Rectal Neisseria gonorrhea and Chlamydia trachomatis incidence in female sex workers

Introduction: Female sex workers (FSWs) continue to carry a heavy burden of sexually transmitted infections (STI). They are generally undereducated, socially marginalized and exposed to violence. Their low socio-economic power hinders their authority to negotiate condom use with their clients and boyfriends and exposes them to sexually transmitted infections (STI). Women who engage in unprotected anal intercourse (AI) are at risk for acquiring rectal Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) infections. The present study aimed to define the rectal GC/CT incidence in female sex workers Method: This study is a review (Review Article) analysis was performed of systematically using keywords Rectal Neisseria gonorrhea, Rectal Chlamydia trachomatis, female sex workers, unprotected, anal intercourse. in information resources PubMed, Science direct, Up to Date, Google Scholar, Wiley online library, Elsevier among 1998 to 2018 years and found 49 articles were connected with topics that that have been used of full-text articles Results: Significant differences were found in likelihood of having anal sex and multiple sex partners. The result of study about the associations between participant characteristics and rectal GC and CT infection showed that Several sexual behaviors in the previous 12 months emerged as significant factors associated with prevalent rectal GC/GT infection, including sex with an injection drug user, sex with a person who exchanges sex for drugs or money, sex with an anonymous partner, and sex while intoxicated/high on alcohol or illicit drugs. The prevalence and correlates of rectal sexually transmitted infections are well described among men who report receptive anal intercourse (AI); however, little is known about the epidemiology of rectal sexually transmitted infections among women.Conclusion: Unprotected anal sex is the riskiest of sexual behaviors for women. Other findings agree with those of earlier studies that documented associations between younger age and rectal GC/CT infection in women. Several studies suggest that part of the resurgence of bacterial STDs (gonorrhea, and chlamydia) may be partially due to the practice of oral sex by FSWs, often to substitute for or avoid anal sex, which increases the risk for HIV acquisition or transmission. Receptive anal sex showed a significant interaction with alcohol use and gender. Among women, anal sex increased linearly with increased alcohol usage; whereas among men rates of receptive anal sex were similar regardless of alcohol usage. Within gender, women binge drinkers were significantly more likely to engage in risky sexual behaviors and had nearly 5 times the rate of gonorrhea compared to women who abstained from alcohol. By contrast, no association was found between alcohol use and sexual behaviors or STDs in men. Men’s high base rates of sexual behaviors and STDs may have attenuated the ability to detect an association with alcohol use. Gonorrhea and Chlamydia positivity were high among women reporting anal intercourse, and a large proportion of these cases would be missed in the absence of rectal testing. The high-risk behaviors of women with rectal infections highlight the need for rectal screening recommendations. Therefore, suggested that providers educate high-risk women, regardless of self-reported behaviors, about the risk of acquisition of rectal GC/ CT infections. We also believe that studies that address the outcomes of rectal GC/CT infections in women are needed, along with standardized screening guidelines to help detect infections that are currently missed

Keywords:

Rectal Neisseria gonorrhea , Rectal Chlamydia trachomatis , female sex workers , unprotected , anal intercourse