岑溪市暗娼商业性性行为使用安全套情况及影响因素

目的了解岑溪市暗娼人群最近1个月商业性性行为安全套的使用情况及其影响因素。方法用分层随机抽样法,调查收集岑溪市高、中、低档场所暗娼商业性性行为相关信息。用非条件Logistic回归方法分析安全套使用的相关因素。结果共调查400名暗娼,最近1个月商业性性行为安全套坚持使用率为66.8%。经非条件Logistic回归分析发现,暗娼最近1个月的商业性性行为是否坚持使用安全套与娱乐场所档次、婚姻状况、艾滋病知识知晓等因素有关。结论应针对不同档次的娱乐场所,不同婚姻状况和不同艾滋病相关知识知晓程度的暗娼开展行为干预工作,特别是对低档场所、相关知识知晓程度较低的暗娼,要加大干预力度,并大力推广安全套的使用。     

黑龙江省四市MSM人群艾滋病相关高危行为及其影响因素分析

目的了解黑龙江省四市男男性行为人群（MsM）艾滋病相关高危行为及其影响因素,为制定针对性干预策略提供建议。方法采用同伴推动法和分类滚雪球抽样法招募MSM,进行一对一问卷调查,并采血检测艾滋病病毒（HIV）、梅毒、丙型肝炎病毒（HCV）抗体。以不安全性行为为应变量,人口学特征、艾滋病知识知晓情况、干预服务覆盖情况、高危性行为情况等因素为自变量,进行多因素逐步向前Logistic回归分析。结果共调查1353名MSM。最近6个月,83．8％的MSM与男性发生过肛交性行为,56．7％有2个以上男性伴,无保护肛交率55．4％;7．5％发生过商业性行为,无保护肛交率44．7％;22．1％与女性发生过性行为,无保护率70．2％。最近1年干预服务覆盖率80．6％。月收入高于2000元、从浴池、公园类场所寻找性伴、艾滋病知识不知晓、首次与男性性行为年龄小于25岁,是发生多男性伴行为的危险因素;月收入低于2000元、干预未覆盖、首次与男性发生性行为年龄小于18岁、浴池、公园类场所寻找性伴,是与男性发生无保护肛交行为的危险因素;初中及以下低文化、非同性恋取向、艾滋病知识不知晓、有多男性伴行为,是与男性发生商业性行为的危险因素;已婚、与男性有无保护肛交行为是与女性发生无保护性行为的危险因素。结论四市MsM人群干预覆盖率低,促成HIV传播的高危性行为情况较严重,急需在相关方面加强。四市目前所开展的干预服务促进了男男性行为的安全套使用,但使用水平较低,且对多男性伴行为、商业性性行为、与女性性行为的安全性均无明显影响,需要在干预的有效性上下功夫,在干预内容上加以完善。     

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。     

低档场所不同入行意愿的女性性工作者的艾滋病相关行为特征

目的了解低档场所不同入行意愿的女性性工作者(FSWs)的艾滋病相关行为特征状况,为开展疾病预防控制工作提供科学依据。方法采取方便样本的方法,对山东省某地低档场所女性性工作者进行一对一问卷调查,内容包括入行意愿、首次性行为、安全套使用、吸食冰毒等艾滋病相关行为学特征等。用SPSS 17.0软件进行统计分析。结果共调查351名FSWs,主动入行者218人,占62.1%;被动入行者133人,占37.9%。首次性行为平均年龄:主动入行者为(17.5±2.7)岁,被动入行者为(19.1±3.6)岁,两组首次性行为平均年龄之间的差异有统计学意义(t=4.48,P=0.000)。主动入行者中,96.3%的首次性行为发生意愿为自愿,被动入行者为85.0%,两组首次性行为发生意愿情况之间的差异有统计学意义(χ2=14.33,P=0.000)。不同入行意愿者最近一次与客人发生性关系时安全套使用情况、最近一个月与固定性伴侣发生性关系安全套使用情况、吸食冰毒和"出冰台"情况之间差异均无统计学意义(P均0.05)。结论不同入行意愿低档场所女性性工作者的首次性行为发生年龄和意愿不同,安全套使用情况和吸食冰毒与"出冰台"情况没有不同。     

北京娱乐场所女性性工作者AIDS/STD干预累积效果评价

目的了解女性性工作者(FSWs)接受性病艾滋病干预的累积效果。方法采用横断面方法,对娱乐场所FSWs进行面对面问卷调查,内容包括过去接受干预情况及效果。结果共调查201名FSWs,干预累积效果显示,性病艾滋病知识得分受接受性病艾滋病宣传教育、免费HIV检测和发放安全套次数的影响;主动检测HIV次数受VCT宣传、免费性病检测次数的影响;主动检查性病受VCT宣传、免费HIV检测和免费性病检查次数的影响;婚姻状况、知识得分是最近一次与临时男性发生性行为使用安全套的影响因素,免费HIV检测是最近一个月与临时男性发生性行为使用安全套的影响因素。结论不同的性病艾滋病干预效果受不同干预措施的影响,不断对FSWs实施干预,将会产生干预的累积效果。     

深圳市男性性工作者HIV/梅毒感染状况及行为调查

目的了解深圳市向女性提供性服务的男性性工作者(MSW)的艾滋病相关知识知晓率、行为及艾滋病病毒(HIV)/梅毒感染状况,探索适合该人群的艾滋病宣传教育和行为干预措施。方法通过以场所为基础的抽样方法,对深圳市MSW进行问卷调查,并抽血检测其HIV/梅毒感染状况。结果本次调查206名MSW,平均年龄(24.1±3.98)岁,HIV阳性率1.5%(3人),梅毒阳性率2.9%(6人)。外省户籍占85.4%(176人);自我性取向评价为异性恋占87.9%(181例)。与女性客人发生无保护性行为的占49.5%(102人);最近一次与女性客人发生性行为的安全套使用率为85.9%(177人);艾滋病知识知晓率为57.3%(118人)。自我性取向评价、与女性客人发生无保护性行为、最近一次与女性客人安全套使用情况,与HIV/梅毒感染有关(P0.05)。多因素分析显示,自我性取向评价为同性恋[比值比(OR)=53.604]、与女性客人有无保护性行为(OR=13.185)是MSW HIV/梅毒感染的危险因素。结论深圳市MSW的流动性大,HIV、梅毒感染率低,艾滋病知识知晓率低,无保护商业性行为发生率高,应加强宣传教育及行为干预,提高安全套使用率。     

MSM中HIV感染者无保护肛交行为及其影响因素分析

目的了解男男性行为人群（MSM）中艾滋病病毒（HIV）感染者的无保护肛交性行为的状况,分析其影响因素,为开展针对性干预活动防止＂二代传播＂提供信息。方法对＂全国男男性行为人群艾滋病综合防治试点＂工作数据库中,HIV感染者的信息进行分析,描述研究对象的社会人口学和高危性行为特点,并分析无保护肛交性行为的影响因素。结果共获得MSM中HIV感染者的有效样本754人,梅毒检出率为28.9%。最近6个月内无保护肛交发生率为67.4%。与无保护肛交发生有关的危险因素是在当地居住时间超过6个月,经常到浴池、公园等场所寻找性伴,以及最近1年内未接受过艾滋病相关服务。结论 MSM中HIV感染者的无保护肛交行为发生率、梅毒感染率高,构成艾滋病进一步传播流行的风险,亟待在该人群中开展针对性行为干预。     

南宁市低档场所女性性工作者艾滋病知信行及感染情况调查

目的 探讨南宁市低档场所女性性工作者人群的艾滋病相关知信行及HIV、梅毒、丙肝感染现状,为艾滋病综合防治和科学干预提供科学依据.方法 2010-05/07通过同伴推动、滚雪球方法,对117名低档场所女性性工作者进行行为学问卷调查及实验室检测.结果 被调查的女性性工作者平均年龄为34.24±7.91岁;以在婚为主,占62.4％;中学或小学文化水平占85.5％,艾滋病知识知晓率为88.0％.艾滋病相关行为情况:87.2％的女性性工作者最近1次与客人发生性行为时使用安全套;65.8％的女性性工作者在最近1个月,与客人发生性行为时每次都使用安全套;女性性工作者中只有2.6％的人员有吸毒史.HIV抗体、梅毒抗体阳性率分别为6.84％、11.11％.结论 南宁市低档场所女性性工作者中艾滋病知识知晓率偏低,存在高危险行为,HIV,梅毒感染率高,需有针对性地加强宣传干预力度.     

深圳市男性性工作者HIV/梅毒感染状况及行为调查北大核心

目的了解深圳市向女性提供性服务的男性性工作者(MSW)的艾滋病相关知识知晓率、行为及艾滋病病毒(HIV)/梅毒感染状况,探索适合该人群的艾滋病宣传教育和行为干预措施。方法通过以场所为基础的抽样方法,对深圳市MSW进行问卷调查,并抽血检测其HIV/梅毒感染状况。结果本次调查206名MSW,平均年龄(24.1±3.98)岁,HIV阳性率1.5%(3人),梅毒阳性率2.9%(6人)。外省户籍占85.4%(176人);自我性取向评价为异性恋占87.9%(181例)。与女性客人发生无保护性行为的占49.5%(102人);最近一次与女性客人发生性行为的安全套使用率为85.9%(177人);艾滋病知识知晓率为57.3%(118人)。自我性取向评价、与女性客人发生无保护性行为、最近一次与女性客人安全套使用情况,与HIV/梅毒感染有关(P<0.05)。多因素分析显示,自我性取向评价为同性恋[比值比(OR)=53.604]、与女性客人有无保护性行为(OR=13.185)是MSW HIV/梅毒感染的危险因素。结论深圳市MSW的流动性大,HIV、梅毒感染率低,艾滋病知识知晓率低,无保护商业性行为发生率高,应加强宣传教育及行为干预,提高安全套使用率。     

来宾市945名低档暗娼艾滋病感染状况及影响因素调查分析

目的分析广西来宾市945名低档暗娼的艾滋病感染状况及其影响因素,为制定干预措施提供决策依据。方法对来宾市辖区的945名低档暗娼进行问卷调查,收集调查对象的社会人口学资料、艾滋病知识知晓率、性行为等基本信息,采集调查对象的血样,检测HIV抗体。结果来宾市低档暗娼平均年龄(38.2±7.6)岁,以小学及小学以下文化为主(89.2%);最近一次性行为安全套使用率为93.2%,最近1个月性行为时坚持使用安全套比例为88.4%;HIV抗体阳性检出率为2.6%;多因素logistic回归分析结果显示,最近1个月使用安全套频率是HIV感染的保护因素。结论来宾市低档暗娼年龄偏大,文化程度低,与客人发生商业性行为时坚持使用安全套频率不高,艾滋病危害意识淡薄,应加强对低档暗娼人群进行艾滋病宣传教育,提高其安全意识。     

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。     

深圳市娱乐场所女性性服务工作者和男性顾客艾滋病相关知识和行为调查

目的了解同一社区女性性服务工作者（FSW）和男性顾客艾滋病相关知识和行为状况。方法在同一社区招募177名FSW和154名性服务男性顾客,分别进行匿名问卷调查。结果（1）超过80％的FSW和顾客都了解艾滋病的基本传播途径,但对于不是艾滋病的传播途径则认识比较模糊。（2）商业性行为使用安全套频率女性为97．7％,男性为84．2％;男性顾客和FSW在和固定性伴侣和临时性伴侣使用安全套频率都低于和商业性伴侣,差异有统计学意义（P〈0．01）。（3）77％男性顾客和83．9％FSW从来没有参加艾滋病自愿咨询检测（VCT）。结论男性顾客和FSW的艾滋病相关知识认知不够,且发现这两个人群是可以进行接触和干预的,由于男性顾客是艾滋病从高危人群向普通人群传播的“中间桥梁”,可以作为艾滋病干预的重点人群。     

暗娼人群2005-2007年行为监测主要指标分析

目的分析中国暗娼人群艾滋病相关行为变化及艾滋病病毒（HIV）感染流行趋势,为艾滋病综合防治和科学干预提供信息和依据。方法对2005-2007年连续开展监测的41个暗娼综合监测点,以重复横断面调查的方法,对社区娱乐场所及街头的暗娼人群进行问卷调查并采血。结果2005-2007年连续开展监测的41个暗娼综合监测点中,三年间监测对象最近一次商业性行为安全套使用率分别为73.7%、81.1%和81.5%;最近一个月商业性行为坚持使用安全套的比例分别为49.3%、56.4%和55.4%;约有1/3的监测点发现监测对象中有注射吸毒暗娼;艾滋病传播途径知晓率分别为62.4%、57.3%和64.8%;接受过HIV检测并知晓检测结果者的比例分别为：10.9%、16.6%和24.9%;最近一年内接受过干预服务者的比例分别为：51.3%、78.8%和89.8%;HIV阳性检出率（中位数）均为0.0%;梅毒阳性检出率分别为0.6%、1.0%和1.2%。结论暗娼人群安全套使用率和艾滋病知识知晓率有待于进一步提高,最近一次安全套使用率判断趋势可能造成高估。接受过干预服务者的比例呈上升趋势,行为干预、自愿咨询检测、宣传教育的覆盖面逐步扩大,可及性不断提高。HIV感染率总体水平低,局部地区流行水平较高,部分暗娼有注射吸毒行为、高危行为状况不容乐观,提示干预工作长期而艰巨,需不断开展综合防治,保证干预的力度、效果和持续性。     

Transactional sex risk and STI among HIV-infected female sex workers and HIV-infected male clients of FSWs in India

To describe sex risk behaviors of HIV-infected female sex workers (FSWs) and HIV-infected male clients of FSWs, to evaluate associations between risky transactional sex and number of unprotected transactional sex episodes, and to assess the association between unprotected transactional sex and self-reported sexually transmitted infection (STI). Adult HIV-infected FSWs (n = 211) and HIV-infected male clients (n = 205) were surveyed in Mumbai about demographics, STI, and past 90-day and past year sex and substance use histories. Gender-stratified Poisson regression models were used to evaluate associations between four risky transactional sex behaviors (number of transactional sex partners; alcohol use before transactional sex; anal transactional sex; and transactional sex with a known HIV-infected partner) and number of unprotected transactional sex episodes; logistic regression was used to assess the association between unprotected transactional sex and self-reported STI. Twenty-nine percent of females and 7% of males reported any unprotected transactional sex episodes in the past 90 days. Thirty-nine percent of females and 12% of males reported past year STI. Among males, a greater number of transactional sex partners was associated with more unprotected transactional sex episodes (adjusted incidence rate ratio [IRR] = 8.2, 95% confidence interval [CI] = 1.8-38.4 highest vs. lowest tertile), and any unprotected transactional sex was associated with a higher odds of self-reported STI in the past year (adjusted odds ratio [AOR] = 5.6, 95% CI = 1.4-22.4). For women, risky transactional sex behaviors were not associated with condom non-use, and unprotected sex was negatively associated with STI (AOR = 0.4, 95% CI = 0.2-0.9). Reports of condom use during transactional sex were high for these samples. However, standard predictors of unprotected transactional sex (i.e., greater number of partners) and STI (i.e., unprotected sex) only held true for males. Further research is needed to guide an understanding of sex risk and STI among HIV-infected FSWs in India.     

Condom use among female sex workers and their non-commercial partners: effects of a sexual risk intervention in two Mexican cities

The purpose of this study was to examine whether a brief behavioural intervention promoting condom use among female sex workers (FSWs) and their clients had the added benefit of increasing condom use among FSWs and their steady, non-commercial partners (e.g. husbands, boyfriends). Participants were 362 FSWs, aged ≥18 years, living in Tijuana or Ciudad Juarez, Mexico, who received a behavioural intervention to promote condom use with clients. Repeated-measures negative binomial regression was used to assess FSWs' condom use with steady partners versus clients across time. Results showed that FSWs engaged in unprotected sex with steady partners more than with their clients, and that the intervention changed FSWs' condom use with clients but not their steady partners. HIV-prevention interventions for FSWs should promote consistent condom use across partner type. Targeting couples rather than individuals may also be necessary.     

Condom use and self-efficacy among female sex workers with steady partners in China

This study attempted to determine the association of self-efficacy with condom-use practice and to explore reasons of not using condoms among female sex workers (FSWs) with steady partners in China. Data from 309 establishment-based FSWs with steady partners in one Chinese county were collected through a cross-sectional study. Consistent condom use with steady partners was lower than with clients in entertainment establishments. Condom-use self-efficacy was positively associated with condom-use communication and condom-use frequency with clients but not with steady partners. It was positively associated with condom-use intention and skill with clients and steady partners. However, it was not associated with appropriate use of condoms. Significant differences of reasons about not using condom were also observed between the two partner types. The results may represent an important challenge to STD and HIV intervention programs aimed at achieving consistent condom use in FSWs. Health workers should focus on psychosocial factors affecting inconsistent condom use among FSWs with steady partners in China. In addition, intervention programs that can promote FSWs' self-efficacy through condom-use skill training will still be necessary.     

Drug use among female sex workers in Hanoi, Vietnam

AIMS: To describe the drug use practices among female sex workers (FSWs) in Hanoi and to identify factors associated with their drug injecting. DESIGN, SETTING AND PARTICIPANTS: A two-stage cluster survey of 400 FSWs was conducted from June to September, 2002. Participating FSWs were both establishment- (160) and street-based (240), who were practising in seven urban and one suburban districts of Hanoi. MEASUREMENTS: Subjects were interviewed face to face using a structured questionnaire. FINDINGS: Among the middle-class FSWs, 27% used drugs, of whom 79% injected. Among low-class FSWs, 46% used drugs and 85% injected. Among drug-using FSWs, 86% had started using drugs within the past 6 years. Among drug-injecting FSWs, 81% had started injecting within the past 4 years. Cleaning of injecting equipment was not common among those who shared. Having drug-injecting 'love mates', drug-using clients, longer residence in Hanoi, more clients and not currently cohabiting were found to be independently associated with drug injecting among FSWs. CONCLUSIONS: The high prevalence of injecting drug use among FSWs makes them susceptible to HIV infection, and is a threat to their clients. There is a strong relationship between drug-using FSWs and male drug-using clients and non-client partners. Intervention to prevent drug use initiation among non-drug-using FSWs and harm reduction among drug-using FSWs are urgently needed.     

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。     

HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil

Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5–9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1–2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention.