High Prevalence of Sexually Transmitted Infections Among Female Sex Workers in the Eastern Highlands Province of Papua New Guinea: Correlates and Recommendations

Drawing on a previous survey that identified more than 200 female sex workers (FSWs) participating in commercial sex along the Highlands Highway of Papua New Guinea, the authors conducted the current study to estimate the prevalence of gonorrhea, chlamydia, syphilis, trichomoniasis and HIV among female sex workers in Goroka and Kainantu in the Eastern Highlands Province (EHP) and to identify correlates to be considered in intervention and control.

The researchers invited self-identified FSWs recruited through the Goroka Sex Workers Peer-Mediated Program to participate. Consenting FSWs received pretest counseling and gave sociodemographic and behavioral data through a structured questionnaire. Investigators asked the women to self-collect vaginal specimens and provide peripheral blood to detect STIs and HIV.

Of 211 FSWs for whom results were available, none tested positive for HIV. Overall estimated rates for gonorrhea, chlamydia, syphilis and trichomoniasis were 21 percent, 19 percent, 24 percent and 51 percent, respectively. Seventy-four percent of study participants were positive for at least one STI; 43 percent had multiple STI infections. The women commonly exhibited high-risk sexual behaviors including low, inconsistent condom use, which most attributed to condom unavailability, dislike by or familiarity with clients, and being drunk and/or high on marijuana.

The authors concluded that FSWs in Goroka and Kainantu in the EHP have a high prevalence of STIs maintained by "widespread high-risk sexual behaviors, including low use of condoms. Apart from a need to promote condom acceptance, distribution, and use, other high-risk correlates identified in this study provide important considerations for intervention and control in this population," the researchers wrote.

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