SEXUAL HEALTH AND USE OF CONDOMS AMONG LOCAL AND INTERNATIONAL SEX WORKERS IN SYDNEY

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.