An Epidermiological Study on the Present Status of Venereal Disease among Prostitutes in Area Surronding Army Bases in Korea

Wang, Chong Soon; Kwon, Sung Won; Koh, Choon Myung; Kim, Joo Deuk; Yu, Seung Hum; Kim, Il Soon; Lee, Jin Moo

Abstract

Following the Korean War, presence of foreign troops in Korea, economic difficulty and changing moral Standards have brought about the development of concentrations of prostitutes around army camps known as "villes". The problems with venereal disease among the prostitutes living in the villes and consequently among soldiers has been a problem which has perplexed both American and Korean health authorities. Research into the problems and efforts to solve the V.D. problem have yielded only fragmentary results. Fortunately, with the cooperation of the U.S. Army Research and Development Group, an extensive research project has been undertaken to determine the root causes and best methods to prevent venereal disease in the villes around American military installations. The villes around large military installations were selected as the target of this research. In particular, the Pyeongtaek ville, the Gunsan "Silver Town" area and the "Texas Town" area of Busan were studied. The study took two years, from April, 1973 to March, 1975. Microbiological and serological studies were undertaken to determine the venereal disease infection rate and the efficacy of different antibiotics both in treatment and in sensitivity tests. In addition to the microbiological and serological studies other factors related to venereal diseases control such as social environment, health facilities, knowledge of venereal disease and its control were studied. The following results were obtained. 1. An overall gonorrheal morbidity rate of 14.1% was found among the 1,282 girls studied. This shows e rather dramatic rise compared to other studies. The majority of the increase is attributed to an actual increase of the V.D. rate, but more precise methods of isolation and culture using Thayer-Martin media also contributed to the increase recorded. 2. In Pyeongtaek, a gonorrhea morbidity rate of 5.39/0 (endocervical), the lowest in any of the villes was recorded. The Pyeongtaek police of enforced hospitalization until cure was effected tended to eliminate contact with infected girls and also make the girls more aware of and concerned about prevention of venereal disease. The Texas town prostitutes in Busan had a 15.5% (endocervical) morbidity rate, the highest of any of the areas. This might be attributed to sexual contact with many foreign sailors. 3. In culturing for gonorrhea, it was found that rectal as well as cervical cultures are necessary. Rectal cultures revealed 71 cases(39.2% to total positive cases) some of which were negative by endocervical culture, and endocervical cultures yielded 181 positives among the 1,282 cases surveyed. 4. A total of 988 serological tests for syphilis were carried out. By the V.D.R.L. method, 11.5% reactive cases were recorded, Kolmer C-F showed 5.9% reactive and RPCF test showed a 4.3% reactive rate. The RPR card test was used to retest 151 persons who were demonstrated to be V.D.R.L. (in prostitutes and general entertainers) reactive and confirmatory reactive results were shown in 74.0% of the cases. The FTA-ABS test was done on 57 RPCF tes/; reactive cases and showed confirmatory reactive results in 96.5% of the cases. It was concluded that the RPR card test, although it is less sensitive than the V.D.R.L test was both simple and effective for use in mass screening. However it is suggested that RPR card test rectors be reconfirmed using either the RPCF test or the FTA-ABS test. 5. Penicillin treatment failed to cure 40% of the gonorrhea patients in clinical tests and 16% of the strains used in the sensitivity tests showed resistance to penicillin. Therefore, penicillin was judged to be rather ineffective against gonorrhea. Ampicillin, however, is still quite effective, and spectinomycin was the most effective antibiotic against gonorrhea. 6. The socio-medical study of prostitutes revealed that their average age 25.5 years and the average number of years of education was 6. 8, implying the completion of primary school. Living conditions were generally poor, for example, in Pyeongtaek, 37% of the girls did not have running water and depended on well water. Data on the toilet facilities revealed that 78% of the prostitutes living in the control area in Wanweoldong, Busan were still using traditional Korean privy style toilets, and in Pyeongtaek 91% also were using privy toilets. Over two-thirds of the prostitutes only bathed once or twice a week. Therefore, improvement of living conditions was considered a critical problem. 7. Generally speaking, the girls had some know/edge of syphilis and gonorrhea and the measures necessary to prevent these diseases. However, over half of the girls abused antibiotics in venereal disease treatment and prevention attempts and only 65% of them required their partner to use a condom. Therefore, much improvement is needed in this area. 8. A survey of knowledge about contraceptive measures showed that 96% of the girls had good knowledge about oral contraceptives, 90 knew about condoms and 88% had knowledge of the douche method. In actual practice however, 95% of the girls used the douche method and 62% used condoms for contraception.