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Behaviour
ORIGINAL ARTICLE
HIV and sexually transmitted infection-related risks among female sex workers in Mongolia: second-generation surveillance survey, 2011–2012 Sergelen Munkhbaatar,1 Bulbul Aumakhan,2 Baigalmaa Jantsansengee,3 Iliza Azyei,1 Zolzaya Sanjaajamts,2 Jugderjav Badrakh,2 Tugsdelger Sovd,4 Susanne Stromdahl,5 Stefan Baral,5 Oyunbileg Amindavaa1 ▸ Additional data are published online only. To view this file please visit the journal online (http://dx.doi.org/10. 1136/sextrans-2013-051443) 1
Global Fund Supported Projects on HIV/AIDS and TB, Ministry of Health, Ulaanbaatar, Mongolia 2 HIV/AIDS and STI Surveillance and Research Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia 3 Mongolian Field Epidemiology Training Program, Ministry of Health, Ulaanbaatar, Mongolia 4 Monitoring, Evaluation and Internal Auditing Department, Ministry of Health, Ulaanbaatar, Mongolia 5 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Correspondence to Dr Bulbul Aumakhan, HIV/AIDS and STI Surveillance and Research Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar 210648, Mongolia; [email protected] SM and BA contributed equally to the manuscript. Received 25 November 2013 Revised 4 March 2014 Accepted 23 March 2014 Published Online First 10 April 2014
To cite: Munkhbaatar S, Aumakhan B, Jantsansengee B, et al. Sex Transm Infect 2014;90: 463–468.
ABSTRACT Background Surveillance studies among female sex workers (FSWs) in Mongolia have found no HIV but high rates of syphilis, ranging from 10.7% in 2002 to 20.8% in 2007. Objectives To determine the current prevalence of HIV and syphilis among FSWs, and to identify syphilis risk factors. Methods 761 FSWs were recruited by time–location sampling between 2 January and 29 March 2012 in Ulaanbaatar city, Darkhan-Uul, Orkhon, Khuvsgul and Dornod provinces in Mongolia. Participants were administered an anonymous structured survey. Blood samples were tested for HIV and syphilis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with syphilis. Results The mean age of participants was 31 (median 30, interquartile range 24–38). HIV knowledge was modest: 41.3% correctly answered all questions. Consistent condom use with clients was reported by 49.1% of participants and exposure to HIV prevention programmes by 50.1%. Although no cases of HIV were found, syphilis prevalence was −27.8% (95% CI 24.3% to 31.7%). In multivariate analyses, variables associated with syphilis were younger age (age >30 years, OR=0.96, 95% CI 0.92 to 0.99) and occurrence of genital ulcer (OR=2.24, 95% CI 1.17 to 4.28). Conclusions A syphilis epidemic continues to grow among FSWs in Mongolia. These women are at high risk of HIV transmission if introduced into their sexual networks. With the increase in migration of mining workers in Mongolia, introduction of HIV may be imminent. Efforts to intensify treatment and prevention programmes among FSWs are needed.
INTRODUCTION More than three decades since HIV/AIDS emergence, Mongolia remains a country with a very low number of reported HIV cases. By the end of 2013, 150 HIV cases had been cumulatively reported in the country (HIV surveillance data, the National Center for Communicable Diseases) with an estimated prevalence among the general population of
Behaviour
ORIGINAL ARTICLE
HIV and sexually transmitted infection-related risks among female sex workers in Mongolia: second-generation surveillance survey, 2011–2012 Sergelen Munkhbaatar,1 Bulbul Aumakhan,2 Baigalmaa Jantsansengee,3 Iliza Azyei,1 Zolzaya Sanjaajamts,2 Jugderjav Badrakh,2 Tugsdelger Sovd,4 Susanne Stromdahl,5 Stefan Baral,5 Oyunbileg Amindavaa1 ▸ Additional data are published online only. To view this file please visit the journal online (http://dx.doi.org/10. 1136/sextrans-2013-051443) 1
Global Fund Supported Projects on HIV/AIDS and TB, Ministry of Health, Ulaanbaatar, Mongolia 2 HIV/AIDS and STI Surveillance and Research Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia 3 Mongolian Field Epidemiology Training Program, Ministry of Health, Ulaanbaatar, Mongolia 4 Monitoring, Evaluation and Internal Auditing Department, Ministry of Health, Ulaanbaatar, Mongolia 5 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Correspondence to Dr Bulbul Aumakhan, HIV/AIDS and STI Surveillance and Research Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar 210648, Mongolia; [email protected] SM and BA contributed equally to the manuscript. Received 25 November 2013 Revised 4 March 2014 Accepted 23 March 2014 Published Online First 10 April 2014
To cite: Munkhbaatar S, Aumakhan B, Jantsansengee B, et al. Sex Transm Infect 2014;90: 463–468.
ABSTRACT Background Surveillance studies among female sex workers (FSWs) in Mongolia have found no HIV but high rates of syphilis, ranging from 10.7% in 2002 to 20.8% in 2007. Objectives To determine the current prevalence of HIV and syphilis among FSWs, and to identify syphilis risk factors. Methods 761 FSWs were recruited by time–location sampling between 2 January and 29 March 2012 in Ulaanbaatar city, Darkhan-Uul, Orkhon, Khuvsgul and Dornod provinces in Mongolia. Participants were administered an anonymous structured survey. Blood samples were tested for HIV and syphilis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with syphilis. Results The mean age of participants was 31 (median 30, interquartile range 24–38). HIV knowledge was modest: 41.3% correctly answered all questions. Consistent condom use with clients was reported by 49.1% of participants and exposure to HIV prevention programmes by 50.1%. Although no cases of HIV were found, syphilis prevalence was −27.8% (95% CI 24.3% to 31.7%). In multivariate analyses, variables associated with syphilis were younger age (age >30 years, OR=0.96, 95% CI 0.92 to 0.99) and occurrence of genital ulcer (OR=2.24, 95% CI 1.17 to 4.28). Conclusions A syphilis epidemic continues to grow among FSWs in Mongolia. These women are at high risk of HIV transmission if introduced into their sexual networks. With the increase in migration of mining workers in Mongolia, introduction of HIV may be imminent. Efforts to intensify treatment and prevention programmes among FSWs are needed.
INTRODUCTION More than three decades since HIV/AIDS emergence, Mongolia remains a country with a very low number of reported HIV cases. By the end of 2013, 150 HIV cases had been cumulatively reported in the country (HIV surveillance data, the National Center for Communicable Diseases) with an estimated prevalence among the general population of
