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。     

Risk factors for HIV infection among sex workers in Johannesburg, South Africa

Our objective was to determine the prevalence and risk factors for HIV infection among female sex workers in Johannesburg, South Africa. A cross-sectional survey of female sex workers was conducted using interviewer-administered questionnaires. Prevalent sexually transmitted infections including HIV were evaluated through standard laboratory testing. HIV infection was identified in 137 (46.4%) of 295 subjects tested. Increasing frequency of condom use was significantly negatively associated with HIV infection (odds ratio [OR] for moderate use = 0.21; 95% confidence interval [CI]: [0.09, 0.50]; OR for high use = 0.14; 95% CI: [0.06, 0.34]). Sex workers aged > or = 29 years reported significantly different patterns of behaviour than younger workers. Among women aged > or = 29, a negative association with HIV infection (OR = 0.16; 95% CI: [0.07, 0.38]) was found, but only among those not infected with Neisseria gonorrhoeae. Older women in the Johannesburg sex industry may have adaptive behavioural strategies besides condom usage which reduce their risk of acquiring HIV. However, older sex workers with gonorrhoea constitute a high-risk subgroup.     

High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City,Vietnam

In Vietnam’s concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a ‘bridge’ of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam’s largest cities, in 2013–2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0–27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2–47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across ‘bridging’ categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87–7.56), current opioid use (OR 2.55; 95% CI 1.02–6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46–19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These results indicate high HIV prevalence among male clients of FSWs, particularly among those with a history of drug use. Programs to expand HIV testing, drug-use harm reduction, and HIV treatment for HIV-infected male clients of FSWs should be considered as key interventions for controlling the HIV epidemic in Vietnam.     

A systematic review of income generation interventions,including microfinance and vocational skills training,for HIV prevention

Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. The authors conducted a systematic review by searching electronic databases from 1990 to 2012, examining secondary references, and hand-searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care, or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of the 5218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with six conducted in sub-Saharan Africa, three in South or Southeast Asia, and three in Latin America and the Caribbean. Target populations included adult women (N = 6), female sex workers/bar workers (N = 3), and youth/orphans (N = 3). All studies targeted females except two among youth/orphans. Study rigor was moderate, with two group-randomized trials and two individual-randomized trials. All interventions except three included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners, or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23–0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these interventions may have important effects on outcomes beyond HIV prevention. Further studies examining not only HIV-related outcomes but also causal pathways and intermediate variables, are needed. Additional studies among men are also needed.     

Factors associated with sex work among at-risk female youth in Cambodia: a cross-sectional study

In Cambodia, despite great achievements in reducing the prevalence of HIV in the general population, reducing new HIV infections among young at-risk women remains a challenge. This study was designed to examine the prevalence of risky behaviors of sexually active female youth in Cambodia and to explore risk factors associated with engagement in transactional sex. We surveyed sexually active female youth aged 10–24 enrolled at risk “hotspots” in eight provinces in Cambodia. We collected data on demographic factors, sexual behavior, and factors hypothesized to be associated with transactional sex. Multivariable logistic regression was used to identify associations between demographic and sexual behavior and transactional sex. Of the 280 respondents, the mean age was 21.2, and 48.1% had been paid for sex in the past year. After adjustment, at-risk females who were never have been married (adjusted odds ratio (AOR) 3.40, 95% confidence interval (CI)?=?1.65–6.97), have completed less than 6 years of school (AOR 3.26, 95% CI?=?1.60–6.66), have 1 or more parents who had died (AOR 4.34, 95% CI?=?2.00–9.38), be a heavy alcohol drinker (AOR 3.58, 95% CI?=?1.78–7.18), have used a condom with their boyfriend during last sexual encounter (AOR 3.50, 95% CI?=?1.68–7.32), and have ever had an HIV test (AOR 3.51, 95% CI?=?1.68–7.32) were more likely to engage in sex work. Our findings suggest that prevention strategies for female youth at risk of engagement in sex work should include upstream structural interventions that aim to encourage girls' education and empowerment. In addition, tailored sex education and behavior change messaging about the risks of heavy drinking, condom use with romantic partners, and the importance of frequent HIV testing for at-risk youth and sex workers should be designed and delivered to youth currently engaging in sex work.     

HIV/AIDS Behavioral Interventions in China: A Literature Review and Recommendation for Future Research

In the past two decades, China has witnessed an alarming increase of HIV/AIDS epidemic. Meanwhile, a number of HIV prevention interventions have been conducted. This study reviews existing studies in literature on behavioral interventions on HIV/AIDS in China. Of 25 studies we identified, most have been concentrated in South and South–West China, mainly targeting injection drug users and female sex workers. The most commonly used intervention strategy was individual-oriented HIV-related knowledge education and behavioral skill training. All studies reported positive intervention effects including improved HIV-related knowledge, increased condom use, reduced needle sharing, and reduced STI. Literature also suggests a lack of intervention among other at-risk populations such as MSM, migrant workers, and non-injecting drug users, lack of studies with rigorous evaluation design, inadequate follow-up, limited outcome measurement, and lack of multi-faceted structural interventions. The existing intervention studies document strong evidence of controlling HIV/AIDS epidemic through effective behavioral intervention. More efforts are needed to control the growing HIV/AIDS epidemic in China. Future studies need to employ more rigorous methodology and incorporate environmental or structural factors for different populations at risk of HIV infection in China.     

Short report: HIV infection among commercial sex workers and injecting drug users in the Czech Republic

Since the first HIV case was diagnosed in the Czech Republic in 1985, there is a lack of information regarding the epidemiology of HIV infection in most high-risk groups. To determine the prevalence of, and risk factors for, HIV among female and male commercial sex workers (FCSW and MCSW, respectively) and injecting drug users (IDUs), cross-sectional studies were conducted in the cities of Cheb, Usti nad Labem, Ostrava, and Prague of the Czech Republic. A total of 1,277 subjects were enrolled, which included 585 FCSWs, 230 MCSWs, and 462 IDUs. The HIV prevalences were 0.7% (95% CI: 0.2-1.7%), 0.9% (95% CI: 0.1-3.1%), and 0.2% (95% CI: 0.005-1.2%) among FCSWs, MCSWs, and IDUs, respectively. Although low HIV prevalences were found, ongoing sentinel surveillance studies, which address modifiable behavioral and biologic risk factors among high-risk groups, are necessary to guide strategies to stem the tide of the epidemic in this country.     

Prevalence and correlates of HIV unsafe sex and STIs among women working in China's entertainment industry

Female entertainment workers in China are at risk of sexually acquiring HIV, but risk factors of their unsafe sex remain understudied. Using information from a venue-based sample of 724 female entertainment workers in Shanghai, this paper examines the prevalence and risk factors of unsafe sex and STIs. While both measures of unsafe sex and history of common STIs suggest that participants in this study appear to have lower rates of unsafe sex and STIs than reported in the literature, venue-based female entertainment workers are at risk of sexually acquiring HIV. Risk factors of unsafe sex include both individual cognitive (information, motivation, and behavioral skills) and social factors. However, HIV-related information and most social factors are not directly and independently associated with unsafe sex. Behavioral intervention is needed for female entertainment workers in China. However, individual-based cognitive approach alone may be limited in effectiveness in reducing unsafe sex among female entertainment workers. Effective intervention needs to take a multi-level approach that addresses both individual cognitive and social risk factors and can particularly benefit from attention to empowering women in sexual relationships and creating a supportive social and working environment.     

Epidemiology of sexually transmitted infections, HIV, and related high-risk behaviors among female sex workers in Guangxi Autonomous Region, China

This study assessed the epidemiology of sexually transmitted infections (STIs), HIV, and associated risk factors among female sex workers (FSWs) in Guangxi autonomous region, China. A cross-sectional study of 488 FSWs was conducted using a structured questionnaire to collect sociodemographic and behavioral information. Biological specimens from subjects were sampled to detect various STIs and HIV infection. Among FSWs, the prevalence rates of syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, genital herpes, condyloma acuminate, and HIV were 7.2%, 1.8%, 18.2%, 0.4%, 2.3%, and 0.8%, respectively. The prevalence rates of single, double, and triple infections were 22.3%, 3.9%, and 0.20%, respectively. Multivariate analysis indicated that STIs and HIV infection was independently related to low education level (OR = 7.244; 95% CI = 3.031-17.213; P < 0.001), low knowledge of STIs/HIV (OR = 0.191; 95% CI = 0.108-0.337; P < 0.001), low-grade working place (OR = 1.64; 95%CI = 1.016-2.648; P = 0.046), and no condom use during the last sexual intercourse (OR = 0.199; 95% CI = 0.113-0.350; P < 0.001). The prevalence of STIs is high among FSWs in Guangxi, is accompanied by a 0.8% HIV-positive rate, and may be largely related to high-risk sexual behaviors. Future interventions should be focused on the reduction of risk factors, including promotion of condom use and improvement of knowledge of STIs and HIV among FSWs.     

Factors associated with HIV-1 infection among sex workers of Addis Ababa, Ethiopia

OBJECTIVE: To study the prevalence and risk factors for HIV infection among sex workers of Addis Ababa, Ethiopia. Design and methods: Cross-sectional survey on socio-demographic characteristics, behaviours, and HIV serological status of sex workers attending two health centres of Addis Ababa. RESULTS: HIV prevalence among sex workers was 274 of 372 (73.7%). Several factors were significantly associated with an increased risk of being HIV-infected [among others, working in 'shared rooms', high number of clients, use of injectable hormones, and positive Treponema pallidum particle agglutination (TPPA) serology], and others with a decreased risk (being born in Addis Ababa, high level of education, peer education on sex work, condom use, use of oral pill, and use of condoms for contraception). Of interest, sex workers who were using condoms for contraception were, compared with others, more likely to use condoms consistently (65 versus 24%, respectively; P < 0.001), and less likely to be HIV-infected (55 versus 86%, respectively; P < 0.001). In multivariate analysis [log-binomial model, giving estimates of the prevalence ratio (PR)], being born in Addis Ababa (PR = 0.74; 95% confidence interval (CI), 0.61-0.91), using condoms for contraception (PR = 0.73; 95% CI, 0.64-0.85), and a positive TPPA serology (PR = 1.21; 95% CI, 1.09-1.36), remained significantly associated with HIV infection. CONCLUSIONS: HIV prevalence was remarkably high among sex workers of Addis Ababa. Condom use was higher, and HIV prevalence lower, in sex workers using condoms not only for prevention of HIV and sexually transmitted diseases, but also for contraceptive purpose. This finding is of particular interest for its implications for prevention strategies among sex workers in the developing world.     

HIV-related behavioral risk factors among older female sex workers in Guangxi,China

Previous literature suggests a high rate of HIV infections among older female sex workers (FSWs) in China. However, limited data are available regarding HIV- related behavioral risk factors among this population. In the current study, we aim to examine the demographic and behavioral factors that place older FSWs at a high risk of HIV infection. We conducted secondary analysis of the 2010 National Sentinel Surveillance (NSS) data from Guangxi, China. A self-administered, standard behavioral surveillance survey was completed by a total of 12,622 FSWs in Guangxi, China. The Guangxi 2010 NSS sample included 19.4% FSWs aged 35 years or older (“older FSWs”). The overall HIV prevalence was 1.0% for the entire sample with 2.0% among older FSWs and 0.8% among younger ones. Older age was an independent predictor of unprotected sex, injection drug use, and a self-reported history of syphilis infection. Future HIV prevention interventions targeting FSWs should consider older FSWs' vulnerable status. Efforts are needed to address their financial needs and invest in skills for socio-economic empowerment.     

Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital,Nairobi

Mothers with HIV are at high risk of a range of psychosocial issues that may impact HIV disease progression for themselves and their children. Stigma has also become a substantial barrier to accessing HIV/AIDS care and prevention services. The study objective was to determine the prevalence and severity of postpartum depression (PPD) among women living with HIV and to further understand the impact of stigma and other psychosocial factors in 123 women living with HIV attending prevention of mother-to-child transmission (PMTCT) clinic at Kenyatta National Hospital located in Nairobi, Kenya. We used the Edinburgh Postnatal Depression Scale and HIV/AIDS Stigma Instrument – PLWHA (HASI – P). Forty-eight percent (N?=?59) of women screened positive for elevated depressive symptoms. Eleven (9%) of the participants reported high levels of stigma. Multivariate analyses showed that lower education (OR?=?0.14, 95% CI [0.04–0.46], p?=?.001) and lack of family support (OR?=?2.49, 95% CI [1.14–5.42], p?=?.02) were associated with the presence of elevated depressive symptoms. The presence of stigma implied more than ninefold risk of development of PPD (OR?=?9.44, 95% CI [1.132–78.79], p?=?.04). Stigma was positively correlated with an increase in PPD. PMTCT is an ideal context to reach out to women to address mental health problems especially depression screening and offering psychosocial treatments bolstering quality of life of the mother–baby dyad.     

AIDS Prevention Research in Low and Middle-Income Countries: Generating the Evidence upon Which Local Decisions are Made

Transgender populations in the United States have been impacted by the HIV/AIDS epidemic. This systematic review estimates the prevalence of HIV infection and risk behaviors of transgender persons. Comprehensive searches of the US-based HIV behavioral prevention literature identified 29 studies focusing on male-to-female (MTF) transgender women; five of these studies also reported data on female-to-male (FTM) transgender men. Using meta-analytic approaches, prevalence rates were estimated by synthesizing weighted means. Meta-analytic findings indicated that 27.7% (95% confidence interval [CI], 24.8–30.6%) of MTFs tested positive for HIV infection (four studies), while 11.8% (95% CI, 10.5–13.2%) of MTFs self-reported being HIV-seropositive (18 studies). Higher HIV infection rates were found among African-American MTFs regardless of assessment method (56.3% test result; 30.8% self-report). Large percentages of MTFs (range, 27–48%) reported engaging in risky behaviors (e.g., unprotected receptive anal intercourse, multiple casual partners, sex work). Prevalence rates of HIV and risk behaviors were low among FTMs. Contextual factors potentially related to increased HIV risk include mental health concerns, physical abuse, social isolation, economic marginalization, and unmet transgender-specific healthcare needs. Additional research is needed to explain the causes of HIV risk behavior of transgender persons. These findings should be considered when developing and adapting prevention interventions for transgender populations.     

Migration/mobility and risk factors for HIV among female sex workers in Andhra Pradesh, India: implications for HIV prevention

We examined the relation between high mobility/migration (sex work in three or more villages/towns within the past year) and HIV risk factors among a sample of female sex workers (FSWs) in Andhra Pradesh, India. We recruited FSWs aged ≥18 years (n = 673) through respondent-driven sampling for a survey on HIV risk. Adjusted logistic and linear regression models assessed high mobility in relation to sexual and physical victimization, sexually transmitted infection (STI) symptoms and treatment, condom use and negotiation, number and/or types of sex trades, number of clients and number of days worked. Twelve percent (n = 82) of FSWs were highly mobile; those with high mobility were more likely to report recent HIV risk factors: sexual violence (adjusted odds ratio [AOR] = 5.2; 95% confidence interval [CI]: 3.0-8.9), physical violence (AOR = 1.7; 95% CI: 1.1-2.7), unprotected sex for more money (AOR = 1.7; 95% CI: 1.1-3.0), at least one STI symptom (AOR = 1.9; 95% CI: 1.1-3.1), a greater number of vaginal sex trades (β = 3.9, P = 0.003), a greater number of clients (β = 2.5, P = 0.02) and anal sex with clients (AOR = 2.4; 95% CI: 1.4-4.1). Findings from this study underscore the violence and HIV-related vulnerability faced by mobile/migrant FSWs and highlight the need to inform and tailor related prevention strategies.     

Latent class analysis of a syndemic of risk factors on HIV testing among black men

Syndemic methodology has been employed in several studies of HIV-related outcomes affecting Black men who have sex with men (BMSM) and rarely in Black heterosexual men. In contrast to the most common method for assessing syndemics, the use of a syndemic component index, latent class analysis can identify unique combinations of risk factors that may form a syndemic. Analyzing a primarily heterosexual sample of 1,786 Black men from the 2015 Behavioral Risk Factor Surveillance System (BRFSS), we used a 4 latent class model based on depression diagnosis, poverty, and healthcare access to predict ever having been HIV tested. Class 1 was characterized by low proportions of all the risk factors. Class 2 had relatively high healthcare barriers, being the most likely to not have a personal doctor (.8175) and the most likely to have no routine checkup in the past year (.6327) but had relatively low depression diagnosis and poverty. Class 3 had relatively high poverty (.8853), but generally low barriers to healthcare access. Class 4 was characterized by high proportions of all the risk factors. Using log-binomial regression models, there was a significantly lower prevalence of ever having been HIV tested among class 3 (PR?=?0.69, 95% CI 0.49, 0.98) and class 4 (PR?=?0.49, 95% CI 0.28, 0.84) compared to class 1. When adjusting for education, age, and marital status, the associations were attenuated but still significant for class 3 (aPR?=?0.71, 95% CI 0.52, 0.96) and class 4 (aPR?=?0.60, 95% CI 0.46, 0.78). Latent class analysis may better serve syndemic research aims in understanding HIV-related outcomes among high-risk populations. Future research using this method to evaluate HIV testing outcomes among BMSM is recommended.     

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.     

河南省2006年高危险人群艾滋病哨点监测分析

目的了解河南省各类高危人群中艾滋病流行状况及相关行为信息。方法按照《国家级HIV哨点监测方案》和《河南省哨点监测实施方案》要求,分别对暗娼、性病门诊就诊者、吸毒者、男性同性恋者4类高危险人群进行问卷调查和艾滋病病毒(HIV)抗体检测。结果2006年共监测4类人群12 219人,检出HIV抗体阳性24人。13.33%的暗娼哨点、40%的性病门诊就诊者哨点和50%的吸毒者哨点检出HIV抗体阳性者,各哨点阳性率均低于1%,三类哨点阳性率的中位数分别是0.0%、0.0%和0.11%。男性同性恋哨点HIV抗体阳性率为2.67%。暗娼中报告每次使用安全套比例的中位数是24.89%,男性同性恋肛交时每次都用安全套的比例是27.89%。结论HIV在河南省高危人群中呈低流行,但存在HIV传播的多种危险因素,应加强高危险人群的健康教育和行为干预。     

低档暗娼人口社会行为学特征与HIV感染状态

目的了解低档暗娼艾滋病病毒（HIV）感染现状,分析相关危险因素。方法按照广西低档暗娼人群专项调查工作方案要求进行问卷、采血、检测。资料经Epidata 3.1进行双录入,用SPSS 19.0进行统计分析。结果共调查低档暗娼7 936人,HIV感染率为1.88%（149例）。其中〉40岁年龄段者HIV感染率为4.63%,文盲者HIV感染率4.54%,离异/丧偶者HIV感染率4.91%,有吸毒行为者HIV感染率达6.42%,流动性暗娼（没有固定场所）的HIV感染率为4.02%。从未使用安全套者,HIV感染率明显高于每次使用者（P〈0.05）;艾滋病知识知晓率低分组,HIV感染也明显高于艾滋病知识知晓率高分组（P〈0.01）。经多因素Logistic回归分析,影响低档暗娼HIV感染率的主要危险因素有：无固定场所、有吸毒行为、〉40岁、越南籍。结论广西低档暗娼HIV感染率较高,不同人口社会学和行为特征的暗娼HIV感染率不同,需对影响感染及传播的因素实施有效的干预措施,加大健康教育、监测与干预力度,做到早干预、早发现、早治疗,有效减少艾滋病在这类人群中和向其他人群的传播。     

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。     

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。