35岁及以上低档暗娼安全套使用及梅毒感染情况分析

周楚; 董薇; 吴尊友; 贾曼红; 李佑芳; 周月姣; 谭广杰; 陈曦; 郑军; 柔克明

Abstract

周楚,董薇,吴尊友,贾曼红,李佑芳,周月姣,谭广杰,陈曦,郑军,柔克明.35岁及以上低档暗娼安全套使用及梅毒感染情况分析[J].Chinese journal of Epidemiology,2018,39(6):745-749

35岁及以上低档暗娼安全套使用及梅毒感染情况分析

Changes of proportion regarding consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above

Received:January 17, 2018

DOI：10.3760/cma.j.issn.0254-6450.2018.06.010

KeyWord: 暗娼安全套梅毒横断面调查低档

English Key Word: Female sex workers Condoms Syphilis Cross-sectional studies Low-fee

FundProject:国家科技重大专项（2012ZX10001-007-004）

Author Name	Affiliation	E-mail
Zhou Chu	National Center for AIDS/STD Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing 102206, China
Dong Wei	National Center for AIDS/STD Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing 102206, China
Wu Zunyou	National Center for AIDS/STD Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing 102206, China
Jia Manhong	Yunan Provincial Center for Diseases Control and Prevention, Kunming 650022, China
Li Youfang	Yunan Provincial Center for Diseases Control and Prevention, Kunming 650022, China
Zhou Yuejiao	Guangxi Zhuang Autonomous Region Center for Diseases Control and Prevention, Nanning 530028, China
Tan Guangjie	Guangxi Zhuang Autonomous Region Center for Diseases Control and Prevention, Nanning 530028, China
Chen Xi	Hunan Provincial Center for Diseases Control and Prevention, Changsha 410005, China
Zheng Jun	Hunan Provincial Center for Diseases Control and Prevention, Changsha 410005, China
Rou Keming	National Center for AIDS/STD Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing 102206, China	kemingrou@chinaaids.cn

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Abstract:

目的针对年龄≥ 35岁低档暗娼（大龄暗娼）开展两轮横断面调查，观察大龄暗娼的安全套使用和梅毒感染状况，为大龄暗娼干预工作提供参考依据。方法选择异性性传播感染HIV情况较严重的6个市（县）作为研究现场，分别为广西壮族自治区柳州市和贵港市平南县、云南省西双版纳傣族自治州景洪市和大理白族自治州大理市、湖南省张家界市和永州市江华瑶族自治县。在低档的性交易场所招募大龄暗娼，排除开展调查前已经在艾滋病综合防治信息系统网络直报为HIV阳性者，收集社会人口学特征、性行为等信息，采血做梅毒血清学试验。分别于2012年10月至2013年1月完成第1轮调查、2015年6-9月完成第2轮调查。每轮调查样本量约为360人。采用EpiData 3.0软件和SPSS 22.0软件进行数据整理和统计学分析。结果第1轮和第2轮调查的研究对象人数分别为371人和403人；年龄分别为（42.4±5.1）岁和（43.8±5.1）岁（t=3.537，P<0.001）；性交易价格分别为（36.8±13.7）元/次和（49.5±15.8）元/次（t=11.961，P<0.001）；性交易工作年限>2年的构成比分别为46.9%（174/371）和61.3%（247/403）（χ²=16.125，P<0.001）；性交易坚持使用安全套的比例，第1轮和第2轮调查的比例分别为46.9%（174/371）和64.3%（259/403）（χ²=23.641，P<0.001）；梅毒感染比例，第1轮和第2轮的比例分别为15.9%（59/371）和7.2%（29/403）（χ²=14.533，P<0.001）。结论两轮横断面调查比较，大龄暗娼的性交易坚持使用安全套的比例有所提高、梅毒感染比例有所下降。但是，还不能满足梅毒等性传播疾病的防治目标。应继续重点关注大龄暗娼，切实有效推进干预措施。

English Abstract:

Objective To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW), in order to provide evidence for targeted intervention strategies.Methods A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region, Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province, Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study, with 60 eligible participants needed in each city, estimated through a pre-study. The first cross-sectional survey was completed from October 2012 to January 2013. Face-to-face questionnaire interview was carried out to collect information on socio-demography, work-related information and condom use situation. Blood was collected for syphilis testing. The second cross-sectional survey was carried out from June to September, 2015 under the same procedure.Results A total of 371 and 403 eligible participants were included in the first and second survey, respectively. When comparing the two surveys, we noticed that the average age showed a slight change, from 42.4 years to 43.8 years old (t=3.537, P<0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961, P<0.001). In the first survey, 46.9% (174/371) of the participants had more than two years of experience working as LFSW, compared to 61.3% (247/403) in the second survey (χ²=16.125, P<0.001). Also, 46.9% (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3% (259/403) (χ²=23.641, P<0.001) in the second one. Rates of syphilis infection were found from 15.9% (59/371) in the first survey reduced to 7.2% (29/403) in the second survey (χ²=14.533, P<0.001).Conclusion Compared with the first survey, the proportion of consistent condoms use showed an increase. Although the proportion of syphilis infection decreased in the second survey, the scope did not meet the criteria on syphilis, set by the government. Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.

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