International Journal of Epidemiology 2000;29:344-354
© International Epidemiological Association 2000
Behavioural and serological human immunodeficiency virus risk factors among female commercial sex workers in Cambodia
a Department of Public Health, Yokohama City University School of Medicine, 3–9 Fukuura, Kanazawa-ku, Yokohama, 236–0004 Japan.
b Department of Hygiene, Faculty of Medicine, Tottori University, Japan.
c Aichi Cancer Center Research Institute, Japan.
d Yokohama City Institute of Health, Japan.
e National HIV/AIDS Program, Ministry of Health, Cambodia.
Background The spread of human immunodeficiency virus (HIV) in Cambodia is mainly caused by sexual transmission and the high-risk group in this country are female commercial sex workers (CSW). There are two types of CSW, direct CSW (DCSW) and indirect CSW (IDCSW), who are different from each other in sexual activities. This study was conducted in order to describe the risk factors on HIV for each type of CSW, and to establish effective preventive strategies against the HIV epidemic among CSW.
Methods The participants, 143 DCSW and 94 IDCSW, were interviewed using a questionnaire to determine their demographic characteristics and behaviour. Blood samples were taken for serological tests on HIV, Chlamydia trachomatis and syphilis. The association between their behavioural pattern and their serological results was analysed.
Results The questionnaire study showed that IDCSW had a riskier behavioural pattern than DCSW. The HIV seroprevalence rates of the DCSW and the IDCSW were 52.4% and 22.3%, respectively. Univariate logistic analyses showed a significant association between HIV antibody (HIV-Ab) and current age, age at commencement of commercial sex work, duration of commercial sex work, and the seropositivity of Chlamydia trachomatis—IgG antibody (CT-IgG-Ab) among the DCSW. The analyses also showed a significant relationship between HIV-Ab and CT-IgG-Ab among the IDCSW.
Conclusions Improving condom use rate is very important in order to prevent an HIV epidemic among the two types of CSW. This study also suggests it is important to prevent sexually transmitted disease (STD) such as Chlamydia trachomatis infection. The STD control programme could be efficient for HIV prevention, especially among DCSW.
Keywords Cambodia, female commercial sex workers, behavioural study, seroprevalence, HIV, Chlamydia trachomatis
Accepted 4 November 1999
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