Cross-sectional Study Of HTV/STD Prevalence Among Street-based Sex Workers In Taizhou Prefecture

Objective (1)To understand the characteristics of sociology, HIV/STD infection and influence factors among street-based sex workers(SSWs). (2)To investigate the epidemiological characteristics and social network among SSWs, and analysis its transmission mechanism as bridge crowd. (3)To understand the health needs and attitudes of SSWs, and to provide evidence for policy suggestion.Methods (1)From August 2012 to August 2013, two surveys focusing on SSWs and female sex workers(FSWs) were conducted to investigate demographic characteristics, sex service, health situation, health care seeking behaviors for STIs, the knowledge of HIV prevention and HIV testing. (2)Statistical methods included descriptive statistics, Chi-square tests, univariate and multivariate Logistic regression model.Results (1)289 SSWs were observed, the Han nationality accounting for 94.5%, other provinces accounting for 83.7%, the married accounting for 66.8%. The degree of education was given priority to with the junior middle school and below,53.3% and 37.7% respectively. Most of them aged 20 to 39, accounting for 71.9%. Most of them came to the city more than one year ago, accounting for 55.4%. Of the 1597 FSWs,93.3% was the Han nationality,15.3% was from other provinces,47.7% was married,60.4% got middle school education,59.7% was aged 20 to 29. The education degree of SSWs is lower than FSWs. The SSWs were older than the FSWs. The SSWs had first sex experience when 19.5±2.4 years old. The average business time of SSWs was 166.2 days a year. The average monthly income was 2691.8±981.5 yuan. The average number of customers ranged 1 to 5 accounted for 41.2% of all, with single sex price ranged 20 to 49 yuan accounting for 41.6%.(2)The condom use rate of last sex with spouse or lifetime partners was 29.3%, significantly lower than the one with the commercial partner and temporary proportion (78.4% and 80.0%). The same rate with last commercial sexual partner was74.6%, higher than the FSWs (48.6%)(P<0.01). The main reasons for using condoms were due to prevent disease, the guest’s insistence and SSWs didn’t like to use, accounting for 69.2%,45.4% and 45.4% respectively.0.3% of the SSWs used to abused drugs, likewise 0.8% of FSWs.(3)The rates of SSWs used to get infected by sexually transmitted diseases were syphilis (5.6%), gonorrhea (4.8%). The FSWs were more commonly for syphilis (1.1%). The priority chooses of STD diagnosis and treatment of the SSWs were general hospital, individual doctor/clinic and pharmacy to buy medicine, accounting for 53.8%,51.9% and 51.9% respectively. The rate of received preventive services in recently year of SSWs (80.8%) was lower than FSWs(98.7%) (P< 0.01). The awareness rate of AIDS related knowledge of SSWs was78.9%, slightly lower than that of FSWs(80.8%) (P> 0.05).(4)The SSWs were confirmed 2 serum HIV antibody positive, the positive rate of HIV antibody was 0.7%. None of FSWs was detected HIV positive. The syphilis TPPA positive rate of SSWs was 15.2%, higher than 3.0% of FSWs (p< 0.01).5.9% of SSWs was detected both syphilis TRUST and TPPA positive, which was higher than FSWs. The positive rate of HCV antibody of SSWs and FSWs were 0.7% and 0.1% respectively, with no statistical difference. The positive rate of HSV-2 antibody of SSWs was 69.2%.(5)Multi-factor analysis showed that: the influence factors of condom use in latest commercial behavior were working years, annual working time, the awareness of AIDS related knowledge. The influence factors of TPPA test positive were age, monthly income. The influence factors of HSV-2 positive were age and situation of receiving preventive services.Conclusion The SSWs in Taizhou prefecture with low degree of education, poor living conditions, had risk behaviors and cognition mistake still commonly existed. Seeking medical advice and prevention service coverage was not enough. It is indicated that we should strengthen the prevention work towards SSWs in order to reduce their risk behaviors, meanwhile, we also need to explore some more effective prevention model to control the prevalence of STIs, especially the prevalence of HIV.