Prevalence of Sexually Transmitted Diseases and Hepatitis C in a Survey of Female Sex Workers in the North-East of Italy

Abstract

A key issue in the prevention and control of Sexually Transmitted Diseases (STD) is to provide access to health centres, and in diagnosing and treating STD. The present study is aimed to assess the prevalence of sexually transmitted diseases (STDs) and Hepatitis C virus (HCV) in a population of immigrant female sex workers (FSWs). We conducted a cross sectional survey of FSWs working in Verona, North-eastern Italy. Screening test included serology for STDs [including Human Immunodeficiency Virus (HIV), syphilis and Hepatitis B virus (HBV)] and hepatitis C virus (HCV).Sixteen out of 345 (4.6%) street FSWs screened during 1999-2007 resulted positive for HIV, 12 (3.5%) were positive for HBsAg, 7 (2.0%) were positive for syphilis serological test, and 3 (0.9%) were positive for HCV. Comparison of the prevalence data between women from Africa (286/345, 82.8%) and other countries showed no statistical difference for HIV infection (R.R. 1.44; 95% CI, 0.34-6.19) and for presence of HBsAg (R.R. 2.27; 95% CI, 0.30-17.24). The positivity of syphilis serologic tests had a lower prevalence among African FSWs (mostly coming from Nigeria) than among FSWs from Eastern Europe (57/345, 16.5%). This difference was statistically significant (R.R. 0.03; 95% CI, 0.00-0.28). The prevalence of HIV infection increased with age (p=0.04, by chi2 for trend analysis), but not with the time worked as sex workers in Italy. Moreover, the presence of any of the screened infections was predictable by both age and earlier time of immigration by way of logistic multivariable regression.The prevalence of HIV and HBsAg was higher in the whole analyzed cohort compared to the general population; prevalence of syphilis was significantly higher in FSWs from Eastern Europe than in FSWs from Africa. HCV prevalence remains low among non intravenous drug abuser FSWs. The data offers a starting point to address targeted intervention that would prevent FSWs acquiring and transmitting STDs.

A Study on the HBV and the HCV Infections in Female Sex Workers and their Co-Infection with HIV

“…Similar rates were found in Zanzibar (2%) [18] and Peru (2%) [23]. A lesser rate was found in Italy (0.9%) [12]. Higher rates were found in Argentina (4.3%), where IVDU was common among the FSWs [1].…”

“…Among the other Indian studies, it ranged from 3.33% in Surat [15] to 12.2% in Peddapuram [16]. Similarly, it ranged from 3.5% in Italy [12], to 5.3% in Zanzibar [17], to 14.3% in Argentina [1], to 62% in Hongkong [22]. This may be due to the differences in the geographic locations and the population behaviours, as well as the risk factors like IV drug abuse.…”

“…Such high rates were also found in the Indian state of Karnataka and in rural Cambodia. An Italian study showed a lower rate of 4.6% [12]. This difference may be due to the different population dynamics.…”

“…It varied from 14.2% in the US-Mexico border cities to 45.7% in Argentina [1,12,[18][19][20][21][22] . This varied prevalence rates may be due to the different population characteristics.…”

Age group differences in HIV risk and mental health problems among female sex workers in Southwest China

“…Inconsistent or ineffective condom use, a history of STD, and lack of HIV testing have been widely considered key HIV risks (Hong et al, 2012; Li et al, 2010; Li et al, 2011; Rusch et al, 2010; Zermiani et al, 2012; Zhang et al, 2011). Even though condom use can effectively prevent HIV transmission and other sexually transmitted infections among FSWs, only a small proportion of FSWs consistently and properly use condoms with their clients (Zhang et al, 2011; Li et al, 2010; Li et al, 2011; Lau et al, 2010).…”