High Prevalence of HIV and Sexually Transmitted Infections Among Indirect Sex Workers in Cambodia

Kim, Andrea A; Li-hua, Sun; Chhea, Chhorvann; Lindan, Christina; Griensven, Frits van; Kilmarx, Peter H.; Sirivongrangson, Pachara; Louie, Janice K.; Leng, Hor Bun; Page, Kimberly

doi:10.1097/01.olq.0000175384.44106.be

Cited by 38 publications

(36 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HIV infection rate for FSW was quite high in our study and is comparable to the rate found in Cambodia (Kim et al 2005). In other previous FSW studies, HIV seroprevalence rates were as high as 75% in Kisumu (Kenya), 69% in Ndola (Zambia), 55% in Cotonou (Benin) and 34% in Yaounde, Cameroon (Morison et al 2001) and as low as Sample size for some variables may be lower due to missing records; * Reference age category for university students was <25; ** Region of origin and were categorised as regions based on cultural similarities, grand north (Adamawa, North, Far north provinces), Other (Centre, East, Littoral, Northwest, West, South and Southwest).…”

Section: Discussionsupporting

confidence: 90%

Human Immunodeficiency Virus Infection and Associated Factors among Specific Population Subgroups in Cameroon

et al. 2007

View full text Add to dashboard Cite

The objective of this study was to identify factors associated with HIV infection among specific population subgroups and complement the HIV surveillance system in Cameroon. Five subgroups (truck drivers, female-sex-workers, university students, health service providers, and residents along Chad-Cameroon petroleum pipeline) were targeted in 2004. Potential participants were approached at their geographically diverse areas and consented to participate in the study. Anonymous blood samples were collected. 4,011 participants were surveyed (35% students, 25% sex-workers, 20% pipeline residents, 12.5% health service providers, 7.5% truck drivers). HIV prevalence was highest among sex-workers [26.4%, (95% CI, 23.6-29.2)], pipeline residents [19.9% (95% CI, 17.1-22.7)] and truck drivers [16.3% (95% CI, 12.3-20.9)] and lowest among health service providers [5.2% (95% CI, 3.4-7.5)] and university students [3.8% (95% CI, 2.9-5.0)]. Risky sexual behaviours were practiced in all subpopulations. Multivariable analysis shows in female-sex-workers that; older age, residing in the grassland region (Northwest and West Provinces) and inconstant condom use were significantly associated with HIV infection. Despite a moderate HIV prevalence in the general Cameroonian population, some subgroups are at much higher risk for HIV transmission and practicing risky sexual behaviours. There is need for expanded prevention and care programs with emphasis on truck drivers, sex-workers and pipeline residents.

show abstract

Section: Discussionsupporting

confidence: 90%

Human Immunodeficiency Virus Infection and Associated Factors among Specific Population Subgroups in Cameroon

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Indirect FSW were distinguished from direct FSW, generally working in entertainment establishments as beer promotion girls, waitresses, hostesses or karaoke girls, for example, and engaged in occasional transactional sex for supplementary income. [21][22][23] In 1997, an estimated 5300 women worked in the entertainment/ service sector and 6000 were brothel-based FSW. The number of women involved in entertainment-based sex work has grown dramatically in recent years in Cambodia.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia

et al. 2013

View full text Add to dashboard Cite

ObjectivesHIV prevalence among Cambodian female sex workers (FSW) is among the highest in Southeast Asia. We describe HIV prevalence and associated risk exposures in FSW sampled serially in Phnom Penh, Cambodia (Young Women's Health Study (YWHS)), before and after the implementation of a new law designed to combat human trafficking and sexual exploitation.DesignCross-sectional analysis of baseline data from two prospective cohorts.SettingCommunity-based study in Phnom Penh, Cambodia.ParticipantsWomen aged 15–29 years, reporting ≥2 sexual partners in the last month and/or engaged in transactional sex in the last 3 months, were enrolled in the studies in 2007 (N=161; YWHS-1), and 2009 (N=220; YWHS-2) following information sessions where 285 and 345 women attended.Primary outcomesHIV prevalence, sexual risk behaviour, amphetamine-type stimulant (ATS) and alcohol use, and work-related factors were compared in the two groups, enrolled before and after implementation of the new law.ResultsParticipants in the two cohorts were similar in age (median 25 years), but YWHS-2 women reported fewer sex partners, more alcohol use and less ATS use. A higher proportion of YWHS-2 compared with YWHS-1 women worked in entertainment-based venues (68% vs 31%, respectively). HIV prevalence was significantly lower in the more recently sampled women: 9.2% (95% CI 4.5% to 13.8%) vs 23% (95% CI 16.5% to 29.7%).ConclusionsSex work context and risk have shifted among young FSW in Phnom Penh, following implementation of anti-prostitution and anti-trafficking laws. While both cohorts were recruited using the same eligibility criteria, more recently sampled women had lower prevalence of sexual risk and HIV infection. Women engaging more directly in transactional sex have become harder to sample and access. Future prevention research and programmes need to consider how new policies and demographic changes in FSW impact HIV transmission.

show abstract

“…National screening and prevention programs for C. trachomatis infection have been implemented, usually among young adults, in industrialized countries (11,14,16). With the exception of sporadic testing of commercial sex workers, Chlamydia screening is rare in developing countries, which have the highest incidence of new chlamydial infections (7,9,17,25). The major barriers to screening programs in the developing world include the high cost of testing and the lack of appropriate staff and diagnostic tools.…”

mentioning

confidence: 99%

Prevalence of Chlamydia trachomatis Infection among Low- and High-Risk Filipino Women and Performance of Chlamydia Rapid Tests in Resource-Limited Settings

et al. 2007

View full text Add to dashboard Cite

The prevalence of urogenital Chlamydia trachomatis infection was determined with a PCR-based test of women from low-and high-risk populations in Iloilo City, Philippines, between August 2002 and March 2006. Two rapid tests for C. trachomatis, Clearview Chlamydia MF and the Chlamydia Rapid Test (CRT), were also evaluated in these resource-limited settings. Specimens were obtained from female sex workers (FSWs; n ‫؍‬ 1,484) attending a social hygiene clinic (SHC) and from women (n ‫؍‬ 838) attending an obstetrics-gynecology (OB-GYN) clinic. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the rapid tests were determined, with PCR as the gold standard. The PCR positivity rate for SHC participants (72% asymptomatic) ranged from 17.9 to 32.0% during the study period. Compared with those of PCR, the sensitivities and specificities of the Clearview test were 53.5 and 99.1%, respectively, with endocervical swab specimens (CS; n ‫؍‬ 822) from the FSWs and 31.1 and 95.2%, respectively, with vaginal swab specimens (VS; n ‫؍‬ 333) from these women. The sensitivity, specificity, PPV, and NPV of the CRT with VS from the FSWs were 71.0, 99.0, 97.1, and 87.9%, respectively. At the OB-GYN site, the PCR positivity rate with VS was 6.3%. The sensitivity, specificity, PPV, and NPV of the CRT with these specimens were 86.8, 99.6, 93.9, and 99.1%, respectively. The performance of the Clearview test at the SHC was thus markedly lower with VS than with CS, whereas the CRT performed well with VS from both populations.Chlamydia trachomatis is responsible for the most common sexually transmitted bacterial infection and the leading cause of pelvic inflammatory disease in women (34,38). In 1999, the World Health Organization (WHO) estimated that 92 million new chlamydial infections occur worldwide annually, with the largest proportion (43 million) of these infections being contracted in south and Southeast Asia (38), a region that is mostly resource limited with respect to infectious disease diagnosis and management.Although up to 94% of women with urogenital chlamydial infections do not manifest obvious symptoms (20, 28), the consequences of such untreated infections, including pelvic inflammatory disease, ectopic pregnancy, and infertility (27), generate a global financial burden of billions of dollars annually. Because most infected individuals are either asymptomatic or have mild, nonspecific symptoms, C. trachomatis infection poses a problem for health control programs. National screening and prevention programs for C. trachomatis infection have been implemented, usually among young adults, in industrialized countries (11,14,16). With the exception of sporadic testing of commercial sex workers, Chlamydia screening is rare in developing countries, which have the highest incidence of new chlamydial infections (7,9,17,25). The major barriers to screening programs in the developing world include the high cost of testing and the lack of appropriate staff and diagnostic tools. Such countri...

show abstract

High Prevalence of HIV and Sexually Transmitted Infections Among Indirect Sex Workers in Cambodia

Abstract: These data suggest high sexual risk among beer girls in Cambodia. Targeted and frequent HIV and STI interventions are urgently needed in this population.

Cited by 38 publications

References 17 publications

Human Immunodeficiency Virus Infection and Associated Factors among Specific Population Subgroups in Cameroon

Human Immunodeficiency Virus Infection and Associated Factors among Specific Population Subgroups in Cameroon

Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia

Prevalence of Chlamydia trachomatis Infection among Low- and High-Risk Filipino Women and Performance of Chlamydia Rapid Tests in Resource-Limited Settings

Contact Info

Product

Resources

About