Repeated Cross-sectional Studies On HIV And Sexually Transmitted Diseases Among Female Sex Workers In Kaiyuan, Yunnan Province

BackgroundThe estimation result showed by the end of 2007, approximately 700,000 are now HIV positive (range 550,000 to 850,000). The prevalence among Chinese population is 0.05%(range from 0.04 to 0.07%). Among the transmission modes, the ratio of sexual transmission is increasing each year. Heterosexual transmission was 10.7% of the total in 2005 and reached 37.9% in 2007. Among the 50,000 estimated new infections during 2007, heterosexual transmission account for 44.7 percent.ObjectiveTo investigate the prevalence and risk factors of HIV/STIs among FSWs in Kaiyuan city; to measure HIV incidence and the characteristics of recently HIV-infected FSWs and risk factors; to estimate the high-risk behaviors and the trend of FSWs.MethodThree cross-sectional surveys were carried out among FSWs in Kaiyuan City, China between March 2007 and May 2008, FSW participants who repeatedly attended serial cross-sectional surveys comprised an open-cohort and FSW who attended all three cross-sectional surveys comprised a closed-cohort. We collected socio-demographic characteristics, floating, medical history, drug use, health and sexual behaviors. The blood was collected to test for HIV, HSV-2 and syphilis, urine speciman was collected to test for morphine, cervical secretions was collected to test for Gonorrhoea and Chlamydia trachomatis, vaginal secretions was collected to test for Trichomonas vaginalis.Result(1) The prevalence of HIV were 13.0% (92/705), 12.4% (50/403) and 11.2% (66/587) among Kaiyuan FSWs who attended the serial cross-sectional surveys respectivly, but there is no significant difference between the trend of increased (P>0.1). Injection drug use history is the main risk factor among FSWs (aOR=4.9), and early for first commercial sexual activities(aOR=1.8) and frequent sexual partner exchange (aOR=1.7) tend to be more important for HIV infection; (2) The incidence of HIV was 1.4 (95% CI 0.04 - 2.8) /100 person years (PY) in the open-cohort. All new HIV infections were non-drug users; (3) There is a significant drop for high-risk behavior in the closed cohort study (e.g. non-insist on condom use) (x~2=5.291, P<0.05), and the symptoms of sexually transmitted diseases has also decreased significantly(x~2=12.314, P<0.001).ConclusionHIV/STIs infection is serious in Kaiyuan city, Yunnan province. Injecting drug use experience remains a major risk factor for HIV infection, and sexual contact has been made an important factor for new infections. So strengthened efforts should be carried out to curb their unprotected sexual behavior. High-risk behavior among FSWs had a significant drop in closed cohort study (e.g. non-insist on condom use). However, HIV and some part sexually transmitted diseases are still high, it may suggests that the reality of self-reported information is subject to further analysis.