Document 0925
 DOCN  M94A0925
 TI    Incident HIV and STDs in direct and indirect commercial sex workers
       (CSWs) in Thailand.
 DT    9412
 AU    Beyrer C; Khamboonruang C; Natpratan C; Celentano D; Nelson KE; Johns
       Hopkins Univ., Baltimore, MD.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):25 (abstract no. 391C). Unique
       Identifier : AIDSLINE ICA10/94371650
 AB    OBJECTIVE: We studied incident HIV and STDs and high risk behavior in
       cohorts of CSWs to assess their suitability for HIV vaccine trials and
       other interventions. METHODS: Female CSWs were screened for HIV and
       seronegatives were followed q3mos. with behavioral interviews, physical
       exams (including pelvic exams), STD cultures and HIV serology. Direct
       (brothel-based) CSWs and Indirect (others) CSWs were compared for their
       risk behavior, followup rates, HIV and STD incidence. RESULTS: Of 1068
       CSWs screened 409(38.3%) were HIV pos at baseline; 396 HIV neg CSWs were
       followed. Direct CSWs (n = 176) were compared to indirect CSWs (n =
       220). Direct CSWs were younger (median age = 20 vs 26 yrs; p < .001),
       had worked shorter time as a CSW (mean 2.3 vs 3.4 yrs, p < .02), were
       less educated (43% vs 7% no schooling, p < .001), and had more customers
       per night (median 4 vs 1, p = .001); the median highest number of
       customer per day was 9.0 (direct CSWs) and 4.0 (indirect CSWs, p < .01).
       Followup at 6 mos. was 58.5% for Direct CSWs and 75.5% for Indirect
       CSWs; 19 CSWs had seroconverted to HIV at 6 mos., 15 HIV seroconverters
       were direct CSWs (11.9/100 person semesters) at baseline; and 4 were
       indirect CSWs (2.0/100 person semesters), i.e. annual incidence of 24%
       and 4.0% respectively. Higher incidence of other STDs were seen in
       direct vs indirect CSWs at 6 mos; gonorrhea (7.1% vs 1.5%, p < .05),
       Chlamydia (6.3% vs 1.5%, p < .05) and Syphilis (5.0% vs 1.0%, p < .05).
       CONCLUSION: Both direct and indirect CSWs in northern Thailand have a
       high incidence of HIV and other STD infections despite current
       interventions, e.g. condom promotion. They could be suitable populations
       to evaluate other interventions such as HIV vaccines if followup could
       be improved.
 DE    Adult  Cohort Studies  Comorbidity  Female  Human  HIV
       Infections/*EPIDEMIOLOGY  HIV Seropositivity/EPIDEMIOLOGY  Incidence
       Occupational Diseases/*EPIDEMIOLOGY  Prostitution/*STATISTICS & NUMER
       DATA  Sex Behavior/STATISTICS & NUMER DATA  Sexually Transmitted
       Diseases/*EPIDEMIOLOGY  Thailand/EPIDEMIOLOGY  MEETING ABSTRACT

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