title: Prevalence of HIV and other sexually transmitted infections, and risk behaviours in unregistered sex workers in Dakar, Senegal.
abstract: OBJECTIVE
  To estimate the prevalence rates of HIV and other sexually transmitted infections (STI) among unregistered sex workers, and to describe their sociodemographic characteristics and sexual behaviours, and the reasons why they were not officially registered as sex workers, in order to design specific public health interventions.
  
  
  METHODS
  A one-stage cluster-sample survey was conducted in Dakar in 2000. Unregistered sex workers were interviewed in randomly selected establishments (official and clandestine bars, brothels and nightclubs), and blood, endocervical and vaginal samples were collected for laboratory diagnosis.
  
  
  RESULTS
  A total of 390 women with a median age of 29 years were recruited. One-seventh of them were under the legal age for prostitution in Senegal (21 years). The median length of prostitution was 24 months and 73.5% of the women stated regular prostitution. Three-quarters of the women were found to have markers for at least one infection. The prevalence rates were as follows: HIV-1, 6.0%; HIV-2, 3.6%; HIV-1+2, 0.4%; syphilis, 23.8%; gonorrhea, 22.0%; chlamydial infection, 20.0%; trichomoniasis, 22.4%; candidiasis, 19.0%; and bacterial vaginosis, 28.8%. The main reported reason for non-registration was ignorance of the legal system and its procedures (19.4%); 18.9% of the women refused to register. One-third of the women reported that their clients used condoms inconsistently or never.
  
  
  CONCLUSIONS
  This survey suggests that a multidimensional public health response is needed in Senegal, comprising legal information, downwards revision of the legal age for prostitution, and specific medical follow-up based on education, condom promotion and management of STI for non-registered sex workers.
authors.affiliation: Institut de Recherche pour le Développement (IRD - UR 36) and Department of International Health, University of Montpellier, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Laurent
authors.forename: Karim
authors.initials: K
authors.lastname: Seck
authors.forename: Ndeye
authors.initials: N
authors.lastname: Coumba
authors.forename: Touré
authors.initials: T
authors.lastname: Kane
authors.forename: Ngoné
authors.initials: N
authors.lastname: Samb
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Wade
authors.forename: Florian
authors.initials: F
authors.lastname: Liégeois
authors.forename: Souleymane
authors.initials: S
authors.lastname: Mboup
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Ndoye
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
mesh_terms: D000328:Adult; D002177:Candidiasis / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D015995:Prevalence; D011634:Public Health; D012309:Risk-Taking; D012675:Senegal / Q000453:epidemiology; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology; D014245:Trichomonas Infections / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology