Prevalence of Sexually Transmitted Infections among Female Sex Workers attending Institute of Venereology.

INTRODUCTION : For a communicable disease to be maintained in a population, an infected individual must infect on an average more than one new susceptible, resulting in a basic reproductive rate for the disease of one or greater. For sexually transmitted disease the basic reproductive rate is the product of the transmission efficiency of the disease pathogen, the effective rate of partner change in the population and the average duration of infectiousness. In the wake of HIV/ AIDS epidemic in India, the sexual behaviour and related risk factors among various vulnerable populations have caught the imagination of the researchers and policy programmers. It is more and more felt that some sections of populations are especially vulnerable because of their marginality, lack of social support and other factors. Of all the vulnerable population towards HIV/ AIDS, Female sex workers occupy a special niche. Female sex worker [FSW] is a person who provides sexual service for immediate cash or a kind in return. The phenomenon of a small number of women having sex with a more number of men is extremely important in STD epidemiology. FSWs are highly tabooed and highly stigmatized. Sex workers are illegal persons in our country. Therefore FSWs are harassed by police and others. As a result of the all hard hostility, FSWs tend to hide their behaviour from others, even from their families. Owing to this, it can be safely assumed that the number of FSWs in this society is larger than that meet our eyes. In developing countries, men purchase sex from female prostitutes more frequently. In the recent past, HIV prevalence among the population of FSWs in different cities across the world is found to be high and is rising fast 1. E.g. Chiang mai (Thailand) – 30%, Mumbai (India) – 60% (1994), Congo – 28% (1996) Making good quality STI care and services available and accessible to sex-workers could effectively reduces transmission of STDs and HIV. In this study, efforts have been made to assess the pattern of STI among FSWs as well as to document their sexual behaviour, who attends the out patient clinic of the Institute of Venereology, Government General Hospital, Chennai from 1st January 2006 to 15th August 2007. AIM OF THE STUDY : 1. To study the pattern of Sexually Transmitted Infections among Female Sex Workers. 2. To study about the age distribution, socio economic back ground, educational level and marital status among the FSWs. 3. To study the prevalence of condom usage by the clients of Female sex workers in the study group. 4. To study the pattern of Sexually Transmitted Diseases among HIV infected Female Sex Workers. 5. To study the sexual behaviour pattern among Female Sex Workers. CONCLUSION : 1. Vaginal discharge was more common than genital ulcer disease. Trichomonas vaginalis vaginitis (34.17%) was the commonest STD among the FSWs followed by Bacterial vaginosis (25.94%) and Vulvo vaginal candidiasis (21.51%). Viral sexually transmitted infection are on the rise in the FSWs. 8.22% of the FSWs were HIV positive. 2. The FSWs belong to the lower socio economic status was 87.83%. 48.1% of FSWs belong to 20 – 29 years age group. 8.86% were uneducated. 3. FSWs using condom consistently with their clients was 17.72%. 61.39% of FSWs did not use condoms all the time with their clients. 20.88% of FSWs were never used condoms with their clients. 4. All the HIV infected FSWs were affected with sexually transmitted infections. Genital herpes was the commonest viral infection among them and 76.9% had multiple STIs. 30.6% of the HIV positive persons had CD4 count less than 300. 5. Peno vaginal was the commonest mode of sex followed by peno oral (26.58%) and peno anal (5.69%). Sexually transmitted disease management in FSWs requires the expert clinician to be conversant with risk assessment, the clinical presentation, and current diagnosis of certain infection to be familiar with new therapeutic agents. Successful STI care of FSWs can be achieved because of many infections are easily diagnosed and curable which paves way to reduce the HIV transmission in the community

Turban PUVASOL: An Effective Treatment in Alopecia Totalis

Alopecia areata is characterized by patchy hair loss involving the scalp, eyelashes, and beard. The disease may at times lead to complete baldness of the scalp (alopecia totalis) or of the entire body (alopecia universalis). Alopecia totalis is usually resistant to therapy. We report two cases of alopecia totalis treated with turban psoralen with sunlight exposure (PUVASOL)