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PubMed1988

Prostitutes: a high risk group for HIV infection?

Female prostitutes are at increased risk for sexually transmitted diseases and HIV infection. However, the prevalence rate of HIV infection among prostitutes varies geographically, with the highest rates occurring in Africa and in areas with large numbers of HIV infected intravenous drug users (IVDU). In Europe the most important risk factors for HIV infection in prostitutes are intravenous drug use and unprotected intercourse with non-paying partners. Whereas in Europe, there is as yet no evidence that female prostitutes are a source of HIV infection for the heterosexual population, they are playing a major role in the spread of HIV in Africa. Education about safe sex practices should be included in prevention programmes aimed at IVDUs. HIV infection should be monitored in prostitutes, and health education on AIDS prevention should be offered to prostitutes and their clients.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Prevalence and risk determinants of human immunodeficiency virus type 2 (HIV-2) and human immunodeficiency virus type 1 (HIV-1) in west African female prostitutes.

The authors studied the prevalence and risk determinants for human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) in female prostitutes from Dakar (1985-1990), Ziguinchor (1987-1990), and Kaolack (1987-1990), Senegal, West Africa. Each cohort showed a distinct distribution of HIVs: 10.0% HIV-2 and 4.1% HIV-1 in Dakar, 38.1% HIV-2 and 0.4% HIV-1 in Ziguinchor, and 27.4% HIV-2 and 1.3% HIV-1 in Kaolack. In 1,275 female prostitutes from Dakar, increase years of sexual activity and a history of scarification were associated with HIV-2 seropositivity. In contrast, HIV-1 seroprevalence was associated with a shorter duration of prostitution and a history of hospitalization. In 278 female prostitutes from Ziguinchor, HIV-2 seroprevalence was associated with women of Guinea-Bissau nationality and increased years of sexual activity. In 157 female prostitutes from Kaolack, HIV-2 seroprevalence was associated with increased years of sexual activity and a history of never using condoms. The authors also studied the risk determinants for HIV-2 in the 1,280 Senegalese prostitutes pooled from all three sites. Controlling for ethnic group, women from Ziguinchor and Kaolack were more likely to be HIV-2 seropositive as compared with women from the Dakar site. Increased years of sexual activity were associated with HIV-2 seropositivity, while a history of excision and BCG vaccinations decreased the risk of HIV-2 infection.

Adult↗
PubMed1994

Evaluation of a targeted AIDS prevention intervention to increase condom use among prostitutes in Ghana.

OBJECTIVE: To assess the short- and long-term impact of a 6-month pilot intervention program on condom use among prostitutes in Accra, Ghana. DESIGN: The 4-year prospective study follows-up cohorts enrolled in the intervention in 1987 and 1988, comparing condom use in 1991 with that among a comparison group not enrolled in the intervention. SETTING: The community-based intervention was initiated in Accra, Ghana in 1987. PARTICIPANTS: Self-identified female prostitutes who volunteered participation. INTERVENTION: The educational intervention used local health workers to train and support selected prostitutes to be health educators and condom distributors to their peers. OUTCOME MEASURES: Self-reported condom use with clients. RESULTS: Reported condom use increased dramatically between 1987 and 1988 during the first 6 months of the intervention. In 1991, after 3 years of program relapse, 107 (43%) of the 248 women who had enrolled in 1987 or 1988 were still in prostitution and located for interview. Their level of condom use in 1991 was higher than pre-enrollment but similar to use among prostitutes never enrolled. Sixty-four per cent of those followed-up reported always using condoms with clients in 1991. These 'always users' were more likely to have maintained informal contact with project staff, know that HIV can be transmitted by healthy clients, and report that clients frequently initiate condom use. CONCLUSIONS: Findings support the development of long-range educational strategies that recognize the career longevity of prostitutes, available channels for informal program diffusion, individual changes in condom use over time, and the role of clients in condom negotiation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prostitutes are a major reservoir of sexually transmitted diseases in Nairobi, Kenya.

Prostitutes are a major reservoir of sexually transmitted diseases in many developing nations. In Nairobi we found that 16%, 28%, and 46%, respectively, of upper-, middle-, and lower-social strata prostitutes were infected with Neisseria gonorrhoeae. Genital ulcers and infections with Haemophilus ducreyi were more prevalent among prostitutes of the middle and lower social strata. A group of 97 prostitutes of the lower social strata were followed longitudinally to determine the rate of reinfection with N. gonorrhoeae. The mean time to acquisition of a new infection was 12.0 +/- 9.2 days. These results show that in Nairobi prostitutes are a readily identifiable group of high-frequency transmitters of gonococcal infection. Strategies based on intervention in the prostitute reservoir could prove to be an effective means of control of gonococcal infections in developing nations.

Chancroid↗
PubMed1993

Trends of human immunodeficiency virus type-1 infection in female prostitutes and males diagnosed with a sexually transmitted disease in Djibouti, east Africa.

A cross-sectional serosurvey for human immunodeficiency virus type 1 (HIV-1) was conducted during the first quarter of 1991 among high risk groups in Djibouti, East Africa, and compared with previous surveys in 1987, 1988, and 1990. The survey demonstrated evidence of HIV-1 infection in 36.0% (n = 292) of street prostitutes, 15.3% (n = 360) of prostitutes working as bar hostesses, and 10.4% (n = 193) of males diagnosed with a sexually transmitted disease. By multivariate modeling, HIV-1 seropositivity in prostitutes was associated with Ethiopian nationality, working as a street prostitute, and residing in Djibouti for two years or less. We suggest that prostitution, particularly street prostitution, is a major route of HIV-1 transmission in Djibouti.

Adolescent↗
PubMed2002

Kaposi's sarcoma herpesvirus and HIV-1 seroprevalences in prostitutes in Djibouti.

Kaposi's sarcoma herpesvirus (KSHV) is linked causally to Kaposi's sarcoma. Epidemiological studies have shown that KSHV transmission can occur during sex among homosexual men, but heterosexual transmission seems to be very rare in KSHV low prevalence countries. A seroepidemiological study was conducted to determine whether KSHV is transmitted sexually between heterosexuals in an endemic country. Sera from 282 subjects of African origin living in Djibouti were tested for antibodies to KSHV and HIV-1. Among the 282 individuals, 43 were female prostitutes working in the streets (group 1), 123 were female prostitutes working in luxury bars (group 2), 41 were non-prostitute females (group 3), and 75 were non-prostitute males (group 4). KSHV seroprevalence was 26, 20, 17, and 36% in groups 1, 2, 3, and 4, respectively. The seroprevalence of KSHV is not different between street or bar prostitutes and non-prostitute females (OR = 1.67; P = 0.34 and OR = 1.18; P = 0.73). These results suggest that in this endemic country commercial sex work does not seem to be a risk factor for KSHV infection and provides evidence against heterosexual transmission of KSHV in the female population studied.

Adolescent↗
PubMed1976

Brothel prostitution in Columbia.

Peculiarities of Colombian brothel prostitution as well as its similarities to that practiced elsewhere are reported. Data gathered through interviews with a group of brothel residents in Manizales, and by means of participant observations in the brothels of several Colombian cities, indicate that economic factors play an important role in its etiology and maintenance. Incomplete "commercialization" of this prostitution system is described along with the negligible role played by pimps and the freedom Colombian prostitutes have to dispose of their earnings. Misconceptions about prostitutes pointed out by other authors (Pomeroy, 1965; Gebhard, 1969), such as marked infertility, irreligiousness, and homosexuality, are also contested by this study. Pomeroy's and Gebhard's findings of the prostitute's lack of regret about her trade are not confirmed. It is the authors' contention that prostitution shows ample sociocultural variations and that theoretical generalizations regarding it do not apply to different cultural milieus.

Adolescent↗
PubMed1992

Mother sold food, daughter sells her body: the cultural continuity of prostitution.

This article provides a cultural interpretation of female prostitution in contemporary lowland Buddhist Thai society. The heterosexual transmission of AIDS through prostitution has exposed the shallowness of our understanding of prostitution as a sociocultural phenomenon. The data were collected through case studies, participant-observation, and review of Thai language media and texts. It is argued that in the past decade or so, the simultaneous rapid growth of prostitution as a lucrative sex industry and of the Thai economy as an emerging newly industrialized country (NIC) have, paradoxically, enabled female prostitutes to conserve the basic institutions of society. This has occurred at a time when landlessness, rampant commercialism and poverty have threatened the survival of traditional lifeways among the majority rural agricultural population. Prostitution, although illegal, has flourished at least in part because it enables women, through remittances home and merit-making activities, to fulfil traditional cultural functions of daughters, conserving the institutions of family and village-level Buddhism, as well as of government.

Buddhism↗
PubMed1999

Heterosexual transmission of GB virus C/hepatitis G virus infection to non-intravenous drug-using female prostitutes in Fukuoka, Japan.

To determine if GB virus C (GBV-C) or hepatitis G (HGV) infection can be transmitted by heterosexual intercourse, we tested serum samples from 234 non-drug-injecting female prostitutes for GBV-C/HGV. We used reverse transcription polymerase chain reaction to test for GBV-C/HGV RNA and ELISA for GBV-C/HGV-E2 antibody. The prevalence of total GBV-C/HGV marker (GBV-C/HGV RNA and/or GBV-C/HGV-E2 antibody) was 58/234 (24.8%) in the prostitutes, and 7/71 (8.9%) in matched controls. The GBV-C/HGV RNA and GBV-C/HGV-E2 antibody concurrence rate was 12.5% for the prostitutes, but was nil in matched controls. Total GBV-C/HGV marker was significantly higher in the prostitutes than in matched controls. Additionally, total GBV-C/HGV marker was associated with the number of years engaged in prostitution after adjusting for age. We found hepatitis B virus and hepatitis C virus infections in prostitutes to be associated with syphilis infection, but GBV-C/HGV infection was not. Thus, it seems likely that GBV-C/HGV can be transmitted by heterosexual intercourse, even in the absence of syphilis.

Adult↗
PubMed1996

Prostitution advertisements suggest association of transvestism and masochism.

Previous research and clinical observation have suggested that the sexual interest of many transvestites include involvement in sadomasochistic sexual acts. Through data gathered via prostitution advertisements in print media, we tested the hypothesis that prostitutes welcoming cross-dressing client would be primarily those describing themselves as dominant. The specialty of the prostitute was recorded by coding the advertisements for the presence or absence of the features of dominance, submissiveness, acceptance of cross-dressing clients, and whether the prostitute was a biological male presenting as a woman or quasi-woman. The findings showed that 20% of prostitutes describing themselves as dominant welcomed cross-dressing clients, whereas none of the other subgroups of prostitutes mentioned cross-dressing clients in their advertisements. These findings reinforce other lines of indirect evidence suggesting that, in heterosexual men, the presence of masochism increases the likelihood of transvestism, and vice versa.

Advertising↗
PubMed1995

Reaching male clients of female prostitutes: the challenge for HIV prevention.

Male clients of prostitutes have proved to be a very difficult group to access for the purposes of HIV research and education. Prevention initiatives to date have placed less emphasis on HIV awareness with this potential target group and more on empowering prostitutes to control the sexual transaction with clients. Data is presented from a study of male clients of prostitutes, conducted as part of a wider study of drug using and nondrug using prostitutes in the Greater Manchester area during 1991-92. The study focuses on sexual activities and risk behaviours of male clients with female prostitutes, and with regular and casual partners. The data provides evidence of high levels of risk-taking, particularly by bisexual clients. Implications for research and HIV prevention are discussed. It is concluded that placing the major burden for behaviour change on prostitutes themselves may have only a limited effect and that other involved persons (including clients) should be more actively targeted in the development and implementation of STD/HIV prevention.

Adult↗
PubMed1995

Sexual transmission of human T-lymphotropic virus type I among female prostitutes and among patients with sexually transmitted diseases in Fukuoka, Kyushu, Japan.

The authors investigated the prevalence of antibody to human T-lymphotropic virus type I (anti-HTLV-I) in 409 female prostitutes, 446 patients with an episode of sexually transmitted diseases, and 17,345 control blood donors. All subjects were Japanese and all studies were done in Fukuoka, Kyushu, Japan, in 1989. The prevalence of anti-HTLV-I was significantly higher in the prostitutes (5.1%, p < 0.001), in the male patients (2.8%, p < 0.05), and in the female patients (5.7%, p < 0.05) than in the controls (males 1.4%, females 2.2%). Prevalence of anti-HTLV-I in the prostitutes increased with the number of years spent in prostitution, but the increase was not statistically significant. Among the subjects with sexually transmitted diseases, female prostitutes with syphilis, male patients with non-gonococcal urethritis, female patients with syphilis, and female patients with gonorrhea had a significantly higher prevalence of anti-HTLV-I than did the controls. A longitudinal study was done on the 168 prostitutes. Two (1.3%) of the 158 initially seronegative subjects seroconverted over the period of 2 years. These data suggest that the risk of male-to-female transmission of HTLV-I through sexual contact is high among high risk groups in Japan, and they support the possibility of female-to-male transmission of HTLV-I.

Adolescent↗
PubMed2004

Mortality in a long-term open cohort of prostitute women.

In this study, the authors estimated overall and cause-specific mortality among prostitute women. They recorded information on prostitute women identified by police and health department surveillance in Colorado Springs, Colorado, from 1967 to 1999. The authors assessed cause-specific mortality in this open cohort of 1,969 women using the Social Security Death Index and the National Death Index, augmented by individual investigations. They identified 117 definite or probable deaths and had sufficient information on 100 to calculate a crude mortality rate (CMR) of 391 per 100,000 (95% confidence interval (CI): 314, 471). In comparison with the general population, the standardized mortality ratio (SMR), adjusted for age and race, was 1.9 (95% CI: 1.5, 2.3). For the period of presumed active prostitution only, the CMR was 459 per 100,000 (95% CI: 246, 695) and the SMR was 5.9 (95% CI: 3.2, 9.0). Violence and drug use were the predominant causes of death, both during periods of prostitution and during the whole observation period. The CMR for death by homicide among active prostitutes was 229 per 100,000 (95% CI: 79, 378), and the SMR was 17.7 (95% CI: 6.2, 29.3). Deaths from acquired immunodeficiency syndrome occurred exclusively among prostitutes who admitted to injecting drug use or were inferred to have a history of it.

Adult↗
PubMed1992

Sexual transmission of hepatitis C virus among female prostitutes and patients with sexually transmitted diseases in Fukuoka, Kyushu, Japan.

The authors investigated the prevalence of antibody to hepatitis C virus (anti-HCV) in 404 female prostitutes, 428 clinic patients with a history of at least one episode of sexually transmitted disease, and 8,944 blood donors who served as the controls. All subjects were Japanese, and all studies were carried out in Fukuoka, Kyushu, Japan, in 1989. The prevalence of anti-HCV was significantly higher in the prostitutes (6.2%), in the female patients with sexually transmitted diseases (6.1%), and in the male patients with sexually transmitted diseases (2.9%) than in the controls (1.5%). Prevalence of anti-HCV increased with age in prostitutes and in the controls. The prevalence of anti-HCV in those who had been involved in prostitution for 1 year or more (8.1%) was higher than in those who had been involved in prostitution for less than 1 year (1.4%), but the difference was not statistically significant. One of the 152 anti-HCV negative prostitutes seroconverted between 1 and 2 years later. Among the subjects with sexually transmitted diseases, patients with a history of at least one episode of syphilis had a significantly higher prevalence of anti-HCV (4.4%) than the controls. Patients with acute urethritis and cervicitis also showed a high prevalence of anti-HCV (3.6% and 6.7%, respectively). These data support the possibility of sexual transmission of hepatitis C virus.

Adolescent↗
PubMedDate not supplied

Prevalence of genital pathogens among female prostitutes in New York City and in Rotterdam.

The authors studied the prevalence of genital microorganisms among 300 female prostitutes in brothels in New York City and 60 female prostitutes attending a sexually transmitted diseases clinic in Rotterdam, The Netherlands. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in the two cities were 9.3% and 8.3%, 25.3% and 16.6%, 57.3% and 74.9%, and 73% and 79%, respectively. Trichomonas vaginalis was detected in 3.6% of New York prostitutes and in 16.6% of those in Rotterdam. Nonspecific vaginitis was found in 33% of prostitutes examined in New York. In New York, Asian prostitutes were more likely to be infected with C. trachomatis (33 of 102; 32.3%) than were prostitutes of other ethnic backgrounds (44 of 194; 21.5%; P less than .05.

Adult↗
PubMed1980

Prostitution in Lagos: a sociomedical study.

A study of 150 hotel prostitutes in Lagos was undertaken to determine their socioeconomic identity and, through an assessment of their health knowledge, attitude, and practice, their probable impact on public health. The subjects were selected from 15 hotels, representing 20% of the estimated hotel universe in Lagos and different socioeconomic strata. Information was obtained from the subjects with the help of the hotel staff, who arranged pre-interview conferences with them. Prostitution in Lagos is not organised and there are no figures on the prostitute population. Ninety-eight per cent of the women in the study population were aged between 15 and 44 and 70% of them had children. Forty per cent were married and 24% were either divorced or separated. The most important reason given for prostitution was unhappiness in the home (50%) but the undercurrent of poverty, especially in a low-income society, is undoubtedly a major motive. More than half (55.3%) of the subjects selected their clients and the most important criteria for selection were physical fitness and ability to pay. Physical fitness was defined as the absence of signs of gonorrhea. The women's level of education was a significant factor in selection of clients and in mode of health care. More than 60% of those who selected their clients had had some education or had completed secondary schooling. Thirty-three per cent of those who did not select their clients had had no education at all and 45% had received primary education only. The attitude of the subjects to health care suggests an opportunity for the control of disease among prostitutes if prostitution is organised.

Adolescent↗
PubMed2005

Male clients of brothel prostitutes as a bridge for HIV infection between high risk and low risk groups of women in Senegal.

OBJECTIVE: To explore the extent to which male clients of prostitutes have a role as a bridge in the spread of HIV into the general population of Dakar, Senegal. METHODS: A sexual behaviour HIV prevalence survey was carried out among clients of female prostitutes working in brothels recruited outside the prostitutes' rooms after the encounter. All men entering the house and leaving the women's rooms were asked to answer the questions and to donate saliva for HIV-1 and HIV-2 testing. RESULTS: Findings suggest that a proportion of clients form a potential bridge for HIV transmission between prostitutes and partners from the general population. They have unprotected sexual contacts with both brothel prostitutes, and steady and casual partners, and expose both unmarried and married women to HIV infection. Findings also indicate that wives are more exposed to HIV than other categories of women in the population. CONCLUSIONS: Clients of brothels' prostitutes have a significant potential for spreading HIV beyond the initial high risk behaviour groups in Senegal. Efforts should be provided to target specific groups at higher risk for HIV infection, such as young men from the densely populated working class neighbourhoods of Dakar, and women outside the commercial sex networks for HIV education and prevention.

Adult↗
PubMed1979

HLA and sexually transmitted diseases in prostitutes.

The HLA profile of 148 unrelated, Chinese prostitutes (56 with repeated gonococcal infection, 31 with syphilis, 31 with gonorrhoea and syphilis, and 30 with no evidence of infection) was compared with that of 238 unrelated, healthy, Chinese control subjects. The joint occurrence of AW19 B17 was observed in 25.8% of prostitutes with double infections compared with 6.7% of control subjects, while that of A11 B15, on the other hand, was associated with a resistance to syphilis and gonorrhoea. The latter profile was observed in 46.7% of prostitutes in business for more than two years who were resistant to disease, in 30% of prostitutes with an overall disease resistance, in 13.4% of control subjects, and in only 3.2% of prostitutes with combined syphilis and gonorrhoea. Because of the statistical uncertainty when multiple variables are being analysed these studies should be repeated in other groups of prostitutes of the same and different ethnic origins.

Adolescent↗