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[The survey of HIV infection among clients of foreign female prostitutes in Tokyo Metropolitan].

OBJECTIVES: It is important to elucidate the risks to foreign female prostitutes of HIV infection from their clients. We determined the prevalence of HIV among clients of foreign female prostitutes using anonymous testing of condom semen samples. METHODS: A total of 250 client condom semen samples were collected with client age and nationality by 15 Latin American and 37 Thai female prostitutes in Tokyo from March to May 1995. We screened by ELISA (GENELAVIA MIXT, Pasteur Sanofi Diagnostics) for antibody to HIV 1 and 2, and then confirmed by Western Blot (LAV Blot 1, LAV Blot 2, Sanofi Diagnostics Pasteur) and distinguished by Immuno Blot PEPTI-LAV 1, 2, (Sanofi Diagnostics Pasteur). RESULTS: The nationality of customers was reported as Japanese (74.8%), Iranian (7.6%), Pakistan (5.6%), Indian (2.8%), Taiwanese (2.0%), and Chinese (1.2%) with other nationalities less than 1.0%. Estimated age categories of the clients were < 20 (1.2%), 20-29 (41.2%), 30-39 (36.4%), 40-49 (12.4%), > or = 50 (6.4%) and undetermined (2.4%). Of the 250 samples collected, only 219 were sufficient for testing. Two samples (0.90%, 95% CI = 0.4-2.2%) were HIV 1 positive, both from Japanese clients (1.2% of Japanese clients, 95% CI = 0.5-2.9%). These data suggested that the prevalence of HIV in clients of female prostitutes was relatively high, and can be considered a risk group in Japan. The sentinel surveillance by anonymous of client condom semen samples is a very useful method to quantify HIV prevalence in this risk group.

Acquired Immunodeficiency Syndrome↗

[Prevalence of Chlamydia trachomatis infection in registered prostitutes in the city of Durango, Mexico].

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis infection among registered prostitutes of Durango City and to establish whether there is a correlation between epidemiological factors and infection. MATERIAL AND METHODS: Two-hundred-and-forty-seven registered prostitutes of Durango city were studied. Endocervical samples and epidemiological data were obtained. C.trachomatis antigen was detected with the Chlamydiazyme test (Abbott Laboratories, USA.) RESULTS: Forty-one (16.6%) out of 247 prostitutes were positive to C. trachomatis. Thirty-seven out of the 41 positive women had had sexual activity on several States of Mexico (95.1%), as compared to only 109 out of 206 negative women (53.0%) (p < .0001). Prostitutes positive to C. trachomatis (39/41, 95.1%) were more likely to belong to low socioeconomic level than negatives (171/206, 83%) (p = 0.05). CONCLUSIONS: The prevalence of C. trachomatis infection was 16.6%. C. trachomatis infection was associated with sexual activity in multiple States of Mexico, and had a tendency to be associated with low socioeconomic level.

Adolescent↗

Psychodynamics of a prostitute: a case report.

The topic of prostitution has been examined from many viewpoints, but psychodynamic contributions have been limited. The authors present material from a psychoanalytic psychotherapy with a prostitute. The intrapsychic determinants of the patient's choice to become a prostitute are discussed. The prostitution appeared to offer numerous hidden gratifications for this patient, including fulfillment of passive sexual wishes and opportunity to experience closeness with men without fear of abandonment or betrayal.

Adult↗

[Prevalence of HIV in clients of an outpatient clinic for sexually transmissible diseases and in a group of prostitutes and their clients].

In order to gain insight into the heterosexual spread of HIV infections in Amsterdam, a study was carried out in 1991 among persons attending an outpatient clinic for sexually transmitted diseases (STD) and among a group of prostitutes and prostitutes' clients. Out of 2362 persons attending the STD clinic, 2138 (90.5%) could ultimately be examined for presence of HIV antibodies. The HIV seroprevalence was 4.2% (90/2138); among homosexual males it was 22% (70/324), among heterosexual male intravenous drug users 12% (2/17) and among heterosexual males who never had used i.v. drugs 0.5% (5/997). The HIV seroprevalence among female intravenous drug users was 41% (12/29) and that among females who never had used i.v. drugs it was 0.1% (1/771). Among the heterosexually active subjects (active in the preceding six months, including the groups of bisexual males and intravenous drug users), the seroprevalence amounted to 1.5% (28/1884). HIV antibodies could be demonstrated in 1.5% (3/199) of the prostitutes and in 0.5% (1/213) of prostitutes' clients. However, the one positive male had had homosexual contacts in the past. Out of the total of nine heterosexually infected persons, two originated from the Netherlands, two from Ghana, two from Turkey, one from Nigeria, one from Pakistan and one from the Dominican Republic; six of them had commercial contacts. The heterosexual spread of HIV among the heterosexual population of Amsterdam can for the moment be classified as slight. However, further heterosexual transmission of HIV cannot be excluded, considering the frequency of unprotected sex.

Cohort Studies↗

[Prostitution--a sequela of sexual abuse].

AIDS has consolidated the isolated state of prostitutes and stigmatized them as HIV carriers. Due to the threat of AIDS, the Berlin senate has worked out a programme for prostitutes. For the programme to succeed, knowledge of the causes of prostitution is a prerequisite, such as sexual abuse during childhood and adolescence. The sexually abused who have gone without psychological help are prone to prostitution. The work and its evaluation by a psychologist is presented to help counselling Services on Venereal Diseases in their work.

Acquired Immunodeficiency Syndrome↗

[Social and work conditions, risk behavior and prevalence of sexually transmitted diseases among female immigrant prostitutes in Madrid (Spain)].

OBJECTIVE: To describe the sociodemographic characteristics, work conditions, sexual behavior, and prevalence of HIV, hepatitis B (HBV), and hepatitis C (HCV) infection and of other sexually transmitted infections among a group of female immigrant prostitutes in Madrid. METHODS: We performed a descriptive study of a group of immigrant women who worked as prostitutes and who attended a sexually transmitted diseases (STD) clinic in Madrid in 1999 and 2000. Information was collected on sociodemographic characteristics, work conditions, use of injected drugs, and sexual practices with their clients and in their private lives. The services provided included screening for the main STDs and serological studies for HIV, HBV and HCV. RESULTS: A total of 579 female immigrants were analyzed. The mean age was 28.7 years. Ninety-six percent were from Latin America. None reported having consumed injected drugs. They began to work as prostitutes at a mean age of 27.4 years and 93.3% of them began in Spain. In the previous month, 98% had always used condoms for vaginal and anal penetrations with their clients and 17.6% had used them in their private sexual relations. Thirty percent reported condom breakage during intercourse. The prevalence of HIV and HCV infection was 0.2 and 0.9%, respectively; 8.1% showed HIV anticore antibodies and 0.5% showed surface antigens. An ulcerative STD was diagnosed in 2.1% and a non-ulcerative STD was diagnosed in 16%. CONCLUSIONS: Condoms are generally used with clients although the frequency of breakage is high. Condom use in prostitutes personal lives is dramatically lower. The prevalence of markers for HIV, HBV and HCV is low and the frequency of STD is moderate.

Adult↗

Legal Network report calls for decriminalization of prostitution in Canada.

In December 2005 the Canadian HIV/AIDS Legal Network released Sex, work, rights: reforming Canadian criminal laws on prostitution. The report examines the ways in which the prostitution-related provisions of the Criminal Code, and their enforcement, have criminalized many aspects of sex workers' lives and have promoted their social marginalization. Evidence indicates that the criminal law has contributed to health and safety risks, including the risk of HIV infection, faced by sex workers. The Legal Network calls for the decriminalization of prostitution in Canada, and for other legal and policy reforms that respect the human rights and promote the health of sex workers. Despite the report's Canadian focus, its human rights analysis is relevant to the situation of sex workers in other countries where prostitution is illegal and sex workers face rights abuses. In this article, Glenn Betteridge, the principal author of the report, briefly sets out the case for law reform.

Canada↗

Recovery of human immunodeficiency virus from asymptomatic prostitutes from Tamil Nadu.

Peripheral blood mononuclear cells (PBMC) from 13 asymptomatic healthy human immunodeficiency virus type-1 (HIV-1) antibody positive prostitutes from Tamil Nadu, southern India, were cocultivated with phytohemagglutinin stimulated PBMC from HIV antibody negative donors for HIV isolation. In addition, plasma samples from two antibody positive prostitutes with HIV antigenemia were processed for virus isolation. The presence of virus in the cultures was monitored by (i) assay for virus particle associated reverse transcriptase (RT) activity, (ii) HIV-antigen enzyme immunoassay, and (iii) indirect immunofluorescence test to detect expression of HIV specific core antigens p-24 and p-17 in infected cells using monoclonal antibodies to these antigens. The virus was isolated from PBMC from 2 prostitutes (86-4 and 86-5) and from plasma of one prostitute (86-20). These isolates have been characterised as HIV type-1 by dot blot hybridization using HIV-1 and HIV-2 proviral DNA probes.

DNA, Viral↗

Factors that could influence the spread of AIDS in Ghana, West Africa: knowledge of AIDS, sexual behavior, prostitution, and traditional medical practices.

Ghana is a West African nation in the early stages of the human immunodeficiency virus (HIV) epidemic. In a series of surveys done between 1987 and 1989, we examined factors related to the spread of HIV infection, including knowledge about the acquired immune deficiency syndrome (AIDS), sexual habits, use of prostitutes, traditional healer practices, and skin-piercing customs. Although a polygamous society, three-fourths of married men had only one wife. The number of sexual partners at any one time was generally low. However, the divorce rate was more than 29% and 55% of married men had current sexual partners in addition to their wives. Knowledge about AIDS was widespread, yet 4% of men interviewed had had a sexual encounter with a prostitute within the last month. Use of condoms was very limited and 66% of customers of high-class prostitutes refused to use a condom even after a request to do so by the prostitute. Skin piercing, including scarification, was done by an unsterile instrument by 39% of 74 rural traditional healers, many of whom had more than one patient per day. To combat the spread of AIDS, Ghanaians will have to apply their knowledge of AIDS risk factors to their actual behavior. Many of the social customs are products of poverty and its ensuing social consequences. Funds are needed for specific AIDS prevention programs as well as improved education and health care throughout the country.

Acquired Immunodeficiency Syndrome↗

[Markers of HIV infection in prostitutes: analysis of preventive and risk factors].

We studied 501 prostitutes from the northern and eastern areas of Santiago in november and december, 1987. HIV infection was studied by the HIV antibody and also by HIV antigen. At that time no positive reactors were found. Prostitutes from the northern area were older, of a lower socioeconomic background and less promiscuous, in comparison to prostitutes of the eastern area. However, other disorders of sexual transmission were found in 41% of prostitutes of the northern area and in only 28% of those from the eastern area. This difference may be attributed to the more frequent use of preservative in the latter group.

AIDS Serodiagnosis↗

Female prostitutes and sexually transmitted diseases.

The epidemiology of HIV infection emphasizes the need to be able to identify and communicate with female prostitutes as a group. Health education, screening and the prevention of STD in female prostitutes remains an essential priority for the well-being of the prostitutes, their clients and the health of society. However, these goals will not be achieved by compulsory screening, as this will miss the highest risk group. Instead, increased official recognition and measures to encourage female prostitutes to participate in and communicate with the health care system may result in an improvement in our management of these women.

Acquired Immunodeficiency Syndrome↗

Adolescent prostitution.

Although juvenile prostitution has been documented since antiquity, its rise since 1970 has been overwhelming. Newsweek (1978) reported an alarming increase in arrests of prostitutes under the age of 25 in New York from 24% to 74% in the previous 10 years. In Boston the average age of prostitutes is 20 years old; in Miami it is 18. The purpose of this paper is to explore the conditions which lead to teenagers' becoming prostitutes, and how our institutions and legal system deal with them.

Achievement↗

[Chlamydia trachomatis IgA and IgG antibodies in prostitutes and women having spontaneous abortion].

In this study, the sera taken from 34 prostitutes, 34 women having spontaneous abortion and 34 control group were tested for C. trachomatis IgA and IgG antibodies. C. trachomatis antibodies were found positive in 30 (88.2%) of prostitutes, 11 (32.3%) of women having spontaneous abortion, 9 (26.4%) of controls. When the positivity rate of prostitutes and women having spontaneous abortion compared with control groups statistically, it was found significant in prostitutes (p < 0.05), but not found significant in women having spontaneous abortion (p > 0.05).

Abortion, Spontaneous↗

HIV, sexually transmitted diseases and gynaecologic disorders in women: increased risk for genital herpes and warts among HIV-infected prostitutes in Amsterdam.

OBJECTIVES: To determine the incidence of sexually transmitted diseases (STD; gonorrhoea, early syphilis, Chlamydia trachomatis infection, trichomoniasis and primary genital herpes) and gynaecologic disorders (vaginal candidiasis, anaerobic vaginosis, genital ulcerations of unknown cause, pelvic inflammatory disease, recurrent genital herpes, recurrent genital warts) in a cohort of HIV-infected and non-infected drug-using prostitutes in Amsterdam between 1986 and 1992. DESIGN: A subgroup of 212 female drug users with a history of prostitution, who made at least one visit to a special STD clinic for drug-using prostitutes was selected from an ongoing cohort study of drug users in Amsterdam. METHODS: Using Poisson regression, the relative risk (RR) for each outcome was calculated for HIV-positive women compared with HIV-negative women. To determine potential causal relations with immune suppression, associations between disease incidence and immunologic markers (CD4 cell count and anti-CD3 response) were assessed in HIV-positive women. RESULTS: Adjusted for number of clients and frequency of condom use, HIV-positive women were at strong and significantly increased risk for primary genital herpes (RR, 7.64), recurrent herpes (RR, 8.33) and recurrent genital warts (RR, 15.93); moderately (significantly) increased risks were found for gonorrhoea (RR, 1.43), trichomoniasis (RR, 1.39), vaginal candidiasis (RR, 2.11) and genital ulcers of unknown aetiology (RR, 2.60). Of these HIV-related outcomes, the risk for recurrent genital herpes and genital warts were strongly associated with decreased CD4 cell counts. CONCLUSIONS: HIV-infected women experience an excess morbidity of STD and gynaecologic disorders. The strongly increased risk for genital herpes and warts in HIV-seropositive women indicates a causal relation with HIV. This study emphasizes the need for accessible medical care for drug-using prostitutes.

Adult↗

Hepatitis B virus markers among the prostitutes of Dhaka.

The objective of this study was to estimate the prevalence of hepatitis B virus (HBV) carrier states among prostitutes in Dhaka. Enzyme linked immunosorbent assay (ELISA) was used to detect HBV markers in a group of 164 prostitutes. Serological evidence of current or past HBV infection was present in 129(78.7%) prostitutes. HBsAg was detected in 16(9.7%) of whom 7(43.7%) were positive for e-antigen and e-antibody was present in another 7 (43.7%). Anti-HBs was detected in 94 (57.3%) of the specimens while anti-HBc in 108(73%) of HBsAg negative sera. Prevalence of HBV markers was 87% and 52.6% in VDRL reactive and non reactive sera respectively. The study indicates that the prevalence of HBV infection is high among the prostitutes in Dhaka city. Infection with Treponema pallidum is associated with increased risk of infection with HBV.

Bangladesh↗

Prevalence and risk factor analysis of GBV-C/HGV infection in prostitutes.

GB virus-C (GBV-C) and Hepatitis G virus (HGV) are variants of a recently cloned virus transmitted parenterally. It is unclear if sexual contact also transmits this virus. In this study, we detected serum GBV-C/HGV RNA in 140 prostitutes by reverse transcription polymerase chain reaction (RT-PCR) using different primers. Thirty (21%) were found with GBV-C RNA by nested PCR although only 22 (73%) had HGV RNA by single round RT-PCR. Both assays had a nearly perfect agreement (kappa value, 0.812). The prevalence of GBV-C RNA in prostitutes was significantly higher than the control group (30/140 vs. 2/40, P < 0.02). Multivariate analysis revealed that a frequency of paid sex more than 120 times per month was the only factor significantly associated with positive GBV-C RNA in prostitutes (P < 0.003). In summary, prostitutes are a high risk group and reservoir of GBV-C/HGV infection due to high frequency of paid-sex.

Acupuncture Therapy↗

Biosocial factors influencing women to become prostitutes in India.

Based on materials collected during a study of risk factors associated with cervix cancer among prostitutes in Domjur, Howrah, West Bengal, this report explores various biosocial factors which may lead women to prostitution. When family and marital ties fail or disintegrate for various reasons, the life situations which a woman encounters may themselves generate a "process" of anchorlessness. The failure of family support along with the lack of ability to provide for themselves due to poverty and illiteracy were key factors why the women in this study had adopted prostitution.

Adult↗

HIV infection among lower socioeconomic strata prostitutes in Nairobi.

A cohort of 418 lower socioeconomic strata prostitutes were enrolled in a study of the epidemiology of sexually transmitted diseases (STDs) between January and April 1985. Sixty-two per cent of the women were seropositive for HIV infection at enrollment. Significant associations were found between HIV seropositivity and Tanzanian origin (OR = 2.12, CI 95% = 1.18-3.81, P less than 0.03), younger age, a shorter duration of prostitution, reduced fecundity, use of oral contraceptives (OR = 1.8, CI 95% = 1.1-2.9, P less than 0.05) and genital ulcer disease (OR = 3.32, P less than 0.00001). No associations were noted with other STD. Stepwise logistic regression analysis confirmed independent associations between HIV infection and Tanzanian origin (OR = 2.27, CI 95% = 1.25-4.14, P less than 0.007), reduced fecundity (OR = 0.83, CI 95% = 0.74-0.94, P less than 0.003), oral contraceptive use (OR = 2.02, CI 95% = 1.22-3.35, P less than 0.006) and duration of prostitution (OR = 0.39, CI 95% = 0.23-0.65, P less than 0.004). Oral contraceptives may increase susceptibility to HIV or may be a marker for other factors which increase risk of acquisition. Further studies are necessary to confirm this association.

Acquired Immunodeficiency Syndrome↗