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Document 0304
DOCN M9650304
TI Socioeconomic status and risk of HIV-1, syphilis and hepatitis B
infection among sex workers in Sao Paulo State, Brazil. Instituto Adolfo
Lutz Study Group.
DT 9605
AU Lurie P; Fernandes ME; Hughes V; Arevalo EI; Hudes ES; Reingold A;
Hearst N; Center for AIDS Prevention Studies (CAPS), University of;
California, San Francisco 94105, USA.
SO AIDS. 1995 Jul;9 Suppl 1:S31-7. Unique Identifier : AIDSLINE
MED/96085741
AB OBJECTIVES: To determine how HIV risk behavior and the prevalences of
sexually transmitted diseases vary according to socioeconomic status and
city among sex workers in Sao Paulo State, Brazil. SUBJECTS AND METHODS:
A cross-sectional study of 600 female sex workers (100 of a higher
socioeconomic status and 100 of a lower socioeconomic status in each
city) was conducted in the cities of Sao Paulo, Campinas and Santos. HIV
risk behavior was assessed by questionnaire; serological tests were
administered to assess prior exposure to HIV-1, syphilis and hepatitis
B. RESULTS: Only statistically significant (P < 0.05) findings are
reported here. Compared to those with a higher socioeconomic status, sex
workers with a lower socioeconomic status worked longer hours each day
(9.6 versus 7.9), had more clients per day (5.4 versus 2.6) and had
fewer episodes of intercourse per client per encounter (1.1 versus 1.4).
Levels of condom use for vaginal, anal and oral sex were significantly
higher in Santos than in Sao Paulo or Campinas. Twenty-three per cent of
the women said they feared violence if they insisted that their clients
wear condoms; 74% voiced similar fears regarding their non-client sexual
partners. Overall, 11% of sex workers were positive for exposure to
HIV-1, 45% for syphilis and 39% for hepatitis B. Those with a lower
socioeconomic status were more likely than those with a higher
socioeconomic status to be infected with HIV-1 (17 versus 4%), syphilis
(66 versus 24%) and hepatitis B (52 versus 26%), but there were no
differences in prevalence rates by city. CONCLUSIONS: These data
demonstrate substantial heterogeneity in HIV risk behavior and the
prevalence of HIV-1 and other sexually transmitted diseases among sex
workers in Sao Paulo State, many of which were related to differences in
socioeconomic status. Interventions to prevent HIV transmission among
sex workers must be tailored to the local environment and, in
particular, to the socioeconomic status of these workers.
DE Adolescence Adult Brazil/EPIDEMIOLOGY Condoms/STATISTICS & NUMER DATA
Cross-Sectional Studies *Developing Countries Female Health Education
Hepatitis B/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION Human HIV
Infections/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION *HIV-1
Incidence Knowledge, Attitudes, Practice Middle Age
Prostitution/*STATISTICS & NUMER DATA Sexual Partners *Socioeconomic
Factors Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.
Syphilis/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION Urban
Population/STATISTICS & NUMER DATA JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).