TRENDS IN SEXUALLY-TRANSMITTED DISEASES AND CONDOM USE PATTERNS AMONGCOMMERCIAL SEX WORKERS IN FUKUOKA CITY, JAPAN 1990-93

Objective: To investigate trends in sexually transmitted diseases (STD s) among female commercial sex workers and in their condom use pattern s during the period from 1990 to 1993 in Fukuoka, Japan. Methods: The study group consisted of a total of 824 commercial sex workers who att ended an STD clinic to undergo screening for STDs including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV-1 infection during the peri od from 1990 to 1993. For detection of Chlamydia trachomatis and Neiss eria gonorrhoeae, endocervical smear specimens were taken from the wom en. Blood samples were obtained for serological diagnosis of syphilis, hepatitis B and HIV-1. Commercial sex workers who visited the clinic during the period from November to December of 1993 were interviewed c oncerning past (1990 and 1991) and recent (1992 and 1993) condom use p atterns. Results: The annual detection rates of C trachomatis and N go norrhoeae declined significantly from 16.3% in 1990 to 12.2% in 1993 ( P < 0.0001) and from 1.5% in 1990 to 0.8% in 1993 (P = 0.0096), respec tively. There was a remarkable reduction in the annual syphilis infect ion rate, from 7.5% in 1990 to 0.5% in 1993 (P = 0.0011). The positive rate for the hepatitis B surface antigen in the women ranged from onl y 0.6% to 1.9% and none were found to be positive for HIV-1 during the 4-year period. During the same period, there was a significant increa se in the proportion of commercial sex workers always using condoms fr om 6.3% in 1990-91 to 25.3% in 1992-93 (P = 0.0023). Conclusion: The p revalences of chlamydia, gonorrhoea, and syphilis infections decreased significantly among commercial sex workers in Fukuoka from 1990 throu gh 1993, and no commercial sex workers were HIV-1 seropositive. The re ductions in the prevalence of major STDs may be related to the increas ed use of condoms.