Family Health International, Country Office, Jakarta, Indonesia.
Sex Transm Infect. 2010 Oct;86(5):377-83. doi: 10.1136/sti.2009.041269. Epub 2010 Jun 3.
To study the prevalence and factors associated with syphilis among female sex workers (FSWs) in Indonesia.
Direct and indirect FSWs were sampled in 10 major cities in Indonesia. A behavioural survey was conducted and samples obtained and tested for HIV (Bioline and Determine) and syphilis (RPR and Determine). Syphilis prevalence and potential factors associated with syphilis were assessed in bivariable and multivariable analysis. Syphilis prevalence among brothel-based sex workers from previous surveillance in 2003 and 2005 was compared to 2007.
A total of 2436 direct and 1888 indirect FSWs participated in both the behavioural and biomarker surveys. Prevalence of active syphilis (RPR≥1:8) was high among direct and indirect FSWs (7.5% vs 3.1%) and was not lower among those who had visited an STI clinic in the last 3 months. Prevalence of active syphilis was lower among those who had received at least one dose of a prior periodic presumptive treatment programme (PPT) for chlamydia and gonorrhoea with 1 g azithromycin and 400 mg cefixime compared to those who had not received PPT (3.9% vs 6.0%; p=0.008). Older age (AOR=1.4), longer duration of sex work (AOR=1.7) and PPT (AOR=0.6) were associated with active syphilis in multivariable analysis. Syphilis prevalence among brothel-based FSWs increased from 2005 to 2007 (7.8% vs 14.5%; p<0.001).
Syphilis prevalence among FSWs in Indonesia was high and increased from 2005 to 2007. Receipt of PPT was associated with lower syphilis prevalence. Current syphilis control programmes need to be evaluated and the possibility of alternative syphilis treatment with azithromycin explored.
研究印度尼西亚性工作者（FSW）中梅毒的流行情况和相关因素。
在印度尼西亚的 10 个主要城市中抽取直接和间接性工作者。进行行为调查，并采集样本进行 HIV（Bioline 和 Determine）和梅毒（RPR 和 Determine）检测。在单变量和多变量分析中评估梅毒的流行情况和与梅毒相关的潜在因素。将 2007 年与 2003 年和 2005 年之前监测中妓院性工作者的梅毒流行率进行比较。
共有 2436 名直接性工作者和 1888 名间接性工作者参加了行为和生物标志物调查。直接和间接性工作者中活动性梅毒（RPR≥1：8）的患病率较高（分别为 7.5%和 3.1%），且在过去 3 个月内就诊过性传播感染（STI）诊所的患者中患病率并未降低。与未接受过衣原体和淋病定期预期治疗方案（PPT）的患者相比，接受过至少一剂含 1 g 阿奇霉素和 400 mg 头孢克肟的 PPT 的患者的活动性梅毒患病率较低（分别为 3.9%和 6.0%；p=0.008）。年龄较大（AOR=1.4）、性工作时间较长（AOR=1.7）和 PPT（AOR=0.6）与多变量分析中的活动性梅毒相关。从 2005 年到 2007 年，妓院性工作者中的梅毒患病率从 7.8%增加到 14.5%（p<0.001）。
印度尼西亚性工作者中的梅毒流行率较高，并从 2005 年到 2007 年有所增加。接受 PPT 与梅毒患病率较低相关。目前需要对梅毒控制方案进行评估，并探讨替代的阿奇霉素梅毒治疗方案的可能性。
