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

Objective:To understand the prevalence of AIDS and related sexually transmitted diseases among female sex workers a decade after the implementation of 100%condom use program and explore the influencing factors of protection and treatment of AIDS in Hubei province.Methods:A multistage random sampling method was used to select 860 subjects in six areas of Hubei province.A questionnaire survey was conducted to understand the demographic characteristics of the subjects,awareness to AIDS related knowledge,condom use and intervention accepted.Blood samples were collected to detect the infection of HIV,syphilis and HSV-2.With the method of qualitative interview,the relevant personnel in the implementation of 100 percent condom are interviewed with a structured interview outline to understand the status and problems of the project implementation.Result:1.Totally,860 female sex workers were surveyed and 816 participants were included in the final analysis with an average age of(31.41±7.14)yrs.The proportion of participants aged 30 and lower was 46.08%.66.91%of female sex workers(FSWs)were married.The education attainment for 42.40%of FSWs was primary school and the proportion for middle school and high school were 40.81%and 16.79%respectively.308 FSWs came from low-tier places making up for 37.75%of the participants and 508 FSWs came from low-tier places making up for 62.25%of the participants.357 FSWs worked no more than 3 months,accounting for 43.75%.The age,education level,marriage and working time of FSWs differed by grade of places and had a significant difference.2.No HIV cases were detected in the study.Syphilis was positive in 81 cases,and the prevalence was 9.93%.herpes simplex virus-2(HSV-2)is positive in 80 cases,and the prevalence was 9.80%.The prevalence of Syphilis and HSV-2 among FSWs from low-tier were 14.28%and 37.01%respectively,which were higher than FSWs from higher grade FSWs(x~2=10.52,P=0.001;HSV-2:x~2=8.22,P<0.001).3.The overall rate of awareness to AIDs knowledge was 90.44%.Knowledge related to communicable routine,prevention and non-communicable routine were high and all above 85%.There was no statistical difference for AIDs related knowledge between low-tier and high-tier places(P=0.530).4.The rate of recent usage of condom in commercial sexual activity was 86.4%.The rate for low-tier and high-tier was 75.00%and 93.31%respectively.Rate of consistent use of condom in last month was 73.04%.The rate of consistent use of condom in last month for low-tier and high-tier was 60.06%and 80.91%respectively.Both rate of condom use for high-tier was higher than low-tier(low-tierx~2=54.68,P<0.001;high-tierx~2=54.42,P<0.001).Results from multivariate analyses showed that the Odds ratio(95%CIs)of peer-education and recent usage of condom in commercial sexual activity for low-tier and high-tier was 1.82(1.03-3.23)and 2.70(1.27-5.88)respectively.5.In the past 6 months,the proportion for FSWs receiving voluntary counseling test(VCT),acquiring AIDs related brochures,receiving free condom,taking AIDs test and having experiences of peer-education was 27.57%,41.30%,34.07%,57.11%and15.69%respectively.In low-tier places,the proportion of receiving VCT and acquiring AIDs related brochures was lower than high-tier places(x~2=61.343,P=0.001;x~2=23.423,P<0.001).6.Through in-depth interviews,relevant personnel believed that since the implementation of 100%condom use project,some achievements have been achieved.However,there are still some problems in the project,which influence the effect of the project to some extent.First,the skills of the outreach staff are deficient,and we need further improvement in outreach skills.Secondly,due to the funding problem,the outreach staff subsidies are not in place,and relevant measures need to be taken to protect their interests.Third,this year's efforts to eliminate pornography are hindering the development of outreach.Therefore,relevant measures should be made to ensure effective cooperation among multiple departments.Finally,we should distribute condoms freely to improve condom accessibility in low-tier places.Conclusion:Great effectiveness has been achieved since the implementation of 100%condom use program.However,more efforts targeting the weak point should be taken in further.