title: Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk.
abstract: OBJECTIVE
  To estimate prevalence and incidence of HIV and sexually transmitted infections (STI) and associated risk factors among young women working as sex workers (SWs) in Phnom Penh, Cambodia.
  
  
  METHODS
  A prospective study of young (<29 years) women working as SWs in brothels, entertainment establishments, and freelance. Sociodemographics, sexual risk, and use of amphetamine-type stimulants (ATS) ("yama" and "crystal") were assessed by self-report. HIV and STI (Chlamydia trachomatis and Neisseria gonorrhoeae) testing were conducted on blood and urine specimens, respectively.
  
  
  RESULTS
  Baseline prevalences of HIV, C. trachomatis, and N. gonorrhoeae were 23%, 11.5%, and 7.8%, respectively. HIV incidence was 3.6 per 100 person-years (95% confidence interval [CI], 1.2%-11.1%); STI incidence was 21.2 per 100 person-years (95% CI, 12.6%-35.8%). At baseline, 26.5% reported recent ATS use. HIV infection was associated with freelance SW (adjusted odds ratio, 5.85; 95% CI, 1.59-21.58) and younger age of first sex (≤15 years; adjusted odds ratio, 3.06; 95% CI, 1.01-8.46). Incident STI was associated with duration (per year) of SW (adjusted hazard ratio, 1.1; 95% CI, 1.1-1.2) and recent yama use (adjusted hazard ratio, 3.9; 95% CI, 1.5-10.3).
  
  
  CONCLUSIONS
  HIV and STI infection rates were high among SWs working in various settings; freelancers had highest risk. ATS use was associated with incident STI. Venue of sex work and drug prevention should be considered in prevention programs.
authors.affiliation: Department of Epidemiology and Biostatistics, University of California-San Francisco, 50 Beale Street, San Francisco, CA 94105, USA.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Couture
authors.forename: Neth
authors.initials: N
authors.lastname: Sansothy
authors.forename: Vonthanak
authors.initials: V
authors.lastname: Sapphon
authors.forename: Serey
authors.initials: S
authors.lastname: Phal
authors.forename: Keo
authors.initials: K
authors.lastname: Sichan
authors.forename: Ellen
authors.initials: E
authors.lastname: Stein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Evans
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.forename: Mean Chhi
authors.initials: MC
authors.lastname: Vun
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology* / Q000209:etiology; D000662:Amphetamines / Q000008:administration & dosage*; D002160:Cambodia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work; D012725:Sexual Behavior; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000662:Amphetamines