云南省德宏州外籍暗娼艾滋病感染及其影响因素

目的了解云南省德宏州外籍暗娼艾滋病病毒（HIV）感染及相关因素状况。方法运用普查方法,对德宏州3个边境县（市）全部暗娼活动场所的外籍暗娼进行调查。匿名问卷调查收集社会人口学、艾滋病防治服务及高危行为等信息,并抽取5毫升静脉血进行HIV抗体血清学检测。结果共有238名外籍暗娼接受调查,HIV感染率为4.2％。34.5％最近1个月与客人发生性行为时未坚持使用安全套。多因素非条件Logistic回归分析结果显示,23～26岁感染HIV风险是≤22岁的10.8倍,最近1次与客人发生性行为时未使用安全套者感染HIV风险是使用者的7.8倍;未使用安全套的危险因素有艾滋病知识不知晓[比值比（OR）=4.4,95％可信区间（CD：1.9～10.2],年龄〉26岁（OR=2.4,95％CI：1.0～5.7）,以及在当地工作≥6个月（OR=2.8,95％CI：l.6～5.1）。结论德宏州外籍暗娼HIV感染率高,安全套坚持使用率不高,迫切需要加大艾滋病预防干预覆盖面及干预力度。     

暗娼行为学及主要STD的感染状况调查

目的　了解强制状态下暗娼的行为学特征及主要性传播疾病 (STD)的感染状况 ,为实施有效的干预措施提供信息。方法　对劳教所内 30 4名暗娼进行匿名问卷调查和血标本采集 ,对入所 <1个月的 5 0名暗娼另取宫颈分泌物。结果　 (1)调查对象平均年龄 2 9 7± 7 3岁 ,卖淫 <1年占 73 9% ;卖淫时从不使用安全套的占 34 8% ,最后一次性交对象 85 3%来自丈夫 /男友、情人和固定性伴侣 ,而最后一次安全套使用率仅 4 6 7%。 (2 )淋球菌、梅毒螺旋体、沙眼衣原体的感染率分别是 4 0 %、31 1%、18 0 % ,未发现艾滋病病毒 (HIV)感染者。结论　暗娼存在高危性行为 ,应尽快推广针对娱乐场所小姐的STD/艾滋病 (AIDS)干预项目 ,以阻断AIDS/STD经性途径传播。     

云南省既往确诊HIV抗体阳性暗娼特征

暗娼作为异性性传播的主体,对艾滋病传播流行有着重要影响[1],尤其是HIV抗体阳性暗娼,是艾滋病传播最危险的人群之一[2].为了解云南省既往HIV抗体阳性暗娼人群特征,探索有针对性的干预措施,本文对2018年发现的既往已确诊HIV抗体阳性暗娼进行分析.     

兰州市娱乐场所暗娼HIV STD HBV HCV感染状况及行为学调查

为了探索兰州市娱乐场所卖淫与艾滋病(AIDS)相关的高危行为特征，于2002年5～7月对暗娼进行了AIDS知识、行为特征及与艾滋病病毒(HIV)感染有关的性传播疾病(STD)、乙型肝炎(乙肝)病毒(HBV)、丙型肝炎(丙肝)病毒(HCV)感染现况的调查，现将结果报告如下。     

低档暗娼对女用安全套和暴露前预防用药的虚拟接受意愿调查

目的了解低档暗娼对女用安全套(女套)和暴露前预防用药(PrEP)两种预防艾滋病病毒(HIV)感染干预措施的虚拟接受意愿及其影响因素。方法采用横断面调查。对广西、湖南、云南三省(自治区)12个市(县)的低档暗娼开展一对一问卷调查,调查员向研究对象展示女套和PrEP药物实物并解释使用方法,收集该人群的社会人口学特征、PrEP和女套的虚拟接受意愿等信息,用SPSS 18.0统计软件进行分析。结果共调查1093名暗娼,有意愿使用女套的有732人(67.0%)。1076名HIV阴性的暗娼中,愿意接受PrEP的有709人(65.9%)。多因素分析结果表明,年龄35岁[比值比(OR)=1.377,P0.05]、艾滋病基本知识问题得分6分(OR=1.789,P0.01)、最近一月坚持使用男用安全套(OR=1.406,P0.05)的暗娼,对女套的虚拟接受意愿更高。文化程度为小学及以下(OR=0.541,P0.01)、艾滋病基本知识问题得分6分(OR=1.696,P0.01)及近一年接受过同伴教育(OR=1.980,P0.01)的暗娼,对于PrEP的虚拟接受意愿更高。结论低档暗娼人群对女套和PrEP两种预防干预措施的虚拟接受意愿较高,了解艾滋病基本知识是低档暗娼接受新干预措施的促进因素,年龄较大的暗娼更愿意接受女套,同伴教育可能是PrEP推广的有效方式。     

南通市2010年暗娼人群梅毒感染情况调查及影响因素分析

目的了解南通市暗娼人群梅毒感染情况及可能的影响因素,为制定预防控制措施提供依据。方法对798名娱乐场所和收容教育所的暗娼进行横断面调查和血清检测,采用非条件Logistic回归分析的方法探讨影响暗娼人群感染梅毒的可能因素。结果南通市暗娼人群梅毒感染率为6.02%。Logistic回归分析结果显示:文化程度、在当地工作时间、安全套使用情况与暗娼人群是否感染梅毒存在统计学关联。结论今后梅毒的防控工作需加大对暗娼人群的宣传教育,重点是提高其安全套的实际使用率。     

街头暗娼AIDS/STD感染危险因素及控制策略

街头暗娼在社会人口学特征、交易特点等方面不同于场所暗娼,存在更多的艾滋病/性病感染危险因素,以及更高的艾滋病/性病感染率.该文就此人群上述特点进行综述,总结了各国针对该人群进行的以街头外展服务和随访中心为依托的艾滋病预防控制策略,并为今后中国街头暗娼人群艾滋病防治工作提出建议.     

保山市2007-2011年暗娼人群HIV感染率与相关行为改变分析

目的分析保山市2007-2011年暗娼人群艾滋病病毒(HIV)感染趋势,以及与艾滋病(AIDS)相关行为的改变状况,为AIDS综合防治和干预提供科学依据。方法从2007-2011年,每年1-7月以重复横断面调查的方法,对保山市5个城市部分社区暗娼进行监测,分析暗娼历年的AIDS相关行为、知识知晓率与HIV实验室检测结果。结果 2007-2011年,分别调查暗娼1 080人、1 082人、1 200人、1 405人、1 409人。5年间监测对象HIV抗体阳性检出率分别为:1.2%(13/1 080)、1.11%(12/1 082)、0.58%(7/1 200)、0.93%(13/1 405)、0.5%(7/1 409)。最近1次商业性行为安全套使用率分别为:94.4%、96.1%、96.8%、92.1%、94.3%;最近1个月商业性行为坚持使用安全套的比例分别为:80.6%、84.7%、89.9%、77.0%、87.4%;AIDS知识知晓率分别为:69.46%、73.35%、94.96%、93.46%、96.19%。结论暗娼商业性行为坚持使用安全套的比例保持在较高水平,AIDS知识知晓率不断提高,HIV感染率总体水平低,接受过HIV检测的比例在不断提高,但知晓检测结果的情况不容乐观,提示在扩大检测的同时应加强检测结果的告知。不断加强干预和综合防治工作。     

中缅边境地区缅籍暗娼使用新型毒品及感染HIV情况调查

目的了解边境地区缅籍暗娼使用新型毒品及其对艾滋病病毒（HIV）感染的影响,为开展后续的干预服务提供参考。方法采用滚雪球抽样法选取缅籍暗娼,进行问卷调查和抽血检测HIV抗体。对承认最近1个月使用过苯丙胺类兴奋剂（ATS）的研究对象进行甲基安非他命尿检。问卷内容包括人口学特征、新型毒品使用情况及高危性行为等。使用Epidata 3.1建立数据库并进行数据双录入,使用SPSS 17.0进行数据分析。结果调查的140名缅籍暗娼中,有46人使用过新型毒品,平均年龄为25.55岁。使用新型毒品的暗娼在中国境内从事商业性行为的时间为（6.00±5.75）个月,显著低于不使用新型毒品暗娼从事商业性行为的时间。71.7%的缅籍暗娼因同伴压力的影响而使用新型毒品,且有56.5%是从朋友处获得新型毒品。新型毒品的使用方式主要是鼻吸和溶于饮料或水中使用,分别占65.2%和84.8%。缅籍暗娼的HIV抗体阳性率为5.7%（8/140）,未使用新型毒品暗娼的HIV阳性率为2.1%（2/94）,显著低于使用新型毒品组的13.0%（6/46）。结论缅籍暗娼中使用新型毒品是HIV传播的重要影响因素,未来的干预中要开展相应的措施。     

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。     

High acceptability of HIV voluntary counselling and testing among female sex workers: impact of individual and social factors

Objectives

Voluntary counselling and testing (VCT) for HIV infection is an important tool for prevention of HIV infection and AIDS in high‐risk groups. Our goal was to describe the acceptability and consequences of VCT among a stigmatized and vulnerable group, female sex workers (FSWs), in Conakry, Guinea.

Methods

Acceptance of the test and return for test results at baseline and consequences of testing 1 year later were described. The perceived risk of HIV infection and perceived benefits and barriers to testing were examined using quantitative and qualitative methods.

Results

All 421 FSW participants agreed to undergo VCT and most participants (92%) returned for their results. The main reason cited for VCT acceptance was the wish to know their HIV status. However, some managers of FSW worksites urged FSWs to be tested, curtailing FSWs' free decision‐making. One year later, status disclosure was common (90% of the 198 individuals who knew their results among those who participated in the follow‐up part of the study). Positive consequences of testing were far more frequently reported than negative consequences (98% vs. 2%, respectively). Negative life events included banishment from the worksite (one case) and verbal abuse (two cases).

Conclusion

Acceptability of VCT appears high in the FSW population in Conakry as a consequence of both perceptions of high individual risk and social pressures.     

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.     

天津市低档场所女性性工作者安全套使用变化情况及影响因素分析

目的评价天津市低档场所女性性工作者(Female sex workers,FSW)艾滋病防治干预措施的落实效果,并分析促进安全套使用的影响因素。方法2007年和2008年,应用分层随机抽样方法,在天津市低档场所FSW中,开展2次横断面调查;通过问卷收集FSW的人口学、艾滋病知识、安全套使用情况及干预服务接受情况等资料,用SPSS13.0软件进行比较分析。结果2007年调查336人,2008年调查354人。FSW最后一次商业性性行为的安全套使用率,2007年为40.48%,2008年为57.63%(P0.001)。2008年调查的FSW中,接受咨询检测的比例及艾滋病知识知晓率均比2007年有显著提高。通过多因素Logistic回归分析,发现促进低档场所FSW使用安全套的影响因素为:年龄、艾滋病知识、接受过免费安全套干预以及接受过宣传材料(P0.05)。结论天津市开展的艾滋病防治干预措施有效促进了FSW使用安全套。提示今后进一步推广安全套及发放宣传材料,注重提高艾滋病知识知晓率。     

Obligations of motherhood in shaping sex work,condom use,and HIV care among Swazi female sex workers living with HIV

Parental obligations influence sexual behaviour among female sex workers (FSW) and may serve as a risk or protective factor for HIV acquisition. How these obligations affect behaviours beyond HIV prevention, including HIV care, is understudied. We analysed 25 interviews conducted with 11 mothers who sell sex and are living with HIV, and 4 key informants as part of a larger study examining the positive health, dignity, and prevention needs of FSW in eSwatini. Despite awareness of HIV reinfection, FSW initiated sex work and engaged in condomless sex due to financial pressures of providing for children. While women attributed having condomless sex to their obligations as a provider, motherhood also served as motivation to engage in HIV care. Further, FSW described children as a source of support in HIV care. Children reminded mothers to take their medications, prepared food to take with medications, and assisted with travel to the clinic.     

Levels of alcohol use and history of HIV testing among female sex workers in Mombasa,Kenya

HIV testing is a critical first step to accessing HIV care and treatment, particularly for high-risk groups such as female sex workers (FSWs). Alcohol use may be a barrier to accessing HIV services, including HIV testing. We analyzed data from a cross-sectional survey of 818 FSWs in Mombasa, Kenya, and estimated the association between different levels of alcohol use and having never tested for HIV. In multivariable analyses, higher levels of alcohol consumption were associated with having never tested for HIV (PR 1.60; 95% CI: 1.07, 2.40). Future interventions should explore whether reducing harmful drinking improves HIV testing among FSWs.     

不同场所暗娼的高危行为和HIV/STI感染状况调查

目的 了解不同场所中暗娼与艾滋病（AIDS）传播有关的行为，以及艾滋病病毒/性传播感染（HIV／STI）的感染状况，为开展有针对性的行为干预提供依据。方法 对贵阳市云岩区宾馆、酒店、卡拉OK歌厅等娱乐场所的暗娼进行两阶段概率抽样，发廊和街头的暗娼在知情同意后全部纳入调查。收集人口学和高危行为信息，并采集静脉血检测HIV、梅毒、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）。结果 432名暗娼中，来自宾馆、酒店及娱乐场所占50．9％，发廊占25．5％，街头占23．6％。与前两组相比，街头暗娼平均年龄较大（30．6岁），文化程度较低（小学和文盲占54．9％），首次性交年龄（18．7岁）和首次从事性交易年龄（27．9岁）较大，从事性交易时间较长（4年及以上者占21．6％）。调查对象最近一次与客人发生性关系时使用安全套的比例为81．3％，最近1个月与客人发生性关系时，每次都使用安全套的比例为44．9％，从未使用的占8．1％。17．6％的街头暗娼有吸毒行为。HIV感染率为0．2％，HBV感染率为4．6％，HCV感染率为4．9％，梅毒感染率为13．0％。结论 街头暗娼高危行为的危险性最高，STI的感染率也高于其他场所的暗娼，应作为监测和干预的重点亚人群。     

云南省某市低档场所女性性工作者无保护性行为及影响因素分析

目的了解云南省某市低档场所女性性工作者(FSWs)无保护性行为发生状况及主要影响因素,为有效地开展艾滋病干预工作提供参考。方法通过滚雪球的方式招募目标人群,进行面对面的调查,数据采用SPSS17.0作统计学处理,运用逐步向前法的Logistic回归分析确定影响安全性行为的因素。结果共得到有效样本426名,在调查中发现被调查者与商业性性伴最近一个月的无保护性行为发生率为16.2%,与男友(配偶)最近一月无保护性行为的发生率为84.5%。多因素Logistic回归模型分析发现,文化程度、近一月与客人发生性行为使用安全套的频率、是否知道上次AIDS检测结果,是FSWs与商业性性伴发生无保护性性行为的危险因素。低档场所FSWs与不同性伴发生无保护性行为的情况有很大差异,尤其是在与亲密伴侣发生性行为时,由于亲密关系等因素,常常忽略无保护性行为的危险。结论低档场所FSWs在与客人发生性行为时,虽无保护性行为的发生率很低,但不能忽视其重复率。提示在低档场所FSWs的艾滋病干预中,应针对不同性伴而采用不同的干预措施,并及时告知检测结果。     

Why female sex workers participate in HIV research: the illusion of voluntariness

The purpose of this study was to examine factors influencing the motivation for and perceived voluntariness of participation in non-intervention HIV research among female sex workers (FSW) in India. FSW (n?=?30) who participated in non-intervention HIV studies in the previous three years were recruited from a local community-based organization. Semi-structured qualitative interviews focused on women’s personal and economic motivations for participation and their perceptions of the informed consent process. Interviews were audio-recorded, translated, transcribed, and reviewed for common themes. Content analysis indicated that while many women reported willing participation, reports of obligatory participation were also a common theme. Obligations included money-related pressures and coercion by other FSW, social pressures, not wanting to disappoint the researchers, and perceiving that they had a contractual agreement to complete participation as a result of signing the consent form. Findings suggest a need for additional efforts during and following informed consent to prevent obligatory participation in HIV research studies among FSW. Findings emphasize the importance of integrating ongoing participant feedback into research ethics practices to identify issues not well addressed via standard ethics protocols when conducting HIV research among vulnerable populations.