Prevalence of sexually transmitted diseases among female drug abusers in Malaysia

Med J Malaysia 1993; 48: 124-8


Isa AR, Moe H, Sivakumaran S


The prevalence of sexually transmitted diseases (STD) among female drug abusers was determined by screening 130 new inmates of a rehabilitation centre. The majority of the subjects (77.7%) were self-confessed sex workers. A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which was low compared to previous studies. Six subjects were seropositive for human immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and working as prostitutes. More than half of them harboured 2 or more STD. A rich reservoir of STD was seen among the drug abusers. With more evidence now available concerning the ease of HIV transmission associated with ulcerative STD, a stage could be set for greater heterosexual HIV transmission. As part of the rehabilitation process, female drug abusers need a thorough screening for STD followed by aggressive treatment regimens. PIP: Drug users may be considered to be at high risk for having sexually transmitted diseases (STD). The government of Malaysia has therefore established facilities in which they incarcerate and attempt to rehabilitate such individuals. 5472 drug users had been imprisoned in the country's fourteen facilities by the end of 1991. Since 97.8% of drug users in Malaysia are male, only on facility exists for female users. The authors determined and report the prevalence of STDs among 130 new female resident drug users at the facility. The women were admitted over the period May 1989-July 1991, and 104 were IV-drug users. They were aged 18-44 years, with 87.7% in the 20-40-year range. Further, 77.7% were sex workers and 13.1% were salaried workers in other fields. 50.8% had syphilis, 52.2% hepatitis B, 23.8% moniliasis, 19.2% trichomoniasis, and 8.5% gonorrhea vaginitis. 6 were HIV-seropositive, of whom 5 admitted to needle sharing and prostitution. More than half of the women were infected with 2 or more STDs. STDs were not found in 14.6% of subjects, however, even though 10 acknowledged being sex workers. Given the high prevalence of STDs in this population and the ease of HIV transmission with ulcerative STDs, the authors recommend that incarcerated female drug users be routinely screened and treated for STDs as part of their rehabilitation program. eng


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