Princeton, N.J. (27 October 1999)—Female prostitutes in Yerevan are significantly more likely than their counterparts in Taipei, Mexico City, London, Sydney, and Atlanta to be infected with HIV, the virus that causes AIDS, reports Yale University epidemiologist George Levon Melikian.

Two hundred women who work as streetwalking prostitutes in Yerevan agreed to participate in a study conducted by Melikian. They were interviewed and tested for infection with the human immunodeficiency virus (HIV) in the summer of 1998. The results of the study, along with Melikian’s policy recommendations, appear in the Spring 1999 issue of the journal Armenian Forum.

Before being tested for HIV infection, the women answered questions about their age, their background, their socioeconomic and medical history, and their sexual practices. Through statistical analysis, Melikian isolated information that can be used to find ways to contain the epidemic.

The interviews revealed that the women almost invariably engage in unprotected sexual intercourse with their clients. Only ten percent reported consistent condom use. "More striking," Melikian writes, "was the finding that only 5.5 percent of respondents reported frequent condom provision on the part of clients."

The study draws attention to cultural and economic obstacles to the use of condoms and to condom acquisition by women. It also shows that more than half the women interviewed did not perceive themselves to be at particular risk for HIV transmission.

In his Armenian Forum article, Melikian discusses specific proven methods of overcoming obstacles to condom use. He recommends that such efforts target potential clients as well as the women themselves.

Preeminent among Melikian’s recommendations is the "social marketing" of condoms, which has been a successful tool in public health campaigns in several countries. According to the article, "this method aims to promote condom use by using commercial marketing techniques. By paying particular attention to condom packaging, advertising, and social trends, public-health authorities (with or without assistance from the private business sector) deliberately attempt to market the condom to the general consumer."

Melikian notes that after a three-year social-marketing campaign among prostitutes in West Bengal, India, condom use rates reportedly rose from 3 percent to 81 percent. Six months into the campaign, free distribution of condoms had declined by 50 percent, while condom sales had increased by that same amount.

Social-marketing strategies, according to Melikian’s article, "may represent significant investment opportunities for many local and foreign businesses, yielding both monetary and public-health incentives for all stakeholders involved."

The article appears in the Spring 1999 issue of Armenian Forum: A Journal of Contemporary Affairs.