Nguyen Thi Thanh Thuy*, Nguyen Xuan Hoan**, Tran Thi
Thanh**,
Vo Tuyet Nhung* Tran Kim Phuong*, Tran Phuc Hau*, Ha Ba
Khiem*.
*Pasteur Institute in
** Center for Preventive Medicine of
We evaluated the prevalence of HIV and other sexually transmitted diseases (STD) and determinants of risk sexual behavior among women working in services such as bars, and massage parlors, etc.
A cross-sectional study was performed in 500 subjects randomly selected from these services, in a tourist city, during a period of 2 months in late 1996 by a face-to-face interview and serological testing.
HIV seroprevalence was found in 0.4% (W. Blot) of the subjects, treponemal seroprevalence in 4.2% (TPHA) and HBsAg prevalence (ELISA) in 10.6%. Among the 266 women who reported having sex in the past year, 70% had irregular sex (defined as a relationship lasting < 12 months), 46% had more than one sexual partner. In addition, a history of an STD was observed more commonly (p<0.05) in women who had sexual intercourse for the first time at the ages of <17 years old (40.7% versus 22.3%), women with irregular sex (32.6% versus 13.4%) and women with > 5 sexual partners in the past year (42.8% versus 21.7%). Treponemal seropositivity was more likely to be detected in women with irregular sex (7% versus 1.2%). The multivariate analysis showed that first sexual intercourse at <17yrs., working at beer, wine or coffee bars, working for less than 6 months, high monthly income >100 USD, and a history of an STD were significantly related to irregular sex (OR=7.9; 4.9; 4.1; 2.5; and 3.2 respectively). Predictors of a large number of partners (>5) were unmarried status and employment at beer or coffee bars (OR=4; 9 respectively). Furthermore, a large number of partners was also associated with high income of study women, and drinking status or age < 40 yrs. of their clients (OR=7.6; 5 and 4 respectively). Inconsistent condom use rate was 47 % among women with irregular sex or more than one sexual partner.
Socio-economic and demographic conditions and some behaviors such as early first intercourse, unmarried status, young age, low schooling level, employment at bars, drinking status and young age of clients were shown to be powerful determinants of high risk sexual behaviors for HIV/STD transmission. Irregular sex and large numbers of sexual partners were identified as risks factors for STDs. Condom use in women with sexual risk of HIV/STDs should be monitored and improved by intervention measures on HIV/STDs.