Sexually transmitted infections among brothel-based sex workers in Tel-Aviv area, Israel: high prevalence of pharyngeal gonorrhoea

Abstract

Sex workers play a major role in spreading sexually transmitted infections (STIs). We studied the prevalence rates and risk factors for STIs among 300 brothel-based sex workers in Tel-Aviv. Throat swabs were cultured for Neisseria gonorrhoeae, urine samples were tested by polymerase chain reaction (PCR) for Chlamydia trachomatis and N. gonorrhoeae, and sera were tested for syphilis, human immunodeficiency virus (HIV) and type 2 herpes simplex virus (HSV) antibodies. N. gonorrhoeae was cultured from throat samples of 9.0% of participants; PCR testing of urine was positive for C. trachomatis in 6.3% and for N. gonorrhoeae in 5.0%. Syphilis serology was positive (Venereal Disease Research Laboratory [VDRL] titres > 1:8) in 1.3% of women, HSV-2-specific immunoglobulin G was detected in 60% and HIV serology was positive in a single case (0.3%). Having STI was significantly associated with age, number of years in Israel, number of clients a week and condom use for vaginal sex. In a multivariate analysis, having STI was significantly associated with number of clients per week and condom use for vaginal sex. The high prevalence of pharyngeal gonorrhoea reflects most probably the expanding demand of clients for oral sex and the insufficient condom use in this form of sex.

Occupational health and safety among commercial sex workers

“…In Tel-Aviv, a study of brothel-based female sex workers (90% of whom were from the former Soviet Union) showed high prevalence (9%) of pharyngeal gonorrhea (39). While vaginal condom use was almost universal, only two thirds of female sex workers practiced condom use with oral sex, and the result was an epidemic of gonorrhea arising from oral sex.…”

“…While vaginal condom use was almost universal, only two thirds of female sex workers practiced condom use with oral sex, and the result was an epidemic of gonorrhea arising from oral sex. The fact that HIV is rarely transmitted by oral sex appears to have been inaccurately generalized to bacterial STI (39).…”

The contribution of oral sex to male urethral Neisseria gonorrhoeae infections in Tel-Aviv district, Israel

“…1 -3 A recent study performed in Tel-Aviv district found that 9% of all commercial sex workers (CSWs) tested were infected with pharyngeal gonorrhoea. 3 Due to the asymptomatic nature of pharyngeal NG infection, the patient may be unaware of his/her risk for onward transmission to other sexual partners. The limited public awareness regarding the risks involved in OS and the relative lower intimacy involved in OS compared with vaginal or anal intercourse may promote fellatio.…”

“…During the last decade, the female CSW population in Israel has been augmented by immigrants, mainly originating from eastern European countries. 3,12,13 In the face of increasing NG incidence and the changing composition of CSWs in Tel-Aviv district, we conducted a study among patients diagnosed with NG to assess behavioural risks and to identify the source of infection. The findings of this study can be used to guide behavioural interventions to decrease STI morbidity.…”

Novel Genes Related to Ceftriaxone Resistance Found among Ceftriaxone-Resistant Neisseria gonorrhoeae Strains Selected In Vitro

“…Although epidemiological data show a decreased trend in gonorrhea incidence as a whole, in some countries, the incidence is increasing, especially in specific population groups (adolescents, men who have sex with men, or sex workers) or specific venues (brothels) (2)(3)(4)(5). The pathogen responsible for this disease is Neisseria gonorrhoeae.…”