| Objective(s):Through questionnaire surveys and HIV and syphilis detection of male high-risk groups in entertainment venues in Kunming,Honghe Prefecture and Lincang in Yunnan Province,the current status of HIV and TP infection among male sex workers(MSWs)in three prefectures in Yunnan Province,and the relevant factors affecting MSWs infection with HIV and TP were analyzed,so as to provide referencefothe formulation of interventions targeting MSWs.Methods:From March 2021 to September 2022,MSWs in entertainment venues were selected for cross-sectional surveys in Kunming,Honghe and Lincang Prefecturesin Yunnan Provinceusing,the electronic questionnaire generated by "questionnaire stars",the demographic characteristics,AIDS knowledge,and sexual behavior characteristics were investigated in the form of anonymous self-filling and staff counseling,and at the same time blood samples were collected for HIV and TP testing,and some MSWs were selected for qualitative interviews which covers issues related to awareness of HIV and STDs,the status of commercial sexual services,and the need for HIV/AIDS prevention services.SPSS20.0 was used to perform statistical descriptions and χ~2 tests on the collected data.Results:In this study,a total of 660 valid questionnaires were collected,and660 respondents were tested for HIV and TP,and the HIV and TP infection rates were0.30%(2/660)and 3.03%(20/660),respectively,and 30 MSWs were selected for qualitative interviews.1.Demographic characteristics: In this survey,the average age of respondents was(26±6)years,with the youngest being 18 years old and the oldest being 57 years old.66.52%(439/660)were unmarried/divorced/widowed,89.70%(592/660)were from Yunnan Province,58.64%(387/660)were Han Chinese,11.21%(74/660)had a college degree or above,61.21%(404/660)had been in the sex survicefor less than one year,77.12%(509/660)had worked locally for less than one year,13.94%(92/660)had a previous working place in another province,and 74.39%(491/660)MSWs have a monthly income of less than ￥10,000.2.HIV/AIDS-related knowledge awareness: the respondents’ awareness rate of AIDS knowledge was 92.88%(613/660),of which "Can a person be judged by the appearance of the genitals whether a person is infected with AIDS?""The lowest correct rate of a question was 73.94%(488/660).27.58%(182/660)and 29.24%(193/660)heard of pre-exposure and post-exposure prophylaxis,respectively,and43.84%(64/146)and 44.94%(71/158)were willing to take pre-exposure and post-exposure prophylaxis,respectively.3.Characteristics of sexual behavior: the most common way for MSWs to find customers was fixed places(bars,KTV,bathing centers),accounting for 73.33%(484/660).87.88%(580/660)of MSWs had female guests in the latest month,76.52%(505/660)had sex with female guests in the last month,of which 76.83%(388/505)used condoms every time when having sex with female guests;61.82%(408/660)of MSWs had male guests in the last month,48.94%(323/660)had sex with male guests in the last month,of which 88.85%(287/323)used condoms every time when having sex with male guests.4.Aids and substance abuse: 8.18%(54/660)of MSWs used recreational aids during commercial sexual activity,3.48%(23/660)had taken new type of drugs,and1.36%(9/660)of MSWs had injecting drugs.5.Previous STD and Testing History: 4.09%(27/660)of MSWs reported having been diagnosed with STDs,45.00%(297/660)of MSWs had been tested for HIV.6.Factors affecting TP infection: MSWs whoseeducation level is high school or technical secondary school,theentry time is ≥1years,the previous work placeis in another province,themonthly income is more than 10,000 yuan,finding customers by telephone appointment/door-to-door service,use of pharmacogenics,sexual history and receiving HIV testing in 2021 have ahigher rate of TP infection;MSWs who consistently use condoms daily have a lower rate of TP infection.7.Acceptance of AIDS prevention services: 96.97%(640/660)had received AIDS prevention services,and most MSWs had received HIV/AIDS prevention and treatment knowledge publicity and education,condom publicity and distribution,and AIDS counseling and testing,accounting for 94.39%(623/660),82.12%(542/660)and 61.97%(409/660)respectively.8.Qualitative Interviews: A total of 30 qualitative interviews with MSWs were collected in this survey.The results show that some casinosin three prefecturesin Yunnan Province require a physical examination for entry and have strict management measures.Some MSWs do not have enough understanding of the correct measures to prevent AIDS and STDs,andbasically understand that they need to go to a regular medical institution for diagnosis and treatment after infection,but there are still some MSWs who choose informal small clinics,resulting in delayed treatment.Most MSWs enter the sex service industry through the introduction of friends,and some are also driven by high income and curiosity to enter the sex service.In terms of condom use,unsafe sex occurs when the MSW is drunk and the guest is an acquaintance,and some MSWs will persuade the guest to use the condom when the guest is reluctant to use,but MSWs will not use condoms duringoral sex activity.MSWs said that in addition to the prevention and treatment knowledge and testing services provided by daily intervention work,psychological support,financial support,legal aid and PrEP/PEP promotion and access channels are also needed.Conclusion(s):Yunnan Province’s "90-90-90 targets " vigorous implementation of entertainment venue practitioners testing and management has effectively controlled the spread of HIV and TP in MSWs.Young,mostly single,and not highly educated are the characteristics of MSWs in three prefectures(cities)in Yunnan Province.This population has incomplete knowledge of HIV and STDs,and there is obvious separation of knowledge and action.The three prefectures(cities)in Yunnan Province have a high prevalence rate of HIV/AIDS prevention interventions such as general knowledge and education,condom distribution and testing services,but they are lacking in the promotion and access channels for PrEP and PEP,and the work in psychological counselling,financial support and legal aid needs to be supplemented.Poor awareness of STDs,long tenure,high mobility,high income,telephone appointment/door-to-door service solicitation,use of aids during sexual activity,sexual history,and frequent testing are more likely to be infected with TP;Consistent condom use protects MSWs and reduces their probability of TP infection.It is suggested that the implementation of the "90-90-90 targets" for MSWs in entertainment venues should be further promoted,and the managers of entertainment venues should be urged to strengthen the management of MSWs,improve their HIV and TP testing rates,and refer those who test positive for treatment;Increase publicity and education on the prevention and treatment of HIV and other STDs through peers or social organizations,distribute free condoms,increase publicity and promotion of PrEP/PEP,improve their accessibility,enhance the awareness of active protection of MSWs,and provide social care,psychological counseling and other care measures for casino MSWs to protect their physical and mental health,and at the same time provide them with legal assistance to ensure their legal rights in work and life. |
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