As a concentrated epidemic, human immunodeficiency virus is spreading rapidly in one or more sub-groups, but in the general population its prevalence is relatively low. Female sex workers and their partners are at greater risk for human immunodeficiency virus infection. A successful comprehensive human immunodeficiency virus surveillance should include the prevalence of human immunodeficiency virus, sexually transmitted infections and associated risk behaviors. The aim of the present study was to determine the prevalence of human immunodeficiency virus and sexually transmitted infections including gonorrhea, Chlamydia, herpes simplex type 2 and syphilis among female sex workers in order to plan appropriate interventions.

This is a cross-sectional study of 278 female sex workers conducted in Shiraz, by using respondent-driven sampling, from June to March 2010. The recruitment chain started with 14 seeds, were taken for human immunodeficiency virus, syphilis, herpes simplex type 2, gonorrhea and Chlamydia tests.

The human immunodeficiency virus prevalence was 4.7% (13/278); the most prevalent sexually transmitted infection was herpes simplex type 2, 9.7% (27/278), followed by Chlamydia 9% (25/278), gonorrhea 1.43% (4/278) and syphilis (0/278). The female sex workers reported history of drug abuse (69.9%) of which 16.4% had history of injecting drug use; 79.8% of the participants stated their incentive for having sex in the previous month was financial. During this period, 24.4% had unprotected intercourse in previous month and 30.1% used condom sometimes, 4.7% almost every time and 40.6% every time.

The necessity of implementing preventative intervention program is an urgent issue. Educational programs on mode of transmission of human immunodeficiency virus/sexually transmitted infections, sexually transmitted infections syndrome and human immunodeficiency virus/sexually transmitted infections counseling, testing and reproductive healthcare should be included in female sex workers–oriented programs.