Factors associated with Chlamydia trachomatis and Neisseria gonorrhoeae infection among female sex workers in Nagaland, India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20171349Keywords:
FSW, NG, CTAbstract
Background: There is limited knowledge on the prevalence and correlates of sexually transmitted infections (STI) among women practicing sex work in the high HIV prevalence settings of northeast India, especially in Nagaland. We assessed the prevalence and risk factors of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among female sex workers (FSW) in Dimapur, Nagaland.
Methods: 417 FSWs were recruited into this cross–sectional study using Respondent Driven Sampling (RDS) in 2009. Information on socio-demographic characteristics, sexual risk behaviours and exposure to prevention interventions were collected from them and urine samples were tested for NG and CT. Multivariate logistic regression analysis was performed to assess the factors associated with NG and CT.
Results: The RDS-adjusted prevalence of HIV, NG and CT was 11.4%, 6.6% and 19.5% respectively. The reported condom use with clients and regular sex partners were only 29.1% and 9.6% respectively. Being in the sex trade within the last 2 years was independently associated with greater risk for NG and CT. Having more than 5 clients was independently associated with greater likelihood for CT and seropositivity for HIV was independently associated with NG.
Conclusions: High prevalence of NG/CT was documented among FSWs with relatively new entrants into sex trade having the highest risk. The combination of high STI prevalence and low consistent condom use is likely to contribute to an escalating HIV epidemic in this already high HIV prevalence setting. There is need to strengthen public health measures for screening and management of NG and CT among FSWs.
References
Lal S. Sexually transmitted diseases control programme in India: a public health approach. Indian J Public Health. 1993;37:33-6.
World Health Organization (WHO). Global prevalence and incidence of selected curable sexually transmitted infections. Overview and estimates. Geneva: WHO, 2001.
Divekar AA, Gogate AS, Shivkar LK, Gogate S, Badhwar VR. Disease prevalence in women attending the STD clinic in Mumbai (formerly Bombay), India. Int J STD AIDS. 2000;11:45-8.
Indian Council of Medical Research and FHI 360 India. Integrated Behavioral and Biological Assessment, Round 2 (2009–2010). National Interim Summary Report. Delhi: Indian Council of Medical Research and FHI 360, 2011.
Van Duynhoven YT, van de Laar MJ, Schop WA, Mouton JW, van der Meijden WI, Sprenger MJ. Different demographic and sexual correlates for chlamydial infection and gonorrhoea in Rotterdam. Int J Epidemiol. 1997;26:1373-85.
Centers for Disease Control and Prevention. Pelvic inflammatory disease: guidelines for prevention and management. MMWR Morb Mortal Wkly Rep. 1991;40:1–25.
Kahn RH, Mosure DJ, Blank S, Kent CK, Chow JM, Boudov MR, et al. Chlamydia trachomatis and Neisseria gonorrhoeae prevalence and coinfection in adolescents entering selected US juvenile detention centers, 1997-2002. Sex Transm Dis. 2005;32:255-9.
Modarress KJ, Cullen AP, Jaffurs WJ Sr, Troutman GL, Mousavi N, Hubbard RA, et al. Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in swab specimens by the Hybrid Capture II and PACE 2 nucleic acid probe tests. Sex Transm Dis. 1999;26:303-8.
Davies SC, Otto B, Partohudoyo S, Chrisnadarmani VA, Neilsen GA, Ciaffi L, Patten J, Samson ET, et al. Sexually transmitted infections among female sex workers in Kupang, Indonesia: searching for a screening algorithm to detect cervical gonococcal and chlamydial infections. Sex Transm Dis. 2003;30:671-9.
Centers for Disease Control and Prevention. HIV prevention through early detection and treatment of other sexually transmitted diseases: United States recommendations of the Advisory Committee for HIV and STD Prevention. MMWR Morb Mortal Wkly Rep. 1998; 47:1–24.
Nessa K, Waris Shama-A, Sultan Z, Monira S, Hossain M, Nahar S, et al. Epidemiology and Etiology of Sexually Transmitted Infection among Hotel-Based Sex Workers in Dhaka, Bangladesh. J Clin Microbiol. 2004;42:618–21.
Shaw SY, Deering KN, Reza-Paul S, Isac S, Ramesh BM, Washington R, et al. Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study. BMC Public Health. 2011;11(6):4.
Ramesh BM, Beattie TS, Shajy I, Washington R, Jagannathan L, Reza-Paul S, et al. Changes in risk behaviours and prevalence of sexually transmitted infections following HIV preventive interventions among female sex workers in five districts in Karnataka state, south India. Sex Transm Infect. 2010;86(1):17-24.
Subramanian T, Gupte MD, Paranjape RS, Brahmam GN, Ramakrishnan L, Adhikary R, et al. IBBA Study Team. HIV, sexually transmitted infections and sexual behaviour of male clients of female sex workers in Andhra Pradesh, Tamil Nadu and Maharashtra, India: results of a cross-sectional survey. AIDS. 2008;22(5):69-79.
Medhi GK, Mahanta J, Paranjape RS, Adhikary R, Laskar N, Ngully P. Factors associated with HIV among female sex workers in a high HIV prevalent state of India. AIDS Care. 2011;24:369-76.
Chandrasekaran P, Dallabetta, G, Loo V, Mills S, Saidel T, Adhikary R, Alary M, et al. Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative. AIDS. 2008;22 (5):1-15.
Saidel T, Adhikary R, Mainkar M, Dale J, Loo V, Rahman M, et al. Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges. AIDS. 2008;22(5):17-34.
Respondent-driven sampling analysis tool (RDSAT) 5.6.0. Ithaca, NY: Department of Sociology, Cornell University; 2006.
Sopheab H, Morineau G, Neal JJ, Saphonn V, Fylkesnes K. Sustained high prevalence of sexually transmitted infections among female sex workers in Cambodia: high turnover seriously challenges the 100% Condom Use Programme. BMC Infect Dis. 2008;8:167.
Nguyen VT, Nguyen TL, Nguyen DH, Le TT, Vo TT, Cao TB, et al. Sexually Transmitted Infections in Female Sex Workers in Five Border Provinces of Vietnam. Sex Transm Dis. 2005;32:550-6.
Batteiger BE, Xu F, Johnson RE, Rekart ML. Protective immunity to Chlamydia trachomatis genital infection: evidence from human studies. J Infect Dis. 2010;201(2):178-89.
Plummer FA, Simonsen JN, Chubb H, et al. Epidemiologic evidence for the development of serovar-specific immunity after gonococcal infection. J Clin Invest. 1989;83:1472-6.
Brunham RC, Nagelkerke NJ, Plummer FA, Moses S. Estimating the basic reproductive rates of Neisseria gonorrhoeae and Chlamydia trachomatis: the implications of acquired immunity. Sex Transm Dis. 1994;21:353-6.
Ohshige K, Morio S, Mizushima S, Kitamura K, Tajima K, Suyama A, et al. Behavioural and serological human immunodeficiency virus risk factors among female commercial sex workers in Cambodia. Int J Epidemiol. 2010;29:344-54.
Porras C, Safaeian M, González P, Hildesheim A, Silva S, Schiffman M, et al. Epidemiology of genital Chlamydia trachomatis infection among young women in Costa Rica. Sex Transm Dis. 2008;35:461-8.
Paz-Bailey G, Koumans EH, Sternberg M, Pierce A, Papp J, Unger ER, et al. The effect of correct and consistent condom use on chlamydial and gonococcal infection among urban adolescents. Arch Pediatr Adolesc Med 2005;159:536-42.
Ness RB, Kip KE, Soper DE, Stamm CA, Rice P, et al. Bacterial vaginosis (BV) and the risk of incident gonococcal or chlamydial genital infection in a predominantly black population Sex Transm Dis. 2005;32:413– 417.
Loza O, Strathdee SA, Martinez GA, Lozada R, Ojeda VD, Staines-Orozco H, et al. Proyecto Mujer Segura. Risk factors associated with chlamydia and gonorrhoea infection among female sex workers in two Mexico-USA border cities. Int J STD AIDS. 2010;21:460-465.
Abdul-Quader AS, Heckathorn DD, Sabin K, Saidel T. Implementation and Analysis of Respondent Driven Sampling: Lessons Learned from the Field. J Urban Health. 2006;83(6):1-5.
Johnstona LG, Sabin K. Sampling hard-to-reach populations with respondent driven sampling. Methodol Innov Online. 2010;5:38-48.
