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Objective:To investigate the effect and influencing factors of anti-retroviral therapy (ART) in human immunodeficiency virus (HIV)-positive female commercial sex workers (CSW) in Guangxi Zhuang Autonomous Region.Methods:A retrospective cohort study was used in this study. A total of 661 HIV-positive CSW receiving ART from the Guangxi Zhuang Autonomous Region′s municipal and county-level Centers for Disease Control and Prevention (CDC) reported to Guangxi Zhuang Autonomous Region CDC from January 1, 2009 to December 31, 2018 were included.The demographic information of the patients, marital status, past medical history, acquired immunodeficiency syndrome (AIDS)-related diseases after six to 12 months of ART, medications, CD4 + T lymphocytes, virological and immunological effects after receiving ART for six to 12 months were collected. Logistic regression model was used to analyze the influencing factors of virological failure and immunological failure of HIV-positive CSW after six to 12 months of ART. Results:Among 661 HIV-positive CSW, 50(7.6%) cases experienced virological failure, 80(12.1%) cases experienced immunological failure, and 13(2.0%) had both virological failure and immunological failure.There were 85 cases (12.9%) who had a history of sexually transmitted diseases. Multivariate logistic regression analysis showed that unmarried (adjusted odds ratio (a OR)=3.298, 95% confidence interval ( CI) 1.285 to 8.461), AIDS-related diseases after six to 12 months of ART (a OR=4.391, 95% CI 1.555 to 12.402) and missed medications in the last seven days (a OR=3.731, 95% CI 1.942 to 7.166) were risk factors for virological failure. Compared with CD4 + T lymphocytes<200.00/μL at baseline, 350.00≤CD4 + T lymphocytes <500.00/μL (a OR=3.543, 95% CI 1.631 to 7.701) and CD4 + T lymphocytes≥500.00/μL (a OR=2.358, 95% CI 1.002 to 5.547) were risk factors for immunological failure. Conclusions:HIV-positive CSW in Guangxi Zhuang Autonomous Region have a better treatment effect, with low rates of virological failure and immunological failure. Marital status, baseline CD4 + T lymphocyte counts, AIDS-related diseases after six to 12 months of ART, and missed medication in the last seven days are factors influencing the effect of six to 12 months of ART.
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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.
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Objective To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW),in order to provide evidence for targeted intervention strategies.Methods A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region,Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province,Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study,with 60 eligible participants needed in each city,estimated through a pre-study.The first cross-sectional survey was completed from October 2012 to January 2013.Face-to-face questionnaire interview was carried out to collect information on socio-demography,work-related information and condom use situation.Blood was collected for syphilis testing.The second cross-sectional survey was carried out from June to September,2015 under the same procedure.Results A total of 371 and 403 eligible participants were included in the first and second survey,respectively.When comparing the two surveys,we noticed that the average age showed a slight change,from 42.4 years to 43.8 years old (t=3.537,P＜0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961,P＜0.001).In the first survey,46.9％ (174/371) of the participants had more than two years of experience working as LFSW,compared to 61.3％ (247/403) in the second survcy (x2=16.125,P＜0.001).Also,46.9％ (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3％ (259/403) (x2=23.641,P＜0.001) in the second one.Rates of syphilis infection were found from 15.9％ (59/371) in the first survey reduced to 7.2％ (29/403) in the second survey (x2=14.533,P＜0.001).Conclusion Compared with the first survey,the proportion of consistent condoms use showed an increase.Although the proportion of syphilis infection decreased in the second survey,the scope did not meet the criteria on syphilis,set by the government.Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.
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Objective To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW),in order to provide evidence for targeted intervention strategies.Methods A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region,Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province,Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study,with 60 eligible participants needed in each city,estimated through a pre-study.The first cross-sectional survey was completed from October 2012 to January 2013.Face-to-face questionnaire interview was carried out to collect information on socio-demography,work-related information and condom use situation.Blood was collected for syphilis testing.The second cross-sectional survey was carried out from June to September,2015 under the same procedure.Results A total of 371 and 403 eligible participants were included in the first and second survey,respectively.When comparing the two surveys,we noticed that the average age showed a slight change,from 42.4 years to 43.8 years old (t=3.537,P＜0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961,P＜0.001).In the first survey,46.9％ (174/371) of the participants had more than two years of experience working as LFSW,compared to 61.3％ (247/403) in the second survcy (x2=16.125,P＜0.001).Also,46.9％ (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3％ (259/403) (x2=23.641,P＜0.001) in the second one.Rates of syphilis infection were found from 15.9％ (59/371) in the first survey reduced to 7.2％ (29/403) in the second survey (x2=14.533,P＜0.001).Conclusion Compared with the first survey,the proportion of consistent condoms use showed an increase.Although the proportion of syphilis infection decreased in the second survey,the scope did not meet the criteria on syphilis,set by the government.Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.
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<p><b>OBJECTIVE</b>To examine the feasibility of RNA pooling technique in the diagnosis on acute HIV infection among female sex workers (FSWs) working at the low-grade venues.</p><p><b>METHODS</b>Plasma samples from the low-grade-venue FSWs in Guangxi, in 2011 were tested for HIV antibody using the rapid testing method. All samples which were HIV antibody negative in the rapid testing were tested for HIV RNA with RNA pooling technique. FSWs who showed HIV RNA positive were tested for HIV antibody by Western blot method in 3 months. The HIV incidence in the low-grade venue FSWs was counted under the estimation formula.</p><p><b>RESULTS</b>There were 6 469 cases of FSWs who were recruited in this study. Through rapid testing, results showed that HIV antibody was positive in 139 cases, with the positive rate as 2.15%. 6 330 FSWs with HIV antibody negative were tested by HIV RNA pooling method, with 7 of them showing HIV RNA positive, in which 6 cases showed HIV-1 antibody seroconversion, thus were diagnosed as acute HIV infection. HIV incidence in low-grade FSWs appeared to be 1.45 per 100 person years (95%CI:1.17-1.76 per 100 person years) in Guangxi.</p><p><b>CONCLUSION</b>Other than regular routine HIV antibody testing, it seemed necessary to adopt the HIV RNA pooling strategy in high-risk groups such as FSWs, so as to early detect the HIV infection and to timely perform the intervention or treatment programs to prevent sexual transmission of HIV.</p>