Prevalence And Incidence Of Sexually Transmitted Infections, HIV Infections, And Associated Factors Among Female Sex Workers In Jiangsu Province

[Abstract] Objectives To examine the demographic features and sexualbehaviors among female sex workers (FSW) in Jiangsu; To measure the prevalence ofsexually transmitted infections(STI), namely, treponema pallidum (TP), chlamydiatrachomatis (CT), neisseria gonorrhoeae (NG) infections, Human ImmunodeficiencyVirus (HIV) and sex behavior among female sex workers as well as associatedfactorsin Jiangsu through large-scale survey; and To investigate the incidence of HIVand TP as well as to analyse the characteristic of female sex workers who were newlyinfected withHIV/TP and who lost to follow-up in cohort study.Methods Convenience sampling was used to recruit the subjects. Demographicand behavioral information was obtained using face to face questionnaire interview.Blood sample and cervical swab were collected for the tests of HIV, TP, CT and NG.A repeated survey was conducted at three month follow-up.Results A total of1,806subjects were recruited with questionnaire informationand blood samples collected. Cervical swabs were collected among47.0%subjects.The median age was25years old. The prevalence of TP, CT, NG and HIV were8.4%,14.7%,5.4%and0.3%respectively. Relevant factors for TP including lowereducation level, working in the middle and lower class venues, being covered by anySTI screening tests or treatments and self-reported STI symptoms or signs in the pastyear; Relevant factors for CT include being younger, higher education level, beingcovered TP screening tests or treatments. Relevant factors for NG include beingcovered by any STI screening tests or treatments, self-reported having vaginal secretion disorder in the past year. The rate of retention in cohort was40.8%(737/1806) at three month follow-up. During the3-month follow-up period, HIV andTP incidence appeared to be0.0per100person-year and6.1per100person-yearsrespectively. Those willing to provide cervical swab, having used drug in the pastyear were more prone to new TP-infection. The subjects who were between20-30agegroup, working in the high class venues, being not covered by any HIV educations,and being TP infected were easier to lose to follow-up.Conclusions High STI incidence rates and widespread risk behaviors areidentified among female sex workers in Jiangsu province although HIV prevalence isstill relatively low. Those lost to follow-up have higher risk of infecting STI and HIV.Preventive interventions, with a focus on those working in high class venues, amongFSWs, shall be designed and implemented to prevent STI epidemic from growing andto keep HIV epidemic low.