title: Unexpectedly high HIV prevalence among female sex workers in Bangkok, Thailand in a respondent-driven sampling survey.
abstract: The pattern of sex work in Thailand has shifted substantially over the last two decades from direct commercial establishments to indirect venues and non-venue-based settings. This respondent-driven sampling survey was conducted in Bangkok in 2007 among female sex workers (FSW) in non-venue-based settings to pilot a new approach to surveillance among this hidden population. Fifteen initial participants recruited 707 consenting participants who completed a behavioural questionnaire, and provided oral fluid for HIV testing, and urine for sexually transmitted infection (STI) testing. Overall HIV prevalence was 20.2% (95% confidence interval [CI] 16.3-24.7). Three-quarters of women were street-based (75.8%, 95% CI 69.9-81.1) who had an especially high HIV prevalence (22.7%, 95% CI 18.2-28.4); about 10 times higher than that found in routine sentinel surveillance among venue-based FSW (2.5%). STI prevalence (Chlamydia trachomatis and Neisseria gonorrhoeae) was 8.7% (95% CI 6.4-10.8) and 1.0% (95% CI 0.2-1.9), respectively. Lower price per sex act and a current STI infection were independently associated with HIV infection (P < 0.05). High HIV prevalence found among FSW participating in the survey, particularly non-venue-based FSW, identifies need for further prevention efforts. In addition, it identifies a higher-risk segment of FSW not reached through routine sentinel surveillance but accessible through this survey method.
authors.affiliation: Global AIDS Program, Thailand/Asia Regional Office, Thailand MOPH-U.S. CDC Collaboration, Ministry of Public Health, Nonthabhuri.
authors.forename: C
authors.initials: C
authors.lastname: Manopaiboon
authors.forename: D
authors.initials: D
authors.lastname: Prybylski
authors.forename: W
authors.initials: W
authors.lastname: Subhachaturas
authors.forename: S
authors.initials: S
authors.lastname: Tanpradech
authors.forename: O
authors.initials: O
authors.lastname: Suksripanich
authors.forename: U
authors.initials: U
authors.lastname: Siangphoe
authors.forename: L G
authors.initials: LG
authors.lastname: Johnston
authors.forename: P
authors.initials: P
authors.lastname: Akarasewi
authors.forename: A
authors.initials: A
authors.lastname: Anand
authors.forename: K K
authors.initials: KK
authors.lastname: Fox
authors.forename: S J
authors.initials: SJ
authors.lastname: Whitehead
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work / Q000706:statistics & numerical data*; D060386:Sex Workers; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
keywords: Asia; HIV; epidemiology; female sex workers; prevalence; sexually transmitted infection