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。

High risk behaviors and syphilis/HIV prevalence among female sex workers in different settings and effectiveness evalua-tion of interfering

Objective To investigate the prevalence and risk behaviors of syphilis/human immunodeficiency virus （HIV） among female sex workers （FSW） in different settings and effectiveness evaluation of interfering, to provide evidence for future intervention. Methods Under the principles of informed consent and confidentiality, relevant da- ta were collected among the FSWs from barber shops, massaging room, rental houses, small private hotels and streets in Qionghai and Sanya cities, blood samples were taken to test HIV/syphilis antibodies. Then a comprehen- sive intervention including free medication, condoms distribution was conducted in the following two years. Results Totally 699 FSWs were investigated in the baseline survey, of whom 297 （42.49%） were from low level settings, 44 （6.29%） were from middle-low settings, 358 （51.22%） were from middle settings; the average age was older, education level was lower, condom use rate was lower and sexually transmitted diseases （STD） like syphilis preva- lence was higher with the setting levels going down. In the post- intervention evaluation, 628 FSWs were ap- proached including 236 （37.58 % ） from low-level settings, 62 （9.87 % ） from middle-low settings, 330 （52.55%） from middle level settings. Condom use rate increased significantly, syphilis and other STDs generally decreased, espe- cially among those from low level settings. Conclusion The risk of infecting HIV/STD is going higher when the level of FSW is getting lower, the risk of AIDS transmission is higher among FSWs. The intervention effect is more obvious in FSW from low level settings than that of middle level settings. FSW from low and middle-low levels should be the key population in the intervention preventing AIDS transmitted via sex contact.