Abstract
A retrospective study of 821 commercial sex workers attending a sexually transmitted disease (STD) clinic in northern Thailands Chiang Rai Province from 1989 to 1993 revealed an explosive epidemic of human immunodeficiency virus (HIV). The overall seroprevalence among the 556 women for whom antibody tests were available was 52.3%. However a dramatic increase in HIV-1 seroprevalence occurred from 1989 (29.3%) to 1990 (54.1%) followed by a leveling off through 1993. Among the 96 (36.2%) initial seronegatives who underwent subsequent testing 64 seroconverted over a mean follow-up period of 5.9 months yielding an incidence rate of 12.6/100 person-months. Incidence increased from 12.0/100 person-months in 1989 and 1990 to 17.0/100 person-months for 1991 and then declined to 9.3/100 person-months in 1992-93. The cumulative risk of seroconversion was 57% at 6 months after initial testing and 77% after 12 months. Diagnosis of chancroid during follow up was the only factor significantly associated with seroconversion. Although the retrospective nature of this study limits analysis of predictors of HIV infection in this population the findings suggest a need for improved STD management.
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