Commercial sex workers in Johannesburg: risk behaviour and HIV status

THE SEX WORK INDUSTRY IN THE Hillbrow area of Johannesburg is unique in sou thern Africa in that it exists in a high-density setting, where sex workers operate from hotels, flats and on the street. There is little information on the sex work trade in the city. Further, there have been few, if any, ta rgeted health services for sex workers in this area. This study collected d emographic data and information on sexual behaviour of women who identified themselves as sex workers. Female sex workers were recruited from the Hillbrow area by outreach worker s. Screening included an interviewer-administered questionnaire and physica l examination including HIV testing and diagnosis of current sexually trans mitted infections. In total, 247 women were screened, of whom 46% had been operating as sex workers for less than one year. Almost half (45%) of the w omen were HIV positive. HIV status was significantly associated with condom use (P = 0.0003) and number of clients seen per day (P = 0.005). Duration of time as a sex worker was not found to be associated with HIV status; tho se working for three or more months showed similar levels of infection to t hose working for one year or more. The study confirmed that sex workers in Hillbrow exhibited the characterist ics of a core transmitter group. Interventions are now addressing the issue s of safer sex and health care of sex workers living and working in this ar ea.