Prostitute women and public health.

long term haemodialysis.3 In the present trial we showed that though a magnesium free dialysis fluid corrected the hypermagnesaemia, it failed to show a related improvement in the renal itch. In addition, the fall in the serum magnesium concentration was associated with an increased concentration of parathyroid hormone, as has been previously noted,' with the potential of producing renal osteodystrophy in the long term. The lack of response might have been due to the brevity of the magnesium free dialysis. A longer treatment period was avoided as we thought that the patients' reliability in completing the visual analogue charts was likely to deteriorate, and the hyper-magnesaenia was corrected within a week. Alternatively , the serum magnesium concentrations may, like phosphate,3 be acting as a marker for the adequacy of dialysis, and this is being investigated. Disappearance of uraemic pruritis after lowering dialysate magnesium concentration. Prostitute women have been allotted a key role in models of heterosexual transmission of human immunodeficiency virus (HIV). Prostitutes are assumed to be especially exposed to infection with HIV because they have a greater than average number of sexual partners, and infected prostitutes may then play an important part in spreading the virus. Debates on public health initiatives reflect this concern with recommendations for registering and screening prostitutes .1 Though some findings from Africa confirm the importance of prostitutes in the heterosexual transmission of HIV, as in Nairobi,2 sexual activity alone has not been described as the principal risk elsewhere in the world. The most important risk factor for prostitutes in the West is sharing needles and syringes for drugs. We studied a cohort of prostitute women in London to assess their risks of infection with HIV. Patients and results Ninety one women were followed up for a median of seven months at the Praed Street Clinic over 17 months to December 1987. Questions about use of condoms showed that the women practised safer sex with clients than with private sexual partners (boyfriends) at their first visit and that this pattern was maintained over time (table). Four of 34 women attending the clinic in the last three months of 1987 reported inconsistent use of condoms with clients. This partly depended on the type of client: one sexual encounter with a new client was unprotected compared with 28 encounters with regular clients, who pay the same woman repeatedly for sex.