Human immunodeficiency virus and other sexually transmitted infections among female sex workers in two major cities in Papua New Guinea.
BACKGROUND
Treatable sexually transmitted infections are very common in developing countries and quite often are inadequately treated or remain untreated despite the fact that they enhance the transmission of human immunodeficiency virus (HIV).


OBJECTIVE
To estimate the prevalence of HIV, syphilis, chlamydial infection, gonorrhea, and trichomoniasis among female sex workers in Port Moresby and Lae, Papua New Guinea, and to collect data on associated behaviors.


METHODS
Self-identified female sex workers recruited through our peer-mediated sexually transmitted disease (STD)/HIV risk-reduction community outreach program were invited to participate in the study. Participants underwent pretest counseling, were interviewed, and were asked to self-collect vaginal swab specimens for the detection of STDs and to provide 10 mL of blood for HIV and syphilis testing.


RESULTS
A total of 407 female sex workers, 207 in Port Moresby and 200 in Lae, were enrolled in the study. The overall prevalence rates of HIV, syphilis, genital chlamydial infection, gonorrhea, and trichomoniasis among these women were estimated to be 10%, 32%, 31%, 36%, and 33%, respectively. The sex workers in Port Moresby had a significantly higher HIV infection rate (17%) than those in Lae (3%) and a significantly lower trichomoniasis rate (21%) than those in Lae (44%). Mixed infections were common, occurring in 45% of the cases. Despite a high rate of symptoms, the rate of treatment-seeking was low. Condom use among the sex workers was very inconsistent; 85% reported that they did not use condoms at all times when having sex with their clients. Common reasons cited were dislike by clients, unavailability, alcohol use, and familiarity with a client.


CONCLUSIONS
STDs are very common among female sex workers in Port Moresby and Lae and very often present as multiple infections. Despite STD/HIV awareness campaigns, unsafe sex-particularly irregular use of condoms-continues among sex workers and their clients. Barriers to safer sexual behavior need to be addressed, as do improvements in provision of STD services.
Mgone
Charles S
CS
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Passey
Megan E
ME
Anang
Joseph
J
Peter
Wilfred
W
Lupiwa
Tony
T
Russell
Dorothy M
DM
Babona
Diro
D
Alpers
Michael P
MP
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology; D017931:DNA Primers; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009512:New Guinea / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D013587:Syphilis / Q000453:epidemiology; D014247:Trichomonas Vaginitis / Q000453:epidemiology; D014504:Urban Health
D017931:DNA Primers