Characterization of genital chlamydia amongst female sex workers in Nairobi, Kenya

Introduction: genital chlamydia, which is caused by diverse Chlamydia trachomatis genotypes, is largely asymptomatic. We aimed to identify C. trachomatis genotypes causing genital chlamydia among female sex workers attending a sex workers outreach program clinic in Nairobi, Kenya. Methods: this cross-sectional study was conducted between 18 April 2017 and 19 March 2021. Genitourinary complaints from eligible female sex workers were documented using a structured questionnaire. Endocervical swabs were collected for laboratory analysis. C. trachomatis plasmid DNA was extracted, PCR-amplified, and sequenced. Consensus sequences were generated and aligned with reference sequences to determine the C.trachomatis genotypes. Bivariate analysis was used to determine the association between genitourinary complaints and genital chlamydia. Results: endocervical swabs were collected from a total of 348 participants. Of these, 46 (13.2%) were positive for C. trachomatis. Most (297, 85.3%) of the participants presented with pelvic discharge with or without other symptoms. Fifteen (15, 4.3%) had abdominal pain and 3 (0.9%) had an itchy vulva. There was no statistically significant relationship between clinical presentation and genital chlamydia. Twenty-three samples were successfully sequenced. Each sequence was at least 90% identical to each of the 13 references C. trachomatis genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b and L3. Conclusion: we found no significant association between individual genitourinary complaints and genital chlamydia infection. The C. trachomatis genotypes circulating amongst female sex workers in Nairobi could be related to genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b, and L3.

Awareness of and willingness to use pre-exposure prophylaxis to prevent HIV infection among female sex workers in Anambra State, south-eastern Nigeria

Background: Pre-exposure prophylaxis (PrEP) is a highly effective preventive measures against HIV infection but its success is strongly based on adherence, which in turn depends on willingness to use. This study is aimed at assessing the level of awareness and willingness to use PrEP to prevent HIV infection among female sex workers (FSWs) in Anambra State, Nigeria, and to identify factors that influence willingness to use PrEP. Methodology: The study was a cross-sectional survey involving 265 brothel-based FSWs recruited through snowballing technique. A structured questionnaire was used to collect relevant information on demographic characteristics, awareness of HIV/AIDS and transmission route, attitudes/behavior related to HIV/AIDS, and awareness of and willingness to use PrEP. Univariate and bivariate analyses with Chi square test (with Odds ratio and 95% confidence interval) was used to determine association of socio-demographic and predictive factors with willingness to use PrEP. Statistical significance was considered when p value was less than 0.05. Results: Of 265 FSW respondents, only 81 (31.2%) have heard of PrEP, 10 (3.9%) indicated they have previously used PrEP while 91.0% indicated willingness to use PrEP. Univariate analysis showed that FSWs in Onitsha had a significantly higher odds (OR=28.6, 95% CI=1.718-476.82, p=0.0006) while those from Awka had a significantly lower odds (OR=0.184, 95% CI=0.0704-0.1812, p=0.0004) of willingness to use PrEP. Also, FSWs with monthly income less than 18,000 Naira had a lower odd of willingness to use PrEP (OR=0.3980, 95% CI=0.1593-0.9945, p=0.08). Bivariate analysis shows that FSWs who wish to have more knowledge of HIV/AIDS had higher odd of willingness to use PrEP than those who did not wish to have more knowledge (OR=4.235, 95% CI=1.577­11.374, p=0.0066). Similarly, FSWs who are worried of being discriminated against have a lower odd of willingness to use PrEP than those who are not worried of being discriminated against (OR=0.3921, 95% CI=0.1582-0.9718, p=0.0439). Conclusion: Our study showed low awareness but high willingness to use PrEP among FSWs in Anambra State,Nigeria. Cost, HIV/AIDS knowledge and fear of discrimination are significant predicting factors of willingness to use HIV PrEP and should be considered when formulating PrEP policy. Adequate enlightenment on PrEP should be emphasized among FSWs.

Uptake and impact of COVID-19 vaccination among HIV key populations: a cohort study from Tamil Nadu, India / Journal of Rural Medicine

Objective: Human Immunodeficiency Virus (HIV) Key Populations (KPs) include Female Sex Workers (FSWs), men who have sex with men (MSM), transgender (TG), and transsexual (TS) persons. This study assessed coronavirus disease 2019 (COVID-19) vaccine uptake among KPs for HIV in India, adverse events following immunization (AEFI), and breakthrough infections among the vaccinated.Materials and Methods: This retrospective cohort study was conducted among 421 KPs enrolled in 41 Targeted Intervention (TI) clusters in 31 districts of the Tamil Nadu State Acquired Immunodeficiency Syndrome (AIDS) Control Society (TANSACS), India, from June to September 2022. A semi-structured, bilingual (English and Tamil), interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, vaccination status, AEFIs, and breakthrough infections among the KPs under the TIs.Results: Among the KPs, 45.4% were FSWs, 37.1% were MSM, 16.2% were TG, and 1.4% were TS persons. Among them, 4.3% had HIV, and 2.9% had syphilis or other sexually transmitted infections (STIs). The COVID-19 vaccine uptake rate was 96%. Among the KPs, TG/TS persons had the highest vaccine uptake (98.6%), followed by FSWs (96.3%) and MSM (94.2%). AEFIs were reported by 85.4% of the participants. HIV positive status was significantly associated with the incidence of AEFI. The breakthrough infection rate was 5.4% among the vaccinated participants.Conclusion: The COVID-19 vaccine uptake among HIV KPs was high in Tamil Nadu. AEFIs and breakthrough infections among COVID-19 vaccinated HIV KPs may be low, with mild AEFIs.

Utilisation of HIV services by female sex workers in Zimbabwe during the COVID-19 pandemic: a descriptive phenomenological study

This study focuses on female sex workers as a key population group that suffers a degree of vulnerability according to the World Health Organisation (WHO). Key populations refer to people at heightened risk of contracting the human immunodeficiency virus (HIV) due to specific behaviours and social and legal environments which increase their vulnerability to the virus. Key populations are disproportionately affected by HIV, yet they have less access to HIV services compared to the general population. The coronavirus (COVID-19) lockdown and its restrictive measures have further widened the inequalities and gaps in accessing HIV services for this group. A descriptive phenomenological study was undertaken to explore female sex workers' experiences of utilisation of HIV services during COVID-19. The study setting was the Bulawayo Metropolitan Province, Zimbabwe. Data were collected through in-depth individual interviews with 10 female sex workers. Purposive sampling coupled with snowballing was utilised for recruiting participants. Data were analysed guided by the seven-step Colaizzi technique. Rigour was ensured through adhering to Lincoln and Guba's trustworthiness criteria. The study found that the COVID-19 pandemic adversely affected the livelihoods of sex workers and their utilisation of HIV services. There was limited access to HIV services due to an initial lack of travel authorisation letters and financial challenges experienced by study participants. In addition, the quality of care in health care facilities was further compromised by poor screening processes and reduced provider-client interactions. Maintaining access to HIV services for female sex workers during pandemics is critical for the country to attain HIV epidemic control.

A study of health seeking behavior about sexually transmitted infection in women with high risk behavior in an urban slum

Background: Health care seeking for sexually transmitted infection is frequently inadequate, particularly among female sex workers because of the low levels of awareness regarding sexual health. Correct diagnosis and treatment with health information are essential components of sexually transmitted infection (STI) services. Objective was to study demographic profile and to assess their health seeking behavior for STI and prevention services.Methods: Study was done in urban slum in Mumbai. It was cross sectional study conducted from May 2018 to December 2018.Results: The median age of women was 26 years. Majority belong to lower socio economic class, 39.4% women admitted that they took alcohol on occasions while 22% had sex with alcohol intake, 41% women were using condom during sexual activity. Only 14.5% women completed treatment who had past history of STI.Conclusions: Ensuring timely complete treatment of STI/RTI among women with high risk behavior is priority to prevent spread among general population.

AIDS sentinel surveillance of female sex workers in Songjiang District of Shanghai / 上海预防医学

Objective To investigate the knowledge of HIV/AIDS among the female sex workers in Songjiang District of Shanghai, changes in their related behaviors, and prevalence of human immunodeficiency virus(HIV), syphilis, and hepatitis C virus (HCV), providing evidence for related prevention and control work in this regard. Methods During 2011-2015 sentinel surveillance period, in the area of Songjiang District, according to the survey method of the National AIDS Sentinel Monitoring Implementation Program, questionnaires were conducted on the female sex workers and their venous blood was collected to detect HIV, syphilis and HCV antibodies. Results A total of 2 064 secret prostitutes were surveyed.The overall awareness rate of AIDS-related knowledge among them was 94.77%, and the annual awareness rates were 93.33%, 95.01%, 93.00%, 99.76%, and 92.57%, respectively(P < 0.05);The total proportion of the female sex workers who used condoms in the last commercial sex was 90.07%, and 84.05%, 80.55%, 93.72%, 99.06%, and 95.79% respectively in the calendar year(P < 0.05);The total proportion of the female sex workers who insisted on using condoms for commercial sex in the last 1 month was 76.74%, and 69.29%, 60.60%, 86.47%, 87.76%, and 78.96% respectively in the calendar year(P < 0.05);The average detection rate of HIV antibodies for 5 years was 0.00%, syphilis antibody detection rate was 3.00%, and HCV antibody detection rate was 0.34%. Conclusion The knowledge level of AIDS related knowledge is high among the female sex workers in Songjiang District.The persistent condom use rate during commercial sex is low in the last month; the syphilis detection rate is slightly higher than the national average.

AIDS sentinel surveillance of female sex workers in Songjiang District of Shanghai / 上海预防医学

Objective To investigate the knowledge of HIV/AIDS among the female sex workers in Songjiang District of Shanghai, changes in their related behaviors, and prevalence of human immunodeficiency virus(HIV), syphilis, and hepatitis C virus (HCV), providing evidence for related prevention and control work in this regard. Methods During 2011-2015 sentinel surveillance period, in the area of Songjiang District, according to the survey method of the National AIDS Sentinel Monitoring Implementation Program, questionnaires were conducted on the female sex workers and their venous blood was collected to detect HIV, syphilis and HCV antibodies. Results A total of 2 064 secret prostitutes were surveyed.The overall awareness rate of AIDS-related knowledge among them was 94.77%, and the annual awareness rates were 93.33%, 95.01%, 93.00%, 99.76%, and 92.57%, respectively(P < 0.05);The total proportion of the female sex workers who used condoms in the last commercial sex was 90.07%, and 84.05%, 80.55%, 93.72%, 99.06%, and 95.79% respectively in the calendar year(P < 0.05);The total proportion of the female sex workers who insisted on using condoms for commercial sex in the last 1 month was 76.74%, and 69.29%, 60.60%, 86.47%, 87.76%, and 78.96% respectively in the calendar year(P < 0.05);The average detection rate of HIV antibodies for 5 years was 0.00%, syphilis antibody detection rate was 3.00%, and HCV antibody detection rate was 0.34%. Conclusion The knowledge level of AIDS related knowledge is high among the female sex workers in Songjiang District.The persistent condom use rate during commercial sex is low in the last month; the syphilis detection rate is slightly higher than the national average.

Status of sexually transmitted infections and seeking medical treatment among Vietnamese cross-border female sex workers in Hekou County, Yunnan / 公共卫生与预防医学

Objective To understand the status of sexually transmitted infection and seeking medical treatment behavior, and influencing factors of Vietnamese cross-border female sex workers (FSWs) in Hekou County, Yunnan, and to provide a basis for promoting reproductive health and preventing and controlling the spread of sexually transmitted diseases (STD) in Vietnamese cross-border FSWs. Methods The snowball sampling method was used to recruit research subjects in entertainment venues in Hekou County, Yunnan, to conduct a questionnaire survey and collect blood, vaginal secretions and cervical swab specimens for HIV/STD testing. Results A total of 262 Vietnamese cross-border FSWs were investigated. The total infection rate of sexually transmitted diseases and HIV was 35.8% (94/262). The positive rate of genital herpes simplex, fungal vaginitis, trichomoniasis, wet warts and chlamydia were 23.5%, 8.0%, 2.7%, 1.5% and 1.5%, respectively. The positive rate of HIV was 1.5%. In the past year, 116 Vietnamese cross-border FSWs had symptoms related to sexually transmitted diseases. Among them, 34.5% chose to go to the hospital or private outpatient clinic, 44.8% bought medicines by themselves, and 20.7% did not receive any treatment. The FSWs who reported having sexually transmitted diseases testing in the past year (OR=3.54, P<0.05), came from medium and high-end places (OR=3.94, P<0.05), had more than two symptoms (OR=3.88, P<0.05), and self-perceived high risk of sexually transmitted infection were more likely to seek medical treatment. Conclusion The Vietnamese cross-border FSW population in Hekou County of Yunnan Province had a high rate of sexually transmitted infections. The proportion of seeking medical treatment among FSWs having symptoms related to sexually transmitted diseases was low. It is necessary to guide the Vietnamese cross-border FSWs to seek formal medical treatment.

Syphilis in female sex workers: an epidemiological study of the highway system of the state of Pará, northern Brazil

Abstract INTRODUCTION: Female sex workers (FSWs) are considered a bridge for transmission of pathogens from high-risk to general populations. We assessed the epidemiological status of syphilis in FSWs along the Pará highway system. METHODS: Two hundred and twenty-two FSWs were interviewed and samples were analyzed using rapid qualitative tests and real-time polymerase chain reaction. RESULTS: The prevalence of syphilis was high (36.94%). The high rate of prostitution, use of illicit drugs, and search for financial resources increased Treponema pallidum transmission through unprotected sex. CONCLUSIONS: Several characteristics of FSWs were identified, which reinforce the need for measures guaranteeing their health and protection.

Predictors related to condom use behaviors based on the theory of planned behavior among female sex workers / 中华疾病控制杂志

Objective To identify predictors related to condom use in different tiered female sex workers (FSWs) in Hubei Province. Methods A cross-sectional study was conducted in Hubei Province in 2015 to investigate 816 eligible FSWs by using a multistage sampling method. All data were collected by using a structured questionnaire with scales on condom use, which was designed based on the theory of planned behavior (TPB). A structural equation model (SEM) was used to identify predictors of condom use in the different tiered FSWs. Results It showed that low-tier FSWs used less condom than higher-tier FSWs in commercial sexual behaviors of the last time and during the last month(P<0.001). The TPB scores were significantly different in different tiered FSWs. The scores of PBC in low-tier FSWs were lower than those in higher-tier FSWs (11.43±2.86 vs 12.06±2.87, respectively, P=0.002); But the scores of behavioral intentions were higher than those in higher-tier FSWs (5.47±1.11 vs 5.20±1.15, respectively, P=0.001). The PBC was the major factor related to condom use in low-tier FSWs (effect coefficient=0.55, P<0.001), while the behavioral intention was the major factor related to condom use in higher-tier FSWs (effect coefficient=0.33, P<0.001). Behavioral attitude was the major factor of intention to use condoms for both low-tier (effect coefficient=0.49, P<0.001) and higher-tier FSWs (effect coefficient=0.42, P<0.001). Conclusions Changing the attitude to condom use in FSWs is an important measure to promote the behavior intention. Condom promotion interventions should focus on the perceived behavioral control in low-tier FSWs, and promote the behavior intention in higher-tier FSWs.

Analysis on condom use negotiation with sex partners and condom use in female sex workers / 中华流行病学杂志

Objective@#To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs.@*Methods@#The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom.@*Results@#A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6%, 499/852), after negotiation, 441 FSWs (88.4%, 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4%, 99/687), after negotiation, 54 FSWs (54.5%, 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3%, 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4%, 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1%,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2%, 21/499) reported that they used other strategies. 22 (4.4%, 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation (OR=4.00, 95%CI: 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use (OR=30.17, 95%CI: 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation (OR=4.44, 95%CI: 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use (OR=5.52, 95%CI: 1.55-19.73).@*Conclusions@#Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.

Prevalence of Trichomonas vaginalis and Human papillomavirus in female sex workers in Central Veracruz, Mexico / Prevalencia de Trichomonas vaginalis y virus del papiloma humano en mujeres trabajadoras sexuales en el centro de Veracruz, México

Female sex workers (FSWs) have been considered a key population for sexually transTrichomonas mitted infections (STIs); therefore, they are periodically screened as a requirement to obtain a work card. However, there is insufficient epidemiological data on STIs among FSWs in Mexico. The detection of Trichomonas vaginalis is limited to microscopic studies and the molecular screening of Human papillomavirus (HPV) is only done to women 35 years of age and older. The objective of this study was to determine the prevalence of T. vaginalis and HPV infections in FSWs in the city of Orizaba, Veracruz, Mexico. Samples from 105 FSWs were obtained by cervical swab and analyzed. The identification of T. vaginalis and HPV was performed by molecular methods. HPV DNA was identified in 5.71% of the samples with the presence of HPV16, HPV18, and HPV58. A percentage of 25.7% samples were positive for T. vaginalis for optical microscopy and 23.8% for PCR. The results of the study indicate the need to incorporate more sensitive methods for the timely diagnosis of STIs as well as comprehensive health promotion programs directed to the most vulnerable groups among FSWs.

Las mujeres trabajadoras sexuales (MTS) han sido consideradas una población clave para las infecciones de transmisión sexual (ITS), por ello son examinadas periódicamente como requisito para obtener una tarjeta de trabajo. Sin embargo, no existen datos epidemiológicos suficientes sobre las ITS en las MTS en México. La detección de Trichomonas vaginalis se limita a los estudios microscópicos, y el cribado molecular del virus del papiloma humano (Human papillomavirus: HPV) solo se realiza en las mujeres de 35 años o mayores. El objetivo de este estudio fue determinar la prevalencia de T. vaginalis e infecciones por HPV en las MTS de la ciudad de Orizaba, Veracruz, México. Se analizaron 105 muestras de las MTS, obtenidas mediante frotis cervical. La identificación de T. vaginalis y HPV se realizó por métodos moleculares. El ADN del HPV se identificó en el 5,71% de las muestras, con la presencia de HPV16, HPV18 y HPV58. El 25,7% de las MTS fueron positivas para T. vaginalis por microscopia óptica el 23,8% por PCR. Los resultados del estudio indican la necesidad de incorporar métodos más sensibles para el diagnóstico oportuno de ITS y programas integrales de promoción de la salud en los grupos más vulnerables, entre las MTS.

High-risk behaviors for hepatitis B and C infections among female sex workers

Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.

Progress of research on influencing factors of condom use among female sex workers / 中华流行病学杂志

Heterosexual transmission has become the main route of HIV transmission in China.As the main body of commercial heterosexual transmission,female sex workers (FSW) have a high-risk behavior of inconsistent condom use that increase the risk of HIV infection and spread.This review summarizes associated factors of condom use among FSW such as demographic characteristics,condom negotiation,sexual partner type,sexual intercourse,violence and HIV testing,which can provide reference for the future prevention and research among the FSWs.

Changes of proportion regarding consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above / 中华流行病学杂志

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.

Progress of research on influencing factors of condom use among female sex workers / 中华流行病学杂志

Heterosexual transmission has become the main route of HIV transmission in China.As the main body of commercial heterosexual transmission,female sex workers (FSW) have a high-risk behavior of inconsistent condom use that increase the risk of HIV infection and spread.This review summarizes associated factors of condom use among FSW such as demographic characteristics,condom negotiation,sexual partner type,sexual intercourse,violence and HIV testing,which can provide reference for the future prevention and research among the FSWs.

Changes of proportion regarding consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above / 中华流行病学杂志

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.

Estimating HIV incidence among female sex workers and injection drug users in Dehong Prefecture, 2009-2017 / 中华预防医学杂志

Objective@#To obtain HIV incidence among injection drug users (IDU) and female sex workers (FSW) in Dehong Prefecture, Yunnan Province during 2009-2017.@*Methods@#We recruited drug users and female sex workers from all sentinel surveillance sites across Dehong Prefecture during 2009-2017. A total of 10 480 IDU and 18 126 FSW in Dehong Prefecture were recruited by fingerprint technique. Data about drug uses, commercial sexual behavior, sociodemographic characteristics was collected by structured questionnaire. HIV-positive patients who were long-term infected or with CD4+ T cell count was ≤200 were not included for further HIV incidence testing. Also, those who self-identified as on antiretroviral treatment (ART) or AIDS cases were also excluded. A total of 841 and 157 plasma specimens from IDU and FSW that met the inclusion criterion were finally included, respectively. Limiting antigen avidity enzyme immunoassay(LAg-Avidity EIA) were performed to calculate the HIV incidence among these two sub-populations.@*Results@#A total of 3 444 IDU were HIV-positive, among which 884 (25.7%) were Burmese with age of (30.4±7.7), and 2 560 were Chinese with age of (36.6±7.3). Among 228 HIV-positive FSW, 109 (47.8%) were Burmese with age of (27.1±6.3), 119 (52.5%) were Chinese with age of (29.9±11.1). For IDU, the estimated HIV incidence among Burmese in 2009-2010, 2011-2012, 2013-2014, 2015-2017 was 4.20% (95%CI: -0.55%-8.95%), 7.75% (95%CI: 2.95%-12.55%), 11.79% (95%CI: 5.38%-18.20%), 10.30% (95%CI: 5.67%-14.94%), respectively, while Chinese were 3.11% (95%CI: 1.59%-4.64%), 0.03% (95%CI: -0.03%-0.08%), 1.55% (95%CI: 0.54%-2.57%), 0.58% (95%CI: -0.06%-1.04%), respectively. In 2009-2011, 2012-2014, 2015-2017, estimated HIV incidence among Burmese FSW was 0.22% (95%CI: -0.21%-0.64%), 1.24%(95%CI: 0.15%-2.32%), 0.55%(95%CI: 0.01%-1.08%). Whereas, estimated HIV incidence among Chinese FSW was 0.62% (95%CI: 0.25%-0.98%), 0.11% (95%CI: -0.04%-0.26%), 0.22% (95%CI: 0-0.44%).@*Conclusion@#HIV incidences among Chinese IDU and FSW are on the downward trend, while Burmese IDU and FSW seem to be gaining momentum.

A Study on the Preventive Drugs for Exposure to AIDS / 昆明医科大学学报

The prevention of occupational exposure to HIV has been carried out in China for many years, and achieved remarkable results. However, the practice of preventive drugs among people with non occupational exposure has many difficulties. Although the high-risk groups show high willingness and demand, their awareness of the preventive drugs is low due to the fear of increasing unprotected sex after the use of the drug. Other factors negatively affecting the application of the drugs are the cost and the side effects. In order to provide preventive treatment on time for the high-risk groups, the awareness of non occupational exposure prophylaxis should be raised.

Studies on behavior change and related factors among female sex workers in Qingdao city of Shandong province, between 2006 and 2015 / 中华流行病学杂志

Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.