Objectives: To assess the prevalence of HIV-1 infection among non-intravenous drug user (IVDU) female prostitutes in Spain and to determine risk factors for HIV-1 infection in this population.
Design: Cross-sectional seroepidemiological study of 519 non-IVDU prostitutes.
Setting: Four university hospitals.
Methods: All participants completed a questionnaire and provided a serum sample. Serum samples were tested for antibodies against HIV-1, hepatitis C virus (HCV) and Treponema pallidum.
Results: Twelve out of the 519 (2.31%) participants were HIV-1-seropositive. HIV-1 infection was associated with the presence of both HCV and T. pallidum antibodies, multiple sex partners, longer history of prostitution, history of genital ulcers and anal intercourse. Condom use was associated with HIV-1 seronegativity.
Conclusions: The prevalence of HIV-1 infection in non-IVDU prostitutes in Spain remains relatively low. Risk increases with a higher rate of sexual exposure and practices such as anal intercourse and unprotected coitus.
PIP: HIV-1 has been spreading according to pattern 1 in Europe and North America. In Kenya and Nigeria, where pattern 2 transmission is established, large increases in the prevalence of antibodies to HIV-1 in non-intravenous drug using (IVDU) female prostitutes were documented before HIV-1 disseminated into the general population. 519 non-IVDU female prostitutes in Spain were studied to assess the prevalence of HIV-1 infection among them and to determine the risk factors for infection in the population. The cross-sectional seroepidemiological study was conducted in four university hospitals in Andalusia, southern Spain. Subjects were of mean age 30 years with range 18-55 years; had an average 59 sex partners/month with range 1-600; and had worked as a prostitute for an average 50 months with range 2-420 months. Respondents answered questionnaires and provided serum samples for analysis. 12/519 or 2.31% were seropositive for HIV-1. Infection was associated with the presence of antibodies to hepatitis C and Treponema pallidum, multiple sex partners, longer history f prostitution, and history of genital ulcers and anal intercourse. Condom use was associated with HIV-1 seronegativity. In sum, relatively low prevalence of HIV-1 infection was found among these sex workers, thereby offering no evidence of a shift from pattern 1 to pattern 2 transmission in the broader population.