Changing trends of HIV, syphilis, HCV infections and behavioural factors among female sex workers in Chongqing, China: findings from six serial surveillance surveys

ObjectivesTo explore the prevalence and changing trends of HIV, syphilis, hepatitis C virus (HCV) infections and risk behaviours among female sex workers (FSWs) and to provide reference and theoretical basis for formulating targeted interventions.DesignSix consecutive cross-sectional surveys.SettingChongqing, China.ParticipantsFSWs were included if they (1) were aged ≥16 years, (2) provided commercial sex for money or goods during the previous month and (3) were willing to participate in the survey and could provide verbal informed consent. This study included 16 791 of 16 810 participants recruited between 2013 and 2018.Primary and secondary outcome measuresThe prevalence of HIV/syphilis/HCV infection.ResultsThe HIV and HCV prevalence among FSWs in Chongqing was stable during the study period, but the prevalence of syphilis had an increasing trend, particularly among low-tier and middle-tier FSWs. Improvements in HIV-related knowledge, condom use, injecting drug use and participation in HIV-related services were observed. However, no change was found in the prevalence of drug use. HIV infection was correlated with no condom use in the last commercial sex (adjusted OR (aOR) 3.48, 95% CI 1.90 to 6.37) and syphilis infection (aOR 4.88, 95% CI 1.95 to 12.18). Syphilis infection was correlated with inconsistent condom use (aOR 1.30, 95% CI 1.02 to 1.65), HIV infection (aOR 5.88, 95% CI 2.40 to 14.41), HCV infection (aOR 7.68, 95% CI 4.37 to 13.49) and sexually transmitted infection (STI) diagnosis in the past year (aOR 3.81, 95% CI 2.40 to 6.03). HCV infection was associated with injecting drug use (aOR 8.91, 95% CI 4.45 to 17.86) and syphilis infection (aOR 7.88, 95% CI 4.49 to 13.83).ConclusionsComprehensive interventions targeting FSWs, particularly low-tier and middle-tier FSWs, should be increasingly implemented to prevent and control HIV, syphilis and other STIs.

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Violence experience by perpetrator and associations with HIV/STI risk and infection: a cross-sectional study among female sex workers in Karnataka, south India

BMJ Open ◽

10.1136/bmjopen-2017-021389 ◽

2018 ◽

Vol 8 (9) ◽

pp. e021389 ◽

Cited By ~ 7

Author(s):

Alicja Beksinska ◽

Ravi Prakash ◽

Shajy Isac ◽

H L Mohan ◽

Lucy Platt ◽

...

Keyword(s):

Condom Use ◽

Sexual Violence ◽

Sex Workers ◽

Partner Violence ◽

Female Sex Workers ◽

South India ◽

Syphilis Infection ◽

Transmitted Infection ◽

The Past ◽

Female Sex

ObjectivesFemale sex workers (FSWs) experience violence from a range of perpetrators, but little is known about how violence experience across multiple settings (workplace, community, domestic) impacts on HIV/sexually transmitted infection (STI) risk. We examined whether HIV/STI risk differs by the perpetrator of violence.MethodsAn Integrated Biological and Behavioural Assessment survey was conducted among random samples of FSWs in two districts (Bangalore and Shimoga) in Karnataka state, south India, in 2011. Physical and sexual violence in the past six months, by workplace (client, police, coworker, pimp) or community (stranger, rowdy, neighbour, auto-driver) perpetrators was assessed, as was physical and sexual intimate partner violence in the past 12 months. Weighted, bivariate and multivariate analyses were used to examine associations between violence by perpetrator and HIV/STI risk.Results1111 FSWs were included (Bangalore=718, Shimoga=393). Overall, 34.9% reported recent physical and/or sexual violence. Violence was experienced from domestic (27.1%), workplace (11.1%) and community (4.2%) perpetrators, with 6.2% of participants reporting recent violence from both domestic and non-domestic (workplace/community) perpetrators. Adjusted analysis suggests that experience of violence by workplace/community perpetrators is more important in increasing HIV/STI risk during sex work (lower condom use with clients; client or FSW under the influence of alcohol at last sex) than domestic violence. However, women who reported recent violence by domestic and workplace/community perpetrators had the highest odds of high-titre syphilis infection, recent STI symptoms and condom breakage at last sex, and the lowest odds of condom use at last sex with regular clients compared with women who reported violence by domestic or workplace/community perpetrators only.ConclusionHIV/STI risk differs by the perpetrator of violence and is highest among FSWs experiencing violence in the workplace/community and at home. Effective HIV/STI prevention programmes with FSWs need to include violence interventions that address violence across both their personal and working lives.

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Injecting Drug Use Among Mexican Female Sex Workers on the US-Mexico Border

Journal of Ethnicity in Substance Abuse ◽

10.1080/15332640.2014.991467 ◽

2015 ◽

Vol 14 (4) ◽

pp. 351-363 ◽

Cited By ~ 4

Author(s):

Alice Cepeda ◽

Kathryn M. Nowotny ◽

Avelardo Valdez

Keyword(s):

Drug Use ◽

Sex Workers ◽

Female Sex Workers ◽

Injecting Drug Use ◽

Female Sex ◽

The Us ◽

Mexico Border ◽

Us Mexico Border

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Experience of HIV Prevention Interventions among Female Sex Workers in Delhi, India

International Journal of STD & AIDS ◽

10.1177/095646249400500113 ◽

1994 ◽

Vol 5 (1) ◽

pp. 56-57 ◽

Cited By ~ 18

Author(s):

Yadu Nath Singh ◽

Anand Narayan Malaviya

Keyword(s):

Hiv Prevention ◽

Hiv Infection ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Seroprevalence ◽

Hiv Prevention Intervention ◽

Female Sex ◽

Prevention Interventions ◽

Hiv Prevention Interventions

This paper describes the effect of HIV prevention intervention among female sex workers in Delhi. Over a 2-year period we found a marked increase in condom use with little increase in HIV seroprevalence. The prevalence of HIV infection did not increase during the study period (1 positive among 701 in 1988 vs 1 positive in 600 in 1990).

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Determinants of HIV Infection Among Female Sex Workers in Two Cities in the Republic of Moldova: The Role of Injection Drug Use and Sexual Risk

AIDS and Behavior ◽

10.1007/s10461-013-0460-x ◽

2013 ◽

Vol 17 (8) ◽

pp. 2588-2596 ◽

Cited By ~ 7

Author(s):

Lev Zohrabyan ◽

Lisa Grazina Johnston ◽

Otilia Scutelniciuc ◽

Alexandrina Iovita ◽

Lilia Todirascu ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Sexual Risk ◽

Injection Drug Use ◽

Sex Workers ◽

Female Sex Workers ◽

Republic Of Moldova ◽

Two Cities ◽

The Republic

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HIV-1 and Syphilis Prevalence Among Local Chinese and Cross-Border Migrant Female Sex Workers in Sino-Vietnam Border Cities in Guangxi, China: A Nine-Year Consecutive Cross-Sectional Study

10.21203/rs.3.rs-400830/v1 ◽

2021 ◽

Author(s):

Bingyu Liang ◽

Fei Zhang ◽

Dongmei Wei ◽

Peidong Zhang ◽

Guangwu Wei ◽

...

Keyword(s):

Sex Workers ◽

Associated Factors ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Hcv Infection ◽

Syphilis Infection ◽

Cross Sectional ◽

Female Sex ◽

Male Clients ◽

Hiv 1

Abstract Background To analyze the trends of HIV-1 and syphilis prevalence as well as associated factors among local Chinese female sex workers (LCFSWs) and cross-border migrant female sex workers (CMFSWs) in Sino-Vietnam border cities in Guangxi, China. Methods A consecutive cross-sectional study was conducted from 2010 to 2018 in three border cities in Guangxi. The survey was conducted through face-to-face interview with a structured questionnaire. HIV-1 and syphilis infections were tested simultaneously. Cochran-Armitage analysis was used to assess the trends of HIV-1, syphilis and HCV prevalence, as well as the trend of risk behaviors, HIV/AIDS knowledge and prevention services. Multivariate logistics regression analysis was used to identify factors associated with HIV-1 and syphilis infection.Results Totally, 19873 LCFSWs and 1723 CMFSWs were enrolled. The overall prevalence of HIV-1 and syphilis infection was 0.91% and 5.14%, respectively. The HIV-1 prevalence among CMFSWs was higher than that among LCFSWs, without a declined trend. However, a downward trend was observed among LCFSWs. Overall, the main associated factors of HIV-1 infection among CMFSWs shifted from age >35 years old, staying in current residence for >12 months, self-reporting of STIs in the last year during 2010-2015 to inconsistent condoms use in commercial sex in the past month, HCV infection, self-reporting of STIs in the last year during 2016-2018. The main correlated factors of syphilis infection among CMFSWs changed from staying in current residence for 6~12 months, self-reporting of STIs in the last year, HCV infection during 2010-2015 to low-tier working venues, self-reporting of STIs in the last year, sexing with commercial male clients who used aphrodisiac drugs during 2016-2018. For LCFSWs, the relative strong associated factors of HIV-1 infection shifted from primary school or illiterate education background, illicit drugs use during 2010-2015 to the marital status of unmarried/divorced/widowed, sexing with commercial male clients who use aphrodisiac drugs during 2016-2018, while the main factors of syphilis infection changed from self-reporting of STIs in the last year, illicit drug use during 2010-2015 to self-reporting of STIs in the last year, HCV infection during 2016-2018.Conclusions The relatively higher prevalence of HIV-1 infection and frequent risk behaviours among CMFSWs in border cities in Guangxi, indicating that CMFSWs is the high-risk population for HIV-1 infection and transmission in the region, and is the key population of HIV/AIDS prevention and control. Meanwhile, the change of HIV infection-associated risk factors over time suggests that HIV intervention strategies need to be changed accordingly.

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HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China

International Journal of STD & AIDS ◽

10.1177/0956462417730258 ◽

2017 ◽

Vol 29 (5) ◽

pp. 424-434 ◽

Cited By ~ 10

Author(s):

Jing Zhu ◽

Rui Yuan ◽

Dan Hu ◽

Zhibin Zhu ◽

Ning Wang ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Sex Workers ◽

Female Sex Workers ◽

Yunnan Province ◽

Border Region ◽

High Risk Population ◽

Risk Population ◽

Female Sex ◽

Male Clients

Female sex workers (FSWs) and their male clients are vulnerable to HIV infection and serve as a bridge in HIV transmission from the high-risk population to the general, low-risk population. To examine the factors of FSWs and male clients that correlate with the prevalence of HIV infection in the Chinese–Vietnamese border region, a cross-sectional survey was conducted in 2014 in the Hekou county of the Yunnan province of China. We performed a questionnaire survey to collect data on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections and drug use. We found that the prevalence of HIV infection among FSWs was 2.74%, and 15 male clients (2.62%) were HIV-positive. Multivariate logistic regression analysis revealed that herpes simplex virus type 2 infection was a risk factor for HIV infection in FSWs and male clients, suggesting the increased role of sexual transmission in the HIV epidemic in the Chinese–Vietnamese border region. Positive urinalysis result for amphetamine-type stimulants was observed in FSWs with HIV infection. History of drug use was correlated with HIV infection, which increased the HIV infection risk of male clients, confirming that drug use is an important target in future interventions for HIV prevention.

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Condom use among brothel-based sex workers and clients in Bali, Indonesia

Sexual Health ◽

10.1071/sh04051 ◽

2005 ◽

Vol 2 (2) ◽

pp. 89 ◽

Cited By ~ 8

Author(s):

Kathleen Ford ◽

Dewa Nyoman Wirawan

Keyword(s):

Hiv Infection ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Educational Interventions ◽

Media Campaigns ◽

Sexually Transmitted ◽

Female Sex ◽

Male Clients ◽

The Media

Background: The objective of this paper is to describe the situation among Indonesian sex workers and clients in Bali, Indonesia, through a series of studies conducted during the 1990s. Methods: Five surveys of sex workers and clients were conducted from 1992 through to 1999. Results: The proportion of female sex workers who have heard about AIDS and condom use has increased tremendously in this area. In 1992–93, 51% of women reported ever hearing of AIDS and this had increased to 97% by 1999 (P < 0.01). Reported condom use with clients increased from 19% in 1992–93 to 78% in 1999 (P < 0.01). However, condom use is still far from 100% and perceived susceptibility towards HIV infection among female sex workers and their male clients remains low. Ineffective preventive strategies such as medication use remain common. HIV infection was very low in this population, although the prevalence of other sexually transmitted infections such as gonorrhea and chlamydia was very high. Conclusions: Educational interventions have been conducted with the sex workers, but the main source of education for clients has been through the media. Future programs need to develop more focused efforts to reach clients. These interventions may include worksite interventions, mass media campaigns, youth programs or other models.

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Sexualized Drug Use Among Female Sex Workers From Eight Cities in China: a Cross-sectional Study

10.21203/rs.3.rs-143800/v1 ◽

2021 ◽

Author(s):

Jason Ong ◽

Mingzhou Xiong ◽

Joseph D. Tucker ◽

Yajie Wang ◽

M. Kumi Smith ◽

...

Keyword(s):

Drug Use ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Sectional Study ◽

Inconsistent Condom ◽

Cross Sectional ◽

History Of ◽

Inconsistent Condom Use

Abstract Background There is rich literature on sexualized drug use (i.e. drug use before or during sex) for men who have sex with men but less data from female sex workers (FSW) particularly from low- and middle-income countries. We describe the sexual and reproductive health outcomes in FSW reporting sexualized drug use.Methods We conducted a cross-sectional study in eight cities from seven provinces in China (2019). We recruited FSW through community organizations working with sex workers, and included those who were age 18 years or above; exchanged sex at least once for money or goods in the past three months. Multivariable logistic regression models were used.Results In total, 1287 women participated: average age was 35.1 years (SD 10.3), 52.4% reported a monthly income over 5000 RMB ($USD 707), and 17.4% completed high school or above. Among participants, 284 (22.1%, 95%CI:19.8-24.4) reported a history of sexualized drug use. Compared to FSW who never reported a history of sexualized drug use, FSW who reported a history of sexualized drug use had greater odds of: reporting inconsistent condom use for vaginal sex (AOR 2.67, 95%CI:1.93-3.69), inconsistent condom use for oral sex (AOR 2.33, 95%CI:1.25-4.37), ever had an unintended pregnancy (AOR 1.43, 95%CI:1.04-1.96), and ever diagnosed with STIs (AOR 5.39, 95%CI:3.92-7.40).Conclusion We recommend routinely asking FSW about sexualized drug use as nearly one in five FSW reported a history of sexualized drug use and these women had an elevated risk profile compared with those who reported no sexualized drug use.

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