Sexually Transmitted Infections Related Health Service Utilization And Its Determinants Among Hotel-based Female Sex Workers In Changsha, China

Objectives: To describe the utilization of sexually transmitted infections(STIs) related health services of the hotel-based female sex workers (FSWs) andto identify factors related to these health services utilization behaviors.Methods: Face-to-face interviews were carried out among 20 female sexworkers and 6 managers to develop the structured questionnaire. A two-stagecluster sampling was conducted for quantitative investigation.Sociodemographic characteristics, sexual behavior and STIs related healthservices utilization behavior of FSWs were collected by self-designedquestionnaire after informed consensus.Results: 164 out of 299 enrolled subjects in two hotels' night clubsparticipated in the study, giving a respondent rate of 54.8%. Of the sample,37.8% had STIs related screening in the previous year. The knowledge aboutSTIs and the resident identity were associated with the STIs related screening(P＜0.05). Multivariate unconditional logistic regression analysis indicated thatage of starting sex work (OR=1.8) and resident identity (OR=2.0) werestatistically significantly associated with the STIs related screening behavior.40.8%of the subjects who had STIs related complaints recently did not visit anyclinics. Clinic visit delay in 53.7% subjects were more than 7 days. For thoseparticipants who had sought medical treatment, 31.0%initiated their visit inprivate medical unit. The age of sex debut was statistically significant associatedwith clinic visit delay(P＜0.05). Multivariate unconditional logistic regressionmethod was used in identifying the determinants of the clinic visit delay. Thetime of clinic visit delay (≤7 days vs.＞7 days) was regressed on age(OR=1.9),income(OR=2.6), educational level(OR=2.0) and the self-attribution for the STIsrelated initial symptom(OR=2.8). Only 30.6% sought their treatment in clinic at first when they had STIs related symptoms recently. Multivariate unconditionallogistic regression analysis showed that significant risk factors associated withdid not seek treatment in clinic at first were income(OR=3.6), the self-attributionfor STIs related initial symptom (OR=4.2) and the age of sex debut(OR=3.5).Conclusions: The STIs related health services utilization behavior variedamong hotel-based female sex workers in Changsha. The STIs related screeningrate was low. More than half of them delayed clinic visit over 7 days since theyhad presented the STIs related symptoms. Majority of the FSWs engaged inself-treatment at first when they had STIs related symptoms. There is a priorityneed for health education and health promotion on the urgency for seekingtimely and correct health care service for FSWs.