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PubMed2006

High-risk HPV types in Tunisia. A pilot study reveals an unexpectedly high prevalence of types 58 and 82 and lack of HPV 18 among female prostitutes.

"High-risk" HPVs (HR-HPV) have sharply different prevalences and there is evidence to suggest this may vary according to regions. Accurate description of HR-HPV circulation is a key feature for the rational design of prevention and screening campaigns. To gain insight into HR-HPV circulation in Tunisia, a pilot study was carried out on 64 healthy prostitutes working in the Tunis area. HPV detection and typing were carried out by MY09/MY11 PCR and restriction fragment length polymorphism (RFLP). A selected set of samples was also assayed by Gp5+/Gp6+ PCR and typed by direct sequencing. Out of 64 women, 28 were HPV positive. HPV-16 and HPV-58, both members of the genus Alpha-Papillomavirus, species 9, accounted for 10 and 7 cases with a prevalence rate of 38% and 27%, respectively. HPV-82, a member of species 5, ranked third with four cases (approximately 15%). Types 31, 33, 35; all members of species 9 were each detected once (approximately 4%) while neither HPV-18 nor related members of species 7 were detected. Type 72 and 83, both members of species 3, were the only low-risk types, each detected only once (4% each). Two samples could not be typed. The prevalence of HPV types appeared sharply different from that of neighboring areas. Should the existence of epidemiological pockets be confirmed by larger, more detailed studies, screening and vaccine campaigns will have to be designed carefully taking into account the actual epidemiological context of the target population.

Adult↗

PubMed1994

Syphilis serology among transvestite prostitutes attending an HIV unit in Rome, Italy.

Sixty-seven transvestite prostitutes from Latin America (49 from Brazil and 18 from Colombia) who attended an HIV unit located in the inner city of Rome between January 1991 and June 1992 were studied for syphilis markers by means of both the Treponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of specific IgM (SPHA-IgM) which are typically present in recent infections. All participants reported more than 500 sexual partners in the past year, and 67.1% of them more than 1500 partners (between 5 and 10 partners per working day). The overall prevalence of anti-HIV antibodies in this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM tests was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was higher among Columbians than among Brazilians (83.3% vs 69.4% and 22.2% vs 6.1%, respectively) and also showed a positive correlation with the duration of their permanence in Italy. The TPHA and SPHA-IgM positivities were significantly higher among subjects older than 29 years. Positive TPHA was also significantly higher in subjects who reported a history of heroin and/or cocaine abuse while positive SPHA-IgM was higher in subjects who did not use condoms or reported irregular use of them than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and anti-HIV positivity, while SPHA-IgM positivity was found to be higher among anti-HIV-negative subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1987

Prevalence of HIV antibodies among prostitutes in Zürich, Switzerland.

The prevalence of antibodies to the human immune deficiency virus was determined in 123 prostitutes. Of 18 intravenous drug abusers 14 were anti-HIV positive, all others, with one exception, were seronegative. Neither race, nor number of clients, nor sexual practices correlated with seropositivity.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Comparison of transmission rates of HIV-1 and HIV-2 in a cohort of prostitutes in Senegal.

To explore the biological similarities and differences between the HIV-1 and HIV-2 viruses, we model the probability of male-to-female transmission of either HIV virus as a function of the number of sexual partners, the prevalence of the viruses and the infectivity per contact. Using maximum likelihood estimation theory and data from a prospective study of registered female prostitutes in Dakar, Senegal, we estimate and compare the infectivities of HIV-1 and HIV-2. Graphical goodness-of-fit methods are used to show that our model fits the data well. We find that in male-to-female transmission HIV-1 is significantly more infectious than HIV-2. This finding is consistent with other data from laboratory and epidemiologic studies comparing the biology of HIV-1 and HIV-2.

Acquired Immunodeficiency Syndrome↗

PubMed1999

Susceptibility of Candida species isolated from female prostitutes with vulvovaginitis to antifungal agents and boric acid.

The aim of this study was to determine the antifungal susceptibility of 108 Candida albicans and 23 Candida glabrata isolates obtained from female prostitutes with vulvovaginitis, a population for which available data is limited. Amphotericin B, flucytosine, and fluconazole were tested by broth microdilution, and boric acid was tested by the agar dilution method. The susceptibility patterns found in this population were the same as those in the general population. Candida glabrata required greater concentrations of boric acid for inhibition in vitro than did Candida albicans.

Antifungal Agents↗

PubMed1991

Do prostitutes need more health education regarding sexually transmitted diseases and the HIV infection? Experience in a Belgian city.

From December 1988 till April 1989 154 women who worked in clubs (120) and behind windows (34) in and around Ghent, Belgium, were interviewed about knowledge, attitudes and practices regarding Sexually Transmitted Diseases (STD) and Human Immunodeficiency Virus (HIV) infection in their professional life. Television scored best (98%) as a source of information for AIDS. A leaflet posted in every door in 1987 was mentioned in 60%. Less than half the women gave more than 7 correct answers on 11 questions about safety of sex techniques. Intercourse with condom, the sexual act mostly done, was considered safer than deep kissing, masturbation and even massage. In 10 to 20% of the professional sex contacts no condoms were used, which leads to 1000 to 4000 unprotected contacts every week in the sex industry in Ghent (population 500,000). Condom use with the private partner is exceptional. Proposals for condom use almost invariably come from the women themselves instead of from their clients. We conclude that up till now health education efforts to prostitutes and their clients were not sufficient and that they should be intensified.

Belgium↗

PubMed2005

Physiotherapy and the shadow of prostitution: the Society of Trained Masseuses and the massage scandals of 1894.

In 1894 the Society of Trained Masseuses (STM) formed in response to massage scandals published by the British Medical Journal (BMJ). The Society's founders acted to legitimise massage, which had become sullied by its association with prostitution. This study analyses the discourses that influenced the founders of the Society and reflects upon the social and political conditions that enabled the STM to emerge and prosper. The founders established a clear practice model for massage which effectively regulated the sensual elements of contact between therapist and patient. Massage practices were regulated through clearly defined curricula, examinations and the surveillance of the Society's members. A biomechanical model of physical rehabilitation was adopted to enable masseuses to view the body as a machine rather than as a sensual being. Medical patronage of the Society was courted enabling the Society to prosper amongst competing organisations. Using Foucault's work on power we explore the contingent nature of these events, seeing the massage scandals in context with broader questions of sexual morality, professionalisation and expertise in the late nineteenth century society. We argue that many of the technologies developed by the founders resonate with physiotherapy practice today and enable us to critically analyse the continued relevance of the profession to contemporary healthcare.

History, 19th Century↗

PubMed1999

An unusual autopsy case of a victim stabbed during sadomasochistic prostitution.

A 29-year-old male who lived alone was found dead with his back leaning against the wall of his room. He had been stabbed in his abdomen with a survival-type knife. The victim's mouth was plugged with a pink-colored glove and was sealed with packing tape. His wrists were tightly tied behind his back with the same type of packing tape. The cause of death was diagnosed as hemorrhage from the right common iliac artery and vein. Due to the strange circumstances of the crime scene, the police initially considered the possibility of homicide by a group of assassins. Two months later, the police arrested a male suspect who was a member of a vice racketeer. The victim was characterized as a masochist and bisexual. He often hired the male suspect to perform sadomasochistic activities. On the day of the crime, the victim prepared a survival-type knife and packing tape himself to experience fear and pain more strongly. The victim hoped to use the knife to increase sexual excitement. In this case of sadomasochistic prostitution leading to death, the legal issues of homicide for money, malicious request of injury by the victim and accidental death were involved.

Journal Article↗

PubMed1994

Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: associations with school problems, running away, substance abuse, prostitution, and suicide.

A common theme identified in empirical studies and clinical reports of lesbian, gay male, and bisexual youths is the chronic stress that is created by the verbal and physical abuse they receive from peers and adults. This article reviews the verbal and physical abuse that threatens the well-being and physical survival of lesbian, gay male, and bisexual youths. This response to gay male, lesbian, and bisexual adolescents by significant others in their environment is often associated with several problematic outcomes, including school-related problems, running away from home, conflict with the law, substance abuse, prostitution, and suicide. Although the causal link between these stressors and outcomes has not been scientifically established, there is suggestive evidence that these outcomes are consequences of verbal and physical harassment.

Adolescent↗

PubMed2006

The evaluation of the JEWEL project: an innovative economic enhancement and HIV prevention intervention study targeting drug using women involved in prostitution.

The JEWEL (Jewellery Education for Women Empowering Their Lives) pilot study examined the efficacy of an economic empowerment and HIV prevention intervention targeting illicit drug-using women (n=50) who were involved in prostitution in Baltimore, Maryland. The intervention was comprised of six 2-hour sessions that taught HIV prevention risk reduction and the making, marketing and selling of jewellery. Bivariate comparisons examined behaviour change pre- and 3-months post-intervention. The intervention's effect on the change in the number of sex trade partners from baseline to follow-up was explored with multiple linear regression. Participants were 62.0% African American, 5.0% were currently employed, and the median age was 39 years old (Inter Quartile Range [IQR]: 34-45). Women attended an average of six (IQR: 4.5-6.0) sessions. The women sold over $7,000 worth of jewellery in eleven sales. In comparing self-reported risk behaviours pre and 3-month post intervention participation, we found significant reductions in: receiving drugs or money for sex (100% versus 71.0%, p<0.0005); the median number of sex trade partners per month (9 versus 3, p=0.02); daily drug use (76.0% vs. 55.0%, p=0.003); the amount of money spent on drugs daily (US$52.57 versus US$46.71, p = 0.01); and daily crack use (27.3% versus 13.1.0%, p = 0.014). In the presence of other variables in a multivariate linear model, income from the jewelry sale was associated with a reduction in the number of sex trade partners at follow-up. The pilot indicated effectiveness of a novel, HIV prevention, economic enhancement intervention upon HIV sexual risk behaviours and drug utilization patterns.

Adolescent↗

PubMed1999

Infrequent detection of TT virus infection in intravenous drug users, prostitutes, and homosexual men.

TT virus (TTV), a recently discovered DNA virus, has been implicated as a cause of non-A to non-C posttransfusion hepatitis. The frequency of TTV in persons considered at high risk for sexual and parenteral infection was investigated (52 prostitutes, 81 homosexual men, 65 intravenous drug users) to assess its mode of transmission. TTV DNA was assayed by polymerase chain reaction using primers from conserved regions in the N22 clone. Viremia frequency was 4.5%-13.0% in study subjects, not significantly different from that in low-risk controls (2 [4.5%] of 44). The frequency of TTV viremia increased significantly with age (P=.018) but was not associated with human immunodeficiency virus coinfection. The low frequency of infection detected in both risk groups suggests that spread by sexual contact or by intravenous drug use is relatively inefficient and unlikely to account for the high prevalence of TTV observed worldwide.

Adult↗

PubMed1984

Chemoprophylaxis and gonococcal infections in prostitutes.

The influence of chemoprophylaxis on gonorrhoea has not been reported recently. 777 prostitutes were interviewed and checked for evidence of chemoprophylaxis. The study showed that chemoprophylaxis does reduce the risk of gonococcal infections and that those who took penicillin chemoprophylaxis had a higher risk of Penicillinase producing Neisseria gonorrhoeae (PPNG) infections compared to those who took non-penicillin chemoprophylaxis and those who did not take any prophylaxis.

Anti-Bacterial Agents↗

PubMed1989

Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes.

Recent epidemiologic studies have implicated genital/anorectal ulcer disease as an important cofactor for acquisition and transmission of human immunodeficiency virus (HIV) during sexual intercourse. To better understand the mechanism for the association between genital ulcers and HIV, exudates from 62 genital ulcers of 56 HIV-seropositive prostitutes in Nairobi (Kenya) were cultured for HIV. Twenty-six ulcer cultures could not be evaluated for the presence of HIV because of bacterial or fungal contamination. HIV was isolated from 4 (11%) of the 36 remaining uncontaminated ulcer cultures (2 introital, 1 vaginal, and 1 cervical) from 4 separate women. HIV was isolated from the cervical os from only 2 of the 4 women. HIV p24 antigen was detected in exudate from 1 of the 4 culture-positive ulcers and 0 of 32 culture-negative ulcers. Genital ulcers in seropositive patients should be regarded as potential sources of HIV, which could be important in transmission of HIV during intercourse. Public health measures aimed at controlling sexually transmitted genital ulcer diseases should be an integral part of acquired immunodeficiency syndrome (AIDS) prevention programs.

Adult↗

PubMed1990

Human T cell lymphotropic virus type I (HTLV-I) among female prostitutes in Kinshasa, Zaire.

Three hundred seventy-seven prostitutes from Kinshasa, Zaire, were enrolled in a study to determine associated risk factors for human immunodeficiency virus type 1 (HIV-1) and human T cell lymphotropic virus type I (HTLV-I) infection. Twelve samples (3.2%) were seropositive for HTLV-I; results for HIV-1 (101 [26.8%]) are reported elsewhere. HTLV-I prevalence increased with age, and seven of the seropositive women originated from the Equateur region, a remote area in northwestern Zaire. The prevalence among women from Equateur (7.2%) was higher than that of women from all other regions (1.8%, P = .02). Presence of HTLV-I antibodies was not associated with frequency or type of sex practice. In a subsequent study, 350 serum samples were obtained from a variety of subjects in the Equateur region in 1986. Nineteen (5.4%) showed antibodies to HTLV-I. These data and a recent report of a cluster of patients with tropical spastic paraparesis from this region suggest that HTLV-I is endemic in the Equateur region of Zaire.

Adult↗

PubMed1993

Human immunodeficiency virus infection among high-risk seronegative prostitutes in Nairobi.

To determine the frequency and duration of antibody-negative human immunodeficiency virus (HIV) infection among heterosexually exposed African women, 56 HIV-seronegative female prostitutes in Nairobi were studied. Polymerase chain reaction (PCR) was used to detect HIV DNA in peripheral blood at enrollment, and women were followed prospectively with serologic testing to determine HIV seroincidence. Six women (11%) were infected with HIV by PCR criteria at enrollment. Seroconversion occurred in 5 of these subjects within 1-12 months, while the sixth remained seronegative when last evaluated at 5 months. The cumulative annual seroconversion rate in the entire cohort was 38%. Using maximum likelihood analysis, the mean interval between HIV infection and seroconversion was estimated to be between 3 and 4 months, similar to that described for homosexual men and blood product recipients in the United States. Prolonged HIV infection in the absence of antibodies appears to be uncommon in this setting.

Adult↗

PubMed2000

Trends in HIV-1 incidence in a cohort of prostitutes in Kenya: implications for HIV-1 vaccine efficacy trials.

BACKGROUND: Accurate predictions of HIV-1 incidence in potential study populations are essential for designing HIV-1 vaccine efficacy trials. Little information is available on the estimated incidence of HIV-1 in such populations, especially information on incidence over time and incidence while participating in risk-reduction programs. OBJECTIVES: To examine time trends in HIV-1 incidence in a vaccine preparedness cohort. DESIGN: Prospective cohort study of female prostitutes in Mombasa, Kenya. METHODS: HIV-1 incidence was determined using open and closed cohort designs. Generalized estimating equations were used to model HIV-1 and sexually transmitted disease (STD) incidence and sexual risk behaviors over time. RESULTS: When analyzed as a closed cohort, HIV-1 incidence declined 10-fold during 3 years of follow-up (from 17.4 to 1.7 cases/100 person-years; p <.001). More than 50% of the cases of HIV-1 occurred during the first 6 months after enrollment, and 73% during the first 12 months. When analyzed as an open cohort, HIV-1 incidence density fell during the first 4 calendar years, influenced by accumulation of lower risk participants and variations in study recruitment. Significant declines occurred in both STD incidence and high-risk sexual behaviors during follow-up. CONCLUSIONS: This study documents a dramatic decline in the risk of HIV-1 infection while participating in a prospective cohort, with most seroconversions occurring within 1 year of enrollment. Variations in HIV-1 incidence within high-risk populations should be anticipated during the design of vaccine trials.

AIDS Vaccines↗

PubMed1996

Who works in the sex industry? A profile of female prostitutes in Victoria.

A large-scale survey was conducted to obtain a comprehensive picture of the range of women involved in prostitution in Victoria and to document their concerns about health in relation to sex work. There was considerable diversity in the ages, education levels, family situations and attitudes to sex work among women working mainly in the legal brothels in Victoria. While their practices in client-worker interactions were low-risk for human immunodeficiency virus and other sexually transmitted diseases, many of the women were more at risk from unprotected sex with private partners and some were more at risk from injecting drug use. Most women reported economic reasons for entering the sex industry and cited problems associated with male clients as the worst aspects. Effective health interventions should be devised and aimed at specific sub-populations of these (and other) sex workers.

Adult↗

PubMed1991

Prostitutes, workers and kidneys: Brecher on the kidney trade.

Brecher argues that the practices of selling blood and kidneys are akin to the practices of prostitution and wage-labour since they all involve commodification and, by implication, should be subject to legal prohibition. I suggest that these practices need not involve commodification and that they should only be condemned if people are forced into them because of their lack of power. Rather than these practices being prohibited, I suggest that it would be preferable if they were subject to state regulation in order to protect the weak from exploitation.

Commerce↗