A Study On The Quality Of Accepted HIV Testing And Counseling Among Vietnamese Female Sex Workers In A County Of Yunnan Province

ObjectiveAccording to the HIV testing and counseling(HTC)services standard of World Health Organizati on(WHO)to study the status,assessments and effectiveness of HTC services among transnational Vietnamese female sex workers.To analysis the quality of HTC services,and to fill in the data gap in HTC services quality of this population,put forward the solutions.More to improve the HCT services the quantity and quality,it will conducive to regional cooperation in AIDS prevention and control.MethodsThis study combined with literature review,field investigation and laboratory testing methods.The method of cross-sectional investigation were adopted in the field investigation.November 2018,Hekou County as the survey site,using the method of objective sampling to select local transnational Vietnamese female sex workers as the object of investigation.According to the HTC services col:ttent of WHO,after informing and consenting,a face-to-face questionnaire survey was conducted by were trained Vietnamese and Chinese bilingual outreach staff using a self-made questionnaire.The survey content included the status,assessments and effectiveness of HTC services,and HIV testing influencing factors.Meantime,blood samples were collected by disease control staff for HIV testing.Venous blood 10ml was collected to test HIV antibody,Enzyme-linked immunosorbent assay(ELISA)was used to initial and again screen.Western blot(WB)test was used to confirm the positive results.Epidata3.1 was used to set up the database and double input the questionnaire data.Statistical description,Chi-square test and non-conditional binary logistic regression analysis with spss25.0,making Statistical Graph with excel 2007.Results1.General situation:a total of 193 Vietnamese female sex workers were surveyed,and the average age is 20.91±5.14 years,the middle school education level 111(57.50%)participants,43(22.30%)participants are very proficient in Chinese.2.Sexual behaviour and mobility:During Hekou 113(58.50%)participants work for less than or equal to 6 months and 100(51.80%)participants were sublet from Hekou to inland.Clients came from 193(100.00%)Chinese,9(4.70%)Burmese,55(28.50%)Vietnamese and 6(3.10%)Japanese.3.The status of HTC services:There were 6(3.10%)participants gained full HTC services.71(36.80%)did not accept a demonstration of how to use condoms,184(95.30%)did not receive assessment of the risk of HIV infection,and 163(94.50%)did not receive AIDS risk reduction services.14(7.30%)have not been tested for HIV,and 5 didn,t know the results of testing among have been tested.Counseling after testing,105(58.66%)had not received the service of informing their partner HIV testing result.Accessed to HTC service information include health institutions 85(44.00%),networkjmedia 83(43.00%),friends/peers 96(49.70%).127(65.80%)were provided by outreach personnel,and 172(89.10%)received services in their own language,Vietnamese.4.The assessments of HTC services:All feel that the staff member had a good attitude and had obtained consent to accept the service.But there were 9(4.70%)participants don't think their privacy were protected when they received the services.And 2(1.00%)said staff discriminated against them.lt is considered that the service cost is appropriate,the time is appropriate,the content is easy to understand,the development time is reasonable,and the place of development is suitable respectively are 184(95.30%),187(96.90%),191(99.00%),190(98.40%),191(99.00%).5.The effectiveness of HTC services:The false cognition for they would be infected HIV if have dinner with AIDS patients,HIV positive should be told to their partners and HTC could reduce the spread of HIV respectively are 55(28.50%),40(20.73%)and 11(5.70%).The true cognition for the knowledge of AIDS transmission route and correctly using of condoms could avoid HIV infection respectively are 181(93.80%)and 192(99.50%).In the last month,10(5.20%)didn't use condom each time when they had sex with guests or temporaly partners and the reason all were that guests didn't like.And 120(62.20%)didn't use condom each time when they had sex with a fixed partner.There are 60(31.09%)had symptoms of gynecological disease in the last year.There are 4(2.10%)used morphine,Maru and other new drugs;1(0.50%)shared needles to take drugs and 1(0.50%)was positive for HIV testing.6.The single factor and multi-factor analysis of HIV testing:The groups of lower rate of HIV testing are those who expertly speak Chinese(P=0.041),and those with an average monthly income of less than 5,000 yuan(P<0.001)and more than 10,000 yuan(P=0.002).Those who sexual working hours less than or equal 6 months(P=0.009),those without subleases(P?0.001).Those who had not received national language services(P=0.001),who consider the cost of service do not appropriate(P=0.001),who don,t know if it's appropriate to spend time(P=0.014),who don't know if the content is easy to understand(P=0.009),who don't know the time of development is reasonable(P=0.026),and that of thinking the place of service is unsuitable(P=0.009),who think privacy didn't be protected(P=0.047),who don't know the route of transmission(P<0.001),who don't know that HIV test positive should tell their partners(P=0.001),and don't know that HTC can reduce the spread of HIV(P=0.001).The results of non-conditional binary logistic regression analysis show that the risk factors of HIV testing include could speak Chinese,without subleases,considering the cost of service inappropriate and have false cognition for HIV transmission route.ConclusionVietnamese FSWs are high mobility.They can obtain HTC services information and services in many ways.They have high evaluation for the accessibility(cost,time,etc.),acceptability(content,location,etc.)and informed consent of HTC services.The model of domestic language service is especially worth popularizing in the HTC services work of transnational population.However,only 3.10%of those who accepted the full HTC services defined by WHO.There are few services to assess infection risk in pre-test consultation,and 36.80%did not accept demonstration of condom use,95.30%of AIDS infection risk has not been assessed,94.50%did not receive AIDS risk reduction services.The consultation information before and after testing is insufficient,the situation of ignoring consultation and stressing testing inspection are obvious,and the privacy and discrimination services need to be improved.Still 5.20%of the guests did not use condoms each time and high risk sexual behavior is obvious.The effectiveness of HTC services needs to be further improve.In the future,the integrity and quality of consulting services should be strengthened,with emphasis on those who speak Chinese and whose average monthly income is lower or more than 10,000 yuan,and those who are newly arrived at Hekou to be subleased to provide service.