广州地区MSM和FSWs的性病知晓情况及梅毒艾滋病感染因素分析

目的:了解广州地区男男同性性行为者(MSM)、女性性工作者(FSWs)的性病知晓情况及梅毒、艾滋病病毒感染现况,并分析感染因素。方法:经知情同意后,2017年4-8月对广州地区MSM和FSWs两类高危人群进行面对面问卷调查,采集静脉血检测梅毒及HIV抗体,并进行统计学分析。结果:314例MSM的性病相关疾病知晓率、性病传播途径知晓率、性病防止感染方式知晓率分别为62.10%、44.59%、41.08%,408例FSWs以上知晓率分别为49.02%、22.06%、31.13%。264例MSM参与梅毒及HIV抗体检测,梅毒感染率为1.52%,HIV感染率为10.23%;多因素Logistic逐步回归分析结果显示,学历高中及以上(OR=0.360,95%CI:0.131~0.989),知晓性病相关疾病(OR=0.373,95%CI:0.157~0.881)是感染HIV的保护因素,认为自己可能感染艾滋病(OR=3.440,95%CI:1.401~8.443)和梅毒检测结果阳性(OR=14.151,95%CI:1.745~114.736)是危险因素。FSWs梅毒感染率为3.92%,HIV感染率为0.25%;场所为中高档是感染梅毒的保护因素(OR=0.166,95%CI:0.052~0.526)。结论:广州地区MSM和FSWs的梅毒、艾滋病病毒感染率高,性病知识知晓率低,应扩大高危人群梅毒、艾滋病病毒筛查范围,并加强性病知识宣教。     

暗娼1144人HBV、HIV及梅毒感染检测结果分析

目的了解暗娼人群乙肝病毒(HBV)、人类免疫缺陷病毒(HIV)及梅毒感染的情况,为制订预防措施提供依据。方法对海南省某妇教所收容的1144名暗娼分别抽取静脉血,用酶联免疫吸附实验(ELISA)进行乙肝两对半、HIV1+2抗体检测和梅毒甲苯胺红不加热血清试验(TRUST)初筛,梅毒阳性者用梅毒螺旋体明胶颗粒凝集确证试验(TP-PA)进一步确证。结果暗娼人群HBV及梅毒感染率分别为15.73%和29.26%,未发现HIV感染者。结论海南省暗娼人群HBV感染率和梅毒感染率较高,增加了HIV的感染的可能性。提示暗娼是感染性病和艾滋病的高危人群,也是向一般人群传播这些疾病的"桥梁人群",加强对暗娼人群的行为干预和监测至关重要。     

广西某县高危性行为者梅毒感染及危险因素分析

目的分析广西南宁市B县低档场所嫖客人群梅毒感染情况及其影响因素,为本市制定针对性预防控制措施提供依据。方法 2013-2015年,每年4-7月在广西南宁市B县采用整群抽样方法,对出入低档场所的嫖客人群进行面对面问卷调查,并采集静脉血3~5m L进行HIV、梅毒抗体检测,分析其中梅毒感染状况及探讨影响低档场所嫖客人群感染梅毒的可能因素。结果 2013-2015年共调查1 174名低档场所嫖客,梅毒抗体阳性75例,阳性率为6.39%,梅毒抗体阳性率各年分别为5.03%(20/398),5.68%(22/387)和8.48%(33/389),有逐年上升的趋势,但差异无统计学意义(P﹥0.05);多因素Logistic回归分析显示,60岁及以上年龄组(OR=2.82,95%CI:1.33~5.99)是低档场所嫖客感染传播梅毒的主要危险因素。结论广西南宁市B县低档场所嫖客梅毒感染率较高,且有逐年上升的势头,60岁及以上为高危因素。梅毒感染是促进艾滋病传播的重要因素,应将艾滋病与性病防治结合,开展针对性的宣传干预,降低梅毒在嫖客人群中的传播与蔓延。     

663名女性高危人群性病流行病学分析

目的:了解服务娱乐场所女性性病患病情况。方法:对不同场所663名暗娼中性传播疾病进行临床检查和实验室检测。结果:663名暗娼中有183例为性病患者(27.6%),其中梅毒占53.55%。结论:应加强对娱乐场所女性性工作者的健康教育,减少性病传播。     

2015年广州市STD高危人群性行为特征及艾滋病梅毒感染率的调查结果分析

目的:了解广州市高危人群艾滋病及梅毒感染状况,分析相应人群的艾滋病及梅毒流行趋势,为制定艾滋病防治策略和干预措施及效果评价提供依据。方法:2015年5~10月对广州市女性性工作者(FSWs)、男男同性恋者(MSM)和吸毒者(DUS)三类人群进行面对面问卷调查,采集静脉血检测HIV及梅毒抗体。结果:共调查1 091人,其中调查FSWs 591人、MSM 300人、DUS 200人,三类高危人群梅毒艾滋病知晓率由高到低依次为DUS(73.5%)、MSM(62.3%)、FSWs(59.4%)。MSM人群的梅毒感染率和HIV感染率均最高,分别是9.3%和2.7%,三类高危人群梅毒感染率和HIV抗体感染率的组间差异均有统计学意义(P值均<0.05)。结论:广州市高危人群的性病艾滋病疫情严峻,危险因素广泛存在,仍需要加大干预控制力度,严格监测和控制高危人群性病艾滋病发病率,提高性病艾滋病防治工作的效果。     

上海市金山区卖淫嫖娼人员892人性病状况分析

目的了解上海市金山区2005～2007年公安强制送检的892名卖淫嫖娼人员的性病状况及其特点,为制订防病政策提供依据。方法对892名金山区各派出所强制送检的卖淫嫖娼人员的一般资料进行分析,对采集的标本进行淋病奈瑟菌(NG)的分离培养、解脲脲原体(UU)培养、沙眼衣原体(CT)检测、梅毒甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体抗体凝集试验(TPPA)及人类免疫缺陷病毒(HIV)1+2型抗体(ELISA)的检测。结果892名卖淫嫖娼人员中以外省人员居多(880人),文化程度初中及以下最多(771人);该3年平均阳性检出率:448名卖淫人员中NG感染为10.49%,UU感染为74.33%,CT为感染7.14%,梅毒12.28%,HIV为0;444名嫖娼人员依次分别为2.25%,45.27%,1.35%,2.93%,0人;同时患两种性病的卖淫人员17.41%,多于嫖娼人员的2.93%,同时患3种性病的卖淫人员4.02%,多于嫖娼人员的0.68%,同时患4种性病的0.22%,多于嫖娼人员的0人。结论卖淫嫖娼人员性病感染率较高,尤其UU感染和梅毒,是艾滋病性病的重要传染源。加强对卖淫嫖娼人员的主动监测和规范治疗,提倡安全性行为,是预防与控制艾滋病性病的有效措施。     

1867例收教所收容人员性病感染情况调查分析

目的:了解深圳市收教所收容的卖淫嫖娼人员的性病感染情况。方法:对2005年深圳市某收教所中因卖淫嫖娼收容的1867名学员进行体检以及性病实验室检测,并收集相关资料作流行病学分析。结果:1867名收容学员中,共检出315例感染性病,检出率为16.9%。检出梅毒病例数最多,占42.5%;HIV感染者1例,为女学员;女学员性病检出率依旧高于男学员。结论:加强对卖淫嫖娼收容人员的性病流行病学监测是预防和控制性病流行的有效措施之一。     

天津市性病门诊男性就诊者性病感染状况分析

目的:了解天津市性病门诊男性就诊者性病感染流行趋势和高危行为发生情况,为制定防治策略提供依据。方法:依照《全国AIDS哨点监测方案》,对性病门诊就诊者进行问卷调查,同时采集静脉血进行HIV、梅毒血清学检测。结果:2010至2014年共调查性病门诊男性就诊者4001人,最近3个月与暗娼、临时性伴、同性发生性行为比例分别为48.0%(1921/4001)、37.6%(1505/4001)、10.5%(422/4001),而既与女性发生过性行为又与男性发生过性行为者占7.4%(297/4001)。最近1年内性病患病率为10.32%(413/4001)。HIV、梅毒抗体阳性率分别为1.55%(62/4001)、19.90%(796/4001)。结论:天津市性病门诊男性就诊者性病感染率较高,存在快速传播的危险因素,应加强监测并对性病门诊就诊者开展健康教育和行为干预。     

不同服务场所女性性工作者心理状况及影响因素分析

目的:探讨英德市不同服务场所女性性工作者(FSWs)心理状况现状及其影响因素。方法:采用问卷调查和实验室检测的方法,在英德市不同服务场所选取女性性工作者进行研究。结果:共纳入232名研究对象,平均年龄为(30.97±8.13)岁,其中高档场所者占33.6%,中档场所占48.7%,低档场所占17.7%;HIV感染率为0.9%,梅毒感染率为6.5%;高档FSWs心理健康阳性者占58.97%,高于低中档FSWs心理健康阳性者,不同场所间差异有统计学意义(x~2=21.16,P0.01);FSWs的文化程度、年龄和是否接受健康服务都会对心理健康产生影响(P值均0.05)。结论:应在FSWs人群中普及性病艾滋病健康服务,尤其需加强对低年龄者和高等场所工作者的重点心理干预。     

依托性病门诊开展男男性行为人群梅毒感染调查

目的:依托性病门诊在佛山地区开展男男同性性行为人群(men who have sex with men,MSM)梅毒感染状况的调查,为预防与控制梅毒的流行、向MSM提供相应的高危行为干预及高质量的公共卫生服务提供科学依据.方法:2010年7月~2011年12月,通过性病门诊共对161名MSM进行血清学检测和问卷调查.应用酶联免疫吸附方法检测血清中特异性梅毒螺旋体抗体和对HIV抗体初筛,用甲苯胺红不加热血清试验检测非特异性梅毒螺旋体抗体.用2 检验进行单因素分析;运用二分类logistic回归模型分析梅毒感染的相关因素.结果:调查对象的梅毒感染率为12.4%(20/161),与梅毒感染相关的高危因素有不与家人同住(OR=4.35)、性伴多于3人(OR=12.58)、最近一次性行为没有使用安全套(OR=5.19)以及HIV感染(OR=16.84)等原因.结论:多性伴、既往HIV感染、发生性行为时不使用安全套等是梅毒感染的高危因素,应在性病防治工作中开展有效干预,遏制梅毒传播.     

广东省江门市1286例女性性工作者性传播疾病调查分析

目的:调查广东省江门市女性性工作者人群中4种性传播疾病的发病情况,为本市制定预防控制对策提供一定的科学依据.方法:2009年7月至2011年3月,开展酒店、桑拿、发廊、站桩点等场所的外展活动,使用中国性病控制中心编制的国家科技重大专项课题FSW基线调查问卷对FSWs进行问卷调查,并同时做血清学梅毒、艾滋病检测及宫颈分泌物淋病、生殖道沙眼衣原体检测.结果:1 286例FSWs中4种性病总阳性231例,阳性率17.96%;特异性梅毒血清学(ELISA法)阳性率9.25%;非特异性梅毒血清学(TRUST)阳性率5.52%;艾滋病血清学(ELISA法)初筛阳性5例,WB法确证阳性4例,阳性率0.31%;淋球菌阳性率1.94%;生殖道沙眼衣原体阳性率6.45%.结论:近年来,FSWs已成为江门市的性病高危人群,应定期对其监测并积极进行干预、治疗.     

Syphilis among female sex workers in southwestern China: potential for HIV transmission

OBJECTIVE: The objective of this study was to investigate the prevalence and risk factors of syphilis infection among female sex workers in a southwestern Chinese city along a drug trafficking route. METHODS: From December 2004 to January 2005, 343 female sex workers (FSWs) were recruited through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual and other sexually transmitted diseases/HIV risk behaviors. Cervical and blood samples were collected to test for syphilis and HIV antibodies and Neisseria gonorrhoeae infection; Condyloma acuminatum infection was diagnosed clinically. RESULTS: Of 343 FSWs, 15.7% were infected with syphilis. The prevalence of HIV, gonorrhea, and C. acuminatum was 0.6%, 2.0%, and 1.5%, respectively. The subtype of 2 HIV-1 infections was both CRF 07BC. Nearly 10% of FSWs reported using illicit drugs. Consistent use, inconsistent use, and never use of condoms with commercial sex clients in the last month were reported by 53.9%, 38.5%, and 7.6% FSWs, respectively. Longer duration of sex work (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.08-3.62), working at low-end establishments (OR = 2.03; 95% CI = 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR = 2.06; 95% CI = 1.08-3.91) were independently associated with syphilis infection. CONCLUSIONS: High prevalence of syphilis and overlapped unprotected commercial sex and drug using behaviors among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injection drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/sexually transmitted disease spread.     

HIV and STIs in clients and female sex workers in mining regions of Gejiu City, China

OBJECTIVE: To investigate HIV/sexually transmitted infections (STIs) among female sex workers (FSWs) and clients in a mining region of China. GOAL: To estimate HIV/STI prevalence and to identify HIV risk factors among FSWs and miner clients. STUDY DESIGN: A cross-sectional study of 96 FSWs and 339 miner clients. RESULTS: In FSWs, prevalence of HIV was 8.3%, herpes simplex virus-2 70.8%, syphilis 12.5%, Neisseria gonorrhoeae 36.8%, Chlamydia trachomatis 46.3%, Trichomonas vaginalis 22.1%, and 90.6% were infected with any STI. Illegal drug use was associated with HIV [adjusted odds ratio (OR) = 45.1, 95% confidence interval, 6.4-317.9] in FSWs, and 45.8% reported no condom use with the last client. In miner clients, HIV prevalence was 1.8%, herpes simplex virus-2 14.9%, syphilis 2.4%, N. gonorrhoeae 2.1%, C. trachomatis 6.5%, and 23.2% were infected with any STI. Never using condoms with FSWs and regular partners were reported in 61.2% and 84.1%, respectively. Independent risk factors for HIV in miner clients were illegal drug use (OR 190.2), symptoms of urethral discharge or frequent urination (OR 32.9), early sexual debut (OR 7.1), and visiting 4 or more FSWs in the last 12 months (OR 11.5). CONCLUSIONS: HIV/STI prevalence is high among FSWs and moderate among clients in mining regions of Gejiu City. Drug use is the most important factor placing FSWs and miner clients at risk for HIV in Gejiu City; risky sexual characteristics such as early sexual debut, frequent visits to FSWs, and STI symptoms are also important factors for miner clients. FSWs and miner clients may constitute bridging groups for HIV to low-risk populations.     

Human immunodeficiency virus and other sexually transmitted infections among female sex workers in two major cities in Papua New Guinea

BACKGROUND: Treatable sexually transmitted infections are very common in developing countries and quite often are inadequately treated or remain untreated despite the fact that they enhance the transmission of human immunodeficiency virus (HIV). GOAL: To estimate the prevalence of HIV, syphilis, chlamydial infection, gonorrhea, and trichomoniasis among female sex workers in Port Moresby and Lae, Papua New Guinea, and to collect data on associated behaviors. STUDY DESIGN: Self-identified female sex workers recruited through our peer-mediated sexually transmitted disease (STD)/HIV risk-reduction community outreach program were invited to participate in the study. Participants underwent pretest counseling, were interviewed, and were asked to self-collect vaginal swab specimens for the detection of STDs and to provide 10 mL of blood for HIV and syphilis testing. RESULTS: A total of 407 female sex workers, 207 in Port Moresby and 200 in Lae, were enrolled in the study. The overall prevalence rates of HIV, syphilis, genital chlamydial infection, gonorrhea, and trichomoniasis among these women were estimated to be 10%, 32%, 31%, 36%, and 33%, respectively. The sex workers in Port Moresby had a significantly higher HIV infection rate (17%) than those in Lae (3%) and a significantly lower trichomoniasis rate (21%) than those in Lae (44%). Mixed infections were common, occurring in 45% of the cases. Despite a high rate of symptoms, the rate of treatment-seeking was low. Condom use among the sex workers was very inconsistent; 85% reported that they did not use condoms at all times when having sex with their clients. Common reasons cited were dislike by clients, unavailability, alcohol use, and familiarity with a client. CONCLUSIONS: STDs are very common among female sex workers in Port Moresby and Lae and very often present as multiple infections. Despite STD/HIV awareness campaigns, unsafe sex-particularly irregular use of condoms-continues among sex workers and their clients. Barriers to safer sexual behavior need to be addressed, as do improvements in provision of STD services.     

Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru

BACKGROUND AND OBJECTIVES: A survey was conducted to determine the sexual behavior practices and prevalence of HIV-1, HTLV-I/II, and T. pallidum infections among unlicensed female sex workers (FSWs) in Lima, Peru. GOAL OF THIS STUDY: To assess the role of unlicensed FSWs as a potential source of retroviral and T. pallidum infection. STUDY DESIGN: Female sex workers from 15 brothels were enrolled. Sera samples were obtained and tested for antibodies to HIV-1, HTLV-I, and Treponema pallidum. RESULTS: Of 158 FSWs studied, all were negative for HIV-1, 6 were positive for HTLV-I, and 5 were positive for Treponema pallidum. Of their male clients, 75% used condoms, whereas only 3% reported condom use with their steady partners. When condoms were always used by clients, the history of a sexually transmitted disease was significantly reduced (p < 0.01), and the prevalence of HTLV-I (p < 0.05) and syphilis was lower among these workers. CONCLUSION: Data suggested that the low rate of sexually transmitted diseases among FSWs reflected the high rate of condom use by their male clients.     

2007～2011年珠海市性病流行情况分析

目的：了解2007～2011年珠海市性病的发病趋势和流行特点,为开展性病防治工作提供科学依据。方法：通过国家疾病预防控制信息系统,收集并分析珠海市19个性病哨点医院2007～2011年全年上报的病例信息。结果：2007～2011年珠海市累计上报性病病例15 186例,年均发病率为203.55/10万,发病率呈逐年上升趋势;病种构成上,衣原体感染报告数最多,占28.32%,其次为梅毒,梅毒与衣原体感染率每年增幅最大;性别分布上,男女比例1.45∶1,但有逐年缩小趋势;年龄分布上,20～34年龄段人群居多,占58.92%;职业分布上,工人、商业服务和家务待业者居多;香洲区为性病高发地区。结论：2007～2011年间,珠海市性病数逐年上升,尤其梅毒上升速度显著,应积极开展更有针对性的防治工作,控制以梅毒为主的各种性病的流行。     

Risk factors and prevalence of HIV and sexually transmitted infections among low-income female commercial sex workers in Mongolia

BACKGROUND: Mongolia has very low HIV prevalence despite high rates of sexually transmitted infections (STIs). Low-income female sex workers (FSWs) may be at high risk for acquiring and spreading the disease in Mongolia. GOAL: The goal of this study was to assess the prevalence and risk factors associated with the acquisition of HIV, syphilis, gonorrhea, and trichomoniasis among low-income female commercial sex workers in 3 urban centers in Mongolia. STUDY DESIGN: One hundred seventy-nine low-income FSWs were tested for HIV (enzyme immunoassay) and 132 were tested for syphilis (Treponema pallidum hemagglutination-confirmed), gonorrhea (Gram stain and culture), and trichomoniasis (wet mount microscopy). Questionnaires detailing socioeconomic characteristics, sexual behaviors, drug and alcohol use, general health, and STI/HIV knowledge were completed by 149 women. RESULTS: No HIV infections were found in 179 women. Of 132 women, 57 (43%), 18 (14%), and 37 (28%) tested positive for syphilis, gonorrhea, and trichomonas, respectively; 88 (67%) tested positive for one or more STIs and 22 (17%) were multiply infected. Socioeconomic factors were correlated to reported condom use and infection status. CONCLUSIONS: Low-income FSWs in Mongolia represent a unique population of very high-risk individuals with very low rates of HIV infection. Interventions targeting this population represent a unique opportunity to prevent a potentially rapid increase of HIV infection in urban Mongolia.     

暗娼高危人群干预效果研究

目的：降低暗娼人员艾滋病性病感染风险,推动性一艾预防控制工作可持续性发展,为遏制艾滋病的蔓延提供实践证据。方法：2010年1月至2011年10月对辖区内低层次暗娼进行为期一年半的综合干预,并评价其效果。结果：干预前共调查234例FSWs,发现梅毒感染者33例（感染率14．10％）;干预结束后调查FSWs220例,未发现HIV新感染者,梅毒感染者15例（感染率6．81％）,梅毒感染率与干预前相比差异有统计学意义（X2=8．543,P〈0．05）;干预前FSWs对艾滋病预防知识8条知晓率为72．3％,干预后知晓率为89．7％,与干预前相比有明显提高（P〈0．01）;干预前接受过疾控中心或社区提供安全套的比例为45．3％,干预后为87．2％,与干预前相比有明显提高（P〈0．01）;干预后每次与客人发生性行为时安全套的使用比例与干预前相比差异有统计学意义（P〈0．01）;出现生殖系统相关疾病到正规医院就诊的比例由20．5％提高到45．4％,干预后与干预前相比差异有统计学意义（P〈0．01）。结论：在FSWs中开展综合干预措施,能提高艾滋病预防知识的知晓率和安全套使用率,降低性病艾滋病感染风险。     

HIV and other sexually transmitted infections among female sex workers in Kinshasa, Democratic Republic of Congo, in 2002

OBJECTIVE: The objective of this study was to determine the prevalence and risk factors of HIV and other sexually transmitted infections (STIs) among female sex workers (FSWs) in Kinshasa, Democratic Republic of the Congo, in 2002. STUDY DESIGN: A cross-sectional study was conducted among FSWs presenting for the first time at the STI clinic of Matonge, Kinshasa. The women were interviewed about sociodemographic characteristics, type of sex work, and sexual behavior. Blood was taken for HIV, syphilis, and herpes simplex virus type 2 serology. Vaginal secretions were collected on swabs for the diagnosis of gonorrhea, chlamydia, and trichomoniasis. RESULTS: The overall HIV prevalence was 12.4% but varied within the different categories of FSWs: 11.8% in hotel-based, 24.0% in home-based, and 20.0% in street-based FSWs; 10.0% in homeless FSWs; and 6.6% in Masquées (clandestine sex workers). The overall herpes simplex virus type 2 seroprevalence was 58.5%. CONCLUSIONS: The prevalence of HIV and other STIs seems to have stabilized since the beginning of the project in 1988.