Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru

Abstract

Background and objectives: A survey was conducted to determine the sexual behavior practices and prevalence of HIV-1, HTLV-I/II, and T. pallidum infections among unlicensed female sex workers (FSWs) in Lima, Peru.

Goal of this study: To assess the role of unlicensed FSWs as a potential source of retroviral and T. pallidum infection.

Study design: Female sex workers from 15 brothels were enrolled. Sera samples were obtained and tested for antibodies to HIV-1, HTLV-I, and Treponema pallidum.

Results: Of 158 FSWs studied, all were negative for HIV-1, 6 were positive for HTLV-I, and 5 were positive for Treponema pallidum. Of their male clients, 75% used condoms, whereas only 3% reported condom use with their steady partners. When condoms were always used by clients, the history of a sexually transmitted disease was significantly reduced (p < 0.01), and the prevalence of HTLV-I (p < 0.05) and syphilis was lower among these workers.

Conclusion: Data suggested that the low rate of sexually transmitted diseases among FSWs reflected the high rate of condom use by their male clients.

PIP: A survey was conducted to determine the prevalence of HIV-I, human T cell leukemia virus I and II (HTLV-I/II), and Treponema pallidum infection and the associated risk factors for the transmission of these sexually transmitted diseases (STDs) among unlicensed female sex workers (FSWs) in Lima, Peru, to further define their role as a potential source of infection. Unlicensed FSWs from 15 brothels were enrolled in this study from March to June 1994. Serum samples were collected and tested for antibodies to HIV-I, HTLV-I, HTLV-II, and Treponema pallidum. Results revealed that of the 158 FSWs studied, all were negative for HIV-I; 6 were positive for HTLV-I, and 5 had T. pallidum antibodies. Of their male clients, 75% had used condoms for the past 6 months, whereas only 3% reported condom use with their steady partners. Among the workers who stated that condoms were always used, the frequency of a history of STDs, including genital ulcers and inguinal adenopathies, was lower compared to occasional users. Similarly, the prevalence of HTLV-I infection and syphilis was lower among these workers. In conclusion, the study results suggested that the low rate of STDs among FSWs reflected a high rate of condom use.