Summary report on the demographic and behavioral study of female commercial sex workers in Thailand

In Thailand in 1989 there was a second epidemic of HIV infection among female commercial sex workers (CSWs); currently HIV is spreading among the total population. In 1992 HIV prevalence rates among CSWs was 41.5% in the northern provinces and 10.4% throughout Thailand. Transmission routes have affected levels by region. Government sponsored AIDS and sexually transmitted disease (STD) prevention and control programs began in 1988 and 1989 during which time this study was commissioned to examine the nature and extent of HIV/AIDS and STDs among commercial sex workers. The number and kind of sexual establishments and the estimation of the number of sex workers was to be determined. Oral interviews were conducted among about 500 CSWs in order to obtain information on CSWs demographic social family and economic characteristics and sex behavior and AIDS prevention (knowledge attitudes and prevention efforts) practices. Information was obtained on sexual risk behavior health risk and health care CSWs attitudes toward their work and geographic mobility. Special emphasis was also placed on estimation of HIV-1 infection and syphilis among different types of CSWs. Blood samples were tested in the local STD/AIDS laboratories and at national government testing facilities in Bangkok. Both urban areas (Chiang Mai City in the northern province of Chiang Mai and Sungai Kolok in southern Narathiwat province) and rural villages (rural villages in Sanpatong district a suburban area of Chiang Mai City) were examined. There were underestimates of 100 sex establishments and about 1900 CSWs in Chiang Mai and 80 places with 900 CSWs in Sungai Kolok. About 43% in the North were brothels and 57% places provided indirect services. In the South there were 55% devoted to brothels and 45% with indirect services. Southern indirect services were of four types while Northern places included restaurants massage parlors night clubs go-go bars bar-beers cafes lounges gay bars karao-ke places and traditional massage parlors. Of 800 blood samples 178 were HIV positive or 22.3% prevalence which was lower in the south. Venereal disease was found to be more active among direct CSWs in the north. Although CSWs wanted to use condoms use patterns differed between the north and the south. More entailed examination of findings and policy implications for Thailand and the world community will be forthcoming in 1993.