title: Correlates and trend of HIV prevalence among female sex workers attending sexually transmitted disease clinics in Pune, India (1993-2002).
abstract: In India, substantial efforts have been made to increase awareness about HIV/AIDS among female sex workers (FSWs). We assessed the impact of awareness regarding safe sex in a cohort of FSWs by studying trends in HIV prevalence, sexually transmitted diseases (STDs), and risk behaviors measured from 1993 to 2002 in Pune, India. A total of 1359 FSWs attending 3 STD clinics were screened for HIV infection, and data on demographics, sexual behaviors, and past and current STDs were obtained. The overall HIV prevalence among FSWs was 54%. Not being married (adjusted odds ratio [AOR] = 1.74, 95% confidence interval [CI]: 1.17 to 2.59), being widowed (AOR = 2.10, 95% CI: 1.16 to 3.80), inconsistent condom use (AOR = 1.60, 95% CI: 1.02 to 2.50), clinical presence of genital ulcer disease (GUD; AOR = 1.66, 95% CI: 1.07 to 2.56), and genital warts (AOR = 4.70, 95% CI: 1.57 to 14.08) were independently associated with HIV infection among FSWs. The prevalence of HIV remained stable over 10 years (46% in 1993 and 50% in 2002; P = 0.80). The prevalence of GUD decreased over time (P < 0.001), whereas that of observed genital discharge remained stable. Reported consistent condom use as well as the proportion of FSWs who refused sexual contact without condoms increased over time (P < 0.001). These data collectively suggest that safe sex interventions have had a positive impact on FSWs in Pune, India.
authors.affiliation: National AIDS Research Institute, Pune, India. rbrahme@hotmail.com
authors.forename: Radhika
authors.initials: R
authors.lastname: Brahme
authors.forename: Shruti
authors.initials: S
authors.lastname: Mehta
authors.forename: Seema
authors.initials: S
authors.lastname: Sahay
authors.forename: Neelam
authors.initials: N
authors.lastname: Joglekar
authors.forename: Manisha
authors.initials: M
authors.lastname: Ghate
authors.forename: Smita
authors.initials: S
authors.lastname: Joshi
authors.forename: Raman
authors.initials: R
authors.lastname: Gangakhedkar
authors.forename: Arun
authors.initials: A
authors.lastname: Risbud
authors.forename: Robert
authors.initials: R
authors.lastname: Bollinger
authors.forename: Sanjay
authors.initials: S
authors.lastname: Mehendale
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003153:Community Health Services; D017280:Condoms; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D017533:Marital Status; D015995:Prevalence; D011477:Sex Work; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*