Sopheab Heng, Morineau Guy, Neal Joyce J, Saphonn Vonthanak, Fylkesnes Knut
National Center for HIV/AIDS, Dermatology and STDs, Cambodia.
BMC Infect Dis. 2008 Dec 12;8:167. doi: 10.1186/1471-2334-8-167.
Cambodia's 100% Condom-Use Programme (CUP), implemented nationally in 2001, requires brothel-based female sex workers (FSWs) to use condoms with all clients. In 2005, we conducted a sexually transmitted infection (STI) survey among FSWs. This paper presents the STI prevalence and related risk factors, and discusses prevalence trends in the context of the 100% CUP in Cambodia.
From March-May, 1079 FSWs from eight provinces consented to participate, provided specimens for syphilis, chlamydia, and gonorrhoea testing, and were interviewed. Univariate and multivariate logistic regression analysis was used to determine factors associated with STIs. STI prevalence was compared with data from the 1996 and 2001 STI surveys.
Most FSWs were young (55% aged 15-24) and new to sex work (60% had worked 12 <or= months). Consistent condom use with clients was reported by 80% of FSWs, but only 38% of FSWs always used condoms with sweethearts or casual partners. Being new to sex work was the only factor significantly associated with "any STI" (OR = 2.1). Prevalence of syphiliwas 2.3%; chlamydia, 14.4%; gonorrhoea, 13.0%; and any STI, 24.4%. Prevalence of each STI in 2005 was significantly lower than in 1996, but essentially the same as prevalence observed in 2001.
New FSWs were found to have substantially higher prevalence than those with longer experience. The percent of FSWs who used condoms consistently was high with clients but remained low with non-paying sex partners. Because of the high turnover of FSWs, the prevention needs of new FSWs should be ascertained and addressed. Despite 100% CUP implementation, the prevalence of STIs among FSWs was the same in 2005 as it was in 2001. Limited coverage and weak implementation capacity of the programme along with questionable quality of the STI services are likely to have contributed to the sustained high prevalence. The programme should be carefully reviewed in terms of intensity, quality and coverage.
柬埔寨于2001年在全国实施的100%避孕套使用计划（CUP）要求在妓院工作的女性性工作者（FSW）与所有客户使用避孕套。2005年，我们对女性性工作者进行了一次性传播感染（STI）调查。本文介绍了性传播感染的患病率及相关风险因素，并在柬埔寨100% CUP计划的背景下讨论了患病率趋势。
3月至5月，来自八个省份的1079名女性性工作者同意参与，提供梅毒、衣原体和淋病检测样本并接受访谈。采用单因素和多因素逻辑回归分析确定与性传播感染相关的因素。将性传播感染患病率与1996年和2001年性传播感染调查的数据进行比较。
大多数女性性工作者很年轻（55%年龄在15 - 24岁）且是性工作新手（60%工作了12个月或更短时间）。80%的女性性工作者报告与客户始终使用避孕套，但只有38%的女性性工作者与情人或临时伴侣始终使用避孕套。性工作新手是与“任何性传播感染”显著相关的唯一因素（比值比 = 2.1）。梅毒患病率为2.3%；衣原体为14.4%；淋病为13.0%；任何性传播感染为24.4%。2005年每种性传播感染的患病率均显著低于1996年，但与2001年观察到的患病率基本相同。
发现新入行的女性性工作者患病率远高于经验更丰富者。与客户始终使用避孕套的女性性工作者比例很高，但与无酬性伴侣使用避孕套的比例仍然很低。由于女性性工作者流动率高，应确定并满足新入行女性性工作者的预防需求。尽管实施了100% CUP计划，但2005年女性性工作者中性传播感染的患病率与2001年相同。该计划覆盖范围有限、实施能力薄弱以及性传播感染服务质量存疑可能导致患病率持续居高不下。应从强度、质量和覆盖范围方面对该计划进行仔细审查。
