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PubMed1988

Clinical, hematologic, and immunologic cross-sectional evaluation of individuals exposed to human immunodeficiency virus type-2 (HIV-2).

We studied the clinical status and certain hematologic and immunologic parameters in healthy prostitutes from Dakar, Senegal who were seropositive for antibodies to human immunodeficiency virus type-2 (HIV-2). Generalized lymphadenopathy and clinical signs or symptoms similar to those which are seen with human immunodeficiency virus type-1 (HIV-1) infection were not present. Comparison to seronegative prostitutes and minor surgery control patients were made and significant elevations were seen in T8 lymphocytes (p = .03), IgG (p = .0001), and beta 2-microglobulin (p = .03). The mean T4 lymphocyte count in seropositive prostitutes was lower than in seronegative prostitutes (757 vs. 1179, p = .15), but this difference was not statistically significant and appeared to be correlated with age. No significant differences were noted between the seronegative and seropositive prostitutes in lymphocyte stimulation studies to certain mitogens. Antilymphocyte antibodies above background were not present in either population. We conclude that HIV-2 is a sexually transmitted agent that produces immunologic alterations consistent with a persistent viral infection. HIV-2 seropositive prostitutes studied to date do not show clinical signs of immune suppression, as has been described with HIV-1 infection. The pathogenic potential of HIV-2 appears to differ from that of HIV-1, the etiologic agent of the AIDS pandemic.

Adult↗
PubMed1994

Determinants of penicillinase producing Neisseria gonorrhoeae infections in heterosexuals in Amsterdam.

BACKGROUND AND OBJECTIVES: At the STD clinic of the Municipal Health Service in Amsterdam, the annual number of infections with penicillinase-producing Neisseria gonorrhoeae (PPNG) strains remained relatively stable from 1983 until 1990, while the number of non-PPNG infections declined dramatically. To investigate the PPNG and non-PPNG epidemic, a cross sectional study was conducted in 1989 and 1990. The purpose of this study was to assess determinants of PPNG infections among heterosexuals diagnosed with gonorrhoeae. METHODS: In addition to routinely collected data in new consultations for STDs, information on alcohol use, drug use and sexual behaviour was obtained from patients diagnosed with gonorrhoea. The diagnosis of gonorrhoea was based on a positive culture and isolates were screened for PPNG. Logistic regression analysis was used to assess independent predictors of PPNG infection. RESULTS: Additional information was available of 328 women and 995 heterosexual men diagnosed with gonorrhoea. PPNG was diagnosed in 86/328 (26%) women and in 329/995 (33%) men. Logistic regression analysis identified a Central/South American nationality (odds ratio(OR) = 2.46) and older age (OR = 1.04 per year) as positively associated with PPNG infection in female patients. An inverse relation was found with use of hard drugs (OR = 0.29). Among men diagnosed with gonorrhoea, sexual contacts with window prostitutes (mainly women from Central/South America) (OR = 1.98) and a foreign nationality (OR = 1.78) were positively associated with PPNG infection, and sexual contact with drug using prostitutes (OR = 0.47) inversely. CONCLUSIONS: PPNG infections were especially common among Central and South American window prostitutes and their clients, but not among hard-drug addicted prostitutes and their clients. Since window prostitutes originating from Central and South American countries are transient in Amsterdam, prevention activities targeted at these prostitutes and their clients should be continued to limit the spread of PPNG and other STDs within these groups.

Adult↗
PubMed1976

Criminal behavior patterns of female addicts: a comparison of findings in two cities.

A great deal of the literature on addiction is devoted to analyses of the relation between drugs of addiction and crime among males. The few studies which have undertaken to describe the relationship between crime and addiction in females have generally concluded that addicted females either become prostitutes or they commit crimes against property. This study of addicted female arrestees in Denver (N = 153) and Philadelphia (N = 227) concluded that the hypothesized either-or pattern of addicted female criminal behavior is overly simplistic. Rather, four criminal behavior patterns of female arrestees are found: (1) prostitutes without a history of serious crimes, (2) females with a history of serious crimes who are not prostitutes, (3) females who are both prostitutes and commit serious crimes, and (4) females who are not prostitutes and who commit only minor offenses. The utility of the four-pattern typology is borne out by analyses which indicate that these patterns are typical of different groups of female addicts and are not stages in a unitary socialization pattern involving drugs, prostitution, and crime.

Adult↗
PubMed1996

[Epidemiological approach for sexually transmitted diseases in Antsiranana (north Madagascar). Between prevention and treatment, the choice of a strategy against sexually transmitted diseases].

We reported a study undertaken in a Sexually Transmitted Disease care unit in Antsiranana amongst two groups of patients: 299 prostitutes and 350 STD patients (204 women and 146 men). The 20-29 years old age group represented 50.3% of the patients. A 12 days average delay between appearance of first symptoms of STD and the visit to the care unit was recorded. The most important clinical signs were cervicovaginal discharge (83%), pelvic pains (67%), and pruritus (53%) in women, urethral discharge and urination pain (64%) in men. Among prostitutes on a routine visit, 22.7% had at least one STD clinical sign. Syphilis serology by TPHA showed a high prevalence among prostitutes (39%) and STD patients (32%). Direct examinations emphazed the major importance of gonorrhoea in more than 70% of STD patients, both men and women, and trichomonasis in women (22%). Chlamydia investigation could not be done. HIV antibodies were recorded in 4 prostitutes (1.3%) and in none of the STD patients. 79.3% of prostitutes and 39.4% of STD patients had at least 2 partners a week and 47.5% of prostitutes used a condom "every time" and only 21.1% STD patients "sometimes" used it. The role of STD care units must be reinforced for information, education and counselling of the population in a non medical context.

Adolescent↗
PubMed1985

[Detection of the gonococcal antigen with an enzyme immunoassay (Gonozyme). Results of the original and modified test procedure].

Urogenital specimens of 2,485 patients were examined by an enzymeimmunoassay for the detection of Neisseria gonorrhoeae antigen (Gonozyme, Abbott). The results of the original test (Gonozyme A) and a modified version (Gonozyme B) were compared to bacterial culture. Three different groups were examined by Gonozyme A: 526 men and 464 women from the clinic for sexually transmitted diseases (STD) and 548 registered prostitutes. Sensitivity in men was 98%, in women from the STD clinic 89%, and in prostitutes 81%. Specificity in men was 99.5%, in women from the STD clinic 94%, and in prostitutes 88%. One of the reasons for the decreased specificity in women could be cross reacting bacteria from the genital secretions of the women. The assay was modified by optimizing the antigonococcal antibody and increased incubation times. These modifications improved the specificity of Gonozyme B by reducing the number of cross reactions with other bacterial antigens. Four different groups were examined by Gonozyme B: 261 men and 220 women from the STD clinic, 121 women from an infertility clinic, and 345 registered prostitutes. Sensitivity in men was 100%, in women from the infertility clinic 100%, in women from the STD clinic 94%, and in prostitutes 77%. Specificity in men was 99%, in women from the infertility clinic 100%, in women from the STD clinic 99%, and in prostitutes 96.5%. Analysis of the Gonozyme-positive/culture-negative test results suggested that most patients (85%) did not have gonorrhoea. In 15% of these specimens it is possible that patients had pretreated gonorrhoea which was only detected by Gonozyme.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Bacterial↗
PubMed1994

[The analysis of factors affecting the sexual behavior and antibody against syphilis of deep sea fishermen].

Prostitutes may be regarded as the reservoir of sexual transmitted diseases and their customers as the transmitters. The use of condom for sexual intercourse with prostitutes is an effective way of preventing sexually transmitted infections. Deep sea fishermen usually spend a long period of time sailing the oceans, and many have contacts with prostitutes when their boat stays in harbor. This is a study of the factors which affect the fishermen who are customers of prostitutes and condom using. In all 859 Taiwanese deep sea fishermen were interviewed and samples of their blood serum were collected between January and June of 1991. Of the interviewees, 628 (73.1%) used at one time the services of a prostitute; 84% of aborigines from reserved areas and 68% of aborigines from non-reserved areas. The factors which were found to be related to a sailor's tendency to become the customer of a prostitute after adjustments in logistic regressions were marital status, educational level, tobacco smoking and alcohol consumption. Of the 628 men 100 claimed to use condoms always, 110 sometimes and the remaining 414 men never. The vast majority of aborigines from reserved areas (113/124; 91.1%) never used condoms as compared with 84.0% of aborigines from non-reserved areas and 81.8% of non-aborigines (included Hakka). As might be expected, the lesser educate as well as the aborigines from reserved areas use condoms the least frequently.

Adult↗
PubMed1987

Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection.

A seroepidemiological study was performed on HTLV-III, T. pallidum, C. trachomatis and Hepatitis B virus (HBV), in Butare, Rwanda, among 33 female prostitutes, 25 male customers of prostitutes, and 60 male and female controls. As compared with female controls the prostitutes had a higher prevalence of antibodies to HTLV-III (29/33 versus 4/33, p less than 0.001), T. pallidum (TPHA: 27/33 versus 6/33, p less than 0.001; RPR: 19/33 versus 2/33, p less than 0.001; FTA-Abs: 27/33 versus 5/33, p less than 0.001) and C. trachomatis (IgG IF: 31/33 versus 13/33, p less than 0.001). HBV serological markers were more often detected in the prostitutes than in the female controls (31/33 versus 18/33, p less than 0.001) although HBs antigen carriage rate was similar in both groups. As compared with male controls, the male customers of prostitutes had more frequently detectable antibodies to HTLV-III (7/25 versus 2/27, p = 0.05), and a positive RPR (10/25 versus 1/27, p less than 0.01). Among the 118 individuals studied, odds ratios and trend analysis disclosed a significant association between HTLV-III seropositivity and a positive TPHA, RPR, FTA-Abs, Chlamydia IgG IF test and serological markers to HBV. No association was found between HTLV-III seropositivity and HBs Ag carriage. This study suggests that HTLV-III has to be considered as an infectious agent transmitted among promiscuous Central African heterosexuals by sexual contact and/or parenteral contact with unsterile needles used for STD treatments.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Condom breakage during commercial sex in Chiang Mai, Thailand.

Used condoms in 30 female brothels in Chiang Mai, Thailand, during the period from August 1992 to October 1992 were examined for breakage. Data were also collected by interviewing 326 prostitutes who accounted for 65 percent of the total prostitutes providing condoms. The prostitutes had a mean age of 20.6 +/- 3.2 years. Sixty-one percent had no formal education. The median duration of prostitution was 13 months. The average number of clients per day in the past 24 hours and in the past 3 months was 4.4 +/- 2.5 and 5.5 +/- 2.2, respectively. Eighty-eight percent charged between $2 and less than $8 for their sexual service. All refused to practice oral or anal sex during the past 24 hours. Of 5,559 condoms, 298 were used two at a time and 15 were used three at a time. The breakage rate per act of intercourse was 5.9 percent (95% CI = 5.3, 6.5). The breakage per total condoms examined was 5.7 percent (95% CI = 5.1, 6.3). Breakage relating to manufacturing defect, i.e., pinholes, and that relating to use was 0.8 percent (95% CI = 0.6, 1.0) and 5.0 percent (95% CI = 4.4, 5.6), respectively. The probability of breakage when using two condoms at the same time was 3.4 percent (95% CI = 0.5, 6.3). Most of the breakage occurred at the distal part of the condom. There was no difference between the breakage rates of condoms provided by the brothels and those brought by the client; nor was there any difference between manufacturing defect or use. The breakage rate per client as estimated by prostitutes in the past 24 hours corroborated with that assessed by examination.

Adolescent↗
PubMed1993

The epidemiology of AIDS in the Vellore region, southern India.

OBJECTIVE: To describe the epidemiology of patients with AIDS in Vellore region, Southern India. DESIGN AND METHODS: Sixty-one patients with AIDS were diagnosed and treated between July 1987 and June 1992. Information on their demographic characteristics and probable modes of acquiring HIV infection was collected at interviews with them and their spouses. RESULTS: There was a progressive increase in the number of patients seen over the 5 years. The mean ages of the 51 men and the 10 women were 33 and 29 years, respectively. Of the 44 patients from our district (population, 5 million), 28 were from Vellore town and 10 from rural areas. Forty-seven (92%) men had frequently used prostitutes. Of the women, four were prostitutes, one had had multiple sex partners and five had not had extramarital sexual contact. One man and one woman had no other risk factor except blood transfusion. Thirty-one (51%) patients had died by August 1992. CONCLUSION: The AIDS epidemic in this region is in its early ascending phase, with a doubling time of approximately 1 year. Most men with AIDS were infected by heterosexual contact with prostitutes, while some women were prostitutes themselves. Together with the male-to-female ratio of 5:1, these results suggest that the male population at risk has sex with a much smaller population of female prostitutes, constituting the major chain of transmission. HIV infection is occurring in both urban and rural populations.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prevalence of sexually transmitted diseases in high-risk women in the Republic of Panama.

This study enrolled 1,032 sexually active women attending social hygiene clinics in Panama City; clinic attendance is mandatory for women employed in houses of prostitution, bars, and cabarets. Women were interviewed, and endocervical specimens were obtained for culture of Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus, and cytomegalovirus. Four occupational groups attended the social hygiene clinics: prostitutes, bar girls denying prostitution, cabaret entertainers, and streetwalkers detained by the police. Prevalence of sexually transmitted disease, nationality, race, contraceptive method, and self-medication varied significantly by occupation; 31% of streetwalkers had gonorrhea as did 10% of prostitutes, 5% of bar girls, and 3% of cabaret entertainers. Rates of positive serologic tests for syphilis followed the same trend: 23% in streetwalkers, 7% in prostitutes, and 3% in nonprostitutes. Rates of chlamydial infection were significantly higher in cabaret entertainers (8%) than in any other occupational group (2%). Cytomegalovirus and herpes simplex virus infections were uncommon and were found in 5% and 1% of the women, respectively. Prevalence of N. gonorrhoeae varied with self-medication and years of "professional" experience. Only one of 160 N. gonorrhoeae isolates was resistant to penicillin and also beta-lactamase-positive.

Contraception Behavior↗
PubMed1989

Heterosexuals at risk for HIV: differences between private and commercial partners in sexual behaviour and condom use.

To study the prevalence of HIV and other sexually transmitted diseases (STDs), sexual behaviour and condom use among heterosexuals, 193 women and 157 men entered a longitudinal study. Participants were recruited through an STD clinic, and had had five or more heterosexual partners in the preceding 6 months but had no other AIDS risk factors. Participants were divided in groups with respect to private and/or commercial sexual partners. One hundred and thirty-six (71%) women worked as prostitutes and had, on average, 115 customers a month, and 99 (63%) men had visited, on the average, eight prostitutes in the past 4 months. One hundred and seventy-one (89%) women (114 prostitutes) had had, on average, four partners, and 112 (78%) men (of whom 64 had visited prostitutes) had had, on average, seven private partners in the past 4 months. Vaginal intercourse was often or always reported by all participants whilst anal contact was seldom reported. Non-high-risk sexual techniques (for example, oro-oral, masturbation) were practised more frequently with private than with commercial partners (P less than 0.001). Although no differences were found in the frequency of practising high-risk sexual techniques (for example, vaginal, ano-genital), differences were found for frequency of condom use. Condom use during vaginal intercourse was reported more frequently with commercial than with private partners (P less than 0.01). However, if the number of partners is taken into account, prostitutes had unprotected vaginal intercourse with an estimated average number of 160 partners in 4 months, which is far more than customers (seven) and men and women with private partners only (four).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1989

Hepatitis B and HIV in Sudan: a serosurvey for hepatitis B and human immunodeficiency virus antibodies among sexually active heterosexuals.

A serosurvey was conducted in Port Sudan and Suakin, Sudan in October and March 1987 to determine the prevalence and risk factors associated with the transmission of hepatitis B, human immunodeficiency virus type 1 (HIV-1), and syphilis among sexually active heterosexuals on the coast of Sudan. A total of 536 subjects, including 202 female prostitutes, 95 long-distance truck drivers, 103 soldiers, 72 Ethiopian refugees, and 54 Sudanese outpatients, were enrolled in the study. Seventy-eight percent (202/259) of the female study subjects were engaged in prostitution, and 57% (157/277) of the men admitted to prior sexual relations with prostitutes. Serologic markers for hepatitis B and syphilis were detected in 68% and 17% of the entire study population, respectively. In contrast, antibody to HIV-1 was detected in none of the 536 sera tested. Risk factors found to be independently predictive of hepatitis B infection by multivariate analysis included prostitution, positive serology for syphilis, and a history of anti-schistosomal therapy. The absence of HIV-1 infection among the prostitutes enrolled in this study is in marked contrast to the current AIDS epidemic in neighboring sub-Saharan countries, suggesting that HIV-1 has not been widely introduced on the coast of Sudan. The high prevalence of serologic markers to hepatitis B and syphilis, however, indicates a potential for HIV-1 in this region.

Adolescent↗
PubMed2000

[The struggle against venereal disease in Łódź at the turn of the 19th century].

At the turn of the 19th century in Łódź - with its poor sanitary conditions - venereal diseases (including the most dangerous, syphilis) were amongst the infectious and social diseases which were a great danger to the health and life of its inhabitants. Prostitution, which was a source of income for low-paid or unemployed women, contributed in great measure to the spread of infection. Bad housing conditions, abuse of alcohol, unawareness of danger and carelessness of treatment were also conducive to venereal diseases. The State authorities, who were obliged to struggle against venereal diseases, did so by repressive and humiliating police methods and by the introduction of controls in 1894 involving the registration and compulsory medical examination of prostitutes. Considering the lack of compulsion (except for prostitutes), venereal patients were hospitalized on a limited scale in only the general, specialist and constantly overcrowded Szpital Sw. Aleksandra (St. Alexander Hospital) - the prostitutes at their own expense and the poor at the expense of the municipality. The rich underwent treatment discreetly, in the surgeries and infirmaries of privately practising doctors. The lasting danger of venereal diseases prompted initiatives by doctors- philanthropists, members of Łódzkie Towarzystwo Lekarskie (the Medical Society of Łódź) and the local branch of Warszawskie Towarzystwo Higieniczne (the Hygienic Society of Warsaw). By their lectures, brochures and articles in medical periodicals they popularized their views on the causes; prevention and the struggle against venereal diseases. They were critical of the police and medical surveillance and the struggle against prostitution amongst juvenile girls and recommended the introduction of public, cost - free and obligatory treatment of the sick.

Communicable Disease Control↗
PubMed1989

[Knowledge of sexually transmitted diseases and attitudes towards them in populations at risk in Djibouti].

Sexually transmitted diseases (STDs) are an increasing public health problem in Djibouti. The authors have attempted to obtain basic information on the level of knowledge concerning STDs and on the sexual behaviour of highly sexually promiscuous individuals for use in the organization of future STD control programmes; the information was obtained from a population of 213 bar hostesses, 66 unlicensed prostitutes, and 115 male sufferers from STDs. The level of knowledge of these diseases was very high among the prostitutes and the bar hostesses, except that little was known about syphilis by the bar hostesses; the male sufferers were relatively ignorant concerning both syphilis and AIDS. Medical and paramedical personnel do not figure among the sources given for knowledge of STDs. On the other hand, friends play an important role in this knowledge, especially among unlicensed prostitutes. The second most frequently instanced source was radio and TV. The bar hostesses and the unlicensed prostitutes often exhibited distinct social characteristics. Neither education nor marriage appeared to prevent men from contracting STDs. The use of condoms is extremely rare among STD patients and not very common among unlicensed prostitutes. Half the bar hostesses report their frequent use.

Djibouti↗
PubMed1995

[Seroepidemiological study of HBV and HCV infection in sexually promiscuous groups].

A serological study on the detection of HBV and HCV infection markers and the investigation of related sexual behaviors were conducted among 431 female prostitutes and 109 normal women. The result showed of anti-HBc prevalence rate was 43.1% (186/431), anti-HBs positive rate was 36.9% (159/431), HBsAg positive rate was 11.1% (48/431) and anti-HCV positive rate 9.51% (41/431). They were all significantly higher in prostitutes than in normal women. The infection indexes of HBV and HCV were also higher in population with STD than in normal women. The prevalence of anti-HCV in female prostitutes tended to increase with increase of age. There was a significant correlation with the number of their clients and years of being prostitutes. This demonstrated that there was a relatively high HBV and HCV infection rates in prostitutes.

Adolescent↗
PubMed1993

[Trends in incidence of sexually transmissible disorders in The Netherlands].

In 1983 the Chief Medical Inspectorate set up a national registration of sexually transmitted diseases (STD), beside the system of statutorily notifiable diseases in the Netherlands. Data for this registration are collected by the nursing staff in STD clinics. Besides diagnosis and sex of the patient epidemiological background information is registered. The data show a decrease in the total number for gonorrhoea and syphilis in the period 1984-1990. Among homosexual men gonorrhoea increased after 1989. A decrease in STD was demonstrated among prostitute women. Further, the share of penicillinase producing Neisseria gonorrhoeae was found to be increasing in various subgroups, but not in homosexual men. Comparison of age, sex, prostitution, and sexual inclination of over 25,000 patients with Chlamydia trachomatis, gonorrhoea or syphilis infections indicate that syphilis was significantly more frequent among older patients and women than gonorrhoea, but less frequent among prostitutes. Syphilis patients were significantly more often visitors of prostitutes than patients with gonorrhoea, and were more often homosexual or bisexual. Chlamydiosis patients were mostly women and younger than gonorrhoea patients, they were less often working as a prostitute and less often homosexual or bisexual.

Adolescent↗
PubMed1993

Sexual activity among never-married men in northern Thailand.

We use data collected in 1991 to investigate sexual activity among never-married men in Thailand, with a focus on age at first intercourse, characteristics of sexual partners, and conditions under which men visit prostitutes. We sampled men from a broad spectrum of northern Thai society, including university undergraduates, soldiers, and semi-skilled/unskilled workers. We found that except for the students, the majority of each subsample is sexually experienced; prostitutes are the most common type of sexual partner for all groups. Alcohol consumption is associated with several measures of sexual activity. Condom use with prostitutes varies among the subsamples. Among men who have both prostitute and nonprostitute partners, the majority of those who do not use condoms with prostitutes also do not use condoms with their nonprostitute partners. We consider the implications of these results for the AIDS epidemic in Thailand.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Impact of Thailand's HIV-control programme as indicated by the decline of sexually transmitted diseases.

The Thai government began an HIV-control programme in 1989. The programme had the following parts: the government bought and distributed sufficient condoms to protect much of the commercial sex in the country; sanctions were brought against commercial sex establishments where condoms were not used consistently; and a media campaign bluntly advised men to use condoms with prostitutes. Between 1989 and 1993 the use of condoms in commercial sex in Thailand increased from 14 to 94%, according to surveys of prostitutes, and the number of cases of the five major sexually transmitted diseases declined by 79% in men. We estimate that sex acts with prostitutes where there was a risk of HIV transmission declined from about 2.6% in June, 1989, to about 1.6% in June, 1993. If condom use in commercial sex stays high, future cohorts of young men and women may experience lower HIV incidence rates than those of the recent past. However, although condom use is high, there are many more infected prostitutes than before and many infected men who will pass HIV to their wives.

Condoms↗