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PubMed1992

Prostitutes and their clients: a Gambian survey.

The social backgrounds and working behaviour of 248 prostitutes in urban and rural areas of The Gambia were investigated. Prostitutes were found to be highly mobile, moving frequently between a number of working locations in The Gambia and neighbouring Senegal, from which most of them originated. The educational level of prostitutes and the standard of living of their natal families were above average. Prostitutes worked on average four days a week and had between two and three clients a night. Condoms were used in up to 80% of contacts. 795 clients of prostitutes were interviewed and found to be on average of low educational and occupational status. Half were non-Gambian and most were currently travelling or living away from home.

Abortion, Therapeutic↗
PubMedDate not supplied

[Social characteristics and risk behaviors for HIV in a group of transvestites and male transsexuals engaging in street prostitution].

OBJECTIVE: To describe life and work conditions, practices associated with HIV transmission, self-informed HIV status and HIV test coverage in a group of male transgender street prostitutes. METHODS: Case descriptive study of male transgender street prostitutes who attended a mobile unit of a harm reduction programme in 1998 in Madrid, Spain Information on sociodemographic characteristics, work conditions, illegal drug use, sexual behaviours and self-informed HIV status was collected. RESULTS: 132 male transgenders were interviewed, of which 56% were Spanish. Median age was 30 years. 50% had primary school education or less. 11% had injected drugs sometime in their lives. Median time in prostitution was 8 years and 66% had worked only in the streets. In the last month, all of them said to use condoms in insertive anal sex with clients, 98% in receptive sex and 49% always used it with their partners in the previous year. 39% referred accidents with condoms within the previous month. 73% had had an HIV test, of which 22% said to be HIV positive (16% in those who had never injected drugs and 58% in the ones who had). CONCLUSIONS: HIV seroprevalence in male transgender street prostitutes is high, even in non-intravenous drug users. They nearly always use condoms with clients but have a high level of accidents. HIV prevention programmes in prostitution should be more specifically adapted to the different groups of commercial sex workers.

Adult↗
PubMed1993

Coping, defending, and the relations between moral judgment and moral behavior in prostitutes and other female juvenile delinquents.

Twenty female juvenile delinquents who acknowledged engaging in prostitution, 20 juvenile delinquents who denied doing so, and 20 same-age control subjects responded to Colby and Kohlberg's (1987) Moral Judgment Interview (MJI), a moral dilemma about prostitution, and Joffe and Naditch's (1977) test of coping and defending. Delinquents scored lower on moral maturity and coping and higher on defensiveness than nondelinquents. Post hoc analyses revealed that low-coping delinquents (but not high-coping delinquents or control subjects) made significantly lower level moral judgments on the prostitution dilemma than on the less personally relevant MJI dilemmas. Groups did not differ in their prescriptive judgments on the MJI, but prostitutes made weaker judgments against prostitution than the other delinquents. Prescriptive judgments were not related to moral maturity. The results elucidate the relation between moral judgment and moral behavior.

Adaptation, Psychological↗
PubMed2003

HIV prevalence and sexual behaviour of male clients of brothels' prostitutes in Dakar, Senegal.

This study reports the results of research designed to determine the prevalence of HIV infection in a group of male clients of brothel prostitutes, and to describe characteristics associated with HIV infection in Dakar, Senegal. Clients come from the lower portion of the social scale rather than from the middle class or from the wealthier groups of the population. A significant number of these men did not use condoms with their regular partners, and another group reported sexual contact with occasional partners with whom condom use was not usual. Additionally, for a fraction, condoms were not systematically used either with prostitutes or with partners. HIV prevalence in clients appeared to be much higher than the prevalence in the general population and HIV-infected clients were older than HIV-negative clients. The significant association between HIV infection and age can be explained by the fact that older clients probably have been exposed to prostitution longer. HIV-positive clients had more contact with prostitutes during the previous seven days, and in addition they also had more occasional sexual encounters than did the HIV-negative clients. This demonstrates that a multiplicity of sexual partners increases the risk of HIV infection beyond the contact with prostitutes for this group of men.

Adolescent↗
PubMed1993

Female streetworker--prostitutes in Glasgow: a descriptive study of their lifestyle.

The objective of this study is to describe the lifestyle of a group of female prostitutes. The collection of information was achieved by: (i) using a self administered questionnaire; and (ii) conducting conversational type interviews. Of 85 women attending a health care drop-in centre for female street prostitutes in Glasgow, 63 completed the questionnaire and 72 participated in conversational interviews. For 63 women the mean age of commencement of prostitution was 21 years. Fifty-one (81%) were injecting drug users, their most commonly used drugs being heroin and temazepam. They worked a mean of 5.5 evenings per week and provided sexual services to a mean of 6.4 clients per working day. Less than half of these services were estimated to be vaginal intercourse. While 59/60 women indicated that they always used condoms during vaginal intercourse, this only applied to commercial sex; only 8/47 (17%) always used condoms with their regular sexual partners. Unconventional sexual services, e.g. voyeurism and physical abuse, were commonly provided and clients were often violent. A typical female streetworking-prostitute in Glasgow was aged 25, unemployed, an injecting drug user and had commenced prostitution 4 years before. Her knowledge of HIV/AIDS was good and for vaginal intercourse she almost always used condoms with clients, though probably not with her regular partner. Her main concern was likely to be violence from clients.

Adolescent↗
PubMed2003

Childhood trauma and adult prostitution behavior in a multiethnic heterosexual drug-using population.

A cross-sectional study of the association between severity of childhood trauma and adult prostitution behaviors was conducted among 676 heterosexual drug addicts in San Antonio, Texas. Three hundred and fifty eight women and 338 men taking part in a national multisite program for AIDS prevention research completed the Childhood Trauma Questionnaire as part of a comprehensive risk behavior assessment. Women addicts in the sample were less educated, more likely to be in a common-law relationship, living with someone of the opposite sex or separated, and had lower incomes in comparison to men addicts. Among male subjects,higher educational levels and older age were positively associated with prostitution activities. Single female subjects were three times more likely to engage in selling sex than married subjects. Single women with higher incomes were more likely to be prostituting than single women with lower incomes. Black women reporting severe degrees of emotional abuse, emotional neglect, or physical neglect were more likely to engage in prostitution behavior than Hispanic or white women with similar levels of trauma. Black men with a history of childhood physical abuse were more likely to use prostitutes than Hispanic or white men.

Adult↗
PubMed1988

Prevalence and risk factors of HIV infections among drug users and drug-using prostitutes in Amsterdam.

In December 1985 we started a study to determine the prevalence and risk factors of HIV infection among drug users and drug-using prostitutes in Amsterdam. Recruitment took place at methadone posts (not drug-free; i.e. a low-threshold programme on which some drug users continue to use hard drugs, but at a lower level) and the weekly evening sexually transmitted diseases (STD) clinic for drug-addicted prostitutes. Three hundred and ten drug users have so far been tested and interviewed. Eighty-one per cent reported intravenous drug use; 83% of the 166 females and 15% of the 144 men reported prostitution. Female prostitutes practised mainly vaginal and orogenital intercourse and reported frequent use of condoms (89% of vaginal and 64% of orogenital contact). Male prostitutes practised mainly orogenital and manual contact. At entry 88 of the 310 (28%) were HIV-antibody-seropositive; 85 of these 88 were intravenous drug users and three were male homosexuals. HIV-antigen was detected in two seropositive and one seronegative intravenous drug-user. Antibodies to HTLV-I were found in four out of 308. Risk factors independently associated with HIV-antibody seropositivity among intravenous drug users were: frequency of borrowing used needle or syringe, date of first intravenous drug use, recent intravenous drug use, time living in Amsterdam and German nationality. Of medical history data, an attack of herpes zoster in the previous 5 years had the greatest value in the prediction of the presence of HIV antibodies (relative risk 20.90; 95% confidence interval 2.41-167.27).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

HIV infection and associated risk factors in female prostitutes in Kinshasa, Zaire.

In Africa, female prostitutes represent a high risk group for HIV infection. In Kinshasa, Zaire, 101 (27%) out of 377 prostitutes were seropositive to HIV by ELISA and Western blot determination. Seropositivity was significantly associated with the number of lifetime partners with a median number of 600 partners, four seropositives and 338 for seronegative individuals (P = 0.02). Seropositivity was also significantly associated with a history of taking oral medications for the prevention of sexually transmitted diseases and/or pregnancy (odds ratio = 2.21, confidence interval = 1.2-4.2), and with the introduction of any product into the vagina for hygiene or other purposes (odds ratio = 2.3, confidence interval = 1.1-4.7). In addition, among 85 prostitutes reporting condom use by their sexual partners during the previous year, the use of condoms by 50% or more of partners was associated with a reduced risk of HIV seropositivity (P = 0.046). An increased risk of HIV seropositivity was not associated with fellatio, anal intercourse, or with any type of kissing. Twenty-nine per cent of prostitutes reported at least one symptom suggestive of HIV infection, and seropositivity was associated with weight loss, either with or without chronic diarrhea or pruritic dermatitis. These data confirm that African prostitutes are at high risk for HIV infection and that the number of lifetime sexual partners, and factors which interfere with the integrity of the vaginal or cervical mucosa, may be associated with an increased risk of HIV infection acquired through heterosexual contact.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The syphilis epidemic in Connecticut: relationship to drug use and prostitution.

Syphilis rates in Connecticut increased four-fold between 1986 and 1988. During this time there were also signs of a large increase in cocaine use in the state. We studied links between these parallel trends in drug use and syphilis by examining two sources of data: information collected during syphilis case interviews and information from the syphilis screening program at the state's prison for women. As syphilis rates rose, there were large increases in the percentage of women with syphilis who reported prostitution or illicit drug use. In 1988, 41% of women with syphilis reported cocaine use, and 19% reported prostitution; 21% of male heterosexuals with syphilis reported cocaine use, and 31% reported sexual contact with prostitutes. Among incarcerated women, syphilis infection was frequent: of 113 women incarcerated for possession of illicit drugs in 1987-88, 7% were found to be infected with Treponema pallidum, and of 187 women incarcerated for prostitution in these years, 14% were infected. In both groups of incarcerated women studied, cocaine users had the highest syphilis rates, and those who administered drugs nonintravenously had rates similar to those who administered drugs intravenously. We concluded that the syphilis epidemic in Connecticut is related to the increase in use of illicit drugs (primarily cocaine) and that female drug users are at very high risk of syphilis regardless of whether they administer drugs intravenously or nonintravenously. We recommend that syphilis control efforts focus on wider serologic screening and early treatment of drug users, prostitutes, and their sex partners.

Connecticut↗
PubMedDate not supplied

Influence of syphilis in hepatitis B transmission in a cohort of female prostitutes.

BACKGROUND AND OBJECTIVES. Prostitutes are a greater risk for hepatitis B virus (HBV) infection than the general population. We studied the influence of age and time as prostitute on HBV infection. We also examined the relationship between syphilis and HBV infection in a cohort of female prostitutes. STUDY DESIGN. The presence of hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), antibodies to hepatitis D virus (anti-HD) and treponemal antibodies (FTA-ABS) were determined in 368 prostitutes, of whom 147 were submitted to medical and serological follow-up every six months to evaluate the influence of syphilis in the transmission of hepatitis B. RESULTS AND CONCLUSION. The prevalence of HBsAg was 4.6%, of anti-HBc 31.2%, anti-HD 0.5% and FTA-ABS 35.0%. There was a statistical association between the presence of treponemal antibodies and anti-HBc (P = 0.022). The cohort study performed shows that the accumulated incidence of HBV infection in the FTA-ABS positive prostitutes (24.6%) was significantly higher than that of the FTA-ABS negative group (9.7%) (RR = 2.544; P = 0.034). Our results indicate that syphilis could facilitate the heterosexual transmission of HBV infection.

Adult↗
PubMed1997

Clinical sexually transmitted diseases among human immunodeficiency virus-infected and noninfected drug-using prostitutes. Associated factors and interpretation of trends, 1986 to 1994.

OBJECTIVES: To describe among drug-using prostitutes from the Amsterdam cohort study: 1) trends in clinical sexually transmitted disease (STD) diagnoses from 1986 through 1994; 2) identify factors associated with STD incidences; and 3) determine explanatory factors for time trends in STD. METHODS: Sexual behavior data and human immunodeficiency virus (HIV) serostatus from the cohort study were linked to diagnoses of gonorrhea (GC), Chlamydia trachomatis infection (CT), and trichomoniasis (TV) made at a special STD clinic for drug-using prostitutes. Diagnosis-specific incidences were calculated per 100 person-years of follow-up. Factors associated with STD incidence were determined bivariately. Crude time trends in incidences were determined and then multivariately adjusted for sets of potential explanatory factors using Poisson regression. RESULTS: Cohort data from 229 current prostitutes were linked to clinical STD diagnoses. During the study period, a fivefold decline in GC was found, and CT declined twofold; trends in TV initially declined, but tended to increase after 1991. Higher incidences for STD were associated with inconsistent condom use, higher numbers of clients, shorter history of prostitution, younger age, non-Dutch nationality, and HIV infection. About half of the decline in STD could be explained by changes toward safer commercial sexual behaviours or changes in the characteristics of the study population. CONCLUSIONS: From 1986 through 1994, the incidence in clinical STD declined significantly among drug-using prostitutes in Amsterdam. Trends in STD were only partly due to risk reduction in commercial sexual contacts. Thus, it may be hazardous to use trends in STD as markers for sexual risk behavior. Other factors probably played a substantial role in the observed declines, including declining STD prevalence among male clients, changes in health-seeking behaviors, and improved quality of STD control.

Chlamydia Infections↗
PubMed2001

Prevalence of anti-human papillomavirus type 16, 18, 31, and 58 virus-like particles in women in the general population and in prostitutes.

Genital human papillomavirus (HPV) infection is sexually transmitted. The aim of the study was to characterize serological responses to HPV types 16, 18, 31, and 58 by exploring type-specific virus-like particles (VLPs) in two groups of women with very distinct sexual behaviors. Anti-VLP antibodies for types 16, 18, 31, and 58 and HPV DNA in cervical cells were investigated with 177 prostitutes and 283 age-matched controls from the female general population in Spain. Anti-VLP positivity increased with number of lifetime sexual partners in women from the general population, and no seroresponse was found in virgins. However, in prostitutes HPV infection was characterized by higher multireactivity to three or four VLPs (25%) than the general population (3%) and by a more frequent antibody response to HPV-58 than in the general population. About 75% of the women seropositive for type 58 had been born in a Latin American country. Seroprevalence of HPV and cervical HPV DNA in prostitutes were 14 and 10 times higher than observed in women in the general population (prevalence odds ratio [POR] of HPV seropositivity, 14.04 [95%; CI = 8.4 to 23.6] and POR for HPV DNA, 10.4 [95% CI = 3.9 to 27.6). Our results indicate that prostitutes are at an increased risk of oncogenic HPV infections, and they confirm the validity of anti-VLPs as markers of present or past HPV infection, that the number of sexual partners is the major determinant in acquisition of oncogenic HPV, and that anti-VLPs could be used as a marker of repeated infection in prostitutes.

Adolescent↗
PubMed1974

Prevalence of hepatitis B antigen and antibody in prostitutes.

We investigated the prevalence of hepatitis B antigen (HBAg) and antibody (HBAb) in 293 prostitutes and in 379 pregnant women of similar age and of low socioeconomic level, who served as controls. HBAg was found in 4.4% of prostitutes and 3.4% of controls. The prevalence of HBAb was significantly higher (P <0.001) in prostitutes (56.7%) than in controls (24.5%). The prevalence of HBAb was clearly age-dependent in both groups. Evidence of hepatitis B virus infection significantly increased with the number of years in prostitution. The evidence of increased infection rates among prostitutes and their distribution support the hypothesis that hepatitis B infection is sexually transmitted.

Adult↗
PubMed1991

Homosexual prostitution among male drug users and its risk for HIV infection.

OBJECTIVE: to assess whether male prostitution is an independent risk factor for HIV infection among male (intravenous and nonintravenous) drug users. DESIGN: a cross-sectional study. SETTING: various low-threshold methadone clinics and the sexually transmitted diseases clinic of the Municipal Health Service in Amsterdam and a drug-treatment centre in The Hague. PARTICIPANTS: 343 male intravenous drug users and 106 male non-intravenous drug users. MAIN OUTCOME MEASURES: characteristics concerning drug use behaviour, sexual behaviour, and sociodemography, related to prostitution and HIV-antibodies. RESULTS: of the 449 study participants, 88 (20%) reported a history of prostitution; no differences were found between intravenous and non-intravenous drug users. Younger age, West German nationality, and having had private homosexual sex contacts, were independent predictors of a history of prostitution. Independent predictors of HIV infection were (1) longer residency in Amsterdam; (2) having had predominantly homosexual private sex contacts; (3) longer duration of intravenous drug use; and (4) frequent needle sharing. CONCLUSION: no evidence was found to suggest that male prostitution in itself contributed to the risk of HIV infection.

Adult↗
PubMed2001

Characteristics of Vilnius street prostitutes.

Women prostituting in Vilnius City, Lithuania, were studied with regard to their socioeconomic background, drug and alcohol abuse, conditions for prostituting and for the carrier rate of sexually transmitted infectious agents. The 73 women studied represented a group of low-socioeconomic prostitutes with a great age span, i.e. 14-52 years. Forty-five per cent had one or more children. Roughly one-third were part-time prostitutes. Some had been trafficking for more than one decade. Some started trafficking at the age of 13, while the other extreme was a woman who began to prostitute at 51 years of age. This group of Vilnius street walkers had few customers per day. Eighteen were intravenous drug users and almost all abused alcohol. All, but one, had one or more sexually transmitted infections (STIs). Syphilis was diagnosed in 8 (13%) and another 10 (16%) had a serological scar of such an infection. HIV infections were not diagnosed. Condoms were not consistently used during their social contacts.

Adolescent↗
PubMed1993

Reduction of AIDS risk among 41 heroin addicted female street prostitutes: effects of free methadone maintenance.

Interviews were previously conducted with 72 heroin-addicted female street prostitutes who spread HIV by sharing injection paraphernalia and engaging in unprotected sex with multiple male customers. Most were willing to enroll in free methadone maintenance if made available. Forty-one female addict-prostitutes subsequently entered free methadone maintenance. Twenty-five remained in treatment after one year. Their personal income from prostitution and other crime was reduced 58%; income from legal sources increased 86%. Total urinalyses positive for non-prescribed drugs decreased from 80% on admission to 51%. This pilot study validates the attraction of free methadone maintenance and concomitant reduction of illegal drug use and prostitution, two predictors of HIV infection. However, close supervision and effective counseling and rehabilitative services provided by better trained staff are required for successful outcomes among addict-prostitutes in methadone maintenance.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Child prostitution: a public health issue].

This article analyzes child prostitution based on a review of the literature, in order to support an approach to this problem by the field of Public Health. First, health, prostitution, and violence are discussed as categories. Prostitution has traditionally been analyzed from a medical perspective, mostly within a hygienist point of view. However, the issue is dealt with here from a different perspective. After this discussion, several aspects about the cruelty of Brazilian reality are revealed showing that prostitution among children and teenagers is a way of survival. From this angle, poverty and child prostitution are closely related, although the study concludes that the latter is not solely a consequence of the former. Over the course of the review, a number of publications on the current issue are taken into consideration in order to best contribute to the discussion of the matter. Finally, the author concludes that to confront this problem it must be considered within the family context and linked to macro-social questions.

English Abstract↗
PubMed1990

Hepatitis B infection in a non-drug abusing prostitute population in Mexico.

The prevalence and risk factors of hepatitis B infection were studied in 354 non-drug abusing female prostitutes and 360 female controls in Tijuana, Mexico. Hepatitis B surface antigen (HBsAg) was found in the same percentage (0.8%) of prostitutes and controls. In contrast, antibody markers (anti-HBs or anti-HBc) were found in a significantly higher percentage of prostitutes than controls (8.2% vs. 2.2%, p = 0.0006). Prostitutes also had a higher prevalence of a positive RPR/FTA-ABS test for syphilis (p less than 0.0001). There was a significant association between the presence of hepatitis B markers and positive syphilis serology and a history of having had a STD. In this non-drug abusing population, prostitution was found to be a risk factor for total hepatitis B infection but not for surface antigenemia. Further studies are indicated to determine the incidence of chronic infection in adult women following sexual transmission of hepatitis B.

Adolescent↗