Institutional members access full text with Ovid®

Share this article on:

Sexually Transmitted Infections and Risk Factors for Gonorrhea and Chlamydia in Female Sex Workers in Soc Trang, Vietnam

Nguyen, Thuong Vu MD, MS, DTM&H*†; Van Khuu, Nghia MD*; Thi Le, Truc Thanh MD, MS; Nguyen, Anh Phuong MD§; Cao, Van PhD*; Tham, Dung Chi MD, MS; Detels, Roger MD, MS

doi: 10.1097/OLQ.0b013e3181812d03
Article

Goal: To determine the prevalence of selected STIs and correlates of chlamydia (CT) and gonorrhea (GC) infection among (FSWs) in Soc Trang province, Vietnam.

Study Design: Four hundred and six FSWs in Soc Trang province participated in a cross-sectional study between May and August, 2003. The study subjects were interviewed to obtain information about socio-demographic and behavioral characteristics and gynecologic and STI history, using a standardized interview. They underwent a physical examination during which cervical swabs were collected for GC and CT testing by polymerase chain reaction (PCR). Vaginal wet mount microscopy was performed to detect candidiasis and trichomoniasis (TV), and blood was drawn for testing for syphilis using rapid plasma reagin (RPR)+ Treponema pallidum hemagglutination assay (TPHA). Univariate and multivariate analyses were used to assess the associations of GC, CT, and GC/CT with selected variables.

Results: Prevalences were 14.9% for GC, 48.4% for CT, 54.9% for GC/CT, 3.8% for syphilis, 8.9% for trichomoniasis, and 12.2% for candidiasis. Increased risk for CT was associated with sex work for more than 6 months (aOR = 2.40, 95% CI: 0.99–5.82), receiving $4 US or less per sexual transaction (aOR = 1.91, 95% CI 1.13–3.23), and ever having terminated a pregnancy (aOR = 1.68, 95% CI 1.00–2.82). Reduced likelihood of CT was associated with older age (aOR = 0.96, 95% CI: 0.93–1.00) and ever having douched in the past month (aOR = 0.60, 95% CI 0.36–1.00). Only ever douching in the past month was associated with decreased risk for GC (aOR = 0.47, 95% CI 0.25–0.87). Higher likelihood of GC/CT was associated with having more than 4 clients per month (OR = 2.35, 95% CI 1.02–5.41) and receiving $4 US or less per sexual transaction (aOR = 1.74, 95% CI 1.04–2.93).

Conclusions: The prevalence of GC/CT is high amongst FSWs in Soc Trang. Therefore, periodic presumptive treatment (PPT) for cervicitis, together with World Health Organization-recommended periodic syndromic sexually transmitted disease management, for FSWs and further interventions should be considered, and a 100% condom use program should be promptly implemented. The existing STI health education program for FSWs should be strengthened, with special consideration of the correlates observed in this study.

The prevalence of sexually transmitted infections (STIs) is high amongst female sex workers (FSWs) in Soc Trang, Vietnam. Periodic presumptive treatment for cervicitis, together with World Health Organization (WHO)-recommended periodic syndromic Sexually transmitted disease (STD) management, for FSWs and further interventions should be considered, and a 100% condom use program should be promptly implemented. The existing STI health education program should be strengthened.

From the *Pasteur Institute, Ho Chi Minh City, Vietnam; †UCLA School of Public Health, Los Angeles, California; ‡Hospital for Dermato-Venereology, Ho Chi Minh City, Vietnam; § Center for HIV/AIDS Control and Prevention, Soc Trang, Vietnam; ∥and National Institute of Hygiene and Epidemiology, Hanoi, Vietnam

The authors thank all the involved staff for their help and support in undertaking this study, particularly Dr. Truong Thi Xuan Lien, Tran Thi Kim Phuong, and Nguyen Duy Phuc (the AIDS Programme of Pasteur Institute Ho Chi Minh City); Dr. Truong Hoai Phong (Soc Trang Department of Health); Dr. Le Minh Toan (Soc Trang Center for HIV/AIDS Control and Prevention); Drs. Tran Ngoc An and The (Soc Trang Center for Social Diseases); Dr. Nguyen Van Thuc (Hospital for Dermato-Venereology of Ho Chi Minh City); and Marie-Claire Rabier (SLCD, Belgium). The authors also thank Wendy Aft (UCLA Dept. of Epidemiology) and Nguyen Thuc Boi Thanh for editing assistance.

Supported by Service Laïque de Coopération au Développement, Belgium.

Correspondence: Thuong Vu Nguyen, MD, MS, DTM&H, Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA 90095-1772. E-mail: nguyenthuong@yahoo.com.

Received for publication January 25, 2008, and accepted May 26, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association