Document 0304
 DOCN  M9650304
 TI    Socioeconomic status and risk of HIV-1, syphilis and hepatitis B
       infection among sex workers in Sao Paulo State, Brazil. Instituto Adolfo
       Lutz Study Group.
 DT    9605
 AU    Lurie P; Fernandes ME; Hughes V; Arevalo EI; Hudes ES; Reingold A;
       Hearst N; Center for AIDS Prevention Studies (CAPS), University of;
       California, San Francisco 94105, USA.
 SO    AIDS. 1995 Jul;9 Suppl 1:S31-7. Unique Identifier : AIDSLINE
       MED/96085741
 AB    OBJECTIVES: To determine how HIV risk behavior and the prevalences of
       sexually transmitted diseases vary according to socioeconomic status and
       city among sex workers in Sao Paulo State, Brazil. SUBJECTS AND METHODS:
       A cross-sectional study of 600 female sex workers (100 of a higher
       socioeconomic status and 100 of a lower socioeconomic status in each
       city) was conducted in the cities of Sao Paulo, Campinas and Santos. HIV
       risk behavior was assessed by questionnaire; serological tests were
       administered to assess prior exposure to HIV-1, syphilis and hepatitis
       B. RESULTS: Only statistically significant (P < 0.05) findings are
       reported here. Compared to those with a higher socioeconomic status, sex
       workers with a lower socioeconomic status worked longer hours each day
       (9.6 versus 7.9), had more clients per day (5.4 versus 2.6) and had
       fewer episodes of intercourse per client per encounter (1.1 versus 1.4).
       Levels of condom use for vaginal, anal and oral sex were significantly
       higher in Santos than in Sao Paulo or Campinas. Twenty-three per cent of
       the women said they feared violence if they insisted that their clients
       wear condoms; 74% voiced similar fears regarding their non-client sexual
       partners. Overall, 11% of sex workers were positive for exposure to
       HIV-1, 45% for syphilis and 39% for hepatitis B. Those with a lower
       socioeconomic status were more likely than those with a higher
       socioeconomic status to be infected with HIV-1 (17 versus 4%), syphilis
       (66 versus 24%) and hepatitis B (52 versus 26%), but there were no
       differences in prevalence rates by city. CONCLUSIONS: These data
       demonstrate substantial heterogeneity in HIV risk behavior and the
       prevalence of HIV-1 and other sexually transmitted diseases among sex
       workers in Sao Paulo State, many of which were related to differences in
       socioeconomic status. Interventions to prevent HIV transmission among
       sex workers must be tailored to the local environment and, in
       particular, to the socioeconomic status of these workers.
 DE    Adolescence  Adult  Brazil/EPIDEMIOLOGY  Condoms/STATISTICS & NUMER DATA
       Cross-Sectional Studies  *Developing Countries  Female  Health Education
       Hepatitis B/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION  Human  HIV
       Infections/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION  *HIV-1
       Incidence  Knowledge, Attitudes, Practice  Middle Age
       Prostitution/*STATISTICS & NUMER DATA  Sexual Partners  *Socioeconomic
       Factors  Support, Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.
       Syphilis/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION  Urban
       Population/STATISTICS & NUMER DATA  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).