Lye MS1, Kiyu A2, Nair RC3, Faizul M4, Yeo HP5, Chan TH6, Sim CK7, Low YH7, Chin F8, Sinniah M1, Archibald C9
1. Institute for Medical Research, Malaysia
2. Sarawak Medical Department, Malaysia
3. Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada
4. Divisional Medical Office, Miri, Sarawak
5. Yeo Clinic, Miri, Sarawak
6. Chan Clinic, Miri, Sarawak
7. Sim Clinic, Miri, Sarawak
8. Chin Clinic, Miri, Sarawak
9. Laboratory & Center for Disease Control Services, Ottawa, Canada
CITATION: Lye M.S., Kiyu A., Nair R.C., Faizul M., Yeo H.P., Chan T.H., Sim C.K., Low Y.H., Chin F., Sinniah M., Archibald C. Human immunodeficiency virus infection among patients with sexually transmitted diseases attending private clinics, Miri, Sarawak. International Medical Research Journal. 1997 Jun;1(1):61–4.
ABSTRACT
A study was conducted to determine the feasibility of establishing a sentinel human immunodeficiency virus (HIV) surveillance system involving patients with sexually transmitted diseases attending private clinics in Miri, Sarawak, Malaysia. Information on risk behaviours for HIV infection were also collected. A total of 73 female and 254 male patients were interviewed and rested for HIV infection. 35.6 % of the women reported working as prostitutes. The commonest diagnosis among women was gonorrhoea (15.1%) followed by syphilis (12.3 %). Other diagnoses included candidiasis (8.2 %), genital warts (6.8 %) and herpes genitalia (4.1%). 33 (45.2 %) of the 73 women had a previous history of STD of whom 11 (63.3 %) have had 2 episodes of infection or more. Only 5.8% of female patients had their male partners using condoms most of the time, 65.2% hardly used condoms at all. Two hundred and fifty two (99.2 %) of the male patients were heterosexual, while 2 (0.8 %) were bisexual. 70.8% had more than one sex partner during the past one year. One hundred and forty seven (57.9 %) said that virtually all (>95% of the time) their sex partners were prostitues. Most men (92.9 %) had sex with prostitutes in Malaysia; 3.2% also have had sex with prostitutes in Thailand or the Philippines while only 2% had sex with prostitutes in other countries. One hundred and eighty-six (73.2 %) of the men never used condoms, while 12.2% used condoms rarely. Only 8 (3.1 %) used condoms most of the time. Having many sex partners, no condom use and sex with prostitutes were significantly correlated with a previous history of STD infection. One or 0.3% of STD patients tested positive for HIV antibodies. The study has shown that it is feasible to carry out a sentinel surveillance programme among STD patients in private clinics and provided useful baseline data for future comparisons. Sentinel surveillance of STD patients combined with the ongoing surveillance of other groups with high risk behaviour (such as intravenous drug abusers) as well as of the general population (such as through antenatal testing and blood donors) will provide much needed information in monitoring trends and for designing programmes to control the spread of HIV. The high prevalence of risk behaviours justifies increased efforts in behaviour change programmes through multiagency collaboration and aggressive education campaigns.
KEYWORDS: epidemiology, sexually transmitted diseases, human immunodeficiency virus, sentinel surveillance
