AEGiS-14IAC: What can data on Sexually Transmitted Infections (STI) from Western Pacific countries tell us about the HIV Epidemic in the region?

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

What can data on Sexually Transmitted Infections (STI) from Western Pacific countries tell us about the HIV Epidemic in the region?

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeC9037)

Nguyen Thi Thanh T, Poumerol G, Sullivan E
WHO, Western Pacific Regional Office, Manila, Philippines

BACKGROUND: Surveillance of sexually transmitted infections (STI) is integral to second generation HIV surveillance. This review examines the use of STI data in explaining the HIV epidemic and informing prevention strategies.

METHODS: STI database was developed based on annual updates from Western Pacific countries (WPC). Prevalence data analysed were from cross-sectional surveys during the period 2000-2001. Laboratory techniques used included RPR and TPHA tests for syphilis and PCR for detecting chlamydia, gonorrhoea and trichomonas.

RESULTS: Although most WPC are of low HIV prevalence, high STI prevalence was recorded. This indicated the presence of high risk sexual behaviour and the potential for the expansion of HIV. At least one STI was observed in 86% female sex workers (SW) in Yunnan China (n= 505), in 41% SW of both sexes in Kuala Lumpur Malaysia (n=208), 18 % male truck drivers in Anhui China (n=550), and in one third of women attending hospital-based antenatal clinics (ANC) in Port Vila Vanuatu (n=547) and Apia Samoa (n=472). The most prevalent STI is Chlamydia, with rates in SWs of 35% in Vientiane Laos and Angeles Philippines and 59% in Yunnan. Syphilis seropositivity varied among SW populations: from 0.4% in Vientiane to 9.5 % in Yunnan among female SWs, to 16% among freelance SWs in Angeles, and to 31% in SWs of both sexes in Kuala Lumpur. Young age is significantly associated with STI in ANC women and SWs. A four-fold increase of reported STI cases was observed in China (1990-2000). In Cambodia, a decrease in chlamydia prevalence in SWs from 22.5 % in 1996 to 12 % in 2001 was consistent with a decrease in HIV prevalence (in 1999 and 2000) and an increase in condom usage.

CONCLUSIONS: STI data from WPC was helpful as an indicator of vulnerability for HIV infection, information for targeting interventions, and a tool to evaluate effectiveness of STI/HIV control programs. Surveillance of STIs should be strengthened in line with STI/HIV program.

Keywords: AEGIS, HIV Infections, Prevalence, Disease Outbreaks, HIV Seropositivity, Condoms, Cross-Sectional Studies, Syphilis, Gonorrhea, Chlamydia Infections, China, Philippines, Cambodia, Laos, Malaysia, Samoa, Vanuatu, Human, Female, Male

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LbPeC9037