Sexually transmitted infections in female sex workers: reduced by condom use but not by a limited periodic examination program.

BACKGROUND AND

OBJECTIVES

The sexually transmitted diseases (STD) control program for female sex workers (FSW) in Lima, Peru, provided periodic serological tests for syphilis and cervical smears for gonococci, but not medication for STD or condoms.

GOAL OF THIS STUDY: To assess program effectiveness.

STUDY

DESIGN

We assessed prevalence of current STD and serum antibody to STD pathogens in FSW in relation to program participation and to condom use.

RESULTS

Program participation was not associated with significantly reduced rates of current gonococcal or chlamydial infections or Venereal Disease Research Laboratory (VDRL) titers > or =4 with reactive fluorescent treponemal antibody absorption (FTA-ABS). However, regardless of control program participation, consistent condom use was associated with reduced prevalence of gonorrhea, and with significantly reduced seroreactivity for FTA-ABS, C. trachomatis, anti-hepatitis B core (HBc), and anti-human T-lymphotropic virus type I. Anti-HBc was associated with years of receiving penicillin injections for syphilis prophylaxis.

CONCLUSION

The scope, quality, and efficacy of STD control programs must be technically appropriate, well managed, and adequately financed. The safety of marginal programs warrants scrutiny.