title: Sexually transmitted infections and risk factors for gonorrhea and chlamydia in female sex workers in Soc Trang, Vietnam.
abstract: OBJECTIVE
  To determine the prevalence of selected STIs and correlates of chlamydia (CT) and gonorrhea (GC) infection among (FSWs) in Soc Trang province, Vietnam.
  
  
  METHODS
  Four hundred and six FSWs in Soc Trang province participated in a cross-sectional study between May and August, 2003. The study subjects were interviewed to obtain information about socio-demographic and behavioral characteristics and gynecologic and STI history, using a standardized interview. They underwent a physical examination during which cervical swabs were collected for GC and CT testing by polymerase chain reaction (PCR). Vaginal wet mount microscopy was performed to detect candidiasis and trichomoniasis (TV), and blood was drawn for testing for syphilis using rapid plasma reagin (RPR)+ Treponema pallidum hemagglutination assay (TPHA). Univariate and multivariate analyses were used to assess the associations of GC, CT, and GC/CT with selected variables.
  
  
  RESULTS
  Prevalences were 14.9% for GC, 48.4% for CT, 54.9% for GC/CT, 3.8% for syphilis, 8.9% for trichomoniasis, and 12.2% for candidiasis. Increased risk for CT was associated with sex work for more than 6 months (aOR = 2.40, 95% CI: 0.99-5.82), receiving $4 US or less per sexual transaction (aOR = 1.91, 95% CI 1.13-3.23), and ever having terminated a pregnancy (aOR = 1.68, 95% CI 1.00-2.82). Reduced likelihood of CT was associated with older age (aOR = 0.96, 95% CI: 0.93-1.00) and ever having douched in the past month (aOR = 0.60, 95% CI 0.36-1.00). Only ever douching in the past month was associated with decreased risk for GC (aOR = 0.47, 95% CI 0.25-0.87). Higher likelihood of GC/CT was associated with having more than 4 clients per month (OR = 2.35, 95% CI 1.02-5.41) and receiving $4 US or less per sexual transaction (aOR = 1.74, 95% CI 1.04-2.93).
  
  
  CONCLUSIONS
  The prevalence of GC/CT is high amongst FSWs in Soc Trang. Therefore, periodic presumptive treatment (PPT) for cervicitis, together with World Health Organization-recommended periodic syndromic sexually transmitted disease management, for FSWs and further interventions should be considered, and a 100% condom use program should be promptly implemented. The existing STI health education program for FSWs should be strengthened, with special consideration of the correlates observed in this study.
authors.affiliation: Pasteur Institute, Ho Chi Minh City, Vietnam.
authors.forename: Thuong Vu
authors.initials: TV
authors.lastname: Nguyen
authors.forename: Nghia
authors.initials: N
authors.lastname: Van Khuu
authors.forename: Truc Thanh
authors.initials: TT
authors.lastname: Thi Le
authors.forename: Anh Phuong
authors.initials: AP
authors.lastname: Nguyen
authors.forename: Van
authors.initials: V
authors.lastname: Cao
authors.forename: Dung Chi
authors.initials: DC
authors.lastname: Tham
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
mesh_terms: D000293:Adolescent; D000328:Adult; D002177:Candidiasis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D006801:Humans; D007407:Interviews as Topic; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work; D013587:Syphilis / Q000453:epidemiology; D014210:Treponema pallidum / Q000302:isolation & purification; D014247:Trichomonas Vaginitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult