Occupational Hazards, Public Health Risks: Sex Work and Sexually Transmitted Infections, their Epidemiological Liaisons and Disease Control Challenges

Abstract

Sexually transmitted infections (STIs) represent a large and diverse category within communicable diseases, comprising more than thirty-five pathogens transmissible through sexual contact. [1] Common, curable bacterial and protozoal STIs manifest with ulceration (syphilis, chancroid, LGV) or inflammation and discharge (gonorrhoea, chlamydia, trichomonas) but are often asymptomatic. These are estimated to account for approximately half a billion new infections each year. [2] Incurable viral infections such as herpes simplex virus (HSV), human papilloma virus (HBV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV) are several times more prevalent. Common and severe sequelae include pelvic inflammatory disease, infertility, ectopic pregnancy, foetal loss and congenital infections. Both the ulceration and inflammation caused by STIs have been shown to facilitate acquisition and transmission of HIV, raising per-exposure transmission probabilities from an improbable event – less than one per thousand – to as high as two in five exposures. [3–7].