High Prevalence of HIV & Syphilis & Associated Factors among Low-Fee Female Sex Workers in Mainland China: A Cross-Sectional Study

The prevalence of HIV and syphilis among middle and high-fee female sex workers (FSWs) has been widely reported but little is known among low-fee FSWs. This study aims to determine the prevalence and associated factors of HIV and syphilis among low-fee FSWs in China.

A cross-sectional study design was used. A convenience sample of low-fee FSWs was recruited from venues by outreach workers in 12 cities. Structured questionnaire interviews and blood sampling for HIV and syphilis were carried out. Univariate and multivariate logistic regression were used for assessing potential associated factors.

This study enrolled 781 low-fee FSWs. There were 37 (4.7%) HIV positive participants and 117 (15.0%) participants were infected with syphilis. Final multivariate analysis identified five factors associated with HIV infection: older age, local household registration, employed in Yunnan province, soliciting in self-rented rooms and "market day" buildings, injection drug use in the past 6 months; and four factors associated with syphilis infection: older age, employed in Yunnan province, soliciting in self-rented rooms and "market day" buildings, and no consistent condom use with clients in the past 30 days.

A high prevalence of HIV and syphilis were found among low-fee FSWs. Those soliciting in self-rented rooms and "market day" buildings with the lowest income, and injection drug users (IDUs) in this population should take priority in further intervention strategies.

Table 1

Demographic characteristics, work related information and HIV-related behaviors among low-fee female sex workers in 12 cities in China, 2012-2013

Variables	N	%
Demographic characteristics
Age (years)a
≤40	460	58.9
>40	321	41.1
Marital status
Married/cohabiting	581	74.4
Single	200	25.6
Years of schooling
>5	230	29.4
≤5	551	70.6
Ethnicity
Han ethnicity	473	60.6
Minorities	308	39.4
Household registration
Non-local	505	64.7
Local	276	35.3
Province of employment
Guangxi	310	39.7
Hunan	246	31.5
Yunnan	225	28.8
Work-related information
Had ever changed work location
Yes	98	12.6
No	681	87.4
Length of being a FSW
<6 months	249	31.9
7-12 months	83	10.6
13-24 months	148	19.0
>24 months	301	38.5
Soliciting venues
Small hair/beauty salons	162	20.7
Small guesthouses	136	17.4
On streets	168	21.5
Self -rented rooms	238	30.5
“Market day” buildings	77	9.9
Price charged for vaginal sex
20-50	633	81.0
≤20	148	19.0
Estimated average age of clients
<50	422	54.0
≥50	359	46.0
HIV-related behaviors
Consistent condom use with clients in the past 30 days
Yes	381	48.8
No	400	51.2
Injection drug use in the past 6 months
Yes	30	3.9
No	751	96.1
Received HIV testing in the past year
Yes	309	39.6
No	472	60.4

aThe cut-off point of 40 years old was set to distinguish older FSWs from younger FSWs [18,19].

Full article at: http://goo.gl/N1Nu4q

By: Zhou C, Rou K, Dong WM, Wang Y, Dong W, Zhou Y, Chen X, Jia M, Liu W, Zheng J, Ma Y, Li Y, Wu Z1; China National HIV Prevention Study Group.

1National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing, Changping District 102206

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