Related Factor Analysis And Status Survey Of HIV And Syphilis Infection Among Underground Prostitutes In Jilin Province

AIDS(Acquired immunodeficiency syndrome),resulting from human immunodeficiency virus(HIV),is characterized by mixed immunodeficiency syndrome and mainly T-cell immunodeficiency.Since its finding in America in 1981,AIDS has been unique around the world in its rapid spread and become one of the most hazardous diseases to people's life and health.Syphilis is a systematic and chronic sexual transmitted disease(STD) resulting,from pallid leptospira and one of the classic STDs which can be found in America,Europe and developing countries with higher incidence.With open policies in society and economic development people's attitude towards sex freedom has been changed a lot and they accept the view of sex freedom gradually.Unsafe sex behaviors have been more popular among various people's groups.Underground prostitutes meet diversified clients as a special moving group providing sex service and their sexual activity make them get infected easily with STI and HIV without permission of laws and social authority.Underground prostitutes become a high risk people group catching HIV and syphilis infection due to their unprotected sex behaviors,habits,social relationship,personal intercourse,social environment and culture,as well as a bridge people group spreading HIV and STD from high risk people group to ordinary people.Jilin Province is a region with low AIDS and STD prevalence rates,but where there are high risk people groups who have high risk behaviors,similar to the regions with higher AIDS and STD prevalence rates.Objective:The objective of this study is to clarify AIDS and STD infection status and related factors among underground prostitute's group and improve,their high risk behaviors for reducing their HIV and syphilis infection and set up a scientific basis for developing health education and behavior intervention.Methods:According to the types of underground prostitute groups(one is in public places,the other is on the street),the subjects were randomly selected through two stages and convenient sampling and the two time surveys were done among underground prostitute groups in Changchun,Jilin cities where the economic situation and recreational activities are developed better and Tong Hua city where it was taken as less developed economic region in July-Sept,2006 and July-Sept,respectively.The face to face investigation were done among surveyed subjects by means of anonymous methods and their blood samples were collected for HIV antibody tests(ELISA for screening and Western Blot for confirmation)and syphilis leptospira test(RPR for screening,TPPA for confirmation).The consultation,introduction and transfer services were provided for the subjects four weeks later following the date collecting their blood samples.Database was set up through Epidata 3.0 and data was statistically analyzed through SPSS 12.0 and risk factors of disease infection were analyzed by Logistic regression method.Results:The results show that no HIV carrier was reported among 1286 subjects in 2006 and one HIV carrier(sex route transmission)was reported among 1342 subjects in 2007,which indicates that the prevalence rate among this people group is still low in three cities.The syphilis infection rates among the underground prostitute group in three cities were 8.5%in 2006 and 2.6% in 2007 respectively and the significant declining trend can be seen between 2006 and 2007 years.The syphilis infection rate in 2007 is significantly lower than that in 2006 among underground prostitutes in Changchun and Tong Hua cities,but no significance difference of syphilis infection rates among underground prostitutes in Jilin city between 2006 and 2007 years.The reasons that the syphilis infection rate decreased can be attributed to the intervention activity implementation and increased underground prostitute proportion from middle and higher tier public places,but the underground prostitute groups remain the same proportion between 2006 and 2007 years.34.7%underground prostitutes in 2006 and 19.8%underground prostitutes in 2007 didn't use condoms to have completed their commercial sex behaviors,which indicates that the condom using rate increased in 2007, compared with that in 2006 and unprotected sex behaviors decreased in 2007. The positive results can be seen from the intervention program,that is 100% condom use.But the condom using rates remain unchanged when they have sex behaviors with their fixed partners,which means that STD will be easily transmitted from infected underground prostitutes to their fixed partners through unprotected sex activity and this group can be called bridge people who will play a role transmitting STD from high risk people to ordinary people,so it is very important to spread the concept of 100%condom use in their fixed partners of underground prostitutes.The reason that underground prostitutes do not use condoms is mainly that clients don't like to use them during their sex activity,which indicates health education and intervention program for underground prostitutes should including not only basic condom use skills but also techniques to persuade clients to use condoms.Some surveyed underground prostitutes had drug use behaviors in both 2006 and 2007 and they went in for commercial sex activity for a longer time and more clients than other underground prostitutes.In order to get more money to buy drug the drug users among underground prostitutes would increase times of commercial sex activity and meet more clients.High risk behaviors among underground prostitutes make them become a vulnerable people group to catch HIV/STI.Additionally,underground prostitutes accompanied by drug use behavior make them become a bridge group transmitting HIV/STI from high risk people to ordinary people and they have dual risks to get infected with HIV/STI.Conclusions:The prevalence rate among this people group is still low in Jilin Province.The syphilis infection rates among the underground prostitute group in three cities were 8.5%in 2006 and 2.6%in 2007 respectively and the significant declining trend can be seen between 2006 and 2007 years.Age factor of demography has part significance,but no statistical significance can be seen among behavior variables through single factor analysis of infection factors of underground prostitutes getting syphilis.