Document 0919
 DOCN  M94A0919
 TI    Incidence of HIV-1 subtype E in a cohort of female prostitutes in
       northern Thailand.
 DT    9412
 AU    Limpakarnjanarat K; Mastro TD; Saisorn S; Young NL; Kunjara-na-ayudya R;
       Korattana S; Weniger BG; CDC, Atlanta, Georgia.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):250 (abstract no. PC0365). Unique
       Identifier : AIDSLINE ICA10/94371656
 AB    OBJECTIVES: To determine the incidence and infecting subtypes of HIV-1
       in a prospective, open-enrollment cohort of female prostitutes (FPs) in
       Chiang Rai, northern Thailand. METHODS: Beginning October 1991, 411
       women (256 brothel-based FPs and 155 indirect FPs working in bars,
       clubs, and massage parlors) were studied every 3 months with interview,
       physical exam, and serologic testing. Serotyping by peptide EIA
       distinguished the two major genotypes circulating in Thailand: genotype
       A/subtype E and genotype B/subtype B. RESULTS: At enrollment, 47.3% of
       brothel FPs were HIV+, compared to 12.9% of indirect FPs (P < 0.001).
       Successful 12-month follow up was 49% in brothel FPs and 68% in indirect
       FPs. There were 16 seroconverters (SCs) among brothel FPs who had 68.9
       person-years (py) of HIV-negative observation, for an HIV incidence of
       25.2/100-py (Poisson 95% CI: 13.3-37.7). Incidence in indirect FPs was
       1.1/100-py (CI 0.03-5.9) (1 SC in 94.3 HIV- py). Most SCs (65%)
       seroconverted within 3 months of enrollment. Among 157 HIV+ women, 138
       (88%) reacted to subtype E, 2 (1%) reacted to subtype B, and 17 (11%)
       were dual- or non-reactive. Compared to HIV(-) FPs, SCs had more clients
       per day (mean 3.4 vs 1.9), had lower charge for service (178 vs 678
       Baht; US$1 = 25 Baht), always used condoms less (25% vs 64%), and had
       more cervical ulceration (31% vs 5%) and chlamydial cervicitis (50% vs
       19%) (all P < 0.05). CONCLUSION: Brothel-based FPs in northern Thailand
       have a very high incidence, equivalent to 25% per year, of HIV-1
       infection of predominantly subtype E. Prevention efforts for women in
       brothels must begin early since seroconversion occurs promptly in new
       FPs.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY  Female  Human  *HIV-1
       Prospective Studies  *Prostitution  Thailand/EPIDEMIOLOGY  MEETING
       ABSTRACT

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