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Sexually transmitted infections among female sex workers in Tunisia: high prevalence of Chlamydia trachomatis
  1. Abir Znazen1,
  2. Olfa Frikha-Gargouri1,
  3. Lamia Berrajah1,
  4. Sihem Bellalouna2,
  5. Hela Hakim1,
  6. Nabiha Gueddana2,
  7. Adnene Hammami1
  1. 1Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
  2. 2Family Planning' Office National de la Famille et de la Population' Centre Urbain Nord, Tunis, Tunisia
  1. Correspondence to Dr Abir Znazen, Laboratory of Microbiology, Habib Bourguiba University Hospital, Route el Ain Km 0.5, 3027 Sfax, Tunisia; abirznazen2001{at}


Objectives The aim of this study was to determine the prevalence of Chlamydia trachomatis infection and other sexually transmitted infections (STI) in female sex workers (FSW) in Tunisia.

Methods 188 prostitutes from three Tunisian towns were enrolled at their weekly medical visit. Demographic and sexual behaviour data were collected. C trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2 (HSV-2) and human papillomavirus (HPV) were detected by PCR. Blood samples were tested for the presence of HIV, hepatitis B core, hepatitis C virus (HCV), HSV-2, C trachomatis and syphilis antibodies and Hbs antigen.

Results The mean age of the FSW was 34 years. They had worked in the sex industry for 6.6 years on average. Nearly all FSW (98.9%) had at least one marker of STI. A current infection was found in 86.7% of cases. Only one STI was noted in 37.2% and two or more in 49.5% of FSW. C trachomatis, N gonorrhoeae, HPV and HSV-2 PCR were positive in 72.9%, 11.2%, 44.1% and 1.1% of cases, respectively. Syphilis, HCV antibodies and Hbs antigen were detected in poor percentages, 2.7%, 1.1% and 0.5% of cases, respectively. No case of HIV infection was noted. No epidemiological or clinical factors were associated with STI. Only disturbed bacterial vaginal flora was found to be associated with C trachomatis infection.

Conclusion In this study, a high rate of C trachomatis infection was observed. The detection of this microorganism should be introduced in systematic surveillance of Tunisian FSW.

  • Chlamydia trachomatis
  • prostitution
  • sexually transmitted infection
  • sexually transmitted disease

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  • Funding This study was funded by the Family Planning ‘Office National de la Famille et des Population’ and the research laboratory ‘Microorganismes et Pathologie Humaine’. de Tunis, Laboratoire de Recherche MPH.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the ethics committee of the Association d'Enregistrement et de Lutte Contre le Cancer du Sud Tunisien.

  • Provenance and peer review Not commissioned; externally peer reviewed.