AEGiS-14IAC: Success of Cambodian HIV prevention efforts confirmed by low prevalence of sexually transmitted infections and declining HIV and risk behaviors.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Success of Cambodian HIV prevention efforts confirmed by low prevalence of sexually transmitted infections and declining HIV and risk behaviors.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrC1271)

Hor LB, Seng WS, Saidel T, Steen R, Ly SP, Seng S, Htun Y, Stuer F, Natpratan C, Dallabetta G
National Center for HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia

BACKGROUND: To determine the impact of HIV prevention efforts on the prevalence of common sexually transmitted infections (STIs) in key risk populations in Cambodia.

METHODS: A self-weighted cluster sampling design was used to select representative population-based samples of brothel-based sex workers (n=141), police (n=165) and women attending reproductive health clinics (n=451) for antenatal or family planning services from 7 provinces. A standardized questionnaire and examination were administered. . Samples were tested for N. gonorrhea, C. trachomatis, syphilis, T. pallidum, H. ducreyi, and HSV-2.

RESULTS: Gonorrhea prevalence was 14.2% among sex workers (SW) and 0.0% for both police (P) and reproductive health clinic women (RHC). Chlamydia prevalence was 12.1% (SW), 1.8% (P) and 2.8% (RHC). Syphilis seropositivity (TPHA+/RPR1:8) was 2.8% (SW), 0.0% (P), and 0.7% (RHC). Genital ulcers due to chancroid were seen in 1.4% (SW) and 0.4% (RHC), and HSV-2 ulcers in 0.7% (SW) and 0.4% (RHC). No primary syphilitic ulcer was seen in any group, and no asymptomatic chancroid or syphilis was detected on routine vaginal swabs from sex workers. 2.4% of sex workers had evidence of asymptomatic HSV-2.

CONCLUSIONS: Low rates of both ulcerative and non-ulcerative STIs support recent behavioral trends showing increased levels of condom use in commercial sex and decreases in commercial sex use among men. These findings are also consistent with recent declining HIV seroprevalence trends showing 21-48% reductions in HIV-1 prevalence for these same groups between 1997 and 2000. Triangulation of data from STI, behavioral and HIV surveys provides evidence that Cambodia's targeted policies of STI control and HIV prevention are having a significant effect on disease transmission.

Keywords: AEGIS, Prevalence, HIV Infections, Prostitution, Risk-Taking, HIV-1, Syphilis, HIV Seroprevalence, Chancroid, HIV Seropositivity, Gonorrhea, Chlamydia Infections, Ulcer, Cambodia, Human, Female, Male, prevention & control, epidemiology

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