ABSTRACT
Objective@#To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China.@*Methods@#Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database.@*Results@#The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (n=1 206). Among the reasons of not using condom, the proportion of client reluctant to use was the highest (81.0% (n=682)). Only 38.1% (n=782) was tested for HIV in the last six months. HIV confirmed positive rate was 6.8% (n=139), previous positive accounts for 76.3% (n=106). Rate of antiviral therapy was 55.4% (n=77). By the end of 2015, the loss rate of antivirus treatment was 18.2% (n=14). Those who self-reported symptoms of sexually transmitted diseases in the last 6 months accounted for 9.4% (n=191). 50.3% (n=96) of reporters chose to go to formal hospitals, 23.0% (n=44) chose to go to private clinics and 20.4% (n=39) chose their own medication. The syphilis infection rate was 13.5% (n=277), among them, 91.3% (n=253) were asymptomatic.@*Conclusion@#Among low-fee FSWs, the rates of HIV and syphilis infection are higher, the condom consistent use rate, HIV antibodies and syphilis test rate are lower. In this group, active seeking medical idea is poor, the rate of anti-virus treatment and the rate of seeking medical treatment in formal medical institutions is low.
ABSTRACT
<p><b>OBJECTIVE</b>To study the loss to follow-up (LTF) rate, HIV emerging incidence and influencing factors in the longitudinal study of female sex workers (FSWs) in Kaiyuan, Yunnan, and their influence on HIV emerging incidence estimate.</p><p><b>METHODS</b>The open cohort study on FSWs was launched in March 2006 and ended in June 2013 in Kaiyuan, Yunnan. Investigations were made every six months and lasted for 7 years. 661 FSWs found as HIV negative in the baseline study in March 2006 were chosen to study their LTF in the 7 year follow-up investigation. The Cox regression model was used to explore risk factors for HIV emerging infection and those for LTF. In June 2013, a survey was also conducted to explore the detailed reasons for loss to follow-up by contacting FSWs themselves.</p><p><b>RESULTS</b>During 1 238.5 person-years of follow-up among 661 HIV negative FSWs, the HIV incidence rate was 1.29 (95% CI: 0.74-2.10)/100 person-year, and the LFT incidence rate was 48.68 (95% CI: 44.88-52.73) /100 person-year. The multivariate analysis showed drug abuse as an independent risk factor for FSWs' infection of HIV (adjusted risk ratio = 4.15, 95% CI: 1.43-12.02); FSWs over 25 years old (adjusted risk ratio = 0.68, 95% CI: 0.57-0.81), and drug abuse (adjusted risk ratio = 0.52, 95% CI: 0.35-0.79) were found with lower LFT rate to remain in the cohort.</p><p><b>CONCLUSION</b>High LFT rate was found in FSW cohort study in Kaiyuan, Yunnan, while the HIV infection risk exposure of the LFT group was lower than the groups of HIV follow-up. HIV prevalence of FSWs in the city might be overestimated. Causes of LFT of FSWs group required further study in the future, and the cohort follow-up retention strategy for FSWs needs to be developed.</p>