Patterns of Risk Behaviour for Patients with Sexually Transmitted Diseases and Surveillance for Human Immunodeficiency Virus in Kuala Lumpur,Malaysia

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 and a government sexually transmitted disease clinic in Kuala Lumpur, Malaysia. Information on risk behaviours for HIV infection were also collected.

A total of 84 female and 91 male patients were interviewed and tested for HIV infection; 41.7% of the women reported working as prostitutes, other occupations included masseuses, hairdressers, waitresses, salesgirls, receptionists, factory workers, and others. The most common diagnosis was gonorrhoea. Other diagnoses included non-specific genital infection, pelvic inflammatory disease, genital herpes and syphilis. 58.3% of the women had a hundred or more sex partners during the previous month; 99% had 6 or more sex partners.

Only 4.8% of female patients had their male partners using condoms most of the time, 11.9% hardly used condoms at all.

Of the males, 93.3% were heterosexual, while 6.7% were bisexuals, 41.1% had between 6–20 different partners in the previous year. 78.0% of them had prostitutes as their sex partners most of the time. 41.8% had experiences in Thailand and the Philippines. 73.6% never used condoms, while 19.8% only used condoms rarely.

Although all patients were tested negative for HIV antibodies, lot quality assurance sampling methods indicate that the upper limits of prevalences for females and males were 3.5% and 3.3% respectively, at a 5% type I error. The study has shown that it is feasible to carry out a sentinel surveillance programme among STD patients and provided useful baseline data for future comparisons. The high prevalence of risk behaviours among STD patients is alarming and underscores the urgency of multiagency cooperation and aggressive health education and behaviour change programmes to combat the growing problem of HIV infection in the country.