2011—2016年北京市女性性工作者HIV梅毒血清学调查
|
摘要
目的了解北京市不同档次场所的女性性工作者(FSW)性病艾滋病相关行为及血清学感染状况及变化趋势。方法 2011—2016年对监管场所、社区来源的不同档次场所FSW进行连续横断面调查。收集人口学、高危行为、血清学等相关信息。监管场所采用全年连续抽样,社区来源暗娼采用概率抽样。结果共调查FSW 29 726人,其中低档场所FSW 11 898人,中高档场所FSW 17 828人。低档场所FSW在本地工作时间一年以上者从2011年的22.2%上升至2016年的46.4%(P=0.001),最近一个月内与客人发生性行为每次使用安全套者从2011年的61.4%下降至2016年的34.5%(P=0.001),艾滋病病毒(HIV)抗体阳性率在0～0.3%之间,梅毒阳性率在2.8%～4.7%之间,有波动但无明显变化趋势。中高档场所FSW安全套使用无明显变化趋势,HIV抗体阳性率在0～0.1%之间,梅毒阳性率从2011年的1.2%上升至2016年的1.8%,无统计学变化趋势。2016年调查的低档场所FSW在文化程度、本地工作一年以上、最近一个月与客人每次使用安全套的比例均低于中高档场所FSW(P=0.001),梅毒阳性率高于中高档场所FSW。结论北京市FSW人群存在流动性强,安全性行为比例低等特点,其中低档场所FSW年龄更大,艾滋病高危行为更严重,未来应继续加强FSW的现场干预和检测工作。
Objective To investigate the demographic characteristics, risk behaviors and prevalence of HIV and syphilis among female sex workers(FSWs) in different levels of entertainment establishments in Beijing. Methods Surveys were conducted during 2011 to 2016 among FSWs in Beijing to collect information on the demographic characteristics, sexual behaviors and HIV and syphilis prevalence. Serial cross-sectional surveys were done in detention places and probability sampling was used in communities. Results A total of 29 726 FSWs were surveyed, with 11 898 from low levels and 17 828 from middle-high levels. The local working time of low levels increased from 22.2% in 2011 to 46.4% in 2016(P=0.001). The rate of condom use each time in their sex with clients in the last month among low-level FSWs decreased from 61.4% in 2011 to 34.5% in 2016(P=0.001). HIV prevalence was between 0-0.3%. Syphilis ELISA and RPR doubled, and 11 898 prevalence was between 2.8-4.7%, without any statistical significance. Among the middle-high-level FSWs, the rate of condom use had no statistical significance. HIV prevalence was between 0-0.1%. Syphilis RPR prevalence was increasing from 1.2% in 2011 to 1.8% in 2016, without any statistical significance. In 2016, education, local working time of low levels among FSWs were all lower than those in middle-high levels(P=0.001). The rate of condom use each time in their sex with clients in the last month among low-level FSWs was lower than that among middle-high-level ones. Conclusion The FSWs in Beijing are very mobile, low education and less safe sex behavior, especially the low-level FSWs. More attention should be paid to intervention and spot testing of HIV with low-level FSWs.
Objective To investigate the demographic characteristics, risk behaviors and prevalence of HIV and syphilis among female sex workers(FSWs) in different levels of entertainment establishments in Beijing. Methods Surveys were conducted during 2011 to 2016 among FSWs in Beijing to collect information on the demographic characteristics, sexual behaviors and HIV and syphilis prevalence. Serial cross-sectional surveys were done in detention places and probability sampling was used in communities. Results A total of 29 726 FSWs were surveyed, with 11 898 from low levels and 17 828 from middle-high levels. The local working time of low levels increased from 22.2% in 2011 to 46.4% in 2016(P=0.001). The rate of condom use each time in their sex with clients in the last month among low-level FSWs decreased from 61.4% in 2011 to 34.5% in 2016(P=0.001). HIV prevalence was between 0-0.3%. Syphilis ELISA and RPR doubled, and 11 898 prevalence was between 2.8-4.7%, without any statistical significance. Among the middle-high-level FSWs, the rate of condom use had no statistical significance. HIV prevalence was between 0-0.1%. Syphilis RPR prevalence was increasing from 1.2% in 2011 to 1.8% in 2016, without any statistical significance. In 2016, education, local working time of low levels among FSWs were all lower than those in middle-high levels(P=0.001). The rate of condom use each time in their sex with clients in the last month among low-level FSWs was lower than that among middle-high-level ones. Conclusion The FSWs in Beijing are very mobile, low education and less safe sex behavior, especially the low-level FSWs. More attention should be paid to intervention and spot testing of HIV with low-level FSWs.
引文
[1] 中国疾病预防控制中心性病艾滋病预防控制中心性病控制中心. 2016年12月全国艾滋病性病疫情[J]. 中国艾滋病性病,2017,23(2):93.
[2] 范和发,张择榕,李建.不同档次暗娼性病艾滋病感染情况调查[J].现代预防医学,2016,43(8):1491-1494.
[3] Chen Y, Abraham Bussell S, Shen Z, et al. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China[J]. Medicine (Baltimore),2016,95(22) :e3726.
[4] 韩孟杰,胡志.中国艾滋病防治督导与评估框架使用手册(试用)[M].北京:人民卫生出版社,2008.
[5] 张祖样,宋丽军,罗红兵,等. 2013年云南省暗娼艾滋病高危行为调查分析[J]. 中华预防医学杂志,2014,48(12):1057-1062.
[6] 李秀苾,张振开,文小青,等. 不同档次场所暗娼人群艾滋病/性病感染状况和高危行为调查[J]. 实用预防医学,2013,20(7):816-818.
[7] 李东民,袁飞,胡绍源,等. 不同场所暗娼的高危行为和HIV/STI感染状况调查[J]. 中国艾滋病性病,2007,13(3):210-213.
[8] 张应留,李昆,马懿,等.玉溪市红塔区暗娼人群艾滋病综合干预效果分析[J].中国艾滋病性病,2007,13 (增刊):44-46.
[9] Hong Y, Zhang C, Li X, et al. HIV testing behaviors among female sex workers in Southwest China[J]. AIDS Behav,2012, 16(1): 44-52.
[10] Wang YX, Kang DM, Liao MZ, et al. Analysis of condom use and its factors on female sex workers in Shandong province[J].Zhonghua Yu Fang Yi Xue Za Zhi, 2011,45(5):435-439.
[11] Chen YY, Li XM, Shen ZY, et al. Contextual Influence on Condom Use in Commercial Sex Venues: a Multi-level Analysis among Female Sex Workers and Gatekeepers in Guangxi, China[J]. Soc Sci Res,2015(52): 1243110.
[12] 张洋,周鼎伦,万绍平,等. 大龄女性性工作者艾滋病传播风险分析[J]. 中国公共卫生,2013,29(12):1725-1728.
[13] Guo Y, Xu X, Fu G, et al. Risk behaviours and prevalences of HIV and sexually transmitted infections among female sex workers in various venues in Changzhou, China[J]. Int J STD AIDS,2017,28 (1135):1030325661.
[14] 李婷,温炬,朱凯星,等.广州市海珠区娱乐场所暗娼的性行为安全性和梅毒感染情况调查[J]. 皮肤性病诊疗学杂志,2006,23(1):57-59.
[15] 周月姣,沈智勇,唐振柱,等.广西低档场所暗娼人群梅毒感染及危险因素分析[J].中国健康教育,2013,29(7):627-630.
[16] Chen XS, Yin YP, Liu GG, et al. Outreach syphilis testing services by different health providers to female sex workers in southern China[J].PLoS One,2013,8(4):e60626.
[2] 范和发,张择榕,李建.不同档次暗娼性病艾滋病感染情况调查[J].现代预防医学,2016,43(8):1491-1494.
[3] Chen Y, Abraham Bussell S, Shen Z, et al. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China[J]. Medicine (Baltimore),2016,95(22) :e3726.
[4] 韩孟杰,胡志.中国艾滋病防治督导与评估框架使用手册(试用)[M].北京:人民卫生出版社,2008.
[5] 张祖样,宋丽军,罗红兵,等. 2013年云南省暗娼艾滋病高危行为调查分析[J]. 中华预防医学杂志,2014,48(12):1057-1062.
[6] 李秀苾,张振开,文小青,等. 不同档次场所暗娼人群艾滋病/性病感染状况和高危行为调查[J]. 实用预防医学,2013,20(7):816-818.
[7] 李东民,袁飞,胡绍源,等. 不同场所暗娼的高危行为和HIV/STI感染状况调查[J]. 中国艾滋病性病,2007,13(3):210-213.
[8] 张应留,李昆,马懿,等.玉溪市红塔区暗娼人群艾滋病综合干预效果分析[J].中国艾滋病性病,2007,13 (增刊):44-46.
[9] Hong Y, Zhang C, Li X, et al. HIV testing behaviors among female sex workers in Southwest China[J]. AIDS Behav,2012, 16(1): 44-52.
[10] Wang YX, Kang DM, Liao MZ, et al. Analysis of condom use and its factors on female sex workers in Shandong province[J].Zhonghua Yu Fang Yi Xue Za Zhi, 2011,45(5):435-439.
[11] Chen YY, Li XM, Shen ZY, et al. Contextual Influence on Condom Use in Commercial Sex Venues: a Multi-level Analysis among Female Sex Workers and Gatekeepers in Guangxi, China[J]. Soc Sci Res,2015(52): 1243110.
[12] 张洋,周鼎伦,万绍平,等. 大龄女性性工作者艾滋病传播风险分析[J]. 中国公共卫生,2013,29(12):1725-1728.
[13] Guo Y, Xu X, Fu G, et al. Risk behaviours and prevalences of HIV and sexually transmitted infections among female sex workers in various venues in Changzhou, China[J]. Int J STD AIDS,2017,28 (1135):1030325661.
[14] 李婷,温炬,朱凯星,等.广州市海珠区娱乐场所暗娼的性行为安全性和梅毒感染情况调查[J]. 皮肤性病诊疗学杂志,2006,23(1):57-59.
[15] 周月姣,沈智勇,唐振柱,等.广西低档场所暗娼人群梅毒感染及危险因素分析[J].中国健康教育,2013,29(7):627-630.
[16] Chen XS, Yin YP, Liu GG, et al. Outreach syphilis testing services by different health providers to female sex workers in southern China[J].PLoS One,2013,8(4):e60626.