Do prostitutes need more health education regarding sexually transmitted diseases and the HIV infection? Experience in a Belgian city

From December 1988 till April 1989 154 women who worked in clubs (120) and behind windows (34) in and around Ghent, Belgium, were interviewed about knowledge, attitudes and practices regarding Sexually Transmitted Diseases (STD) and Human Immunodeficiency Virus (HIV) infection in their professional life. Television scored best (98%) as a source of information for AIDS. A leaflet posted in every door in 1987 was mentioned in 60%. Less than half the women gave more than 7 correct answers on 11 questions about safety of sex techniques. Intercourse with condom, the sexual act mostly done, was considered safer than deep kissing, masturbation and even massage. In 10 to 20% of the professional sex contacts no condoms were used, which leads to 1000 to 4000 unprotected contacts every week in the sex industry in Ghent (population 500,000). Condom use with the private partner is exceptional. Proposals for condom use almost invariably come from the women themselves instead of from their clients. We conclude that up till now health education efforts to prostitutes and their clients were not sufficient and that they should be intensified.