SUMMARY This study to assess differences between street walking prostitutes and sauna girls who attended this clinic in 1986 and 1987 showed that fewer street walkers used barrier methods for disease prevention with clients or accepted tests for antibody to human immunodeficiency virus (HIV) when offered and more street walkers practised their profession in both Sheffield and London. They therefore represent a potential pathway for the heterosexual spread of HIV to the region.Trichomonas vaginalis was the only organism more commonly isolated from street walkers. Other sexually transmitted diseases diagnosed, and the sources of acquisition of gonococcal cervicitis, were similar in both groups of prostitutes. Prostitutes rarely used barrier methods with their regular consorts, who were found to be responsible for most cases of gonorrhoea in both groups.As 11 out of 58 prostitutes attending were found to have dysplasia on routine cervical cytological examination, we suggest that all prostitutes be advised to undergo cytology yearly.Prostitution is recognised as a form of high risk behaviour important in the heterosexual spread of human immunodeficiency virus (HIV).'2 In Africa HIV transmission from infected prostitutes is promoted by concomitant sexually transmitted diseases (STD).3 Previous studies have emphasised the role of prostitutes in the spread of gonorrhoea, but have not looked at possible differences between prostitutes concerning their mobility, disease prevention behaviour, and acceptance of screening for HIV antibody.' Such differences may reflect a variable potential for HIV acquisition and transmission in different prostitute groups.The aims of this retrospective study were to assess what proportion of heterosexually acquired gonorrhoea in 1983-7 was attributed to prostitutes and also to investigate the demographic characteristics and genital infections diagnosed in prostitutes who attended this clinic in 1986 and 1987, to provide baseline data on which to develop or modify health education efforts aimed at controlling STD.
Patients and methodsTo assess the contribution that prostitutes have made to locally diagnosed gonorrhoea we investigated the Address for reprints: Dr P D Woolley, Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield S10 2JF Accepted for publication 10 July 1988 case records of all heterosexual men attending with acute gonococcal urethritis in 1983-7 to find out how many infections were acquired from prostitutes.We also reviewed the case records of all women prostitutes attending the clinic in 1986 and 1987. We identified two groups: street walkers (women who seek clients in public places or who walk the streets) and sauna girls (women who practise prostitution from fixed premises or local massage parlours). In Sheffield prostitutes offer their services while working for fixed periods oftime from premises advertised openly and in the local press as saunas. Girls often operate from several different establishments. Street walking prositutes operate predom...
