Thursday, January 14, 2016

Unexpectedly High HIV Prevalence among Female Sex Workers in Bangkok, Thailand

The pattern of sex work in Thailand has shifted substantially over the last two decades from direct commercial establishments to indirect venues and non-venue-based settings. This respondent-driven sampling survey was conducted in Bangkok in 2007 among female sex workers (FSW) in non-venue-based settings to pilot a new approach to surveillance among this hidden population. Fifteen initial participants recruited 707 consenting participants who completed a behavioural questionnaire, and provided oral fluid for HIV testing, and urine for sexually transmitted infection (STI) testing. 

Overall HIV prevalence was 20.2%. Three-quarters of women were street-based (75.8%) who had an especially high HIV prevalence (22.7%); about 10 times higher than that found in routine sentinel surveillance among venue-based FSW (2.5%). STI prevalence (Chlamydia trachomatis and Neisseria gonorrhoeae) was 8.7% and 1.0%, respectively. Lower price per sex act and a current STI infection were independently associated with HIV infection. 

High HIV prevalence found among FSW participating in the survey, particularly non-venue-based FSW, identifies need for further prevention efforts. In addition, it identifies a higher-risk segment of FSW not reached through routine sentinel surveillance but accessible through this survey method.

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1Global AIDS Program, Thailand/Asia Regional Office, Thailand MOPH-U.S. CDC Collaboration, Ministry of Public Health, Nonthabhuri.

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