贵港市大龄女性性工作者梅毒感染情况及其影响因素

目的 探索贵港市大龄女性性工作者（OFSWs）梅毒感染情况及其影响因素，为该人群梅毒防控制定切实有效的措施和策略提供科学的理论依据。方法 2010-2016年按照《全国艾滋病哨点监测实施方案》的要求，在贵港市各女性性工作者（FSWs）哨点抽取调查对象，经过培训的调查人员使用《国家艾滋病哨点监测FSW调查问卷》对调查对象进行面对面匿名咨询调查，同时采血检测其梅毒等感染情况。结果 共调查贵港市2 851名OFSWs，以在婚/同居、外省户籍、汉族、小学文化程度以及低档场所来源为主，中位年龄41（四分位间距：38~45）岁。2 851名OFSWs中，梅毒、HIV和HCV抗体阳性率分别为17.33%、2.84%和1.89%；有5.02%在最近一年诊断过性病，88.46%在最近一次商业性性行为时使用了安全套，57.42%在最近一个月的商业性性行为中每次都使用安全套。接受过安全套宣传和发放/艾滋病咨询与检测和同伴教育干预服务的OFSWs分别为87.93%和34.86%。多因素分析发现，低档场所、壮族、文盲、年龄≥ 35岁、未接受过安全套宣传和发放/艾滋病咨询与检测干预服务、HIV和HCV抗体检测阳性为OFSWs感染梅毒的独立危险因素。结论 贵港市OFSWs梅毒感染情况严峻，低档场所、壮族、文盲、年龄≥ 35岁、未接受过安全套宣传和发放/艾滋病咨询与检测干预服务、HIV和HCV抗体检测阳性的OFSWs感染梅毒的风险较高。应加强该人群安全套宣传和发放等干预服务，提高该人群安全套的使用率，对梅毒、HIV和HCV等性传播疾病采取综合防控措施。

Syphilis infection and influencing factors among older female sex workers in Guigang City

Objective To explore syphilis infection and its influencing factors among older female sex workers (OFSWs) in Guigang City, provide scientific theoretical basis for making effective measures and strategies for prevention and control of syphilis among this population. Methods In 2010-2016, a sentinel sampling survey among female sex workers (FSWs) in Guigang City was performed according to the "National AIDS Sentinel Surveillance Program", a face-to-face anonymous survey on subjects was conducted by trained investigators using "Questionnaire of National AIDS Sentinel Surveillance on FSWs", and blood specimens were taken to detect syphilis and other infections. Results A total of 2 851 OFSWs in Guigang City were investigated, the main sources of OFSWs were marriage/cohabitation, household registration in other provinces, Han nationality, primary education, and low-grade locations, the median age was 41 years old (interquartile range:38-45). Among 2 851 OFSWs, the positive rates of syphilis, HIV, and HCV were 17.33%, 2.84%, and 1.89% respectively; 5.02% of OFSWs were diagnosed with sexually transmitted diseases (STDs) during the last year, 88.46% used condoms in the latest commercial sexual intercourse, and 57.42% used condoms every time during the latest month commercial sexual intercourse. 87.93% and 34.86% of OFSWs respectively received condom publicity and distribution/AIDS counseling and detection as well as peer education intervention services. Multivariate analysis showed that low grade locations, Zhuang nationality, illiteracy, age ≥ 35 years, without receiving condom publicity and distribution/AIDS counseling and detection intervention services, as well as positive for HIV and HCV antibody detection were independent risk factors for syphilis infection in OFSWs. Conclusion Infection status of syphilis among OFSWs in Guigang City is severe, low grade locations, Zhuang nationality, illiteracy, age ≥ 35 years, without receiving condom publicity and distribution/AIDS counseling and detection intervention services, positive for HIV and HCV antibody detection are high risks for syphilis infection in OFSWs. It is necessary to strengthen intervention services such as condom publicity and distribution, increase condom use among OFSWs, and adopt comprehensive prevention and control measures against sexually transmitted diseases such as syphilis, HIV and HCV.