性传播疾病

20122111江苏省不同档次场所暗娼梅毒及艾滋病感染状况分析/徐金水(江苏省疾控中心艾防所),刘晓燕,傅更锋…∥中国皮肤性病学杂志.-2012,26(6).-513～515对江苏省10926名暗娼分别进行问卷调查,抽取静脉血进行梅毒、HIV和HCV检测,采用Excel2007和SPSS15.0统计学软件对江苏省2011年暗娼人群监测资料进行分析。结果:10926名暗娼中经确认试验发现艾滋病病毒感染者7例,阳性率0.06%,梅毒ELISA     

暗娼1144人HBV、HIV及梅毒感染检测结果分析

目的了解暗娼人群乙肝病毒(HBV)、人类免疫缺陷病毒(HIV)及梅毒感染的情况,为制订预防措施提供依据。方法对海南省某妇教所收容的1144名暗娼分别抽取静脉血,用酶联免疫吸附实验(ELISA)进行乙肝两对半、HIV1+2抗体检测和梅毒甲苯胺红不加热血清试验(TRUST)初筛,梅毒阳性者用梅毒螺旋体明胶颗粒凝集确证试验(TP-PA)进一步确证。结果暗娼人群HBV及梅毒感染率分别为15.73%和29.26%,未发现HIV感染者。结论海南省暗娼人群HBV感染率和梅毒感染率较高,增加了HIV的感染的可能性。提示暗娼是感染性病和艾滋病的高危人群,也是向一般人群传播这些疾病的"桥梁人群",加强对暗娼人群的行为干预和监测至关重要。     

建筑工地男性农民工艾滋病防治知识及性行为调查

目的：了解贵阳市2011年至2013年建筑工地男性农民工艾滋病防治知识、性行为情况及HIV、HCV和梅毒感染率。方法：采用整群随机抽样的方法对建筑工地1203名男性农民工进行问卷调查及HIV、HCV和梅毒检测。结果：2011年至2013年艾滋病知晓率分别为29.1%、42.1%、52.5%。年龄20～39岁、未婚、高文化程度者知晓率较高。感染HIV高危行为发生普遍,最近1年与暗娼每次都用安全套的分别为22.2%、16.7%、64.0%;最近1年与临时性伴每次用安全套的分别为27.3%、22.2%、17.9%;梅毒感染率2.5%、0.7%、1.0%;HCV感染率0.2%、0.5%、0.3%,2011年发现1例HIV阳性。结论：贵阳市建筑工地男性农民工知晓率和安全套使用率较低,今后要加强该人群宣传、干预及监测力度。     

2013-2015年楚雄州艾滋病哨点监测结果分析

目的：了解楚雄州艾滋病哨点监测情况,掌握艾滋病流行趋势,为完善艾滋病哨点监测检测体系和制定防治策略提供依据。方法对(2013~2015)年楚雄州艾滋病哨点监测结果进行数据整理和统计分析。结果(2013~2015)年楚雄州吸毒人群艾滋病哨点监测感染率维持8.68%~22.72%之间;暗娼人群HIV感染率维持0.21%~0.31%,男性性病门诊就诊者人群HIV感染率0.5%,梅毒和丙肝均有检出;男男性行为人群HIV感染率7%,梅毒感染率0.33%;总体呈现为中度流行态势。结论完善楚雄州艾滋病监测检测体系,在不同人群中持续开展多形式的艾滋病宣传教育和行为干预工作,是降低HIV高感染率,减缓艾滋病向一般人群扩散蔓延的关键。     

831名男男性行为者HIV和梅毒感染状况分析

目的了解男男性行为者（MSM）HIV和梅毒感染状况,为制定针对该目标人群的干预措施,控制艾滋病和性病的传播提供科学依据。方法对进行咨询检测和就诊的男男性行为者进行梅毒甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶颗粒凝集试验（TPPA）和HIV抗体检测,筛查阳性者在确证实验室用免疫印迹试验（WB）确认。数据经整理核对后用SPSS 13.0进行统计分析。结果男男性行为人群分别在2008年、2009年、2010年HIV和梅毒的感染率差异均无统计学意义,三年共检测831名男男性行为者,HIV感染率11.43%,梅毒感染率13.60%,与同时期929名暗娼人群HIV和梅毒感染情况比较,HIV和梅毒的感染率差异均有统计学意义。结论男男性行为人群HIV和梅毒感染率都处于一个高水平,而且居高不下,是目前高危人群中感染率较高的人群,针对这样一个人群,干预工作亟待加强。     

北京市2012年男男性行为者HIV及梅毒感染状况调查

【摘要】 目的 了解北京市男男性行为（MSM）人群HIV及梅毒感染状况,探讨两者之间的相关性。 方法 对北京市艾滋病哨点监测MSM人群600例进行HIV及梅毒实验室检测。用ELISA方法对所有研究对象样本进行HIV初筛,初筛阳性者用免疫印迹方法进行确认;梅毒检测采用快速血浆反应素环状卡片试验（RPR）与梅毒螺旋体明胶凝集试验（TPPA）两种方法同时进行,TPPA阳性者即视为梅毒感染者（包括既往感染与现症感染）;符合条件的HIV阳性血清还接受HIV-1 BED捕获酶联法（BED方法）检测并计算HIV在此人群中的发病率;对MSM人群HIV及梅毒感染状况进行统计学相关性分析。 结果 MSM人群600例,HIV阳性49例,阳性率8.17%;HIV新近感染14例,发病率为4.68%。HIV感染者表现出外地户籍比重大、学历层次相对较高的特点。梅毒RPR与TPPA均阳性51例（8.5%）,感染率（含既往感染）为18.5%（111/600）。 结论 北京市哨点监测MSM人群HIV感染率及发病率、梅毒感染率均维持在较高水平;HIV感染与梅毒感染有显著相关性。     

2010年-2013年曲靖市孕产妇艾滋病哨点监测分析

目的分析曲靖市孕产妇艾滋病性传播疾病流行趋势及相关行为变化情况。方法 2010年-2013年,对到哨点医院就诊,且符合监测条件的孕产妇开展行为学问卷调查,并进行HIV,丙型肝炎和梅毒抗体检测。结果共监测1 600人。孕产妇艾滋病知识知晓率(51.0%~70.3%)、梅毒阳性率(0~1.0%)各年度差异有统计学意义(P﹤0.01);HIV阳性率为0~0.8%,HCV阳性率为0.3%~0.8%;0~2.3%的孕产妇患过性传播疾病,0~0.8%的孕产妇丈夫患过艾滋病/性传播疾病,0~0.5%的孕产妇有除丈夫以外的性伙伴。结论曲靖市孕产妇艾滋病知晓率较低,HIV,HCV及梅毒阳性率在该人群中相对较高,且存在婚外性行为等高危行为,应加强健康教育和干预,提高知晓率,降低性传播疾病艾滋病感染率。     

2010-2014年遵义市男男性行为人群艾滋病哨点监测结果分析北大核心CSCD

目的了解遵义市男男性行为人群(MSM)艾滋病、梅毒感染状况及相关行为因素,为调整防治策略,制定有针对性的干预措施提供科学依据。方法对2010-2014年遵义市MSM人群哨点监测结果进行分析,计算历年艾滋病、梅毒、丙肝感染状况及相关行为因素进行分析,并进行统计学分析。结果5年共调查MSM人群922人份,确认HIV抗体阳性184例(19.96%),历年HIV阳性率分别为3.92%,42.41%,22.38%,13.89%和17.23%,各年度差异有统计学意义(P<0.01);梅毒抗体阳性44例(4.77%),HCV抗体阳性13例(1.41%)。最近半年内,有肛交行为者79.33%,其中坚持每次使用安全套比例30.14%,最近一次肛交时安全套使用比例为78.25%。有1.92%与同性发生过商业性行为,坚持每次使用安全套比例仅占7.14%;11.71%与异性发生过性行为,坚持每次使用安全套比例占12.15%。结论遵义市MSM人群HIV感染率高,安全套使用率偏低,防控形式非常严峻,调整和采取有针对性的防治措施非常必要。     

男男性行为人群HIV、梅毒和HCV专题调查结果分析

目的 了解盐城市男男性行为者(MSM)人类免疫缺陷病毒(HIV)、梅毒和丙肝(HCV)感染状况以及有关艾滋病(AIDS)防治知识、态度、行为(KAP)特征,为今后对此类人群有效开展防治工作提供依据.方法 对盐城市一城区和一县城MSM人群进行匿名问卷调查,同时采样作HIV、梅毒和HCV检测.结果 118名MSM平均年龄29岁,文化程度较高.HIV感染率11.0％,梅毒感染率22.9％,HCV感染率7.6％,存在共感染.AIDS预防知识知晓率为89.8％,AIDS传播知识知晓率为75.4％,安全套预防AIDS知识知晓率为91.5％,同性性行为安全套使用率35.8％.结论 盐城市MSM人群HIV、梅毒和HCV感染率较高,高危行为较为普遍,必须加强监测和干预,控制性病艾滋病通过此类人群传播和扩散.     

1201例劳教人员HIV、HBV、HCV及梅毒检测结果分析

目的:掌握劳教场所吸毒类人群艾滋病病毒(HIV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及梅毒感染状况及特点,以采取有效的预防和干预措施。方法:对新收容入所的吸毒人员进行静脉抽血,分别检测HIV抗体、HBV五项标志物、HCV抗体及RPR抗体。结果:在1201例吸毒劳教人员中,HIV抗体阳性32例(占2.66%);HBV五项标志物阳性810例(占67.44%);HCV抗体阳性984例(占81.93%);RPR阳性148例(占12.32%)。结论:劳教场所吸毒类高危人群HCV抗体阳性和HBV五项标志物阳性率较高;梅毒阳性检出率次之;吸毒人群的HIV、HBV、HCV及梅毒合并感染比例较大;HIV抗体阳性检出率呈快速增长的势头。面对劳教所HIV和梅毒感染的现状,采取切实可行的所内宣传教育和防治干预措施非常重要。     

Syphilis among female sex workers in southwestern China: potential for HIV transmission

OBJECTIVE: The objective of this study was to investigate the prevalence and risk factors of syphilis infection among female sex workers in a southwestern Chinese city along a drug trafficking route. METHODS: From December 2004 to January 2005, 343 female sex workers (FSWs) were recruited through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual and other sexually transmitted diseases/HIV risk behaviors. Cervical and blood samples were collected to test for syphilis and HIV antibodies and Neisseria gonorrhoeae infection; Condyloma acuminatum infection was diagnosed clinically. RESULTS: Of 343 FSWs, 15.7% were infected with syphilis. The prevalence of HIV, gonorrhea, and C. acuminatum was 0.6%, 2.0%, and 1.5%, respectively. The subtype of 2 HIV-1 infections was both CRF 07BC. Nearly 10% of FSWs reported using illicit drugs. Consistent use, inconsistent use, and never use of condoms with commercial sex clients in the last month were reported by 53.9%, 38.5%, and 7.6% FSWs, respectively. Longer duration of sex work (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.08-3.62), working at low-end establishments (OR = 2.03; 95% CI = 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR = 2.06; 95% CI = 1.08-3.91) were independently associated with syphilis infection. CONCLUSIONS: High prevalence of syphilis and overlapped unprotected commercial sex and drug using behaviors among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injection drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/sexually transmitted disease spread.     

Risk factors and prevalence of HIV and sexually transmitted infections among low-income female commercial sex workers in Mongolia

BACKGROUND: Mongolia has very low HIV prevalence despite high rates of sexually transmitted infections (STIs). Low-income female sex workers (FSWs) may be at high risk for acquiring and spreading the disease in Mongolia. GOAL: The goal of this study was to assess the prevalence and risk factors associated with the acquisition of HIV, syphilis, gonorrhea, and trichomoniasis among low-income female commercial sex workers in 3 urban centers in Mongolia. STUDY DESIGN: One hundred seventy-nine low-income FSWs were tested for HIV (enzyme immunoassay) and 132 were tested for syphilis (Treponema pallidum hemagglutination-confirmed), gonorrhea (Gram stain and culture), and trichomoniasis (wet mount microscopy). Questionnaires detailing socioeconomic characteristics, sexual behaviors, drug and alcohol use, general health, and STI/HIV knowledge were completed by 149 women. RESULTS: No HIV infections were found in 179 women. Of 132 women, 57 (43%), 18 (14%), and 37 (28%) tested positive for syphilis, gonorrhea, and trichomonas, respectively; 88 (67%) tested positive for one or more STIs and 22 (17%) were multiply infected. Socioeconomic factors were correlated to reported condom use and infection status. CONCLUSIONS: Low-income FSWs in Mongolia represent a unique population of very high-risk individuals with very low rates of HIV infection. Interventions targeting this population represent a unique opportunity to prevent a potentially rapid increase of HIV infection in urban Mongolia.     

广州地区女性性工作者梅毒感染率及影响因素分析

目的:调查广州地区女性性工作者(FSWs)梅毒感染率及危险因素,指导针对该人群的梅毒防治工作。方法:采用方便抽样法,知情同意后填写结构式问卷,并采集2 m L静脉血分离血清,TRUST、TPPA分别检测梅毒非特异性、特异性抗体,结果和问卷资料用SPSS 13.0分析。结果:共调查FSWs279名,血清TPPA阳性率为8.2%,梅毒感染率为1.43%。按照服务场所分类,中低档场所服务FSWs的血清TPPA阳性率为9.4%,梅毒感染率为1.64%;高档场所FSWs梅毒血清阳性率及感染率为0。多因素分析发现婚姻状态单身者(OR=14.85,95%CI 1.69~130.71)、既往有非梅毒STD史(OR=19.54,95%CI 4.21~90.61)是危险因素。结论:广州地区FSWs梅毒血清阳性率比国内其他城市略低,且主要是中低档FSWs为主,结合其特点开展针对该人群的梅毒防治工作非常必要。     

HIV in female sex workers in five border provinces of Vietnam

OBJECTIVES: To determine the prevalence of HIV and associated risk factors among female sex workers (FSWs) in border provinces of Vietnam. METHODS: 911 FSWs in five border provinces of Vietnam (Lai Chau, Quang Tri, Dong Thap, An Giang, and Kien Giang) were enrolled in a cross sectional study. Subjects were interviewed using a standardised questionnaire about selected sociodemographic and behavioural characteristics, history of STIs, and information about their cohabiting partners (husbands or live-in partners). Serological tests were done for HIV and syphilis (TPHA+RPR) and urine tests (PCR) for chlamydia and gonorrhoea. Associations between HIV and selected features of FSWs and their partners were examined using univariate and multivariate logistic regression analysis. RESULTS: Overall, the prevalence of HIV among FSWs in the five provinces of Vietnam was 4.5%. The prevalence of HIV was higher in the southern border regions (4.0%-7.0%) than the northern (2%) and central (1%) regions. In multivariate analysis between HIV and selected features of FSWs, income < or =$33/month (OR 2.36, p = 0.04), age of first sex < or =15 (OR = 5.48, p = 0.005), and > or =9 clients per week (OR 2.80, p = 0.018) were associated with HIV infection. Positive syphilis serology achieved a borderline significant association with HIV (OR 2.30, p = 0.095). Having a regular non-paying partner (OR = 0.35, p = 0.060) was a borderline protective factor for HIV. CONCLUSION: Interventions to limit HIV transmission among FSWs in Vietnam should be implemented early and focus on young poor populations in these border areas.     

High prevalence of sexually transmitted infections among female sex workers in the eastern highlands province of Papua New Guinea: correlates and recommendations

BACKGROUND: More than 200 female sex workers (FSWs) participating in commercial sex along the Highlands Highway of Papua New Guinea were identified in a previous survey. This has implications for the spread of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) to areas and population groups serviced by the road. GOAL: The goal of this study was to estimate the prevalence of gonorrhea, chlamydia, syphilis, trichomoniasis, and HIV among FSWs in Goroka and Kainantu in the Eastern Highlands Province (EHP) and to identify correlates that could be considered in intervention and control. STUDY: Self-identified FSWs recruited through the Goroka Sex Workers Peer-Mediated Programme were invited to participate. All consenting FSWs underwent pretest counseling and provided sociodemographic and behavioral data using a structured questionnaire. The women were also asked to self-collect vaginal specimens and to provide peripheral blood to detect the respective STIs and HIV. RESULTS: Results were available for 211 FSWs. None of the women were positive for HIV. The overall estimated rates for gonorrhea, chlamydia, syphilis, and trichomoniasis were 21%, 19%, 24%, and 51%, respectively. Seventy-four percent were positive for at least 1 STI and 43% had multiple STI infections. High-risk sexual behaviors were found to be common among the women, including low and inconsistent use of condoms, with most of them attributing this to unavailability, dislike by or familiarity with clients, and being drunk and/or high on marijuana. CONCLUSIONS: STIs are prevalent among FSWs in Goroka and Kainantu in the EHP and are maintained by widespread high-risk sexual behaviors, including low use of condoms. Implications for their spread through the highway warrants increased efforts in intervention. Apart from a need to promote condom acceptance, distribution, and use, other high-risk sexual behavior and correlates identified in this study provide important considerations for intervention and control in this population.     

HIV and STIs in clients and female sex workers in mining regions of Gejiu City, China

OBJECTIVE: To investigate HIV/sexually transmitted infections (STIs) among female sex workers (FSWs) and clients in a mining region of China. GOAL: To estimate HIV/STI prevalence and to identify HIV risk factors among FSWs and miner clients. STUDY DESIGN: A cross-sectional study of 96 FSWs and 339 miner clients. RESULTS: In FSWs, prevalence of HIV was 8.3%, herpes simplex virus-2 70.8%, syphilis 12.5%, Neisseria gonorrhoeae 36.8%, Chlamydia trachomatis 46.3%, Trichomonas vaginalis 22.1%, and 90.6% were infected with any STI. Illegal drug use was associated with HIV [adjusted odds ratio (OR) = 45.1, 95% confidence interval, 6.4-317.9] in FSWs, and 45.8% reported no condom use with the last client. In miner clients, HIV prevalence was 1.8%, herpes simplex virus-2 14.9%, syphilis 2.4%, N. gonorrhoeae 2.1%, C. trachomatis 6.5%, and 23.2% were infected with any STI. Never using condoms with FSWs and regular partners were reported in 61.2% and 84.1%, respectively. Independent risk factors for HIV in miner clients were illegal drug use (OR 190.2), symptoms of urethral discharge or frequent urination (OR 32.9), early sexual debut (OR 7.1), and visiting 4 or more FSWs in the last 12 months (OR 11.5). CONCLUSIONS: HIV/STI prevalence is high among FSWs and moderate among clients in mining regions of Gejiu City. Drug use is the most important factor placing FSWs and miner clients at risk for HIV in Gejiu City; risky sexual characteristics such as early sexual debut, frequent visits to FSWs, and STI symptoms are also important factors for miner clients. FSWs and miner clients may constitute bridging groups for HIV to low-risk populations.     

广州市暗娼嫖客收教人员性病感染情况分析

目的:了解广州市暗娼嫖客收教人员的性病感染情况。方法:选取2005²011年间广州市公安局收容教育所共3 076名暗娼(FSWs)及嫖客收教人员,调查其人口学特征,进行HIV、淋病、梅毒等性病的临床和实验室检查。结果:3 076名学员中,324人患1种性病,8名女性学员同时患2种性病,1名女性学员同时患3种性病,总感染率为10.83%。共检出各类性病343例,性病检出率为11.15%(343/3 076),以梅毒检出率最高为6.05%(186/3 076),其次为尖锐湿疣2.34%(72/3 076)和滴虫感染1.33%(41/3 076),HIV阳性检出率为0.19%(6/3 076)。男女性病检出率分别为4.17%(48/1 150)和15.32%(295/1 926),差异有统计学意义(2=90.24,P<0.01)。20052011年间广州市公安局收容教育所共3 076名暗娼(FSWs)及嫖客收教人员,调查其人口学特征,进行HIV、淋病、梅毒等性病的临床和实验室检查。结果:3 076名学员中,324人患1种性病,8名女性学员同时患2种性病,1名女性学员同时患3种性病,总感染率为10.83%。共检出各类性病343例,性病检出率为11.15%(343/3 076),以梅毒检出率最高为6.05%(186/3 076),其次为尖锐湿疣2.34%(72/3 076)和滴虫感染1.33%(41/3 076),HIV阳性检出率为0.19%(6/3 076)。男女性病检出率分别为4.17%(48/1 150)和15.32%(295/1 926),差异有统计学意义(2=90.24,P<0.01)。2005²011年性病检出率总体呈稳中下降的趋势,2011年检出率较2005年下降了56.95%。结论:广州市暗娼嫖客性病感染情况仍然不容忽视,以梅毒的危害性最为严重,应加强对该人群的健康教育和行为干预。     

暗娼高危人群干预效果研究

目的：降低暗娼人员艾滋病性病感染风险,推动性一艾预防控制工作可持续性发展,为遏制艾滋病的蔓延提供实践证据。方法：2010年1月至2011年10月对辖区内低层次暗娼进行为期一年半的综合干预,并评价其效果。结果：干预前共调查234例FSWs,发现梅毒感染者33例（感染率14．10％）;干预结束后调查FSWs220例,未发现HIV新感染者,梅毒感染者15例（感染率6．81％）,梅毒感染率与干预前相比差异有统计学意义（X2=8．543,P〈0．05）;干预前FSWs对艾滋病预防知识8条知晓率为72．3％,干预后知晓率为89．7％,与干预前相比有明显提高（P〈0．01）;干预前接受过疾控中心或社区提供安全套的比例为45．3％,干预后为87．2％,与干预前相比有明显提高（P〈0．01）;干预后每次与客人发生性行为时安全套的使用比例与干预前相比差异有统计学意义（P〈0．01）;出现生殖系统相关疾病到正规医院就诊的比例由20．5％提高到45．4％,干预后与干预前相比差异有统计学意义（P〈0．01）。结论：在FSWs中开展综合干预措施,能提高艾滋病预防知识的知晓率和安全套使用率,降低性病艾滋病感染风险。     

Impact of a community sexually transmitted infection/HIV intervention project on female sex workers in five border provinces of Vietnam

OBJECTIVES: To determine changes in the prevalence of sexually transmitted infection (STI)/HIV in female sex workers (FSWs) after a community HIV prevention intervention project in five border provinces of Vietnam. METHODS: The project focused on providing user-friendly STI services for FSWs using mobile teams operating at multiple sites depending on local client preferences. 911 FSWs were enrolled at baseline and 982 in the exit survey. Study participants were interviewed about sociodemographic characteristics, sexual behaviour, history of STIs and selected features of their husbands or cohabiting partners, and were tested for STIs. RESULTS: The overall prevalence rates of HIV, syphilis, herpes simplex virus 2 (HSV-2) antibodies, gonorrhoea (GC), Chlamydia trachomatis (CT), and GC and/or CT among FSWs in the five border provinces in 2004 were 3.6%, 12.9%, 24.9%, 2.9%, 9.1% and 11.3%, respectively. Compared with baseline values, GC and/or CT decreased significantly from 19.9% to 11.3%, GC from 10.7% to 2.9% and CT from 11.9% to 9.1%. HIV decreased from 4.5% to 3.6%, and HSV-2 antibodies from 27.7% to 24.9%. After adjustment for possible confounders, a significant overall decrease in having GC and/or CT (OR = 0.46, 95% CI 0.33 to 0.65; p<0.001) and GC alone (OR = 0.22, 95% CI 0.13 to 0.37; p<0.001) was found, and the overall prevalence of syphilis increased significantly (OR = 1.55, 95% CI 1.11 to 2.17 p = 0.011). A marked increase in syphilis from 1.0% to 14.1% was identified in the Lai Chau province. CONCLUSIONS: Implementation of the project was associated with a reduction in GC and/or CT infections in FSWs, more so with GC than with CT. A notable increase in syphilis in Lai Chau was identified. HIV/STI interventions in FSWs can be implemented by government services and should be intensified and expanded to other provinces.     

Characteristics of female sex workers with US clients in two Mexico-US border cities

BACKGROUND: HIV prevalence is increasing among female sex workers (FSWs) in Tijuana and Ciudad Juarez, 2 Mexican cities on the US border. Quasilegal prostitution in both cities attracts large numbers of sex tourists. We compared FSWs with and without US clients in both cities. METHODS: FSWs aged > or =18 years reporting unprotected sex with > or =1 client within the last 2 months, who were not knowingly HIV-infected, were enrolled in a behavioral intervention study. At baseline, participants underwent interviews, antibody testing for HIV and syphilis, and vaginal swabs for detecting gonorrhea and Chlamydia. Logistic regression identified factors associated with reporting >1 US client. RESULTS: Of 924 FSWs, 69% had US clients. Median age and duration in sex work were 32 and 4 years. Prevalence of HIV, infectious syphilis (titer > or =1:8), gonorrhea, Chlamydia, and any STI was 6%, 14%, 6%, 13%, and 27%, respectively. Compared with other FSWs, FSWs with US clients were more likely to have syphilis titers > or =1:8 (16% vs. 10%, P = 0.01), gonorrhea (8% vs. 2%, P <0.001) or any STI, including HIV (30% vs. 20%, P = 0.002). Factors independently associated with having US clients were: living in Tijuana, being younger, speaking English, being paid more for having sex without a condom, having >250 clients in the last 6 months, having syphilis titers > or =1:8, and injecting drugs. CONCLUSIONS: In these border cities, FSWs reporting US clients were more likely to have current STIs and to engage in higher-risk behaviors. Intensified binational prevention efforts involving both FSWs and their clients are urgently needed.