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  1. Sexual health and use of condoms among local and international sex workers in Sydney
    O'Connor CC, Berry G, Rohrsheim R, Donovan B
    Genitourin Med, 1996 Feb;72(1):47-51.
    PMID: 8655167
    OBJECTIVES:
    To compare indicators of sexual health and predictors of condom use for commercial sex among local and international female sex workers first attending an STD clinic.

    SETTING:
    A public STD clinic in Sydney, Australia.

    SUBJECTS:
    All sex workers first attending between June 1991 and May 1993.

    METHODS:
    Cross-sectional analysis of demographic, behavioural and morbidity data from proforma medical records.

    RESULTS:
    91 local sex workers and 123 international sex workers (predominantly from Thailand, Malaysia and China) first presented during the study period. There were significantly higher prevalences of chlamydia (0 v. 15%, p = 0.0002), gonorrhoea (0 v. 14%, p = 0.0006), syphilis (0 v. 10%, p = 0.006) and clinical genital herpes (0 v. 5%, p = 0.04) among international sex workers. The only case of HIV infection was in an international sex worker. Inconsistent condom use for commercial sex was significantly more common among international sex workers (RR = 4.5; 95% CI 3.1-6.5). On multivariate analysis, inconsistent condom use in international sex workers was associated with a recent history of prostitution outside Australia (p = 0.04), while inconsistent condom usage among local sex workers was associated with increasing age (p = 0.003).

    CONCLUSIONS:
    These data illustrate the efficacy of condoms and the success of targeted education programmes in local sex workers in Sydney. By contrast, international sex workers continued to be at high risk of STDs. The international sex industry in Sydney requires enhanced culture-specific interventions. Immigration laws as they affect sex workers should also be reviewed.

    PIP:
    This study analyzes data on all female sex workers who attended the Sydney Sexual Health Center for a first visit for a sexually transmitted disease (STD) screening during June 1, 1991, and May 31, 1993. International sex workers were identified as women who do not speak English at home and were born outside Australia. Diseases were confirmed clinically, by specimen or culture or by antibody or serological tests. Results apply to 91 local and 123 international prostitutes. 47% of international prostitutes and 34% of local prostitutes were aged 21-25 years. Most international sex workers spoke Thai or a Chinese dialect. 10% of local prostitutes were born in Asia. 90% of international prostitutes were born in Thailand, Malaysia, or China. Local prostitutes were better educated. 7% of the local prostitutes and none of the international sex workers had a history of injectable drug use. Local prostitutes tended to use condoms for birth control, and international prostitutes tended to use oral contraceptives. One international prostitute tested HIV positive. 1 in 7 international prostitutes had gonorrhea and the same proportion had chlamydia. Viral STDs (chronic hepatitis B, HIV infection, and genital warts) were more prevalent, but uncommon among international prostitutes. More international prostitutes had multiple STDs. 79 international sex workers and only 9 local sex workers had an STD. 47% of international sex workers and only 10% of local sex workers had worked overseas as a prostitute in the preceding 12 months. Over half of local sex workers and only 8% of international sex workers consistently used condoms. Failure to use condoms was associated with being an international sex worker. Inconsistent use of condoms among local prostitutes was related to increased age.
  2. Fulltext Trends in mortality among ART-treated HIV-infected adults in the Asia-Pacific region between 1999 and 2017: results from the TREAT Asia HIV Observational Database (TAHOD) and Australian HIV Observational Database (AHOD) of IeDEA Asia-Pacific
    Jung IY, Rupasinghe D, Woolley I, O'Connor CC, Giles M, Azwa RI, et al.
    J Int AIDS Soc, 2019 Jan;22(1):e25219.
    PMID: 30615271 DOI: 10.1002/jia2.25219
    INTRODUCTION: AIDS-related deaths in people living with HIV/AIDS have been decreasing in number since the introduction of combination antiretroviral treatment (cART). However, data on recent causes of death in the Asia-Pacific region are limited. Hence, we analysed and compared AIDS-related and non-AIDS-related mortality in high- and low-income settings in the region.

    METHODS: Patients from the TREAT Asia HIV Observational Database (TAHOD) and Australian HIV Observational Database (AHOD) receiving cART between 1999 and 2017 were included. Causes of death verification were based on review of the standardized Cause of Death (CoDe) form designed by the D:A:D group. Cohorts were grouped as AHOD (all high-income sites), TAHOD-high (high/upper-middle income countries) and TAHOD-low (lower-middle income countries). TAHOD sites were split into high/upper-middle income and lower-middle income country settings based on World Bank classifications. Competing risk regression was used to analyse factors associated with AIDS and non-AIDS-related mortality.

    RESULTS: Of 10,386 patients, 522 died; 187 from AIDS-related and 335 from non-AIDS-related causes. The overall incidence rate of deaths during follow-up was 0.28 per 100 person-years (/100 PYS) for AIDS and 0.51/100 PYS for non-AIDS. Analysis indicated that the incidence rate of non-AIDS mortality decreased from 0.78/100 PYS to 0.37/100 PYS from year groups 2003 to 2007 to 2013 to 2017 (p 

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