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
