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[HTLV-III monitoring in prostitutes in Vienna].

Since the end of May 1985 registered Viennese prostitutes are regularly screened for HTLV-III/LAV antibodies. Up to the end of January 1986 839 prostitutes had been investigated and 7 of them (0.8%) revealed positive test results. 5 persons are intravenous drug addicts, whilst 2 only admitted connection to drug addicts. Furthermore, HTLV-III antibodies were detected in 1 non-registered prostitute and in 5 men (3 homosexuals, 2 drug addicts). 11 out of these 13 seropositive patients have confirmed lymphadenopathy syndrome, whilst latent infection has to be assumed in the remaining 2 cases.

AIDS-Related Complex↗

[Transmission of urogenital trichomoniasis in female prostitutes].

A group of female prostitutes (n = 41) was found to be infected with Trichomonas vaginalis to 36.6%, diagnosed by using culture methods. The examination of these women for T. vaginalis and their treatment is not obligatory, therefore the transmission of these parasites by infected prostitutes is not properly controlled; transmission of the trichomoniasis continues under nearly optimal conditions. It is urgently necessary to examine female prostitutes for T. vaginalis infections without exception. In these cases culture methods must be used and all infected women must be treated immediately with effective drugs. The last meeting of the German Society of Gynecologists in 1984 has stressed the necessity to control trichomoniasis systematically.

Adult↗

Sperm-agglutinating antibodies and decreased fertility in prostitutes.

Forty-eight prostitutes were studied for the presence of sperm-agglutinating antibodies. Thirty-five, or 72.7%, were positive. A control group of 25 unmarried women had a 20% incidence of reactions. The specificity of the microagglutination test is discussed. No false positive reactions have occurred from pH, dilution effects, or washing technics used in our procedure. The test reaction is related to seminal plasma-coating antigen. Prostitutes have a poor reproductive history and a high incidence of abortion. Our data suggest a relationship between circulating antibody titers and decreased fertility, but no relationship to increased abortion rate. Tissue-fixed antibodies are demonstrated in cervical and endometrial tissue of 5 prostitutes with circulating antibody titer. The significance of this finding is discussed.

Adolescent↗

[Detection of Chlamydia trachomatis in prostitutes working in a brothel in Izmir].

Endocervical specimens obtained from 251 registered prostitutes working in a brothel in Izmir, were screened for Chlamydia trachomatis by using a direct fluorescent antibody test. Twenty seven of these specimens were excluded because of inadequate sampling. Of the remaining 224 samples, 57 (25.4%) were found positive for C. trachomatis. It is concluded that, prostitutes play an important role in the transmission of chlamydial and other sexually transmitted diseases, and routine screening and appropriate treatment of chlamydial infections in prostitutes will help to control this disease in the general population.

Cervix Uteri↗

[Prevalence of HTLV-I antibodies and possible risk factors in Chilean prostitutes].

Aiming to know the prevalence of HTLV-1 infection among high risk groups in Santiago, the antibodies against HTLV-1 were measured in 502 prostitutes coming from north and east Santiago. Antibodies were measured using ELISA and the positive samples were confirmed with an indirect immunofluorescence technique. Four subjects were positive, establishing a HTLV-1 infection prevalence of 0.8%. This number similar to that of other groups of prostitutes from South America and lower than that of prostitutes from Central America, region in which this infection is endemic. The measured prevalence was similar to that of other non promiscuous groups, suggesting that sexual transmission does not play an important role in our population.

Adolescent↗

[Prevalence of hepatitis C virus and human immunodeficiency virus infection among Japanese female prostitutes].

To investigate the incidence of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection in Japanese sexual workers, 191 out of 194 female prostitutes working in a certain district of the Tokyo metropolitan area were tested for anti-HCV, anti-hepatitis B virus (HBV), anti-HIV and anti-Treponema pallidum (TP). They were also interviewed with regard to their past history of blood transfusion, vaccination against HBV, liver diseases and repeated skin piercing treatments such as tattooing, acupuncture and intravenous drug use. Sera from 300 female blood donors (aged 20 s-40 s), of the same district, collected during the same year, were assessed for comparison. Incidence of seropositives for anti-HCV and anti-TP were found to be significantly high in the prostitute group (11.0% and 16.2%, respectively) compared to the control (0% for both). Anti-HBV seropositives were 14.1% in the prostitute group and 12.7% in the control group without significant difference and none of our subjects were found to be anti-HIV positive. Among HCV infected only 5 experienced repeated skin-piercing treatment and none underwent blood transfusion. From these results it is concluded that HCV has a potential for being transmitted by heterosexual contact, although the exact risk for infection needs to be determined by further investigation.

Adult↗

[Living conditions of prostitutes: consequences for the prevention of HIV infection].

Since 1990, several community-based interventions have been set up for populations of prostitutes in France with the principal objective of preventing HIV infection in prostitutes and their sexual partners. Field workers have suggested that extremely precarious living conditions are a major obstacle for the diffusion of prevention messages. A multidisciplinary working group thus set up a study in order to determine which living conditions could affect the adoption of behaviour at low risk for HIV infection. In May 1995, six of the seven teams conducting prevention actions among prostitutes in France used a short standardised questionnaire to collect information including type of housing, health insurance cover, physical aggressions, drug use. It was planned to collect data from all persons attending the drop-in centres. A total of 355 questionnaires were completed (sampling was exhaustive for 3 of the 6 teams). The population comprised women, men and transvestites. The median age was 28 years. Only 39% (135/348) of the subjects had access to health insurance. Approximately 50% (160/324) of the persons lived in precarious accommodation (hotel or no fixed address) and 33% (119/355) had been victims of physical aggressions during the 5 months preceding the study. Transvestites and young people had the most precarious living conditions. Despite the limits of this study due to the difficulty in carrying out a survey in this very marginalised population, the unique information collected may enable community health action strategies to be suitably adapted. In particular, it is important to improve partnership between field workers and existing social and health services, to improve access to better accommodation, health care and physical security while disseminating prevention messages and distributing condoms.

Adolescent↗

GB virus-C/hepatitis G virus infection in prostitutes: possible role of sexual transmission.

The modes of transmission of GB virus-C/hepatitis G virus (GBV-C/HGV) other than by blood transfusion are largely unknown. The prevalence of GBV-C/HGV viremia and the associated risk factors in 145 female prostitutes were examined. The seroprevalence of hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV), and GBV-C/HGV RNA were 14%, 18%, and 11%, respectively. The demographic characteristics were similar between subjects with and without HBsAg. In contrast, those with HCV or GBV-C/HGV infection had practised longer as prostitutes and received blood transfusion more frequently. Moreover, the prevalence of GBV-C/HGV RNA and anti-HCV tended to increase in parallel with the duration of prostitution. These results suggest that like HCV, sexual transmission of GBV-C/HGV occurs and the risk increased with prolonged duration of exposure. The transmission efficiency between GBV-C/HGV and HCV appears to be similar.

Adult↗

HIV and other sexually transmitted diseases among female prostitutes in Kinshasa.

In 1988, 1233 prostitutes from different geographic areas of Kinshasa participated in a cross-sectional survey on HIV infection and other sexually transmitted diseases (STDs). Despite relatively good knowledge about AIDS and STDs, the reported preventive behaviour was poor. Only 12% of the women reported regular use of condoms, while greater than 50% of the women reported regular use of antibiotics and 38% reported doing nothing specific to prevent STDs. Thirty-five per cent of the women were HIV-positive compared with 27% in a similar survey in Kinshasa in 1986. The prevalence of other STDs was very high, ranging from 5% for genital ulcer disease (GUD) to 23% for gonococcal infection. HIV-positive women were older than HIV-negative women (26.9 versus 25.4 years; P less than 0.001), had a significantly lower level of reported condom use (9 versus 14%, P = 0.009), and reported more frequent use of antibiotics to prevent STDs (55 versus 42%, P = less than 0.001). The prevalence of syphilis, gonorrhoea, chlamydial infection and trichomoniasis was not higher in HIV-positive women compared with HIV-negative women. However, HIV-positive women had a higher prevalence of GUD (9 versus 3%, P less than 0.001), antibodies against Haemophilus ducreyi (82 versus 57%, P less than 0.001), antibodies against herpes simplex virus type 2 (96 versus 76%, P less than 0.001), condylomata accuminata (5 versus 1%, P = 0.003) and cytologic evidence of human papilloma virus on Papaniclaou cervical smear (11 versus 5%, P = 0.006). This study confirms the high incidence of HIV and other STDs among prostitutes in Africa.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The effects of post-test counselling on condom use among prostitutes in The Gambia.

OBJECTIVES: To determine the effect of counselling on condom use by prostitutes. DESIGN: Cohort study. SETTING: Field-based study in The Gambia. PARTICIPANTS: Thirty-one (12 HIV-positive and 19 HIV-negative) prostitutes. INTERVENTIONS: Post-test HIV counselling. MAIN OUTCOME MEASURES: Levels of condom use. RESULTS: Overall, counselling had no effect on condom use. CONCLUSIONS: Scarce resources should be directed towards providing condoms in bars rather than counselling.

Cohort Studies↗

Condom use prevents genital ulcers in women working as prostitutes. Influence of human immunodeficiency virus infection.

Control of genital ulcer disease (GUD) is a proposed intervention to slow the dissemination of human immunodeficiency virus (HIV) infection. Programs for the control of sexually transmitted diseases (STD) should focus on groups of high-frequency transmitters, such as prostitutes and their clientele. This study illustrates the interaction between the prevalence of chancroid, use of barrier prophylaxis against STDs, and HIV infection in a population of female prostitutes in Nairobi. Four hundred and twenty three women were evaluated. Despite the increased use of condoms, the prevalence of genital ulcers remained constant between 1986-87 and 1987-88. Genital ulcer disease was simultaneously associated with HIV infection (adjusted odds ratio: 3.7, P less than .01) whereas it was independently and inversely associated with more consistent condom use (P less than .01). The authors conclude that genital ulcer disease can be controlled in these populations but concurrent HIV infection increases the difficulty of this intervention.

Chancroid↗

Human immunodeficiency virus, human papillomavirus, and cervical intraepithelial neoplasia in Nairobi prostitutes.

To evaluate the impact of human immunodeficiency virus (HIV) on human papillomavirus (HPV) and cervical intraepithelial neoplasia (CIN), a study was conducted of 147 HIV-seropositive and 51 HIV-seronegative prostitutes in Nairobi, Kenya. Among the women infected with HIV, 10 (7%) had signs or symptoms of significant HIV-related disease, and the remaining 93% were asymptomatic. The prevalence of cervical HPV DNA was 37% among HIV-seropositive women and 24% in HIV-seronegative women (odds ratio [OR] 1.7, 95% confidence intervals [CI] 0.8, 3.6, after adjusting for potential confounding factors). Genital warts, cervical HPV DNA, and cytologic findings consistent with CIN were all significantly associated with younger age and fewer years of prostitution, but were unrelated or weakly related to number of sexual partners per week or frequency of condom use. In a subset of 63 women with evaluable Papanicolaou smears, CIN was found in 50% of the women with HPV but only in 8% of those without HPV (adjusted OR 7.2, 95% CI 1.6, 32.1, P = 0.006). However, CIN was unrelated to HIV seropositivity (prevalence of 26% among HIV-seropositive women and 24% in HIV-seronegative women). Among women with cervical HPV DNA, HIV infection was not associated with an increased prevalence of CIN (47% prevalence among women with HIV versus 57% prevalence among women without HIV). Thus, in this population of HIV-seropositive women, most of whom had CDC Stage II or III infection, there was no demonstration of an adverse impact of HIV on CIN.

Adult↗

Human immunodeficiency virus and female prostitutes, Sydney 1985.

One hundred and thirty two female prostitutes and 55 non-prostitutes who were tested for antibodies to human immunodeficiency virus (HIV) were surveyed by questionnaire at this centre. The two groups were well matched for age and were very similar in other except for numbers of their sexual partners. Questions were asked about drug taking, sexual practices, general health, and episodes of sexually transmitted diseases (STDs). None of the women in the survey was found to be seropositive, but both groups were found to be seriously at risk of HIV infection through using intravenous (IV) drugs, having unprotected sexual intercourse with men who used IV drugs, having unprotected sexual intercourse with bisexual men, or exposure to several STDs.

Acquired Immunodeficiency Syndrome↗

Human immunodeficiency virus infection and syphilis in Hondurian female prostitutes.

The seroprevalence of human immunodeficiency virus (HIV) infection and syphilis was investigated in 181 female prostitutes in Tegucigalpa, Honduras. One particle agglutination test and two enzyme immunoassays, as well as one immunofluorescence test were used for the screening of HIV antibodies. Confirmation of positive results by the screening tests was carried out by Western blot. The prevalence of HIV seropositivity was 4% (8 women). Specific treponemal antibodies were found in 50% (90/181) of the prostitutes as judged by Treponema pallidum haemagglutination assay (TPHA) and/or fluorescent treponemal antibody-absorption (FTA-ABSIgG) test. As estimated by the positivity of any or both non-treponemal tests (VDRL and RPR), a total of 31 (17%) out of the 181 women had active syphilis. A good correlation was found between the results obtained by TPHA and FTA-ABSIgG. IgM antibodies were found in 72% of sera positive by TPHA and/or FTA-ABSIgG. Four out of the 181 women were found to have antibodies to both HIV and Treponema pallidum.

Female↗

Infection by hepatitis B and C virus in female and transsexual Greek prostitutes with serological evidence of active syphilis.

Two hundred and thirty female and 43 male-to-female transsexual Greek prostitutes were screened for serological evidence of active syphilis as judged by positivity in both rapid plasma reagin (RPR) test and treponemal (FTA-ABS and TPHA) tests. The rate of active syphilis was 20.9% in the male-to-female transsexual prostitutes and 4.3% in the female ones (P < 0.001, odds ratio = 5.82). In the former group 65.1% had evidence of hepatitis B virus (HBV) infection, and 4.7% of hepatitis C virus (HCV) infection while the respective rates among the latter group were 50.4% and 3.9%. There was no correlation of viral hepatitis marker prevalence with positive syphilis serology.

Adult↗

HIV-2-induced immunosuppression among asymptomatic West African prostitutes: evidence that HIV-2 is pathogenic, but less so than HIV-1.

Two hundred and forty-one prostitutes working in The Gambia were tested for retroviral infections and their immune system evaluated. Sixty-three were seropositive for HIV-2 only, five for HIV-1 only and six for both HIV-1 and HIV-2 (26.1, 2.1 and 2.5%, respectively). When compared to seronegative individuals, the 63 women infected with HIV-2 clearly had an abnormal immune system, with significantly lower CD4+ and higher CD8+ lymphocyte counts and percentages, lower CD4+:CD8+ ratios, lower CD25+ (activated) lymphocyte counts, and lower lymphocyte proliferation responses after stimulation with phytohaemagglutinin, purified protein derivative (PPD), Candida or pokeweed mitogen, and higher levels of neopterin and beta 2-microglobulin. However, when the HIV-2-seropositive prostitutes were compared with the five women infected with HIV-1, the former were less abnormal, with significantly higher CD4+ percentages and CD4+:CD8+ ratios and lower CD8+ percentages and counts. Immunological anomalies were seen in five women known to have been infected with HIV-2 for less than 17 months. Coinfection with HTLV-1 resulted in more severe immunological alterations than infection with HIV-2 alone.

Acquired Immunodeficiency Syndrome↗

HIV-2 infection among prostitutes working in The Gambia: association with serological evidence of genital ulcer diseases and with generalized lymphadenopathy.

Three hundred and fifty-five prostitutes working in The Gambia were enrolled in a study of retroviral infections. Eight-seven (24.6%) were infected with HIV-2 only, two (0.6%) with HIV-1 only, four (1.1%) had sera showing double HIV-1/HIV-2 reactivity, and 37 (10.4%) were seropositive for HTLV-I. After allowing for socioeconomic and serological variables in a multivariate analysis, HIV-2 infection was associated with serological evidence of a previous episode of syphilis [a rapid plasma reagin (RPR) positive/Treponema pallidum haemagglutination assay (TPHA) positive; odds ratio (OR) = 2.18, 95% confidence interval (CI) = 1.19-3.98], with having antibodies against Haemophilus ducreyi (OR = 2.05, 95% CI = 0.89-4.70) or against HTLV-I (OR = 2.17, 95% CI = 0.91-5.19). HIV-2-seropositive prostitutes were three times more likely [17 out of 78 (22%) versus 15 out of 219 (7%), P less than 0.001] to have generalized lymphadenopathy than those who were seronegative. These data suggest that genital ulcer diseases may facilitate the transmission of HIV-2, and that HIV-2 rapidly induces the appearance of generalized lymphadenopathy in a substantial proportion of infected individuals.

AIDS-Related Complex↗

Cervical HPV infection among HIV-infected prostitutes addicted to hard drugs.

An investigation into the prevalence of human papilloma virus (HPV) infection, abnormal cervical cytology and the relationship between HIV- and HPV infection was done in a group of intravenously (IV) and non-IV drug-using prostitutes. From July 1991 through May 1992, hard drug-addicted prostitutes attending a sexually-transmitted-disease (STD) clinic in Amsterdam were recruited. A questionnaire was administered to obtain demographic characteristics, and medical and STD history. Apart from routine STD examination, cervical scrapes for cytology and samples for HPV DNA detection by polymerase chain reaction (PCR) were collected. Some of the women included in this study also participated in HIV studies among drug users. Their data on HIV- and immunologic status could be combined. A total of 121 women entered the study; 25 women were HIV-seropositive, 44 women were HIV-negative, and the HIV status of 52 women was unknown. All 25 HIV-positive women had normal Pap smears, two of the 44 HIV-negative women had a Pap smear III A, and in the HIV-unknown group, two women with Pap III A and one with Pap III B were found. Eight of the 25 (32%) HIV-positive women were HPV DNA-positive, three of the 44 (7%) HIV-negative women and 10/52 (19%) of the HIV-unknown group. Logistic regression analysis showed that in the total group, presence or cervical HPV DNA was associated with HIV infection (order ratio [OR] for HIV-positives 7.8, 95% confidence interval [CI] 1.8 to 34.6) and with diagnosis of condylomata acuminata at entry to the study (OR 7.5, 95% CI 1.5 to 36.5).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗