Sexually transmitted infections in female sex workers in five border provinces of Vietnam

Background: Although high prevalences of sexually transmitted infections (STIs) have been reported among female sex workers (FSWs) in some countries of Asia, there is little data about this issue in Vietnam. Goal: The goal of this study was to determine 1) the prevalence of selected STIs and correlates of chlamydia or gonococcal infection, and 2) contraceptive practices, STI-related symptoms, and healthcare-seeking behavior in FSWs in border provinces of Vietnam. Methods: Nine hundred eleven FSWs in five border provinces of Vietnam (Lai Chan, Quang Tri, Dong Thap, An Giang, and Kien Giang) were enrolled in a cross-sectional study between December 2002 and January 2003. Study subjects were interviewed about selected sociodemographic and behavioral characteristics, history of STIs, and information about cohabiting partners by a standard interview schedule. Serologic samples were collected for syphilis and urine specimens for gonorrhea and chlamydia. Univariate and multivarliate logistic regression analysis was used to determine behavioral and other selected risk factors for gonorrhea/chlamydia among FSWs. Results: Overall, the prevalences of syphilis, gonorrhea, chlamydia, and gonorrhea/chlamydia among FSWs in the five border provinces were 10.7%, 10.7%, 11.9%, and 19.9%, respectively. The prevalence of gonorrhea/chlamydia was higher in the northern and central regions (27-33%) than in the southern region (11-24%). The prevalence of syphilis was low in Lai Chan (1 %), but higher than 10 % in the other four border provinces. Among FSWs with cohabiting partners, income :533 US$ per month (odds ratio [OR] = 5.8, P = 0.009), ever having worked outside Vietnam (OR = 78.2, P = 0.007), partner's age < 30 years (OR = 11.7, P = 0.001), and partner's complaint of burning or pain during sex (OR = 15.6, P = 0.02) were significantly associated with gonorrhea/chlamydia. Among single FSWs, sex work < 6 months (OR = 2.6, P < 0.001) and ever douching in the last month (OR = 1.7, P = 0.026) were associated with gonorrhea/chlamydia. For all FSWs, a complaint of lower abdominal pain (OR = 1.6, P = 0.028) and sex work < 6 months (OR = 2.3, P = 0.001) were significantly associated with gonorrhea/chlamydia. Conclusions: There is a high prevalence of gonorrhea/chlamydia among FSWs in these border provinces of Vietnam. Correlates of gonorrhea/chlamydia identified in this study could be incorporated into treatment algorithms for cervicitis in FSWs in Vietnam.