Analysis Of The Voluntary Counseling And Testing Use And Influential Factors Among The Male Clients Aged 50 Or Older Of Commercial Sex Worker In Liuzhou City

ObjectiveTo understand the conditions and influential factors of the use of AIDS voluntary counseling and testing among clients aged 50 years or older of female sex workers(FSWs)in Liuzhou city,so as to provide scientific basis for the establishment of HIV/AIDS prevention and control measures.MethodsA cross-sectional survey was carried out in the entertainment venues of Liuzhou city and Luzhai county from October 2015 to January 2016.Older male clients(age? 50years;self-reported having had commercial sexual behaviors in the last 12 months)were recruited for completing a questionnaire and providing blood samples for testing.The contents of the investigation included demographic characteristics,AIDS knowledge,attitude to patients with HIV/AIDS,behaviors related to HIV/AIDS,sexual behavior,the situation of VCT and experimental results.A database was established by EpiData 3.1,to input data.Data analysis was performed using the statistical software SPSS 16.0.Results1.Quantitative findingsA total of 461 clients aged 50 years or older of FSWs were included for this study.Their age varied from 50 to 85,and the average is 58.82±7.41.As to marital status,283(61.4%)were married,85(18.4%)were unmarried,84(18.2%)were divorced or widowed,and 9(2.0%)were cohabiting.There were 410(88.9%)local residents and 51(11.1%)from other areas.With regard to nationalities,350(75.9%)were Han Chinese and 107(23.4%)were Zhuang People.Among the 461 included ones,441(95.7%)people lived here more than 1 year.Regarding cultural degree,341(74.0%)were the junior high school and the below and 120(26.0%)were high school level and the above.With respect to profession,174(37.7%)were job hunters or unemployed,74(16.1%)were retired and 73(15.8%)were workers.The majority of personal monthly income was below 500 yuan for which the number reached 189(41.0%).140(30.4%)participants whose personal monthly income ranged from 2001 to 3000 yuan ranked second.When it comes to the awareness of AIDS knowledge,81.1% were aware of AIDS related knowledge.Among the 8 questions,“Mosquito bites do not spread AIDS”scored the lowest for the correct probability was only 59.2%.The antibody positive rate for HIV,HCV and syphilis in the study were 1.30%,0.43% and 3.50%,respectively.252 participants have had sexual behaviors with fixed sexual partners in the last year and175(69.5%)of them haven't used condoms.Besides,48.2% participants have had commercial sexual behaviors within the last six months,only 13.0% of which always used condoms for each commercial sexual behavior.Logistic regression analysis indicated that the main factors influencing the acceptance of VCT among older clients included “awareness of HIV/AIDS prevention”,“fear of HIV infection”,“marital status” and “discrimination”.2.Qualitative findings.A total of 11 objects were interviewed,including 6 from Liuzhou city and 5 from Luzhai county.The average age was 57.3±1.4.Among the 11 subjects,8 were married or cohabiting,3 were unmarried,divorced or widowed.9 were Han Chinese and the other 2 belonged to other ethnic groups.As to education background,5 were illiteracy or primary school level,3 were junior high school level,and 3 were high school level or secondary technical level.With respect to profession,4 worked as farmers,5 were unemployed,and 2 were engaged in industry.The average earning was 610 RMB(IQR :400-1200).Their commercial sex behaviors mainly because their wives had no sexual needs or they wanted to seek for excitement.After high risk behaviors happened,the main reason of failing to detect attributed to their thinking themselves older and out of time,so that it was not necessary to accept check.Besides,they were afraid of being looked down upon by others.ConclusionsThis study indicates that despite the high awareness of knowledge related with HIV/AIDS,the proportion of VCT use among older clients was found to be low.Meanwhile,the proportion of always using condoms during commercial sexual behaviors was also found to be low.“Awareness of HIV/AIDS prevention”,“fear of HIV infection” and “having a fixed sexual partner” could promote the proportion of older clients using VCT,to a certain extent.On the contrary,“discrimination” could inhibit the use of VCT.