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Teenage African women and HIV-1 infection

2002; Elsevier BV; Volume: 360; Issue: 9348 Linguagem: Inglês

10.1016/s0140-6736(02)11757-0

1474-547X

J. Ladner, Michel Cartoux, Luc Dauchet, Philippe Van de Perre, Pierre Czernichow,

Sex work and related issues

Simon Gregson and colleagues (June 1, p 1896)1Gregson S Nyamukapa CA Garnett GP et al.Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe.Lancet. 2002; 359: 1896-1903Summary Full Text Full Text PDF PubMed Scopus (427) Google Scholar show empirically that teenage women who have sex with older men contribute to the spread of HIV-1 infection in rural Zimbabwe. They discuss the local cultural and socioeconomic context as major determinants of this epidemiological pattern. However, they do not sufficiently stress the high risk of exposure to HIV-1 infection in teenage commercial sex workers. Between December, 1997, and September, 1998, we did a cross-sectional study to explore the epidemiological and anthropological characteristics of female sex workers in Bobo-Dioulasso, Burkina Faso.2Nagot N Ouangre A Ouedraogo A et al.Spectrum of commercial sex activity in Burkina Faso: validation of a classification model in relation to HIV exposure.J Acquir Immun Defic Syndr. 2002; 29: 517-521Crossref PubMed Google Scholar The women were enrolled in the study and separated into six different classifications, including secondary school students. Specially trained peer educators recorded epidemiological data on sociodemographic characteristics, history of treated sexually transmitted infections (STIs), and prostitution practices in the past week on a standard questionnaire. Qualitative anthropological in-depth interviews explored the reasons for engaging in commercial sex activity. Among the 737 sex workers, 92 were secondary school students with a mean age of 18·6 years (SD 2·4). The mean duration of commercial sex activity was 1·9 years (1·4). In the past year, 22 (24%) students had had at least one treated STI. In the past week, all students had had at least one client (mean number 3·8 [3·4]), 25% of whom had had six or more clients. For the three latest clients, the mean earning was US$4·1 per client and the mean earning in the past week was $16. 65 (71%) students used condoms for all sexual acts with their clients, 27 did not use condoms during sexual intercourse, and 16 had never used condoms. The main reason for not using condoms was refusal by clients. The reasons stated by the students for starting commercial sex activity were payment of tuition fees and living expenses because of poverty of parents, or to acquire pocket money to buy fashionable clothes or jewels. Most research studies have concentrated on women who attempt to assert themselves as professional sex workers.3Lankoandé S Meda N Sangare L et al.Prevalence and risk of HIV infection among female sex workers in Burkina Faso.Int J STD AIDS. 1998; 9: 146-150Crossref PubMed Scopus (33) Google Scholar The students we studied represent a social and behavioural group who are especially vulnerable to HIV-1 infection. Prevention activities directed at young students are needed, especially through peer-group education. By increasing the capacity in negotiating safer sexual practices with their clients, these young women will acquire more power to protect themselves. However, for strategies to be effective, a special interventions programme must be established to educate clients to make them aware of their responsibilities and to attempt a change their desire for unprotected sex.1Gregson S Nyamukapa CA Garnett GP et al.Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe.Lancet. 2002; 359: 1896-1903Summary Full Text Full Text PDF PubMed Scopus (427) Google Scholar, 4Stover J Walker N Garnett GP et al.Can we reverse the HIV/AIDS pandemic with an expanded response?.Lancet. 2002; 360: 73-77Summary Full Text Full Text PDF PubMed Scopus (141) Google Scholar DEPARTMENT OF ERRORLadner J, Cartoux M, Dauchet L, Van de Perre P, Czernichow P. Teenage African women and HIV-1 prevention. Lancet 2002; 360: 1889–Philippe Van de Perre was incorrectly listed as an author of this Correspondence letter (Dec 7). Full-Text PDF