An Epidemiological Study On The Prevalence And Risk Factors Of HIV And Sexually Transmitted Diseases Among Cross-border And Local Female Sex Workers In One County Of Yunnan

BackgroundPopulation migration is the stimulus to HIV/AIDS transmission; cross-border female sex workers are more vulnerable to HIV/AIDS than local ones. Researches indicated that HIV/AIDS infection rate of FSWs who repatriated from India to Nepal was found to be as high as 38%; that of cross-border FSWs in south Thailand reached 18-24%; the rate of cross-border FSWs in border-areas of Guangxi Province was 4.3%, higher than that of local FSWs (2.0%); and infection rate of cross-border FSWs from Menglian County of China to Thailand, Myanmar or Malaysia was 1.72%. Therefore, it is practically significant to examine the prevalence and risk factors of HIV and sexually transmitted diseases among cross-border FSWs for better HIV/STDs prevention and control in border areas.ObjectivesTo understand infection status and risk factors of HIV/STDs among Vietnamese and Chinese FSWs in cross-border county H, to investigate their relevant knowledge, attitudes, reproductive health status and doctor-seeking behaviors, to explore the influence of HIV/STDs among Vietnamese FSWs on local HIV/AIDS epidemics, and to provide operational implications for HIV/AIDS interventions in border areas.MethodsThe cross-section survey design was adopted, where all Vietnamese and Chinese FSWs who met standards were recruited. The data collected from questionnaire interviews and lab tests for samples of blood, urine, and cervix and vagina swabs were compared by the nationality of FSWs. The data were statistically analyzed and discussed.Results(1) HIV/AIDS infection rates of 219 Vietnamese and 113 Chinese FSWs are 8.2% and 0.9% respectively, with a statistically significant difference (χ2=7.43, P< 0.05). Sexual transmission is the main route of HIV transmission among FSWs. The study finds that major HIV risk factors for HIV infection of Vietnamese FSWs include the infection with Condyloma Acuminate (aOR=20.89,95%CI 3.29-132.45), under 12 scores of HIV/AIDS knowledge (aOR=6.52,95%CI 1.88-22.59), living in County H for over 6 months (OR=5.42,95%CI 1.65-17.78), and the age of first-time commercial sex behavior (20 and above) (OR=3.27,95% CI 1.04-10.27)(2) It is common that FSWs both in Vietnam and China have STDs. The HSV-2 infection rates are 64.8% and 47.8% respectively, those of Chlamydia Trachomatis 19.6% and 10.6%, Neisseria Gonorrhoeae 14.2%and 4.4%, condyloma acuminate 3.7% and 0.9%, syphilis 0.5% and 0.9%, vaginal trichomonads disease 0.9% and 4.4% and the positive rates of morphine in urine samples are respectively 0.08% and 0%. The multiple infection of STDs is severe. The percentages of patients infected with at least one STDs reach respectively 77.6% and 57.5%, with the dominant infection type of HSV-2. There is a serious problem for both Vietnamese and Chinese FSWs of HIV of being infected with other STDs, all of which contract one STD or more at the same time. In County H, the main risk factors of Vietnamese FSWs of HSV-2 are being aged over 20 years (OR=5.39,95%CI 1.71-16.96), and living in County H for over 6 months(OR=5.06,95%CI 2.54-10.08); while the main risk factors of Chinese FSWs are being aged over 20 years (OR=3.95,95%CI 1.65-9.43), and smoking(OR=2.61,95%CI 1.16-5.86).ConclusionsThe HIV/STDs epidemic is very serious among Vietnamese FSWs in County H, Yunnan Province. Therefore, supervision and management of Vietnamese FSWs should be strengthened. Intensive interventions in FSWs should be carried out to reduce their high risk behaviors and increase their knowledge about HIV/STDs. It will be helpful to prevent HIV transmission into general population by providing more condoms to FSWs, strengthening VCT and management of HIV positives (e.g. follow-up, referral, treatment and care).