Risk Factors and Prevalence of HIV and Sexually Transmitted Infections Among Low-Income Female Commercial Sex Workers in Mongolia

Abstract

Mongolia has very low HIV prevalence despite high rates of sexually transmitted infections (STIs). Low-income female sex workers (FSWs) may be at high risk for acquiring and spreading the disease in Mongolia. The goal of this study was to assess the prevalence and risk factors associated with the acquisition of HIV, syphilis, gonorrhea, and trichomoniasis among low-income female commercial sex workers in 3 urban centers in Mongolia. One hundred seventy-nine low-income FSWs were tested for HIV (enzyme immunoassay) and 132 were tested for syphilis (Treponema pallidum hemagglutination-confirmed), gonorrhea (Gram stain and culture), and trichomoniasis (wet mount microscopy). Questionnaires detailing socioeconomic characteristics, sexual behaviors, drug and alcohol use, general health, and STI/HIV knowledge were completed by 149 women. No HIV infections were found in 179 women. Of 132 women, 57 (43%), 18 (14%), and 37 (28%) tested positive for syphilis, gonorrhea, and trichomonas, respectively; 88 (67%) tested positive for one or more STIs and 22 (17%) were multiply infected. Socioeconomic factors were correlated to reported condom use and infection status. Low-income FSWs in Mongolia represent a unique population of very high-risk individuals with very low rates of HIV infection. Interventions targeting this population represent a unique opportunity to prevent a potentially rapid increase of HIV infection in urban Mongolia.