Epidemiology of HIV and STI among female sex
workers in Panana
C.T. Bautista1, G. Arteaga2, A. Nuñez2, Y. Ibarra3, S. Peel1, G. Paz-Bailey4, O. Quintero5, P.T. Scott1, J.M. Pascale2
1US Military HIV Research Program/WRAIR, Rockville, United States, 2Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama, 3National HIV/AIDS Program, Ministry of Health, Panama, Panama, 4Del Valle University of Guatemala, Guatemala, Guatemala, 5Fundación PROBIDSIDA, Panama, Panama
Background: Female sex workers (FSW) have a high risk of exposure to sexually transmitted infections (STI) including HIV. There is a lack of information on the epidemiology of these infections in this high-risk group in Panama.
Methods: A cross-sectional study among FSW was performed in Panama City between November 2009 and February 2010. Socio-demographic information and behavioral data were collected. Samples were tested for antibodies to HIV, HSV-2, syphilis, hepatitis C (HCV), hepatitis B core antigen (anti-HBc), and hepatitis B surface antigen (HBsAg). Odds ratios (OR) along with confidence intervals (CI) were estimated by using logistic regression.
Results: A total of 181 FSW enrolled. The mean age (SD) of participants was 30 (8.1) years. Fifty-nine percent of participants were Panamanian and 64% were single. Main workplaces were streets (40%), bars (24%), and whorehouses (3%). The prevalence of HIV, HSV-2, syphilis, hepatitis C, anti-HBc, and HBsAg were 1.1% (n=2), 77.3% (n=140), 5.0% (n=9), 1.6% (n=3), 13.8% (n=25), and 0.6% (n=1), respectively. No significant associations were found for HIV, syphilis, HCV, anti-HBC, and HBaAg. Associations correlated with HSV-2 were age (OR-per-year = 1.06, 95% CI = 1.01-1.12), being a Panamanian FSW (OR = 3.92, 95% CI = 1.84-8.31), pain during sexual intercourse (OR = 2.23, 95% CI = 1.04-4.77), years as a sex worker (OR-per-year = 1.33, 95% CI = 1.10-1.63), and anal sex with clients (OR = 4.59, 95% CI = 1.04-20.37).
Conclusions: The prevalence of HSV-2 was higher than HIV prevalence and other infections among FSW in Panama. Risk behavior analysis suggests the need of developing specific educational prevention programs among FSW. The high prevalence of HSV-2, an incurable STI, may increase the risk of HIV acquisition and transmission in this high-risk group over time.
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