ABSTRACT
OBJECTIVE: To estimate the prevalence of reproductive tract infections (RTIs) among the Female Sex Workers (FSWs), Male Sex Workers (MSWs), Injecting Drug Users (IDUs) and truck drivers. STUDY DESIGN: Cross-sectional. PLACE AND DURATION OF STUDY: Lahore and Karachi, from March to August, 2004. METHODOLOGY: Four hundred FSWs, 400 MSWs, 200 eunuchs, 400 IDUs and 400 truck drivers were interviewed and examined. Biological testing included PCR and ELISA. RESULTS: The mean prevalence of syphilis was 17.7% (95% CI: 15.1-20.3%). Genital gonorrhoea was found among 0.8-12.3% of subjects with mean of 4.5% (95% CI: 0.8-5.2%). Genital chlamydia was seen in 0.2-11% individuals with mean of 2.6% (95% CI: 2.1-3.1%). Trichomonas was present in 19.3% FSWs of Lahore and 5.52% FSWs of Karachi. Only 0.8% truckers in Lahore had trichomonas. In Lahore, 47.6% FSWs and in Karachi, 27.4% FSWs were positive for bacterial vaginosis. A vast majority of IDUs, 91.8% in Lahore and 87% in Karachi were hepatitis C positive. CONCLUSION: The prevalence of syphilis is very high among all high-risk groups; particularly so among eunuchs (60.2% in Karachi and 32.3% in Lahore). Such a high levels of RTIs indicate a serious threat for HIV epidemic because of socially transmitted infection.
Subject(s)
Genital Diseases, Female/epidemiology , Genital Diseases, Male/epidemiology , Sexually Transmitted Diseases/epidemiology , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Chlamydia Infections/microbiology , Confidence Intervals , Enzyme-Linked Immunosorbent Assay , Female , Genital Diseases, Female/diagnosis , Genital Diseases, Female/microbiology , Genital Diseases, Female/parasitology , Genital Diseases, Male/diagnosis , Genital Diseases, Male/microbiology , Genital Diseases, Male/parasitology , Gonorrhea/diagnosis , Gonorrhea/epidemiology , Gonorrhea/microbiology , Humans , Male , Pakistan/epidemiology , Prevalence , Risk Assessment , Risk Factors , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/microbiology , Sexually Transmitted Diseases/parasitology , Surveys and Questionnaires , Syphilis/epidemiology , Trichomonas Infections/epidemiology , Trichomonas Infections/parasitology , Vaginosis, Bacterial/epidemiologyABSTRACT
The objective of this study was to measure HIV prevalence and risk behaviour in injecting drug users (IDUs), male sex workers (MSWs), Hijras (transgenders), female sex workers (FSWs) and male truckers in Karachi and Lahore, Pakistan. The design was a linked-anonymous cross-sectional study of individuals identified at key venues or through peer referral. Approximately 400 respondents in each group (200 for Hijras) responded to a standardized questionnaire and were tested for HIV antibodies at each site. In Karachi, 23% of IDUs and 4% of MSWs were HIV positive, and HIV-positive individuals were identified in all risk groups in at least one city. Two-thirds of all IDUs used a shared needle in the previous week, and unprotected commercial sex activity with men and women was high. The HIV epidemic has entered IDU and male and female commercial sex networks in Karachi and Lahore. Targeted intervention services must be scaled up and risk group surveillance intensified.
