Residual Resistance Area Female Sex Workers Syphilis Infection Risk And Aids Community Comprehensive Intervention Study

Part1Risks of HIV/AIDS and Syphilis among Female Sex Workers in Yuhang District[Objectives] To examine prevalence and correlates of risk behaviors of HIV infection and Syphilis among female sex workers (FSWs) in Yuhang District.[Methods] In2008, an investigation to clarified the disposition of FSWs in Yuhang District had been carried out. Using cluster sampling method based on entertainment places, the research subjects had been selected from those townships where the FSWs concentrated in. Then, by making cross-sectional study, under the condition of obtaining the informed consent, each subject was administered with a questionnaire interview and venous blood collected. Their blood samples were collected for Human Immunodeficiency Virus (HIV) antibody tests (ELISA for screening and Western Blot for confirmation) and Treponema Pallidum test (TPPA for confirmation and TRUST for titre test). Database was set up through Epidata3.1, data was statistically analyzed through SPSS16.0and risk factors of disease infection were analyzed by Logistic regression methods.[Results]836FSWs were involved in this research. The average age among FSWs was22.97years old; non-registered permanent residents accounted for93.7%; unmarried participants accounted for81.7%; junior middle school education level accounted for79.7%. The rate of FSW with abortion history accounted for54.5%. The age at the first sex intercourse from15 to19years old accounted for74.0%; the age at initiation into commercial sex from20to24years old accounted for58.6%. Furthermore,31.3%subjects suffered from urinary and genital tract infection and4.4%abused drugs in the past year.83.5%of FSWs used condoms in the last recent commercial sex behaviors, but the rate of using condoms for the commercial sex behaviors every time in the last month was only39.0%. The prevalence of HIV was0.1%, and the prevalence of syphilis was3.0%. Low price of sex service, low rate of the condom usage in the last commercial sex behaviors, more than3commercial sex behaviors per day, and abusing drugs were statistically associated with AIDS and Syphilis prevalence.[Conclusions] In Yuhang District, the years of education for FSWs was short and their ages of providing the first sexual services was young. They lacked awareness of prevention of genital tract diseases. When they had infectious genital tract diseases, they usually did not seek care in public hospitals. The rate of using condom consistently was also low. Lower price of sex service, lower rate of the condom usage, more commercial sex behaviors in a day, and abusing drugs were the risk factors of AIDS and Syphilis prevalence.Part2Study of AIDS/STD prevention and intervention among FSWs in communities in Yuhang District[Objectives] To implement and evaluate a comprehensive AIDS/STDs prevention and intervention model among FSWs based on community centers for health services(CHS). [Methods] Intervention study method was used in this study. One intervention group based on CHS, the other one based on center for disease control and prevention (CDC) and a control group were set up. Baseline survey was carried out in2008. In according with the mode of pre-designed intervention, the preventative intervention had been carried out for two years and effectiveness evaluation was conducted in2010. Through compared with the rate of condom usage, the prevalence of syphilis and the rate of seek qualified medical care in2008vs.2010, this survey assessed the intervention effect by the methods of quantitative study.[Results] The intervention subjects of CHS were those FSWs who provide sex service with low-price. To the contrary, the FSWs who received intervention from CDC provided sex service with high-price. The rate of condom use during the last recent commercial sex behaviors in CHS intervention group and in CDC intervention group respectively increased from83.0%and81.5%in2008to99.3%and92.7%in2010, while in the control group, it descended from96.1%in2008to80.2%in2010. These differences were statistically significant. In a similar situation, the rate of condom use for the last non-commercial sex behaviors in CHS intervention group and in CDC intervention group respectively elevated from56.8%and35.7%in2008to87.9%and59.7%in2010, however in the control group, it declined from46.6%in2008to15.8%in2010. These differences were statistically significant. In2008, the prevalence of syphilis in CHS intervention group, CDC intervention group and control group were respectively1.1%、2.0%and10.7%, and in2010the rate became7.4%, 1.7%and5.8%. There were no statistically significant difference in each group in2008vs.2010. In2008, the rate of seek qualified medical care in CHS intervention group, CDC intervention group and control group respectively were50.0%、34.7%and23.5%, and the difference was no statistically significant. But in2010, the rates improved to73.3%^50.0%and38.1%, and the rate in CHS intervention group was significantly higher than that in control group.[Conclusions] The comprehensive intervention model of AIDS/STDs for FSWs based on CHS played an active role in extending the interventional coverage of FSWs with low sex service price, elevating the rate of condom use and improving the norm treatment of genital tract diseases. The intervention effect in the CHS intervention group was better than the effect in the CDC intervention group and the control group.