Patterns of risk behaviour for patients with sexually transmitted diseases and surveillance for human immunodeficiency virus in Kuala Lumpur, Malaysia

Abstract

A study was conducted to determine the feasibility of establishing a sentinel human immunodeficiency virus (HIV) surveillance system involving patients with sexually transmitted diseases attending private clinics and a government sexually transmitted disease clinic in Kuala Lumpur, Malaysia. Information on risk behaviours for HIV infection were also collected. A total of 84 female and 91 male patients were interviewed and tested for HIV infection; 41.7% of the women reported working as prostitutes, other occupations included masseuses, hairdressers, waitresses, salesgirls, receptionists, factory workers, and others. The most common diagnosis was gonorrhoea. Other diagnoses included non-specific genital infection, pelvic inflammatory disease, genital herpes and syphilis. 58.3% of the women had a hundred or more sex partners during the previous month; 99% had 6 or more sex partners. Only 4.8% of female patients had their male partners using condoms most of the time, 11.9% hardly used condoms at all. Of the males, 93.3% were heterosexual, while 6.7% were bisexuals, 41.1% had between 6-20 different partners in the previous year. 78.0% of them had prostitutes as their sex partners most of the time. 41.8% had experiences in Thailand and the Philippines. 73.6% never used condoms, while 19.8% only used condoms rarely. Although all patients were tested negative for HIV antibodies, lot quality assurance sampling methods indicate that the upper limits of prevalences for females and males were 3.5% and 3.3% respectively, at a 5% type I error. The study has shown that it is feasible to carry out a sentinel surveillance programme among STD patients and provided useful baseline data for future comparisons.(ABSTRACT TRUNCATED AT 250 WORDS)

PIP: The authors interviewed and tested 91 male and 84 female sexually transmitted disease (STD) patients for HIV infection to determine the feasibility of establishing a sentinel HIV surveillance system involving patients with STDs attending private clinics and a government STD clinic in Kuala Lumpur, Malaysia. 77.3% of the women were aged 20-34 years and 7.1% under age 20. Information was collected on risk behaviors for HIV infection. 41.7% of the women reported working as prostitutes, while others worked as masseuses, hairdressers, waitresses, salesgirls, receptionists, factory workers, and in other capacities. 58.3% of the women had 100 or more sex partners during the preceding month and 99% had six or more sex partners. Only 4.8% of the women, however, had their male partners use condoms most of the time, while 11.9% hardly used condoms at all. Gonorrhea was most commonly diagnosed, while nonspecific genital infections, pelvic inflammatory disease, genital herpes, and syphilis were also diagnosed. Among the males, 93.3% were heterosexual and 6.7% bisexual, with 41.1% having 6-20 different partners in the previous year. 78.0% had prostitutes as their sex partners most of the time, 41.8% had experiences in Thailand and the Philippines, 73.6% never used condoms, 19.8% used condoms rarely, and 6.6% used condoms most of the time. Despite such behavior, all tested negative for antibodies to HIV. Lot quality assurance sampling methods did, however, indicate that the upper limits of prevalences for females and males were 3.5% and 3.3% respectively, at a 5% type I error. An HIV prevalence of several percent could therefore exist. While offering useful baseline data for future comparisons, this study found it feasible to carry out a sentinel surveillance program among STD patients.