Unexpectedly high HIV prevalence among female sex workers in Bangkok, Thailand in a respondent-driven sampling survey

Abstract

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% (95% confidence interval [CI] 16.3-24.7). Three-quarters of women were street-based (75.8%, 95% CI 69.9-81.1) who had an especially high HIV prevalence (22.7%, 95% CI 18.2-28.4); 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% (95% CI 6.4-10.8) and 1.0% (95% CI 0.2-1.9), respectively. Lower price per sex act and a current STI infection were independently associated with HIV infection (P < 0.05). 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.

Factors associated with consistent condom use and STIs among foreign female entertainment workers: results from a cross-sectional survey in Singapore

“…The prevalence of STI positivity (13.6%) was higher in this survey when compared with the registered brothel-based FSWs in Singapore in 2013 (∼1.0%)11 and FSWs (both direct and indirect) in Thailand in 2007 (8.7%)23 but was lower than the FSWs (both direct and indirect) in Vietnam in 2002 (19.9%) 24. Other than differences in study methodology, participant characteristics and condom use, the social and work conditions of the FEWs may impact on their ability to seek preventive care services.…”

Bridging Populations—Sexual Risk Behaviors and HIV Prevalence in Clients and Partners of Female Sex Workers, Bangkok, Thailand 2007

“…In the data reported from Thailand, the adjusted HIV prevalence for the FSW in this study was 20% (95% CI 16-25%). 37 Among all FSWs recruited, 67% reported having previously had a HIV test, but data regarding knowledge of previous HIV test result were not available as few women completed this questions in the FSW survey. 37 Bivariate analyses of factors associated with HIV infection in clients are summarized in Table 2.…”

“…37 Among all FSWs recruited, 67% reported having previously had a HIV test, but data regarding knowledge of previous HIV test result were not available as few women completed this questions in the FSW survey. 37 Bivariate analyses of factors associated with HIV infection in clients are summarized in Table 2. Clients whose first sexual experience was at ageG20 years had a higher relative risk of being HIV-positive (RR=3.10, 95% CI 1.…”

“…Bivariate analysis for nonpaying partners was not conducted because sample size was small and not powered for such analyses. Results from the FSW study have been previously presented 37 and will not be presented here.…”

Prevalence of Human Immunodeficiency Virus and Sexually Transmitted Infections Among Cisgender and Transgender Women Sex Workers in Greater Kuala Lumpur, Malaysia: Results From a Respondent-Driven Sampling Study

“…9 While there are no studies from the region specific to TWSW, HIV prevalence in transgender women is 18.0% in Vietnam 10 and 24.4% in Indonesia. 11 In Malaysia, however, little attention has been directed at assessing the HIV burden among CWSW and TWSW.…”