HIV-INFECTION AND RISK-FACTORS AMONG FEMALE SEX WORKERS IN SOUTHERN VIETNAM

Objectives: To determine the extent of HIV infection among female comm ercial sex workers (CSW), to identify risk factors, and to provide bas eline data for developing and targeting prevention measures. Subjects and methods: A total of 968 female CSW were enrolled in a cross-sectio nal study from August 1995 to October 1996. Information was obtained f rom confidential face-to-face interview, physical examination, and lab oratory testing. Results: A total of 65.5% of female CSW reported inco nsistent condom use. Overall seroprevalence was 5.2%. The highest sero prevalence (9.5%) was detected in An Giang province, a border area adj acent to Cambodia. Out of seven HIV isolates in An Giang province, six were characterized as Thai subtype E and one as subtype B. Multiple l ogistic regression analysis showed an independent significant associat ion between HIV seroprevalence and the following: age less than or equ al to 30 years [odds ratio (OR), 5.1; 95% confidence interval (CI), 1. 7-15.2]; high frequency of sex (> 20 times per week; OR, 13.5; 95% CI, 3.6-50.2); inconsistent condom use (OR, 2.8; 95% CI, 1.01-8.0; sign o f genital ulcers (OR, 18.1; 95% CI, 1.8-182); venereal warts (OR, 9.0; 95% CI, 2.5-33.0); brothels as sex venue (OR, 7.0; 95% CI, 2.0-24.3); and working at the border area (OR, 5.1; 95% CI, 2.4-11.0). Brothels as work-sites were significantly related to inconsistent condom use an d the socioeconomic background of clients. Only 0.5% of CSW reported i njecting drug use. Conclusions: Female CSW at brothels who reported in consistent condom use and ulcerous sexually transmitted disease, parti cularly in the border area with Cambodia, had greater risk of HIV infe ction. Brothels were more frequently used as sex venues in the border area and were more likely to be visited by occasional clients who were difficult to access. Drug use among female CSW in this region was rar e. The development of prevention measures should be based on these res ults. (C) 1998 Rapid Science Ltd.