Investigation On HIV/AIDS Related Knowledge, Attitude And Behavior And Evaluation Of Intervention Among Female Sex Workers

Objective:To investigate HIV/AIDS related knowledge, attitude and behavior among female sex workers (FSWs); to define predictors relevant to society, economy and culture of condom use during commercial sex activities; to find effective comprehensive intervention strategy aiming at FSWs.Method:A town with synergic government willing to support the study, quite a number of floating population and FSWs and a good health service in Guangdong was selected as the study spot. A comprehensive intervention based on the results of baseline investigation had been implemented for four months, which included propaganda, free condom distribution, venereal clinic's providing and community intervention network. Finally, an evaluation survey was carried out to evaluate the effect of the comprehensive intervention.Qualitative and quantitive methods had been used during the process of the study.Results:1. Before intervention, the general knowledge rate of Sexually transmitted diseases (STDs) and HIV/AIDS were quite low among FSWs. Male/female STDs and HIV/AIDS knowledge rate were only 18.0%, 14.4% and 36.0%_respectively. Few FSWs perceive about the risk of being infected with HIV. Only 15.1% FSWs thought they might get infected in future, and 44.9% of those didn't believe therewere people with HIV/AIDS around them at all. Although 86.8% FSWs used condoms every time during their commercial sex activity, but the condom use rate with their fixed partners was only 42.9%. The rate of FSWs who could basically correctly used male condoms was only 60.3%.2. The most important reason that FSWs had not used condoms during their sex activities is the dislike or refusal from their sex partners. Further multiple factors analysis indicates that condom use was negatively associated with the age of FSWs appeared their first sex intercourse and engaged in the commercial sex activities, and the condom use rate among those who had taken STDs examinations during the last 6 months was higher than those who had not(OR=5.472,P=0.013).3. After the comprehensive HIV/AIDS intervention, the female STDs knowledge rate was increased 22.4 %(x2=17.630, P=0.000), male STDs knowledge rate was increased 27.6%(x2=15.014, P=0.000) and HIV/AIDS knowledge rate was increased 24.8%(x2=16.263, P=0.000). The cognition of the condom's function in the prevention of HIV/AIDS was improved, the knowledge rate of 'HIV/AIDS can be prevented by persistent correct use of condoms' was increased from 49.6% to 68.8%(x2=9.967, P=0.002). The rate of FSWs who could basically correctly use male condoms was increased 16.7%. The proportion using condoms persistently to prevent HIV/AIDS was increased from 66.2% to 82.4%(x2=8.469, P=0.004).Conclusions:1. Before intervention, FSWs knew little about the knowledge of STDs and HIV/AIDS, and were imperceptive about the risk of being infected with HIV. There were quite a lot mistakes about their condom using. HIV related high-risk behaviors also existed. Comprehensive intervention need to be carried out urgently, widely and deeply in this population.2. Qualitative and quantitive analysis of the influential factors for condom use indicates that the obstruction of condom use during the commercial sex activity was mainly from the FSWs' clients, and the ability of FSWs to_negotiate thecondom use with their clients is usually limited. The measures aiming at FSWs should be performed in the process of HIV/AIDS prevention.3. Comprehensive intervention which included propaganda, condom's popularization, venereal clinic's providing and community intervention network can effectively improve not only FSWs' knowledge of STDs and HIV but also hygiene consciousness, as well decrease their rate of high-risk behaviors.