Document 0152
 DOCN  M9490152
 TI    Trends in sexual behaviour and the incidence of sexually transmitted
       diseases and HIV among drug-using prostitutes, Amsterdam 1986-1992.
 DT    9411
 AU    van Ameijden EJ; van den Hoek AJ; van Haastrecht HJ; Coutinho RA;
       Municipal Health Service, Department of Public Health and; Environment,
       Amsterdam, The Netherlands.
 SO    AIDS. 1994 Feb;8(2):213-21. Unique Identifier : AIDSLINE MED/94318205
 AB    OBJECTIVE: To determine trends in commercial sexual risk behaviour among
       drug-using prostitutes in Amsterdam after local and national prevention
       campaigns began in 1987. DESIGN: A subgroup of 281 drug-using
       prostitutes was selected from a comprehensive, open cohort study of drug
       users in Amsterdam. METHODS: Cross-sectional (at intake) and
       within-person trends in sexual behaviour were evaluated. Person-time
       analysis was used to determine trends in incidence of sexually
       transmitted disease (STD). RESULTS: From 1986 to 1992, 'always' use of
       condoms in the 6 months preceding intake increased from 21 to 58% (P <
       0.001) and the number of commercial contacts declined from 84 to 64 per
       month (P = 0.06). Consequently, the mean number of unprotected
       commercial contacts declined from 26 to nine per month (P < 0.001).
       Temporal trends within individual prostitutes from visits 1 to 8 (mean
       interval between visits, 4 months) showed a somewhat larger risk
       reduction than the cross-sectional trends. From 1989 to 1992, the STD
       incidence declined from 61 to 40 episodes per 100 person-years (P =
       0.06). Prostitutes residing in Amsterdam for shorter time periods
       reported more STD and a relatively small core group reported the
       majority of STD episodes. At intake, when < 10% of all participants knew
       their HIV serostatus, HIV-positive prostitutes reported significantly
       lower levels of condom use and more STD than HIV-negatives, while, after
       learning their serostatus, levels of condom use and the STD-incidence
       were comparable. Prevalent and incident HIV infections were not observed
       among non-injecting prostitutes. CONCLUSIONS: Drug-using prostitutes
       have reduced sexual risk behaviour. There is evidence for the
       effectiveness of HIV testing and counseling. At present, new infections
       among clients of drug-using prostitutes are expected to occur, although
       not on a large scale. Since the incidence of STD continues to be high,
       it is important to monitor the spread of HIV among heterosexuals,
       including prostitutes and their clients, closely.
 DE    Adult  Cocaine  Cohort Studies  Comorbidity  Condoms/*UTILIZATION
       Cross-Sectional Studies  Female  Follow-Up Studies  Germany/ETHNOLOGY
       Heroin Dependence/EPIDEMIOLOGY/PREVENTION & CONTROL  Human  HIV
       Infections/*EPIDEMIOLOGY/PREVENTION & CONTROL  HIV Seroprevalence
       Incidence  Netherlands/EPIDEMIOLOGY  Program Evaluation
       Prostitution/*STATISTICS & NUMER DATA  Sex Behavior/*STATISTICS & NUMER
       DATA  Sexually Transmitted Diseases/*EPIDEMIOLOGY  Substance
       Abuse/*EPIDEMIOLOGY  Substance Abuse Treatment Centers  Substance Abuse,
       Intravenous/EPIDEMIOLOGY  Support, Non-U.S. Gov't  Urban Population
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).