Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk
- PMID: 21085056
- PMCID: PMC3729941
- DOI: 10.1097/OLQ.0b013e3182000e47
Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk
Abstract
Objectives: To estimate prevalence and incidence of HIV and sexually transmitted infections (STI) and associated risk factors among young women working as sex workers (SWs) in Phnom Penh, Cambodia.
Methods: A prospective study of young (<29 years) women working as SWs in brothels, entertainment establishments, and freelance. Sociodemographics, sexual risk, and use of amphetamine-type stimulants (ATS) ("yama" and "crystal") were assessed by self-report. HIV and STI (Chlamydia trachomatis and Neisseria gonorrhoeae) testing were conducted on blood and urine specimens, respectively.
Results: Baseline prevalences of HIV, C. trachomatis, and N. gonorrhoeae were 23%, 11.5%, and 7.8%, respectively. HIV incidence was 3.6 per 100 person-years (95% confidence interval [CI], 1.2%-11.1%); STI incidence was 21.2 per 100 person-years (95% CI, 12.6%-35.8%). At baseline, 26.5% reported recent ATS use. HIV infection was associated with freelance SW (adjusted odds ratio, 5.85; 95% CI, 1.59-21.58) and younger age of first sex (≤15 years; adjusted odds ratio, 3.06; 95% CI, 1.01-8.46). Incident STI was associated with duration (per year) of SW (adjusted hazard ratio, 1.1; 95% CI, 1.1-1.2) and recent yama use (adjusted hazard ratio, 3.9; 95% CI, 1.5-10.3).
Conclusions: HIV and STI infection rates were high among SWs working in various settings; freelancers had highest risk. ATS use was associated with incident STI. Venue of sex work and drug prevention should be considered in prevention programs.
References
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- NCHADS. Annual Report. Vol. 2006. National Centre for HIV/AIDS, Dermatology and STDs; Cambodia: 2006. [Accessed December 18, 2008]. Ministry of Health National Center for HIV, AIDS, Dermatology and STDs. Available at: http://www.nchads.org/report.php.
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- UNIAP. Exodus to the sex trade? Effects of the global financial crisis on women's working conditions and opportunities. Cambodia: [Accessed August 31, 2009]. United Nations Inter-Agency Project on Human Trafficking (Phase III) Report. Available at: http://www.no-trafficking.org/reports_docs/siren/siren_cb-04.pdf.
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- Plummer R. The sex industry in Cambodia: The traffic police. The Economist. 2009 Jun 11;
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