Integrated HIV/STI Biological and Behavioral Surveillance among Female Sex Workers Using Handheld Computer in 12 Provinces in Thailand: Results from a Survey in 2014

Abstract

          Bureau of Epidemiology, Department of Disease Control has developed an integrated HIV/sexually transmitted infction (STI) biological and behavioral surveillance (IBBS) among female sex workers (FSW) in order to collect information which can explain the relationship between HIV and sexually transmitted infections with behaviors in a more comprehensive way. The first survey was performed in 12 provinces in 2010. The second survey was repeated in 2013, using handheld computer to collect behavior data. This report aims to describe the results of the second survey.           FSW in the survey were 15-49 years old. Blood and urine samples were collected to test for HIV infection and sexually transmitted infection including Neisseria gonorrhea and Chlamydia trachomatis. Subjects responded to self-administered questionnaire using handheld computer. There were 3,254 FSWs participated in the survey. Of these, 1,103 (33.9%) were direct FSW and 2,151 (66.1%) were indirect FSW. The average age was 28.7±9 years old. Aggregated rates of HIV, Neisseria gonorrhea and Chlamydia trachomatis infection were 1.9, 4.2 and 18.1% respectively. For behavior data, 58.5% of FSW knew and used to receive distributed condoms and 88.8% had experience of HIV testing during the last one year before survey. 92.1% reported using condom in their last sex act. Data on condom used in every sex act during the past month was 95.2% with regular customer, 97.0 with periodic customer, 75.9% with other men and 27.3% with husband or boyfriend.           The results of the survey showed lowering trend of HIV infection in FSW comparing to the 2010 results while in Neisseria gonorrhea and Chlamydia trachomatis infections, the trends had been highly increased. This increasing trend may be the effect from low rates of condom used with other men and husband or boyfriend. It is recommended that the STI control program must be strengthened in this group of population in order to get a better outcome in controlling the diseases.