Cc. Oconnor et al., SEXUAL HEALTH AND USE OF CONDOMS AMONG LOCAL AND INTERNATIONAL SEX WORKERS IN SYDNEY, Genitourinary medicine, 72(1), 1996, pp. 47-51
Objectives: To compare indicators of sexual health and predictors of c
ondom use for commercial sex among local and international female sex
workers first attending an STD clinic. Setting: A public STD clinic in
Sydney, Australia. Subjects: All sex workers first attending between
June 1991 and May 1993. Methods: Cross-sectional analysis of demograph
ic, behavioural and morbidity data from proforma medical records. Resu
lts: 91 local sex workers and 123 international sex workers (predomina
ntly from Thailand, Malaysia and China) first presented during the stu
dy period. There were significantly higher prevalences of chlamydia (0
v. 15%, p = 0.0002), gonorrhoea (0 v. 14%, p = 0.0006), syphilis (0 v
. 10%, p = 0.006) and clinical genital herpes (0 v. 5%, p = 0.04) amon
g international sex workers. The only case of HIV infection was in an
international sex worker. Inconsistent condom use for commercial sex w
as significantly more common among international sex workers (RR = 4.5
; 95% CI 3.1-6.5). On multivariate analysis, inconsistent condom use i
n international sex workers was associated with a recent history of pr
ostitution outside Australia (p = 0.04), while inconsistent condom usa
ge among local sex workers was associated with increasing age (p = 0.0
03). Conclusions: These data illustrate the efficacy of condoms and th
e success of targeted education programmes in local sex workers in Syd
ney. By contrast, international sex workers continued to be at high ri
sk of STDs. The international sex industry in Sydney requires enhanced
culture-specific interventions. Immigration laws as they affect sex w
orkers should also be reviewed.