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1994-09-03
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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).