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A study on HIV and hepatitis C virus among commercial sex workers in Tallinn
  1. A Uusküla1,
  2. K Fischer1,2,
  3. R Raudne2,
  4. H Kilgi2,
  5. R Krylov5,
  6. M Salminen6,
  7. H Brummer-Korvenkontio6,
  8. J St Lawrence7,
  9. S Aral7
  1. 1
    Department of Health, University of Tartu, Tartu, Estonia
  2. 2
    MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK
  3. 3
    National Institute for Health Development, Tallinn, Estonia
  4. 4
    Department of Mathematical Statistics, University of Tartu, Tartu, Estonia
  5. 5
    NGO Atoll, Tallinn, Estonia
  6. 6
    Department of Infectious Disease Epidemiology, National Public Health Institute, Helsinki, Finland
  7. 7
    Division of Sexually Transmitted Diseases, CDC, Atlanta, Georgia, USA
  1. Dr A Uusküla, Department of Public Health, University of Tartu, Ravila 19, Tartu 50411, Estonia; anneli.uuskula{at}


Introduction: Estonia is confronted by a dramatic expansion of the initially injection drug use-driven HIV epidemic. Little is known about HIV occurrence in population groups at high risk other than injection drug users.

Objective: To obtain data on the prevalence of HIV and hepatitis C virus (HCV) among female sex workers (FSW) in Tallinn.

Design: An unlinked, anonymous, cross-sectional survey of FSW recruited in Tallinn from October 2005 to May 2006.

Methods: 227 FSW were recruited for the survey and biological sample collection (HIV, HCV antibodies detection) using a combination of time-location, community and respondent-driven sampling.

Results: Among 227 women the HIV and HCV prevalences were 7.6% (95% CI 4.6% to 12.5%) and 7.9% (95% CI 4.5% to 12.6%), respectively. HIV prevalence was higher among FSW working in the street (odds ratio (OR) 6.4; 95% CI 1.1 to 35.6) and at the brothels and apartments supervised by the organised sex industry (OR 5.0; 95% CI 1.3 to 18.4). The duration of sex work was negatively associated with HIV prevalence (OR 0.78; 95% CI 0.63 to 0.97).

Conclusions: Prevention needs of FSW in this area include increasing rates of HIV testing and putting in place effective programmes that can help extend HIV prevention behaviours across a range of sexual and drug use risk behaviours.

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  • Funding: The Global Fund to Fight AIDS, Tuberculosis and Malaria funded this study through the National Institute for Health Development in Estonia. Funding was also received from the Fogarty International Center, National Institutes of Health, USA (R01 TW006990).

  • Competing interests: None.

  • Ethics approval: Ethical approval was obtained from the National Institute for Health Development, Medical Research Ethics Committee IRB, Tallinn, Estonia.

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