HIV and STD among sex workers and technical students in a Northeast province Thailand.

A study was conducted to explore the epidemiology and social behavior of commercial sex workers in brothels to gain insight into their demographic characteristics HIV seroconversion rate and incidence of sexually transmitted disease (STD). The study also explored the prevalence of HIV and VDRL among technical students and their experiences with commercial sex workers (CSW). 220 CSWs from 24 brothels aged 21-22 in business for a period ranging 6.5-30 months were followed-up over a period of 1-year with interviews and testing every 3 months; weekly check-ups and treatment were also provided at a government STD center. Student information was obtained through questionnaires voluntary confidential VDRL testing and anonymous HIV testing in a school-based cross-sectional study. 1214 students were sampled of average age 18 years over the range 17-26 years. 15.8% had had sex with a CSW by the 1st year of school while 79% had done so by the 7th year. 0.8% were HIV positive. 60% always used condoms with CSWs and 13% with other girls. Alcohol consumption was related to sex with CSWs and the mean number of CSWs and other sex partners was not available. The study found that HIV is spreading widely among CSWs and that male students aged 15-25 years are at risk of being infected by CSWs and passing it on to others. Interventions for CSWs should be pursued by establishing a working relationship between health personnel and CSWs; providing STD service on a weekly or bi-weekly basis along with health education and counseling; promoting condoms through owner participation; and expanding compulsory education from primary school to secondary school. Interventions for students should be strengthened by raising awareness among related authorities; revising the sex education model in primary and secondary schools to promote family life; and initiating a model of peer groups in technical or vocational schools to foster health education reduced alcohol intake and condom use. Periodic cross-sectional investigations of behavioral change qualitative studies and HIV seroconversion and other STD monitoring should also be conducted.