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Background: The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people., Goal: To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center., Study Design: A cross-sectional, follow-up study was conducted., Results: Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion., Conclusions: The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.

Sixty-seven transvestite prostitutes from Latin America (49 from Brazil and 18 from Colombia) who attended an HIV unit located in the inner city of Rome between January 1991 and June 1992 were studied for syphilis markers by means of both the Treponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of specific IgM (SPHA-IgM) which are typically present in recent infections. All participants reported more than 500 sexual partners in the past year, and 67.1% of them more than 1500 partners (between 5 and 10 partners per working day). The overall prevalence of anti-HIV antibodies in this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM tests was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was higher among Columbians than among Brazilians (83.3% vs 69.4% and 22.2% vs 6.1%, respectively) and also showed a positive correlation with the duration of their permanence in Italy. The TPHA and SPHA-IgM positivities were significantly higher among subjects older than 29 years. Positive TPHA was also significantly higher in subjects who reported a history of heroin and/or cocaine abuse while positive SPHA-IgM was higher in subjects who did not use condoms or reported irregular use of them than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and anti-HIV positivity, while SPHA-IgM positivity was found to be higher among anti-HIV-negative subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Fifty-seven male prostitutes who were also drug users, underwent HIV-1 testing in a drug dependency unit in Rome. The overall prevalence of HIV antibody was 74% (42/57). Of the 57 subjects, 46 completed a standard questionnaire and were interviewed by a trained psychologist about use of drugs, sexual and AIDS-related behaviours. Among the 46 patients responding to the questionnaire, the prevalence of HIV was 67% (31/46). HIV prevalence increased with the duration of drug use, rising from 48% for less than 2 years use, to 64% for 2 to 4 years, and 100% for more than 4 years. It also increased with duration of stay in Italy: from 59% for less than 2 years, 78% for 2-4 years and to 83% for more than 4 years. Prevalence of HIV antibody was higher among those who reported injecting drugs (73% vs 63%), or who reported needle sharing (83% vs 62%). Higher prevalence was also related to the number of partners in the last year (74% for more than 1,500 partners vs 50% for less than 1,500), and to non-use of condoms (70% for 'sometimes/never' vs 50% for 'always'). The results indicate that further educational outreach efforts are required among male transvestite prostitutes since they may constitute a potential source of infection for their clients.