Patterns of sexually transmitted diseases in female sex workers in Surabaya Indonesia.

A sexually transmitted disease (STD) prevalence survey of 1873 female sex workers recruited from six types of sex establishments in Surabaya Indonesia in 1992-93 failed to reveal any cases of HIV. The prevalence rates of the other STDs included in the study (chlamydia gonorrhea syphilis and trichomoniasis) by setting were as follows: brothels (n = 696) 48%; streets (n = 192) 42%; massage parlors (n = 344) 16%; barber shops (n = 150) 25%; call-girl houses (n = 73) 17%; and nightclubs (n = 418) 10%. Sex workers based in brothels and on the streets had the lowest socioeconomic status while nightclub and call-girl house workers had the highest status. Brothel workers had the highest rates of gonorrhea (24%) and trichomoniasis (8%) while street and barber-shop based workers had the highest prevalences of syphilis (30%) and chlamydia (18%). Condom use in the week preceding the survey ranged from 14% among brothel workers to 67% among call girls. STD rates decreased with increases in age and education and with any condom use. The high rates of STDs documented in this survey especially among sex workers in brothels indicate the need for programs aimed at preventing an HIV epidemic. For example the medical monitoring available from a private physician to workers in most massage parlors barber shops call-girl houses and nightclubs should be made available to brothel-based prostitutes. Also urged are free distribution of condoms to sex establishments sanctions against establishments where condoms are not used consistently and a media campaign to encourage men to use condoms with sex workers.