中越边境地区暗娼人群HIV感染及性行为特征对比分析

目的  了解中越边境地区中国籍与越南籍暗娼人群(female sex workers, FSWs)的人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染现状，分析两组人群HIV感染相关因素以及性行为特征。 方法  2015-2016年期间在云南省河口县开展横断面调查，方便抽样纳入中国籍与越南籍FSWs。问卷收集调查对象的社会人口学特征、HIV相关知识态度、性行为等信息；采集血液样本进行HIV、单纯疱疹病毒2型(herpes simplex virus type 2, HSV-2)以及梅毒感染检测；多因素Logistic回归分析模型筛选HIV感染相关因素。 结果  合计纳入1 263名FSWs，中国籍调查对象227人，HIV感染率为0.44%；越南籍调查对象1 036人，HIV感染率为2.12%。越南籍FSWs最近1月商业性性伴数量以及性服务费用均高于中国籍FSWs(均有P＜0.001)。经多因素Logistic回归分析模型分析，HSV-2感染(OR=3.83, 95% CI: 1.37~10.76; P=0.032)、HIV知识知晓不合格(OR=10.40, 95% CI: 3.77~28.66; P=0.001)，以及接受HIV相关干预服务(OR=0.27, 95% CI: 0.08~0.84; P=0.022)是越南籍FSWsHIV感染的相关因素。 结论  中国籍与越南籍FSWs感染HIV的风险模式可能存在差异，后续HIV干预工作应针对越南籍FSWs增加服务的覆盖与可及性；对于中国籍FSWs，建议加强与固定性伴安全套使用的行为干预。

Comparative analysis of HIV prevalence and sexual behaviors between Chinese and Vietnamese female sex workers

  Objective  To assess the prevalence of human immunodeficiency virus (HIV) infection of Chinese and Vietnamese female sex workers (FSWs), and to examine the risk factors and patterns of sexual behaviors that associated with HIV between the two groups.  Methods  A cross-sectional survey was conducted between 2015 and 2016 in Hekou County, Yunnan Province, China. Convenience sampling method was used to recruit participates, and a questionnaire survey was conducted to collect information on demographics, sexual behavior, HIV related knowledge and attitude. Blood samples were collected for testing of HIV, herpes simplex virus type 2 (HSV-2) and syphilis. Multivariate Logistic regression model was used to examine factors correlated with HIV infection.  Results  Of 1 263 respondents who participated in the study, 227 were Chinese and 1 036 were Vietnamese. HIV prevalence in Chinese FSWs and Vietnamese FSWs were 0.44% and 2.12%, respectively. Vietnamese FSWs were more likely to have higher commercial sexual service charge and more commercial sexual partners compared with Chinese FSWs. HSV-2 positive (OR=3.83, 95% CI: 1.37-10.76, P=0.032), insufficient HIV related knowledge (OR=10.40, 95% CI: 3.77-28.66, P=0.001), and accepted HIV related interventions (OR=0.27, 95% CI: 0.08-0.84, P=0.022) were associated with HIV infection in the multivariate Logistic regression model.  Conclusions  There may be different risk patterns of HIV acquisition between Chinese and Vietnamese FSWs. Improving coverage and accessibility in future interventions of HIV prevention is in great need for Vietnamese FSWs. In addition, condom use with regular, no commercial sexual partners need to be strengthened targeting Chinese FSWs.