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Epidemiology poster session 2 : Population: Commercial sex worker
P1-S2.14 Neisseria gonorrhoea and Chlamydia trachomatis Re-infection and associated risk factors among cohort of female sex workers in India
  1. A R Risbud1,
  2. G R Deshpande1,
  3. P Narayanan2,
  4. P Parimi2,
  5. Anjana Das2
  1. 1National AIDS Research Institute Pune, India
  2. 2Family Health International, India. New Delhi, India


Background Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) infections can be completely cured by appropriate medication. Syndromic STI management often fails to cover asymomatic NG/CT infections. Additionally, Female sex workers (FSWs), due to their risky behaviour are vulnerable to repeated infections. Frequency of repeated infections with these pathogens was studied in a cohort of FSWs.

Methods In 6 months prospective cohort study, FSWs aged 18–40 years were recruited from three STI clinics in two states in India as a part of Bill & Melinda Gates Foundation funded operational research. Vaginal swab specimens were collected in all visits and were tested for NG/CT by Gen-Probe APTIMA Combo II assay. Presumptive treatment for gonorrhoea and chlamydia at the baseline visit and syndromic STI management at all subsequent visits was provided during the study period. Re-infection was defined as a laboratory confirmed NG/CT infection occurring after 30 days from an initial confirmed positive test result.

Results Of 417 FSWs recruited during 2008–2009, 360 made at least 1-monthly follow-up visit. At baseline and during follow-up, 184 were NG infected and 210 were CT infected see Abstract P1-S2.14 Table 1. A total of 39 (11.8%) NG re-infections and 30 (8.3%) CT re-infections were identified at follow-up visits. Among the factors studied, alcohol consumption (OR=2.4, p=0.01); relatively new to commercial sex work (within 3 years) (OR=2.16, p=0.03); had STIs in the past (OR=3.85, p=0.00) were significantly associated with the NG, CT re-infection.

Abstract P1-S2.14 Table 1

Re-infection frequency among female sex workers Cohort in India

Conclusion High frequency of NG and CT re-infection among FSWs highlights the need for regular screening for etiological diagnosis for effective treatment. New sex workers and those consuming alcohol need special attention in STI management.

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