库尔勒市第三轮暗娼人群行为监测调查报告

目的了解库尔勒市暗娼人群HIV/AIDS知晓情况及相关行为特征,为评估本市HIV/AIDS/STI干预效果提供科学依据。方法随机整群选择娱乐场所、街头从事商业性性服务的女性,用统一问卷的方法,对151名性工作者进行问卷调查。结果艾滋病相关知识总体知晓率较高;有95.4%的性工作者最近一次与＂客人＂发生性关系时使用了安全套,但与固定性伴发生性关系时使用安全套只占30.9%。结论被调查人群艾滋病相关知识总体知晓率较高,但应加强健康教育及干预活动,预防艾滋病从高危人群向一般人群传播。     

2006-2008年北京市暗娼人群梅毒和HIV感染率及梅毒感染率影响因素

目的了解暗娼人群梅毒、艾滋病病毒（HIV）感染率及梅毒感染率的影响因素。方法根据《国家级HIV综合监测点监测方案》,2006—2008年,每年对北京市性服务场所进行分层抽样,对抽中的性服务场所内的暗娼进行HIV抗体检测、梅毒快速血浆反应素试验（RPR）检测和问卷调查。结果2006、2007、2008年,暗娼人群HIV抗体阳性检出率分别为0．12％、0、0．04％,梅毒RPR阳性率分别为1．2％、1．4％和0．8％。影响梅毒阳性率的因素包括：文化程度、婚姻状况、从事性服务的时间、最近一周客人数、与固定性伴发生性行为时安全套使用情况。结论暗娼的性病艾滋病风险不仅来源于商业性行为,还可能来源于非商业性关系。在开展艾滋病行为干预工作时,需要提示暗娼注意与固定性伴性关系中的疾病风险,并鼓励她们坚持使用安全套。文化程度低的暗娼应成为预防干预工作的重点。     

2012年柳州市嫖客艾滋病哨点监测结果分析

目的了解柳州市嫖客人群艾滋病（AIDS）相关行为与艾滋病病毒（HIV）感染状况。方法2012年4—7月,对市区部分嫖客进行调查,分析AIDS知识知晓率、性行为、吸毒行为、既往HIV检测情况,以及HIV、梅毒和丙型肝炎病毒（HCV）感染状况。结果调查的400名嫖客中,AIDS知识知晓率为51．00％,最近一年与暗娼发生商业性性行为中坚持使用安全套的比例为45．83％,最近一年与固定性伴发生性行为时每次都使用安全套的比例仅为1．25％,既往接受HIV检测并知道检测结果的比例为4．75％。HIV阳性率为2．25％（9／400）,梅毒阳性率为8．00％（32／400）,HCV阳性率为8．00％（32／400）。危险因素分析显示,嫖客中HCV的感染与注射吸毒史有关（P=0．000）,嫖客中HIV的感染与安全套使用呈负相关（P=0．007）。结论市区嫖客人群AIDS相关危险行为暴露风险较大,亟须进一步探讨社区嫖客流行病学调查和有效行为干预方法。     

204例MSM人群HIV／梅毒感染状况及行为学特征分析

目的了解天津市部分男男同性性行为人群（MSM）艾滋病相关危险行为,以及艾滋病病毒（HIV）、梅毒（SP）感染状况,为预防性病、艾滋病传播提供依据。方法采用横断面调查,对进入酒吧的男同性恋者进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测。结果调查的204人中,HIV感染率为5．9％,梅毒感染率为18．7％。艾滋病知识知晓率为81．4％,近6个月每次性行为均使用安全套的比例为47．9％,HIv感染者安全套使用率低,仅为11．1％,71．4％的HIV感染者最近6个月存在多性伴现象。结论天津市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高,应加强对该人群艾滋病性病相关的宣传教育及干预工作,控制HIv的传播。     

新型毒品吸食人群的知识行为特征及相关疾病感染状况调查

目的了解青岛市新型毒品吸食人群的知识、行为特征及艾滋病病毒（HIV）、梅毒、丙型肝炎病毒（HCV）感染状况,探索有效的干预模式,控制性病艾滋病的流行和蔓延。方法采用问卷调查方法收集信息,SPSS17.0统计软件分析资料。结果200例调查对象的艾滋病防治知识总知晓率为48.0％（96／200）;最近1次吸食新型毒品后有75.0％（150／200）的人发生过性关系,发生性关系时安全套使用率仅为15.3％（23／150）;HIV检出率为1.0％（2／200）,梅毒检出率为IO.0％（20／200）,HCV检出率为3.0％（6／200）。结论新型毒品吸食者安全意识差,应加强对该人群的健康教育与行为干预力度,提高该人群安全套使用率。     

沈阳市高危人群艾滋病、梅毒、肝炎的调查分析

目的：了解辽宁省高危人群艾滋病，梅毒和肝炎的感染现状。方法：应用固相酶免疫测定（ELISA）法或间接血凝法分别检测了488名吸毒者，暗娼和STD门诊患者及2000例普通患者血清中HIV抗体，HBsAg，抗－HBs，抗－HCV，抗梅毒抗体。结果：吸毒者丙型肝炎感染率为47．5％，显著高于暗娼（6．8％）和STD门诊患者（1．4％），（P＜0．01），吸毒者，暗娼，STD门诊患者梅毒感染率均高于普通患者，且STD门诊梅毒感染率显著高于吸毒者（P＜0．01），吸毒者，暗娼，STD人群和普通患者各组间抗－HBs阳性率无显著差异（P＞0．05），本次调查未发现AIDS患者／HIV感染者，结论：辽宁省高危人群梅毒、丙型肝炎感染率较高，应加强高危人群管理，防止艾滋病在辽宁省的流行。     

新疆喀什地区2004年艾滋病综合调查分析

目的摸清各类人群艾滋病病毒（HIV）感染率和行为学指标,弥补监测数据不足,掌握喀什地区艾滋病（AIDS）流行现状,为制定可行的防治策略提供科学依据.方法随机抽取吸毒者、暗娼、性病门诊就诊者、孕产妇和调查时医院就诊者等5类人群,进行行为危险因素问卷调查和HIV抗体、梅毒和吸毒人群的丙型肝炎病毒（HCV）抗体检测.结果调查的400名吸毒者中,注射吸毒者占36.75%,近1个月内的共用针具率为15%.吸毒者最近一次与其配偶或性伴有性行为时安全套的使用率仅为10.78%,其HIV、HCV和梅毒感染率分别为24.25%、42.00%和42.25%,共用注射器吸毒者的HIV、HCV感染率均高于非共用者.暗娼、性病患者、孕产妇和调查时医院就诊者的HIV和梅毒感染率分别为0.67%和8.00%、0和5.75%、0.12%和4.61%、0.19%和1.45%.被调查人群艾滋病知识水平较低,普遍存在高风险行为.结论当地吸毒人群艾滋病的流行处于较高水平,流行的危险因素广泛存在,扩大流行的可行性极大.     

兰州市城关区暗娼人群性病／艾滋病患病率调查

目的了解甘肃省兰州市城关区娱乐场所提供商业性性服务（暗娼）人群性传播疾病感染情况,通过分析影响因素,为制定暗娼人群综合干预措施提供科学依据。方法对城关区高、中、低档娱乐场所702名暗娼进行一对一问卷调查,同时进行性传播疾病感染情况检测。结果702名暗娼艾滋病相关知识知晓率57．98％;最近一次性服务安全套使用比例为84．33％,最近一个月性服务每次使用安全套的比例占76．64％,有时使用占22．22％,从未使用占1．14％;性传播疾病阳性率为22．22％,其中梅毒感染率5．98％,生殖道沙眼衣原体感染率12．11％,淋球菌感染率4．13％。结论兰州市城关区不同场所暗娼人群性病／艾滋病防治知识知晓率、性行为特征、性病患病率、防病意识等方面存在差异,暗娼仍是艾滋病干预的重点人群,特别是站街等低档场所暗娼人群更易受到性病、艾滋病的威胁。     

新疆伊宁市暗娼人群艾滋病哨点监测分析

目的了解新疆伊宁市暗娼人群艾滋病流行现状和相关危险因素,为制定综合防控措施提供参考依据。方法采用分层随机抽样法,抽取伊宁市从事商业性性交易的女性作为调查对象,每年不少于400人;使用国家哨点监测统一问卷调查艾滋病相关知识知晓情况,并检测HIV、梅毒和HCV抗体。结果 2009─2014年共监测暗娼2 400人,年龄最小13岁、最大55岁,平均年龄(25.4±7.4)岁;未婚占63.1%、新疆户籍占63.8%、汉族占74.1%、初中文化占53.7%;艾滋病防治知识总体知晓率为98.6%,最近一次发生商业性性行为时安全套总体使用率为99.3%,最近一个月发生商业性性行为时安全套每次使用率98.0%;检测HIV、梅毒和HCV抗体,阳性率分别为0.6%、2.2%和1.0%。结论伊宁市暗娼人群艾滋病相关知识知晓率及安全套使用率呈下降趋势,应调整对娱乐场所暗娼人群的干预模式,加强行为干预、规范性病诊疗工作,降低艾滋病发病率。     

2010--2012年攀枝花市暗娼艾滋病哨点监测结果分析

目的分析攀枝花市2010—2012年暗娼的艾滋病（AIDS）相关行为变化,以及艾滋病病毒（HIV）感染流行趋势,为评价暗娼艾滋病综合干预效果及调整干预措施提供依据。方法采用重复横断面调查的方法,于每年的4—6月,对艾滋病监测哨点的从事商业性性交易的女性进行问卷调查并采血检测。结果2010—2012年共调查暗娼2400人,其AIDS知识知晓率分别为90．9％、93．9％和98．0％,差异有统计学意义（χ2=37．78,P〈0．001）。最近一次与客人发生性行为时使用安全套率分别为64．3％、89．9％和93．9％,最近一个月与客人发生性行为时每次使用安全套率分别为43．3％、61．8％和69．0％,差异均有统计学意义（χ2=286．97,P〈0．001;χ2=155．15,P〈0．001）。HIV抗体检测阳性率分别为1．3％、0．8％和0．6％,差异无统计学意义（χ2=2．02,P=0．365）。结论攀枝花市暗娼艾滋病综合干预工作效果明显;今后应借鉴新的方法,以促进咨询检测、促进安全套使用为重点内容,对重点暗娼人群实施持续的、高覆盖的综合干预。     

西部地区50个县（区）不同活动场所暗娼人群艾滋病行为学监测结果分析

目的了解我国西部地区50个县（区）不同活动场所暗娼（FSW）人群的艾滋病病毒（HIV）抗体阳性检出率和行为学指标情况。方法通过高危人群规模估计,对不同场所内FSW人群进行分层随机抽样和一对一问卷调查,收集高危行为信息,检测血清HIV抗体。结果 15 526名调查对象中,第一类来自宾馆、酒店、桑拿、洗浴中心、夜总会、卡拉OK厅、歌舞厅、酒吧等,占48.04%;第二类来自洗脚屋、发廊、路边店、小饭店和街头站桩,占51.96%。年龄20～29岁者占60.96%;初中以下文化程度占83.77%。第二类FSW人群最近一次性交易时安全套使用率（68.9%）,最近一个月性交易时安全套使用率（37.07%）,艾滋病知识知晓率（17.53%）,最近一年接受预防服务率（67.31%）,均低于第一类。FSW人群HIV阳性率为1.58%。结论 FSW人群中艾滋病知识知晓率较低,存在商业性行为中不使用安全套等高危行为,尤其是在街头等第二类场所中的FSW,是监测和干预工作的重点人群。     

不同场所暗娼干预前后高危行为和梅毒/HIV感染情况比较

目的了解不同场所暗娼的梅毒、艾滋病病毒（HIV）的感染状况,以及与传播有关的高危因素,评估采取相关干预措施后的效果,为进一步干预提供依据。方法对三亚市、琼海市的按摩院、发廊、私人小旅馆、出租屋及街头等场所的暗娼,在知情同意后,分层收集有关人口学和行为学信息,并采集静脉血检测梅毒、HIV抗体。之后持续开展2年的包括提供安全套、免费治疗等的行为干预措施,并进行效果评估。结果基线调查暗娼699人,其中低档297人（42.49%）,中低档44人（6.29%）,中档358人（51.22%）;档次越低其平均年龄越大,文化程度越低,安全套使用率也越低,梅毒等性病感染率越高。干预后评估调查暗娼628人,其中低档236人（37.58%）,中低档62人（9.87%）,中档330人（52.55%）。干预后暗娼安全套使用率显著提高,梅毒等性病现患率普遍降低,尤其是低档暗娼。结论暗娼档次越低,其梅毒等性病感染率越高,经性传播HIV的危险性越大,干预效果以低档及中低档者最好,低档及中低档人群是预防艾滋病经性传播的重点干预人群。     

Difference in Risk Behaviors and STD Prevalence Between Street-Based and Establishment-Based FSWs in Guangdong Province,China

The major mode of HIV/AIDS transmission in China is now heterosexual activities, but risk for HIV and sexually transmitted diseases (STDs) may differ among different strata of female sex workers (FSWs). Respondent-driven sampling was used to recruit 320 FSWs in Guangdong Province, China. The respondents were interviewed using a structured questionnaire, and tested for HIV, syphilis, gonorrhea, and Chlamydia. The street-based FSWs had lower education levels, a higher proportion supporting their families, charged less for their services, and had engaged in commercial sex for a longer period of time than establishment-based FSWs. The proportion consistently using condoms with clients and with regular non-paying partners was also lower. The prevalence of syphilis, gonorrhea, and Chlamydia was higher among street-based sex workers. Being a street-based sex worker, having regular non-paying sex partners, and having non-regular non-paying partners were independent risk factors for inconsistent condom. Street-based FSWs had more risk behaviors than establishment-based FSWs, and should therefore be specifically targeted for HIV as well as STD intervention programs.     

Determinants of condom use in female sex workers in Surabaya, Indonesia

In the developing world condom use among sex workers and their clients plays a dominant role in the transmission of HIV/STD. In Surabaya, Indonesia, data from the 1993 STD prevalence survey in female sex workers (brothels, street, massage parlours, barber shops, call-girl houses, and nightclubs) reveal that only 5% (33/692) of the brothel workers and 14% (25/177) of the street walkers had condoms in their possession at the time of the interview. During the last paid sexual intercourse, sex workers from the brothels, streets, and nightclubs used condoms infrequently (14%, 20%, and 25%, respectively). Sex workers from massage parlours, barber shops, and call girls were about 5 to 3 times more likely to use condoms than sex workers from nightclubs (adjusted odds ratio of 3.5, 4.9, and 4.2, respectively); thus condom promotion programmes should be targeted at sex workers at brothels, streets, and nightclubs. Programmes should include: (1) free distribution of condoms to sex establishments at the initial stage, and condom social marketing at later stages; (2) penalties, including legal sanctions, against any sex establishments that do not consistently use condoms; (3) participation of brothel owners and madams in encouraging sex workers to consistently have clients use condoms during sexual intercourse; and (4) establishment of sentinel surveillance to monitor STD/HIV and condom-use compliance.     

Demographic and behavioral correlates of HIV/STI among Vietnamese female sex workers in southwest China

Previous literature has suggested high rates of HIV/STIs among Chinese FSWs. However, limited data were available regarding HIV-related risks among Vietnamese FSWs – a rapidly increasing, vulnerable population in southwest China. The current study examined the demographic and behavioral factors associated with the infection rates of HIV, syphilis, and Hepatitis C (HCV) among Vietnamese FSWs in Guangxi, China. We conducted a secondary data analysis of a cumulative sample of 1026 Vietnamese FSWs (aged 14–66) recruited over five years (2010–2014) from 35 National Sentinel Surveillance sites in Guangxi. Analyses included Fisher’s exact chi-square test, t-test, and binary logistic regression. The overall prevalence of HIV, syphilis, and HCV infections among the cross-border women were 3.2%, 6.9%, and 2.6%, respectively. Multivariate analysis showed that greater lengths of sex work and low paying work venues were significant risk factors for HIV infection; for syphilis infection, older age, drug use experience, and forgoing condom use were significant risk factors; for HCV infection, drug use experience was the only significant risk factor. Our findings suggest that elevated HIV-related risks among the Vietnamese FSWs are closely related to their financial disadvantages and that drug use is a prominent risk factor for cross-border women in the sex trade. Furthermore, culturally tailored and linguistically accessible HIV prevention and intervention initiatives that target cross-border FSWs, with a close international collaboration between China and Vietnam, are urgently needed.     

Sexually transmitted infections and sexual behaviour among youth clients of hotel-based female sex workers in Dhaka, Bangladesh

A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them.     

四川省某市街头暗娼及其顾客艾滋病相关行为研究

目的了解街头暗娼及其顾客的社会人口学特征、艾滋病相关行为及其影响因素。方法以站桩点(街头暗娼聚集地)为调查现场,由街头暗娼同伴教育者识别对象,调查员主动接近并面对面匿名调查街头暗娼和男性顾客,运用SPSS 12.0进行统计分析。结果100名性服务男性顾客平均38.03岁;在街头的性交易频率为16次/年;最近1年商业性性交易中坚持使用安全套的比例14%,与艾滋病知识得分呈正相关(OR=2.25);36%的男性顾客最近1次商业性行为中使用了安全套,与年龄(OR=1.45)和艾滋病知识得分(OR=4.54)呈正相关。43名街头暗娼平均35.03岁,吸毒者比例较大(37.21%),平均每周接待客人14.07次,其服务对象多为工地工人、老年人和农民。结论街头商业性性交易频率高,安全套使用率低,应主动对街头暗娼及其顾客采取针对性干预措施。     

北京市城郊两区娱乐服务场所暗娼艾滋病相关危险行为调查分析

目的了解北京市城郊两个区娱乐服务场所的暗娼艾滋病相关危险行为现状,评估暗娼感染艾滋病的风险,为在暗娼中开展行为干预提供科学依据。方法采用方便抽样方法对娱乐场所进行抽样,对场所内暗娼进行面对面问卷调查及采血检测。结果调查341名暗娼,最近一周商业性伴数中位数为3人。最近一次与商业性伴和固定性伴发生性关系时,使用安全套的比例分别为72.9%和49.3%;最近一月与商业性伴和固定性伴每次都用安全套的比例分别为44.1%和26.7%。城区暗娼商业性伴数高于郊区,最近一次与商业性伴使用安全套的比例和最近一月与商业性伴每次都用安全套的比例,均小于郊区。2.9%的暗娼吸毒。最近一年出现性病相关症状的比例为41.1%,其中到正规医院就诊的占75.7%。无一例感染艾滋病,梅毒快速血浆反应素环状卡片试验和梅毒螺旋体抗体阳性检出率分别为1.17%和12.1%。结论北京市城郊两区娱乐服务场所暗娼中存在引起艾滋病感染和流行的危险行为因素,且城区暗娼感染艾滋病的风险高于郊区。提示应加强娱乐服务场所的艾滋病干预工作,尤其是应把城区作为干预工作的重点。     

常德市武陵区2010年暗娼人群艾滋病哨点监测分析

目的了解武陵区暗娼人群艾滋病相关知识、行为现状及艾滋病、梅毒、丙型肝炎(丙肝)的感染状况,为干预工作提供依据。方法按照《全国艾滋病哨点监测实施方案(试行)》(2010年版)要求,抽查辖区内暗娼人群进行问卷调查和艾滋病病毒(Human immunodeficiency virus,HIV)、梅毒、丙肝病毒(Hepatitis C virus,HCV)抗体的检测。结果共调查400名暗娼,年龄中位数26岁,25～47岁占55.00%,本省户籍占90.00%,初中及以下文化占79.00%,有过婚史或有固定性伴者占58.00%。艾滋病知识知晓率为80.00%,最近1次与客人发生性行为时使用安全套的比例,最近1个月与客人发生性行为时坚持使用安全套的比例,分别为94.00%和77.50%。最近一年做过HIV检测并知晓检测结果的占34.50%,HIV、梅毒、HCV抗体阳性检出率分别为0.25%(1/400)、3.25%(13/400)、1.25%(5/400),HIV确认阳性率为0.25%。对HIV感染者追踪调查发现,第二代和第三代HIV感染者各1例。结论低档次的本土暗娼是该区性服务场所的"主力军",尽管目前HIV、梅毒、HCV的感染率较低,但传播风险不容忽视,控制传播是现阶段艾滋病性病防控工作的重点。     

HIV,HCV, HBV,HSV, and syphilis prevalence among female sex workers in Tehran,Iran, by using respondent-driven sampling

To find out the prevalence of HIV, HCV, HBV, HSV, and syphilis infections among female sex workers (FSWs) in Tehran, a cross-sectional study by using respondent-driven sampling (RDS) method was conducted. From December 2012 to April 2013 FSWs in Tehran were recruited. Inclusion criteria consisted of trading sex during the 12 months prior to this study and selling sex for at least 6 months in participants’ lifetime. Among 161 consenting participants, 5% were infected with HIV. Moreover, 8.1% of FSWs were HCV positive, 37.9% were of HSV type1/type2, 1.2% of participants were infected with HBV, and none of the participants were infected with syphilis. HIV-positive participants were significantly more likely to be co-infected with HSV type1/type2, be younger, have more sexual partners and especially more clients during seven days prior to this study and report more history of having at least one of sexually transmitted infections symptoms in 12 months prior the study. In the multiple logistic regression analysis, being infected with HSV and also being under 25 years of age were found to be independently associated with HIV infection. Compared with the prevalence of HIV among general population of Tehran, relatively high prevalence of HIV and other viral infections among FSWs should be considered. All in all, it is critical to commence effective counter-measures for this high-risk group if the aim is to prevent spreading of these viruses to general population.