title: Sexual health and use of condoms among local and international sex workers in Sydney.
abstract: OBJECTIVE
  To compare indicators of sexual health and predictors of condom use for commercial sex among local and international female sex workers first attending an STD clinic.
  
  
  METHODS
  A public STD clinic in Sydney, Australia.
  
  
  METHODS
  All sex workers first attending between June 1991 and May 1993.
  
  
  METHODS
  Cross-sectional analysis of demographic, behavioural and morbidity data from proforma medical records.
  
  
  RESULTS
  91 local sex workers and 123 international sex workers (predominantly from Thailand, Malaysia and China) first presented during the study period. There were significantly higher prevalences of chlamydia (0 v. 15%, p = 0.0002), gonorrhoea (0 v. 14%, p = 0.0006), syphilis (0 v. 10%, p = 0.006) and clinical genital herpes (0 v. 5%, p = 0.04) among international sex workers. The only case of HIV infection was in an international sex worker. Inconsistent condom use for commercial sex was significantly more common among international sex workers (RR = 4.5; 95% CI 3.1-6.5). On multivariate analysis, inconsistent condom use in international sex workers was associated with a recent history of prostitution outside Australia (p = 0.04), while inconsistent condom usage among local sex workers was associated with increasing age (p = 0.003).
  
  
  CONCLUSIONS
  These data illustrate the efficacy of condoms and the success of targeted education programmes in local sex workers in Sydney. By contrast, international sex workers continued to be at high risk of STDs. The international sex industry in Sydney requires enhanced culture-specific interventions. Immigration laws as they affect sex workers should also be reviewed.
authors.affiliation: Academic Unit of Sexual Health Medicine, University of Sydney, Australia.
authors.forename: C C
authors.initials: CC
authors.lastname: O'Connor
authors.forename: G
authors.initials: G
authors.lastname: Berry
authors.forename: R
authors.initials: R
authors.lastname: Rohrsheim
authors.forename: B
authors.initials: B
authors.lastname: Donovan
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D009517:New South Wales; D011477:Sex Work; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000523:psychology*