Mawu Ferra O, Davies Stephen C, McKechnie Michelle, Sedyaningsih Endang R, Widihastuti Asti, Hillman Richard J
Faculty of Medicine, University of Sam Ratulangi, Manado, 95115 Sulawesi Utara, Indonesia.
Sex Health. 2011 Mar;8(1):52-60. doi: 10.1071/SH10023.
Sexually transmissible infections (STIs) remain highly prevalent, and HIV is increasing, among female sex workers (FSWs) in Indonesia. Our aim was to determine the prevalence of, and risk factors for, STIs among FSWs in Manado, Indonesia.
We recruited FSWs mainly at their workplace: they completed a questionnaire and provided a urine sample and self-collected vaginal swab. Samples were tested using multiplex polymerase chain reaction, followed by reverse line blot hybridisation.
We recruited 221 FSWs, (median age: 25 years). During the previous 3 months, 30% reported never using condoms; only 2.7% always used condoms. Of 217 women with urine samples, 49% had a 'curable STI': 10.6% with gonorrhoea, 26.7% with chlamydia, 12.4% with Mycoplasma genitalium and 22.6% with trichomoniasis. Independent risk factors for gonorrhoea were: domiciled outside North Sulawesi (P = 0.001) and age 16-25 years (P = 0.02); for chlamydia: no prior history of STI symptoms (P = 0.003) and age 16-25 years (P = 0.02); for Mycoplasma genitalium: number of clients on last day of sex work (P = 0.004); for trichomoniasis: number of clients per week (P = 0.04). When these four infections were grouped as any 'curable STI', independent associations were: number of clients on the last day of sex work (P = 0.001), age 16-25 years (P = 0.02) and sex working for fewer than 2 years (P = 0.03).
This is the first report of M. genitalium infection in Indonesia. The high prevalence of STIs and low condom use among these FSWs suggest their vulnerability to the HIV epidemic in Indonesia. They need enhanced interventions, including outreach screening, and periodic presumptive treatment.
在印度尼西亚的女性性工作者中，性传播感染（STIs）仍然非常普遍，且艾滋病毒感染率正在上升。我们的目的是确定印度尼西亚万鸦老女性性工作者中性传播感染的患病率及其危险因素。
我们主要在女性性工作者的工作场所招募她们：她们填写了一份问卷，并提供了一份尿液样本和自行采集的阴道拭子。样本采用多重聚合酶链反应进行检测，随后进行反向线印迹杂交。
我们招募了221名女性性工作者（中位年龄：25岁）。在过去3个月中，30%的人报告从未使用过避孕套；只有2.7%的人始终使用避孕套。在217名提供尿液样本的女性中，49%患有“可治愈的性传播感染”：淋病患者占10.6%，衣原体感染患者占26.7%，生殖支原体感染患者占12.4%，滴虫病患者占22.6%。淋病的独立危险因素为：居住在北苏拉威西岛以外地区（P = 0.001）和年龄在16 - 25岁之间（P = 0.02）；衣原体感染的危险因素为：既往无性传播感染症状史（P = 0.003）和年龄在16 - 25岁之间（P = 0.02）；生殖支原体感染的危险因素为：性工作最后一天的接客数量（P = 0.004）；滴虫病的危险因素为：每周接客数量（P = 0.04）。当将这四种感染归为任何一种“可治愈的性传播感染”时，独立相关因素为：性工作最后一天的接客数量（P = 0.001）、年龄在16 - 25岁之间（P = 0.02）以及性工作年限少于2年（P = 0.03）。
这是印度尼西亚关于生殖支原体感染的首次报告。这些女性性工作者中性传播感染的高患病率和避孕套的低使用率表明她们在印度尼西亚易感染艾滋病毒。她们需要强化干预措施，包括外展筛查和定期推定治疗。
