SEXUALLY-TRANSMITTED INFECTIONS IN FEMALE SEX WORKERS - REDUCED BY CONDOM USE BUT NOT BY A LIMITED PERIODIC EXAMINATION PROGRAM

Background and Objectives: The sexually transmitted diseases (STD) con trol program for female sex workers (FSW) in Lima, Peru, provided peri odic serological tests for syphilis and cervical smears for gonococci, but not medication for STD or condoms. Goal of this Study: To assess program effectiveness. Study Design: We assessed prevalence of current STD and serum antibody to STD pathogens in FSW in relation to program participation and to condom use. Results: Program participation was n ot associated with significantly reduced rates of current gonococcal o r chlamydial infections or Venereal Disease Research Laboratory (VDRL) titers greater than or equal to 4 with reactive fluorescent treponema l antibody absorption (FTA-ABS), However, regardless of control progra m participation, consistent condom use was associated with reduced pre valence of gonorrhea, and with significantly reduced seroreactivity fo r FTA-ABS, C. trachomatis, antihepatitis B core (HBc), and anti-human T-lymphotropic virus type I, Anti-HBc was associated with years of rec eiving penicillin injections for syphilis prophylaxis. Conclusion: The scope, quality, and efficacy of STD control programs must be technica lly appropriate, well managed, and adequately financed, The safety of marginal programs warrants scrutiny.