Desai V K, Kosambiya J K, Thakor H G, Umrigar D D, Khandwala B R, Bhuyan K K
Department of Community Medicine, Government Medical College, Surat, India.
Sex Transm Infect. 2003 Apr;79(2):111-5. doi: 10.1136/sti.79.2.111.
To measure prevalence of selected sexually transmitted infections (STI) and HIV among female sex workers (SWs) in the red light area of Surat, India, and to evaluate the performance of STI syndrome guidelines (for general population women in India) in this group against the standard aetiological diagnosis of STIs by laboratory methods.
In a cross sectional study, 124 out of an estimated total of 500 SWs were mobilised to a health camp near the red light area during 2000. After obtaining consent, a behavioural questionnaire was administered, followed by clinical examination and specimen collection for different STIs. 118 SWs completed all aspects of the survey. HIV testing was unlinked and anonymous.
The mean number of different sexual partners of SWs per day was five. 94.9% reported consistent condom use with the clients. 58.5% of SWs had no symptoms related to STDs at the time of examination. Reported symptoms included lower abdominal pain (19.5%), abnormal vaginal discharge (12.7%), painful sexual intercourse (12.7%), painful micturition (11.0%), itching around the genital area (10.2%), and genital ulcer (5.9%). The prevalence of STI "syndromes" were vaginal discharge syndrome 51.7%, pain in lower abdomen 19.5%, enlarged inguinal lymph nodes 11.9%, and genital ulcer 5.9%. Based on the laboratory reports (excluding HIV tests), 62 (52.5%) SWs did not have any of the four tested STIs. Prevalence of laboratory confirmed STIs were syphilis 22.7% (based on reactive syphilis serology tests), gonorrhoea 16.9%, genital chlamydial infection 8.5%, and trichomoniasis 14.4%. HIV prevalence was 43.2%. The performance of Indian recommended treatment guidelines for vaginal discharge syndrome (VDS) and genital ulcer syndrome (GUS) against aetiological diagnosis was poor.
Prevalence of different STIs and HIV among the FSWs in the Surat red light area is high despite high reported condom use with clients. Syndromic case management is missing a large number of asymptomatic cases and providing treatment in the absence of disease. Therefore, it is necessary to explore alternative strategies for control of STIs in female sex workers. STI services need to be improved.
测定印度苏拉特红灯区女性性工作者中特定性传播感染（STI）和艾滋病毒的流行情况，并对照通过实验室方法进行的性传播感染标准病因诊断，评估印度针对普通女性人群的性传播感染综合征指南在该群体中的表现。
在一项横断面研究中，2000年期间，在红灯区附近的一个健康营动员了估计总数500名女性性工作者中的124名。获得同意后，发放了一份行为问卷，随后进行临床检查并采集不同性传播感染的标本。118名女性性工作者完成了调查的所有环节。艾滋病毒检测不关联个人身份且匿名。
女性性工作者每天不同性伴侣的平均数为5个。94.9%报告与嫖客始终使用避孕套。58.5%的女性性工作者在检查时没有与性传播疾病相关的症状。报告的症状包括下腹部疼痛（19.5%）、异常阴道分泌物（12.7%）、性交疼痛（12.7%）、排尿疼痛（11.0%）、生殖器周围瘙痒（10.2%）和生殖器溃疡（5.9%）。性传播感染“综合征”的患病率分别为阴道分泌物综合征51.7%、下腹部疼痛19.5%、腹股沟淋巴结肿大11.9%和生殖器溃疡5.9%。根据实验室报告（不包括艾滋病毒检测），62名（52.5%）女性性工作者没有这四种检测的性传播感染中的任何一种。实验室确诊的性传播感染患病率分别为梅毒22.7%（基于梅毒血清反应检测呈阳性）、淋病16.9%、生殖器衣原体感染8.5%和滴虫病14.4%。艾滋病毒患病率为43.2%。印度推荐的阴道分泌物综合征（VDS）和生殖器溃疡综合征（GUS）治疗指南对照病因诊断的表现不佳。
尽管报告显示与嫖客使用避孕套的比例很高，但苏拉特红灯区女性性工作者中不同性传播感染和艾滋病毒的患病率仍然很高。综合征病例管理遗漏了大量无症状病例，且在没有疾病的情况下提供治疗。因此，有必要探索控制女性性工作者中性传播感染的替代策略。性传播感染服务需要改进。
