Project 173827

Cambodia is the country in Southeast Asia that is the most affected by the HIV epidemic. Factors contributing to the epidemic include poverty, sexually transmitted infections (STI), trafficking of women, widespread patronage of female sex workers (FSW) and a highly mobile workforce. FSW are a high risk group for HIV/STI and often use amphetamine-type substances (ATS). This is a great public health concern since ATS users are usually are more prone to engage in risky sexual behaviours, and thus have a greater risk of STI/HIV infections. In addition, ATS can produce aggressiveness and make their users more susceptible to experience violence. For its part, violence has also been associated with unprotected sexual intercourses and increased risk of HIV/STI infections. Until now, little is known about ATS use among FSW or its effects on HIV/STI acquisition or transmission. This project first aims to describe ATS use among FSW working in brothels and entertainment or drinking establishments in Phnom Penh, Cambodia. Secondly, the ATS use reported by the FSW will be compared to the ATS drug levels detected in their urine in order to examine the concordance and the validity of self-report. Finally, the study will verify the hypothesis that FSW who use ATS are more susceptible to engage is risky sexual behaviours, be infected by HIV/STI, experience diverse forms of violence, and less likely to adhere to an antiretroviral (ART) treatment against HIV and vaccine schedule for HPV (Human papilloma virus). In order to achieve these objectives, a prospective cohort study will be conducted which will follow FSW for one year, with visits every three months. Findings from this study will help better understand the underlying mechanisms involved in the influence of ATS use on HIV transmission. Also, this study will yield important data on the interactions between transactional sex, drugs, violence and HIV risk, which will help improve current prevention interventions.