P. Sawanpanyalert et al., HIV-1 SEROCONVERSION RATES AMONG FEMALE COMMERCIAL SEX WORKERS, CHIANG-MAI, THAILAND - A MULTI CROSS-SECTIONAL STUDY, AIDS, 8(6), 1994, pp. 825-829
Objectives: To determine HIV seroconversion rates among female commerc
ial sex workers (CSW) in Chiang Mai, Thailand. Design: A three-round m
ulti cross-sectional study was used at approximately 3-month intervals
. Methods: In December 1989, 38 brothels (60%) in Chiang Mai were rand
omly selected. All 518 female CSW in the brothels were interviewed abo
ut their sociodemographics, sexual practices, condom use, history of s
exually transmitted diseases (STD) and other risk factors. Blood was t
ested for Venereal Disease Research Laboratory (VDRL)-reactivity and H
IV-1 antibody. The same brothels, which were all still operating, were
revisited in March and July 1990 and 431 and 320 CSW, respectively, w
ere interviewed and blood-tested. Pelvic examination, cervical, urethr
al and rectal cultures for gonococcus were added to the study in March
1990, although rectal culture was dropped from the study in July 1990
. Results: There were 5.2% [95% confidence interval (Cl), 4.1-10.6] an
d 3.6% (95% Cl, 1.5-5.4) per woman-month HIV seroconversion rates for
the December-March and March-July periods, respectively. Of the CSW, 7
1.6-77.0% reported histories of at least one STD. Condom-use rates amo
ng these CSW were reported to be 85.8-91.8%. High rates of positive ce
rvical (11.2-12.3%) and urethral (8.8-11.4%) cultures for gonococcus w
ere also found in the CSW. Conclusions: The fact that high HIV serocon
version rates and high STD prevalence rates occur despite high rates o
f reported condom use suggests that more aggressive education programs
are needed in Thailand.