RESUMO
This study aimed to evaluate the relationship between HSV-2 infection and several socio-demographic and sexual practices of Mexican and Central American female sex workers (FSWs) in the Soconusco region in the State of Chiapas, Mexico. A cross-sectional study was carried out based on a sample frame of bars where FSWs were active in the Soconusco region. FSWs consented to investigations and answered a questionnaire and provided a blood sample for specific HSV-2 antibody analysis. One hundred and sixteen bars were studied and 484 women were interviewed. The overall frequency of HSV-2 infected women was 85.7%. Variables that reflected exposure to HSV-2 were significantly associated with the frequency of the infection. Additionally, variables such as education and country of origin were significantly associated with HSV-2 infection. These results suggest that this infection is highly endemic in the Soconusco, posing a health risk for the study population.
Assuntos
Transmissão de Doença Infecciosa , Herpes Genital/transmissão , Herpesvirus Humano 2 , Trabalho Sexual , Doenças Virais Sexualmente Transmissíveis/transmissão , Adolescente , Adulto , Análise de Variância , Anticorpos Antivirais/sangue , Western Blotting , América Central/epidemiologia , Estudos Transversais , Feminino , Herpes Genital/epidemiologia , Humanos , Modelos Logísticos , México/epidemiologia , Prevalência , Fatores de Risco , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Cervical cancer, a human papillomavirus (HPV)-caused neoplasia, is highly prevalent in Mexico. GOAL: To determine the prevalence of HPV infection in female sex workers (FSW) from Mexico City and to assess the association between HPV infection and the characteristics of these women. STUDY DESIGN: A questionnaire was applied to 495 FSW. Cervical cell specimens were obtained for DNA amplification and hybridization to detect 27 HPV types. A risk factor analysis was performed. RESULTS: The overall prevalence of HPV infection was 48.9%. The prevalence of high-risk HPV types was 43%, whereas that of low-risk types was 24.6%. A total of 18.8% of study participants was infected with both high-risk and low-risk HPV types, and 28.5% were infected with two or more HPV types. Younger age and failure to use a condom were independently associated HPV risks (odds ratio, 7.3 and 2.3; 95% CI, 3.5-15.0 and 1.2-4.4, respectively). CONCLUSIONS: Infection with high-risk and multiple HPV types is high among Mexican FSW. This study corroborated a higher infection rate in younger women. A higher risk of HPV infection is also observed in women who have been involved with sex work for less than 1 year. However, condom use showed a protective effect against HPV infection.
Assuntos
DNA Viral/isolamento & purificação , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Trabalho Sexual/estatística & dados numéricos , Infecções Tumorais por Vírus/epidemiologia , Adolescente , Adulto , Fatores Etários , Colo do Útero/citologia , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Papillomaviridae/genética , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
BACKGROUND: This paper describes the seroprevalence and risk factors of Herpes simplex virus (HSV) infection in a group of female prostitutes from Mexico City. METHODS: Women who consented to participate in the study voluntarily attended a sexually transmitted disease (STD) clinic during 1992. A standardized questionnaire was administered and a blood sample was obtained from each participant. Type-specific Western blot serology was performed to determine the serostatus of HSV-1 and HSV-2 for participants. Bivariate and multivariate analyses were applied to identify variables associated with an increased risk for HSV infection. RESULTS: Prevalences of infection among the 997 prostitutes studied were 93.9% for HSV-1 and 60.8% for HSV-2. Only 1.8% of the women were seronegative for both viruses. The only variable associated with HSV-1 seropositivity was crowding index. The following variables were associated with an increased risk for infection with HSV-2: age, level of education, working site, born outside Mexico City and increasing time as a prostitute. CONCLUSIONS: This is the first assessment of HSV infection in Mexico and may be useful for the development and application of control and preventive measures among the prostitute population at risk of acquiring and transmitting human immunodeficiency virus (HIV) and other STD.
Assuntos
Herpes Genital/epidemiologia , Herpes Simples/epidemiologia , Trabalho Sexual , Adolescente , Adulto , Feminino , Humanos , México/epidemiologia , Fatores de Risco , Estudos SoroepidemiológicosRESUMO
A scarce number of studies have been carried out to determine the epidemiology of herpes simplex virus type 2 (HSV-2) infection in female sex workers (FSWs). The objective of this study was to examine the correlates of infection for HSV-2 with socioeconomic and demographic characteristics, sexual behaviour and history of sexually transmitted diseases (STDs) among FSWs in Mexico City. A sample frame of commercial sex work sites was constructed during the fall of 1992. Sites identified were streets, bars and massage parlours. During 1993 we surveyed 757 FSWs aged 18-76 years, from a random sample of sites. Participating women provided a blood sample and answered a standardized questionnaire. HSV-2 antibodies were identified based on a Western blot assay, using type-specific recombinant glycoprotein gG2. In a multivariate analysis, the presence of HSV-2 antibodies was correlated (P < 0.005) with increasing age and time working as prostitutes, low education, street working site and positive serology for syphilis. The results showed that the working site and the education level are contextual variables related to the risk of HSV-2 infection, where poorly educated and street FSWs had the highest probability of infection. Characteristics that represent periods of exposure to the virus as age and time working in prostitution were predictors of the HSV-2 infection.
PIP: The authors investigated the relationship between herpes simplex virus type 2 (HSV-2) infection and socioeconomic and demographic characteristics, sexual behavior, and history of STDs among female prostitutes in Mexico City. During 1993, 757 female prostitutes aged 18-76 years, of mean age 28.5 years, from a random selection of prostitution sites provided blood samples and answered a standardized questionnaire. The presence of HSV-2 antibodies was identified through Western blot assay, using type-specific recombinant glycoprotein gG2. Overall seroprevalences for the study population were 65.1%, 0.6%, 3%, and 6.4% for HSV-2, HIV, hepatitis B virus, and syphilis, respectively. There was no significant correlation between HIV and HSV-2 serological results, although all 5 HIV-seropositive women were HSV-2 seropositive. In a multivariate analysis, the presence of HSV-2 antibodies was correlated with relatively higher age and longer time working as prostitutes, low education, prostitution at a street site, and positive serology for syphilis.
Assuntos
Herpes Genital/epidemiologia , Herpesvirus Humano 2 , Trabalho Sexual , Adolescente , Adulto , Idoso , Feminino , Herpes Genital/psicologia , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Sexual , Classe SocialRESUMO
Sexually transmitted diseases (STDs) are an important public health problem, due to their medical, social and economic repercussions. Therefore, more knowledge is needed about the sexual behaviour that promotes their spread, in order to improve control and prevention strategies. Our aim was to determine the frequency of male condom use associated with sexual behaviour factors, a history of and knowledge about STDs in a sample of the male population in Mexico City. During 1994 a cross-sectional epidemiological study was carried out, using multi-stage sampling with conglomerates, in 1377 men from 15 to 49 years old. The mean age was 34.5 years (SD 7.5 years). Mean age at first sexual relations was 17.7 years (SD 2.8 years). The global proportion of condom use during the last sexual relation was 24.6%; use according to type of female sex partner in the last year was 18.8% with regular partners and 62.5% with occasional partners. The principal predictors of male condom use, identified through statistical modelling, were: younger age (<25 years), middle and high education level (>9 years), middle and high socioeconomic level and type of sexual partners (occasional and regular). This population has risk factors for acquiring and transmitting some STDs, such as occasional sexual partners and a history of STDs. Characteristics which are important in relation to male condom use were identified, such as age (younger than 35), education (complete junior high school or more) and type of sexual partners (occasional and regular).
PIP: A cross-sectional epidemiological study was conducted in 1994 to determine the frequency of condom use in Mexico City among sexually active men aged 15-49 years old, and the association with sexual behavior and a history of or knowledge about STDs. The 1377 men interviewed were of mean age 34.5 years, and experienced their first sexual intercourse at mean age 17.7 years. 47% of the men reported using a condom at least once in their lives and 81.6% were married. 79.4% reported having a formal partner, 14.6% had relations with occasional partners, and 6.1% with both regular and informal partners. 26.4% used a condom during their most recent sexual intercourse, 18.8% with formal partners and 62.5% with casual partners. Condom use with formal partners was largely to prevent pregnancy, while condom use with casual partners was to prevent the transmission of STDs. Young and single men were almost twice as likely to use condoms as older married men. The main predictors of male condom use were therefore being under 25 years old, having more than 9 years of formal education, being of middle to high socioeconomic status, and type of sex partners.
Assuntos
Preservativos/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Parceiros SexuaisRESUMO
OBJECTIVES: To estimate the prevalence and associated risk factors of hepatitis B virus (HBV) serological markers in female sex workers (FSW) in Mexico City. METHODS: The study population consisted of 1498 FSW who attended a detection centre for human immunodeficiency virus (HIV) in Mexico City, between January and October 1992. Study participants responded to a standardised questionnaire and provided a blood sample for serology of syphilis, HIV, and HBV. RESULTS: A total of 0.2% (95% CI 0.1-0.3) of the population were hepatitis B surface antigen (HBsAg) carriers. The general prevalence of antibodies to hepatitis B core antigen (anti-HBc) was 6.3% (95% CI 5.5-7.1). This marker of previous exposition to HBV, was independently associated by logistic regression multivariate analysis with age, working in the street, and history of blood transfusion (BT) before 1987 (OR 4.8, 95% CI 2.1-11.3). Syphilis prevalence was 7.6% (95% CI 6.2-8.9) and HIV prevalence was 0.1% (95% CI 0-0.3). CONCLUSIONS: The prevalence of HBV infection in this group of Mexican FSW is lower than previously reported in other countries. In addition, the frequency of HBsAg carriers is similar to that in the general Mexican population. The absence of two major risk factors for HBV transmission in this group of FSW--that is, injecting drug use and anal intercourse, could help to explain this finding. However, the positive association between anti-HBc and history of blood transfusion demonstrated here, highlights the need to reinforce strict control of blood supplies in Mexico.
Assuntos
Hepatite B/epidemiologia , Trabalho Sexual/estatística & dados numéricos , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Feminino , Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Doenças Virais Sexualmente Transmissíveis/sangueRESUMO
OBJECTIVES: This study tried to determine human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevalences among female commercial sex workers in Mexico City. METHODS: A sampling frame was constructed that included bars, massage parlors, and street corners. RESULTS: Prevalences for Treponema pallidum, herpes simplex virus type 2, HIV, Neisseria gonorrhoeae, and Chlamydia trachomatis were 6.4%, 65%, 0.6%, 3.7%, and 11.1%, respectively. A significant association was found between higher STD frequencies and working at street sites. CONCLUSIONS: Most STD frequencies were lower in comparison with rates found for female sex workers in other countries. However, preventive programs against STD/ HIV are needed in this population.
Assuntos
Infecções por HIV/epidemiologia , Trabalho Sexual/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Feminino , Humanos , México/epidemiologia , PrevalênciaRESUMO
OBJECTIVES: To estimate the prevalence and associated risk factors of hepatitis B virus (HBV) serologic markers in 1,377 men with high-risk sexual behavior attending a center for human immunodeficiency virus (HIV) detection in Mexico City. METHODS: The study population consisted of all men who were tested for HIV from March to September, 1992. Study participants responded to a standardized questionnaire and provided a blood sample for serology. RESULTS: A total of 1.9% of the population were hepatitis B surface antigen (HBsAg) carriers, and there was a significant difference in HBsAg prevalence between HIV-negative (0.8%) and HIV-positive individuals (7.9%). Sexual preference was associated with HBsAg prevalence; only 0.3% of men who had female sexual partners exclusively were HBsAg carriers, compared with 4.8% of men who had male sexual partners exclusively. Prevalence of antibodies to hepatitis B core antigen (anti-HBc) was 15.4%. However, men who reported only female partners had a 4.6% prevalence, whereas men who had only male partners had a 30.4% prevalence. Logistic regression analysis demonstrated an association of anti-HBc prevalence with age, marital status, sexual preference, seropositivity for HIV, and antibodies to herpes simplex virus type 2. CONCLUSIONS: These data demonstrate that coinfection with HBV is common in the HIV-positive men studied. The highest prevalences of HBsAg and anti-HBc were observed among homosexual men. These results highlight the need to intensify safe-sex education campaigns and to promote hepatitis B vaccination especially among this population group.
Assuntos
Sorodiagnóstico da AIDS , Soropositividade para HIV/complicações , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/complicações , Aceitação pelo Paciente de Cuidados de Saúde , Adolescente , Adulto , Biomarcadores , Feminino , Hepatite B/imunologia , Humanos , Modelos Logísticos , Masculino , México , Prevalência , Fatores de Risco , Comportamento Sexual , Inquéritos e Questionários , Saúde da População UrbanaRESUMO
OBJECTIVES: To study the seroprevalence of syphilis, herpes simplex-2, hepatitis B and HIV, and main sociodemographic characteristics and sexual behavior in women seeking testing for human immunodeficiency virus (HIV) in Mexico City. METHODOLOGY: A self-applied questionnaire was used in 454 women; and a blood sample was taken for the detection of markers for syphilis, herpes simplex virus-2 (HSV-2)), antibodies against core and surface antigens for hepatitis B virus (HBV), and ELISA and Western blot for HIV. RESULTS: Seroprevalences for antibodies against T. pallidum, HSV-2, HBV and HIV were 4.6%, 29.3%, 3.5% and 4.0%, respectively. Forty-six percent of the women were 20 to 29 years old; 70% reported complete junior high school or higher education level; 75% were sexually active; 56% reported at least one stable male sexual partner, 17% reported at least one occasional male sexual partner in the last three months, and 60% had had at least one sexual relation in the last three months; of these, only 18% (n = 82) reported the use of a condom as a preventive measure. Almost 30% of the HIV positive women had a history of blood transfusion, while less than 10% of the HIV negative women had received a transfusion. In addition, 10.6% said that one of their sexual partners was infected with HIV or had AIDS. CONCLUSIONS: Risks of HIV/STD transmission for this group of self-selected women were linked to blood transfusion, low education and, most important, the risk from male sexual partners who were HIV seropositive. It is expected that these results will contribute to the improvement and development of strategies for the control and prevention of STD among this population group, as well as the general population in Mexico.
Assuntos
Soropositividade para HIV/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Viroses/epidemiologia , Sorodiagnóstico da AIDS , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Infecções Sexualmente Transmissíveis/imunologia , Fatores Socioeconômicos , Viroses/imunologiaAssuntos
Gonorreia , Adulto , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Ceftriaxona/uso terapêutico , Cefalosporinas/uso terapêutico , Ciprofloxacina/uso terapêutico , Estudos Transversais , Doxiciclina/uso terapêutico , Feminino , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Gonorreia/terapia , Humanos , Masculino , México/epidemiologia , Norfloxacino/uso terapêutico , Gravidez , Estados Unidos/epidemiologiaRESUMO
GOAL: To determine the prevalence and the incidence of serologic markers for syphilis, and the characteristics associated with the risk of infection in female commercial sex workers in Mexico City. To identify female commercial sex workers at greater risk of infection with syphilis. STUDY DESIGN: The authors performed a cross-sectional study of 3,100 female commercial sex workers who sought human immunodeficiency virus testing at a National Council on AIDS clinic between January 1992 and April 1993. The authors collected information about socioeconomic and demographic characteristics, history of sexually transmitted diseases, sexual practices, and preventive measures against such diseases. All of the women provided a blood sample for identification of infection markers and in a subgroup of 1,802 women, repeat samples were obtained to estimate the rate of seroconversion to syphilis. RESULTS: Prevalence of syphilis was 8.2%, with an incidence of 2.4 per 100 person years. A positive linear relation between age and time working in commercial sex and prevalence of infection markers was observed. Women with less education, born in states other than Mexico City, and who worked on the street had significantly greater risks of infection with syphilis. CONCLUSIONS: Frequency of infection by both estimators is relatively low in the women studied. Characteristics related with periods of exposure such as age and time working in commercial sex, as well as socioeconomic and demographic characteristics, such as place of birth, education, and type of work site, were significantly related to the frequency of infection.
PIP: The goal of this study was to determine the prevalence and the incidence of serologic markers for syphilis and the characteristics associated with the risk of infection in female commercial sex workers (CSWs) in Mexico City. It also sought to identify female CSWs at greater risk of infection with syphilis. The authors performed a cross-sectional study of 3100 female CSWs who sought human immunodeficiency virus testing at a National Council on AIDS clinic between January 1992 and April 1993. The authors collected information about socioeconomic and demographic characteristics, history of sexually transmitted diseases, sexual practices, and preventive measures against such diseases. All of the women provided a blood sample for identification of infection markers, and in a subgroup of 1802 women repeat samples were obtained to estimate the rate of seroconversion to syphilis. Prevalence of syphilis was 8.2%, with an incidence of 2.4/100 person-years. A positive linear relation between age and time working in commercial sex and prevalence of infection markers was observed. Women with less education, born in states other than Mexico City, and who worked on the street had significantly greater risks of infection with syphilis. Frequency of infection by both estimators is relatively low in the women studied. Characteristics related to periods of exposure such as age and time working in commercial sex, as well as socioeconomic and demographic characteristics, such as place of birth, education, and type of work site, were significantly related to the frequency of infection.
Assuntos
Trabalho Sexual , Sífilis/prevenção & controle , Adulto , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Incidência , México/epidemiologia , Razão de Chances , Prevalência , Fatores de Risco , Assunção de Riscos , Fatores Socioeconômicos , Sífilis/epidemiologia , Local de TrabalhoRESUMO
OBJECTIVE: This research work intended to describe the characteristics and the seroprevalence of some sexually transmitted diseases (STD), in men working in bars where female commercial sex takes place. MATERIAL AND METHODS: The study included an evaluation of 171 males during 1993, who were employed in bars and who were potentially at risk of contact with female commercial sex workers (FCSW). A structured survey was conducted in order to collect information about social, demographic and sexual behavior characteristics. Blood samples were also obtained to test for antibodies against Treponema pallidum (RPR/FTA-ABS), human immunodeficiency virus (VIH) (ELISA, Western blot), Herpes simplex virus type-2 (HSV-2) (Western blot) and the core antigen of hepatitis B virus (HBV) (ELISA). RESULTS: Test results showed low infection rates of HIV, T: pallidum and HBV: 0%, 2.4% and 1.8%, respectively. However, their HSV-2 infection proportion (32.4%) was considered intermediate in comparison to the prevalence of FCSW from bars (55.5%), to that found in heterosexual men (14.6%), and to proportions found in women general population (29.3% and 17.9%). CONCLUSIONS: The men's age and a history of sexual intercourse with FCSW were strong predictors of HSV-2 infection. These findings evidence a relationship between men working in bars and FCSW in terms of STD transmission and show the need for preventive care directed to this group.
Assuntos
Infecções por HIV/epidemiologia , Ocupações , Trabalho Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Anticorpos Antibacterianos/análise , Western Blotting , Educação , Ensaio de Imunoadsorção Enzimática , Feminino , Teste de Absorção do Anticorpo Treponêmico Fluorescente , HIV/imunologia , Anticorpos Anti-HIV/análise , Infecções por HIV/diagnóstico , Infecções por HIV/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/análise , Herpesvirus Saimiriíneo 2/imunologia , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/imunologia , Sífilis/epidemiologia , Treponema pallidum/imunologiaRESUMO
This paper describes a serological survey applied to 3098 female commercial sex workers, in order to determine the prevalence of syphilis. The women attend regularly an AIDS orientation center sponsored by CONASIDA in Mexico City. The laboratory tests included the rapid plasma reagin assay (presumptive analysis) and the fluorescent treponemal antibody-absorption technique (confirmatory test). No primary syphilis cases were detected and the prevalence of latent asymptomatic syphilis was 8.2% (255/3098). The sensitivity and specificity of the presumptive test compared to the confirmatory test were 74% and 98% respectively, and the positive predictive value was 77% and the negative predictive value 98%. All seropositive women received the standard penicillin treatment for syphilis. Considerations of importance are offered regarding interpretation and usefulness of this kind of research.