Oral sex among female sex workers in Singapore has risen sharply from 27.1% in 1992 to 81.7% in 1997. A prospective cohort study was carried out on 724 female brothel-based sex workers who practised oral sex, to determine the risk of contracting pharyngeal gonorrhoea through inconsistent condom use. The prevalence of consistent condom use for oral sex was 70.4% compared to 96.8% for vaginal sex. One hundred and twenty-nine (17.8%) were lost to follow up because they quit prostitution. The other 595 sex workers were followed up for a maximum period of 6 months. Thirty-eight (5.2%) sex workers contracted pharyngeal gonorrhoea compared to 2.5% who contracted cervical gonorrhoea. Sex workers with inconsistent condom use for oral sex were 17.1 times (95% CI: 8.0-36.5) more likely than consistent condom users to develop pharyngeal gonorrhoea, after controlling for ethnic group, class and number of clients. STD control programmes for sex workers should place stress on consistent condom use for oral sex.
PIP: This study examines the risks of pharyngeal gonorrhea due to inconsistent condom use among female sex workers in Singapore. A total of 724 brothel-based female sex workers who practiced oral sex were interviewed between December 1996 and June 1998. Data collected included sociodemographic characteristics, sexual behavior, and use of condom for oral sex. The results demonstrated a 70.4% prevalence of consistent condom use for oral sex as compared to 96.8% for vaginal sex. Of the 595 sex workers that were followed up for a maximum period of 6 months, 38 (5.2%) contracted pharyngeal gonorrhea, while 2.5% contracted cervical gonorrhea. It was revealed that sex workers with inconsistent condom use for oral sex were 17.1 times more likely to develop pharyngeal gonorrhea than consistent condom users. Since the risk of acquiring pharyngeal gonorrhea was significantly higher for inconsistent condom users, sexually transmitted disease control programs for sex workers should also emphasize the need for the consistent use of condoms with oral sex.