if they are to provide relevant and appropriate health promotion interventions. This article explores the social economical and political issues surrounding childhood prostitution, and highlights come interesting initiatives which have been implemented by health and social care professionals.

Adolescent↗
PubMed1988

On "being a prostitute".

The book "On Being a Prostitute" (Perkins & Bennett, 1985) is a valuable contribution to the sociology of deviance and sexual ideologies. However, comprehensive as it is, the book presents certain omissions and flaws, with implications for both is empirical data and theoretical underpinnings. In focusing on male (homoerotic) prostitution, and drawing upon Bennett's (1983) "Twenty-Ten" survey (which forms the main empirical base of that aspect of the book), I argue that certain categories of male prostitutes have been excluded. These omissions, I suggest, were necessary to allow Bennett's hypothesis that most male prostitution derives from economic necessity--a recurrent economic determinism reminiscent of Havelock Ellis (1906/1936), and somewhat contrary to a broader structural approach (see Mathews, 1983).

Gender Identity↗
PubMed1993

Male transvestite prostitutes and HIV risk.

Human immunodeficiency virus (HIV)-1, syphilis, and hepatitis B prevalence and associated risk factors were assessed among male transvestite prostitutes. Structured street-level interviews were conducted with 53 respondents in Atlanta, Ga, from July 1990 through July 1991. Test results from serum samples revealed that 68% were seropositive for HIV-1, 81% had seromarkers for syphilis, and 80% had seromarkers for hepatitis B. Univariate logistic regression analysis indicated that seromarkers for syphilis and Black race were the primary factors associated with HIV-1 infection. The results show that transvestite prostitutes are a heterogenous population and distinct from nontransvestite prostitutes; specific outreach is thus needed. Targeted interventions should address the sexual and drug-use-related HIV risk behaviors of transvestite prostitutes.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Childhood victimization and subsequent risk for promiscuity, prostitution, and teenage pregnancy: a prospective study.

OBJECTIVES: This study examined the extent to which being abused and/or neglected in childhood increases a person's risk for promiscuity, prostitution, and teenage pregnancy. METHODS: A prospective cohorts design was used to match, on the basis of age, race, sex, and social class, cases of abused and/or neglected children from 1967 to 1971 with nonabused and nonneglected children; subjects were followed into young adulthood. From 1989 to 1995 1196 subjects (676 abused and/or neglected and 520 control subjects were located and interviewed. RESULTS: Early childhood abuse and/or neglect was a significant predictor of prostitution for females (odds ratio [OR] = 2.96). For females, sexual abuse (OR = 2.54) and neglect (OR = 2.58) were associated with prostitution, whereas physical abuse was only marginally associated. Childhood abuse and neglect were not associated with increased risk for promiscuity or teenage pregnancy. CONCLUSIONS: These findings strongly support a relationship between childhood victimization and subsequent prostitution. The presumed causal sequence between childhood victimization and teenage pregnancy may need to be reevaluated.

Adolescent↗
PubMed1994

Prostitution or sex work in the common market?

Prostitution has recently come under public and political scrutiny in the countries of the European Economic Community. A "pro-prostitution" lobby is promoting a program that portrays prostitution as sex work, which has provoked much debate. The author describes the debate, putting forward two paradigms of prostitution: the functionalist versus the socially critical views.

Denmark↗
PubMedDate not supplied

Perceived health needs of inner-city street prostitutes: a preliminary study.

OBJECTIVE: To survey inner-city prostitutes' perceived health needs. METHODS: One hundred forty street prostitutes in Washington DC, were surveyed to determine their perceived health needs, in addition to levels of post traumatic stress disorder (PTSD). RESULTS: The final sample comprised 100 individuals, representing 3 subgroups of prostitutes, female, male, and transgender male. Major health needs included protection from physical and sexual assault, social support, counseling, addictions treatment, job training, and medical care. Over 42% of the population was identified as meeting established criteria for PTSD. CONCLUSION: Effective program development for inner-city prostitutes needs to acknowledge the presence of distinct subpopulations and the pervasive influence of PTSD on health status.

Adolescent↗
PubMed1988

Sexually transmitted diseases among prostitutes in Fukuoka, Japan.

The prevalence of sexually transmitted diseases (STDs) among prostitutes was investigated at a genitourinary hospital in Fukuoka, Japan, in 1985 and 1986. The most common STD was Chlamydia trachomatis infection, followed by gonorrhea and condyloma acuminatum. Candidiasis, trichomoniasis and genital herpes were relatively uncommon. The rate of prostitutes who had STD but had no subjective symptoms were 42.9% in 1985 and 30.9% in 1986. The rate of prostitutes having mixed STD infection was 35.8% among the summed 162 STD-contracted prostitutes.

Adolescent↗
PubMed1998

Diagnosis of sexually transmitted infections in female prostitutes in Dakar, Senegal.

OBJECTIVE: To study the validity and performance of a number of rapid indicators for the diagnosis of sexually transmitted infections (STIs) in female prostitutes in Dakar, Senegal; characteristics of these indicators were rapidly obtainable, easy to perform, accurate, useful at district level, and reasonable cost. METHODS: An STI prevalence study in female prostitutes (n = 374) seen at the STD clinic in Dakar, Senegal was done; a history, clinical examination, simple laboratory tests, and "gold standard" microbiological tests were performed. For a number of sociodemographic data, actual or past symptoms of STI, clinical signs, and rapid laboratory tests, validity variables, performance characteristics, and likelihood ratios for detection of gonococcal or chlamydial cervical infection were determined. RESULTS: Cervical infection (chlamydial or gonococcal) was present in 24.9% of prostitutes; 46% had trichomoniasis and 29.4% had syphilis. Young age, abnormal vaginal discharge, endocervical mucopus, a positive leucocyte esterase test on urine, and 10 or more leucocytes in Gram stained smears of vaginal, cervical, or urine samples were significantly associated with cervical STI. Some of the rapid indicators had high sensitivity, others high specificity but none had acceptable overall validity. None of the indicators had at the same time a sensitivity above 50% and a positive predictive value above twice the background prevalence of cervical infection. 10 or more leucocytes in the cervical smear had a likelihood ratio of 1.83 increasing pretest probability of 24.9% to post-test probability of 38%, the best result obtained by any of the rapid indicators. CONCLUSIONS: Rapid indicators of cervical STIs are insufficiently valid, which largely restricts their usefulness to high STI prevalence situations for instance, in prostitute populations and in STD patient management.

Adolescent↗
PubMed1999

[HIV prevention for migrant prostitutes].

A growing number of women from poor countries consider an engagement as sex workers in the wealthy industrialized countries as their only chance for making a decent living. This forces them into a variety of dependencies and obligations. They often accept high risks to their psychological and physical wellbeing. For these reasons migrant prostitutes have to be considered as an important target group for preventive measures, despite of an overall low HIV-prevalence among non-drug-using female prostitutes in Western Europe. Coercive methods in public health care against prostitutes cannot be justified neither from an epidemiological point of view nor from the point of view of efficacy considering the high mobility of the target group. Street work in cooperation with native speakers combined with confidential and free of charge counselling and medical care has proved to be effective to reach migrant prostitutes also in Germany.

Acquired Immunodeficiency Syndrome↗