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Healthy girls and women of the reproductive age, as well as women immediately before and after menopause, were examined. Neutrophils and immunoglobulins of cervical and vaginal secretions were studied and, as a result, age-dependent differences in the activity of the anti-infectious protection of the reproductive tract of women were found.
This paper presents a socioeconomic profile and the prevalence of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), among 341 female commercial sex workers (CSWs) in Kathmandu Valley. Most of the CSWs are from outside the valley, but from within Nepal. Over 50% of the CSWs have a secondary or higher level of education. The average age of the CSWs is 21 years. The average age of first sexual intercourse was 16 years; and, at entering the sex trade, 18 years. The most frequently reported type of sexual activity is vaginal intercourse followed by anal intercourse. Although a large proportion of CSWs are aware of condoms, only one-fifth of them reported using condoms most of the time they had intercourse. The majority of the CSWs are aware of general types of STDs. Slightly over 60% are aware of AIDS, and the majority of them know of at least one mode of AIDS transmission. Gynecological examination based on symptoms revealed that 72% of the CSWs were infected with some type of STD. About 47% had vaginal discharges, 36% had pelvic inflammatory disease, 24% had ulcerative disease, and 4% had urethritis. Blood tests of the CSWs revealed that 28% had VDRL (a test for syphilis), hepatitis B, or HIV. The prevalence of VDRL was the most common, followed by hepatitis B. Of the 341 CSWs, 3 (0.9%) were HIV-positive.
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It is generally accepted that transport workers will have a higher level of seroprevalence than the general population--and that their employment means that they are at greater risk. There have been a few studies on this, primarily in east Africa. Among the studies reported in Yokohama was a 1993 survey of 128 truck drivers in Douala and 40 bus drivers in Ekok (on the Cameroon-Nigerian border). The survey found that drivers (whose mean age was 24.5 years) spent an average 14 days away from home on each trip. As might be expected there was a high incidence of seeking partners away from home, 62% had sex during the trip and 25% had sex every night they were away. The main partners were commercial sex workers, followed by girl friends. Drivers had high levels of STDs. 50% had had gonorrhea during the past six months, while 16% had had syphilis. As might be expected, the level of HIV prevalence were also high. 15% of drivers tested positive, the third highest prevalence in the country after commercial sex workers (35%) and prisoners (17%). The conclusion was that special prevention messages should be designed for drivers. The first need is to see the groups as a target who need to change their behavior, the second is to look at the determinants of this behavior and to seek to change the environment in which the drivers operate. For example, can the trips be shorter? Could drivers be encouraged to take partners with them? There is a need to move beyond the simple measuring of prevalence and identifying of the "risk groups" to looking at the socioeconomic setting in which they operate.
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