Surveys of HIV-1, HTLV-I, and other sexually transmitted diseases in female sex workers in Taipei City, Taiwan, from 1993 to 1996

Abstract

Between 1993 and 1996 in Taipei, Taiwan, we studied the prevalences of HIV-1, HTLV-I, HSV-2, Chlamydia trachomatis, and syphilis infection in female commercial sex workers (CSW) and the pathogens' associated risk factors. Female CSW from nine massage parlors, two karaoke bars (KB), and 22 brothels in Taipei city participated in this study. Two of 557 (0.4%) KB CSWs from those who participated during the period from 1993 to 1994 had HIV-1 infection, whereas no KB CSWs in the periods 1994 to 1995 or 1995 to 1996 had HIV-1 infection. None of the 725 MP CSWs or 291 brothel CSWs who participated in the study between 1993 and 1996 had HIV-1 infection. In contrast, CSWs from brothels had elevated rates of both HTLV-I and active chlamydia infections compared with KB and MP CSWs (p < .05 and p < .005, respectively). KB CSWs showed an elevated rate of HSV-2 infection in the years 1993 and 1994 when compared with CSWs employed by brothels and MPs (p < .005). The prevalence rates of syphilis for CSWs from brothels dropped from 42.8% in the year 1993 to 1994 to 26.3% in the 1995 to 1996 period, whereas for KB and MP CSWs, the rates were < 6% in each of year studied.

PIP: National AIDS prevention program efforts in Taiwan have been hindered by the illegal status of the vast majority of commercial sex workers (CSWs) and a lack of information about their sexual behaviors and HIV status. The present study investigated the prevalences of HIV and other sexually transmitted diseases in female CSWs from 9 massage parlors (n = 725), 2 karaoke bars (n = 1036), and 22 brothels (n = 484) in Tapei City in 1993-96. Mean ages were 30.6, 24.8, and 35.5 years, respectively. 2 (0.36%) karaoke bar CSWs had HIV-1 infection; no other cases were detected. The human T-cell lymphotrophic virus (HTLV)-1 infection rate was 4.23% among brothel workers, 1.30% in the karaoke bar group, and 0.61% among massage parlor CSWs. Herpes simplex virus infection was higher in karaoke bar CSWs (7.54%) than either massage parlor CSWs (2.44%) or brothel CSWs (2.99%). Chlamydia infection was elevated in all 3 groups, but remained highest among brothel CSWs (69.9%). Syphilis seroprevalence decreased significantly between 1993 and 1996 among brothel workers, from 42.8% to 26.3%; in the other 2 groups, prevalence was under 6% in each year studied. In interviews conducted with brothel and massage parlor CSWs in 1994 and 1995, 45.2% and 94.3%, respectively, reported they always used condoms with their clients. On the other hand, 46.2% of brothel CSWs and 32.4% of massage parlor CSWs had never used condoms with their regular sexual partners. The high rates of condom use by CSWs presumably account for the unexpectedly low HIV seroprevalence detected in this study. However, high prevalences of chlamydia and syphilis (among brothel CSWs) may signal impending HIV infections.