High Prevalence of Syphilis among Street-Based Female Sex workers in Nanchang, China

Female sex workers (FSWs) play a critical role in the heterosexual transmission of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) in China. Several studies reported that street-based FSWs have higher risk behaviors than establishment-based FSWs. Therefore, street-based FSWs should be specifically targeted for HIV and STIs intervention programs.

This study aims to investigate the prevalence rates and risk factors of HIV and syphilis among FSWs in Nanchang, China.

Using convenience sampling methods, 361 street-based FSWs were recruited from August 2011 to February 2012. All participants completed an anonymous questionnaire on socioeconomic and sex behavioral information and were tested for HIV and syphilis. Risk for HIV and syphilis infection was assessed using univariate and multivariate logistic regression analyses. 

• No HIV infections were found. 
• The prevalence rate of syphilis was 43.5%. 
• Nearly 46.1% of street-based FSWs reported having education for no more than 6 years. 
• Having reproductive tract infections at current visit, duration of sex work more than 5 years, indulgence in unprotected sex trade in the last time, unprotected sex trade in the last month, and unprotected sex with boyfriend or spouse in the last month were reported by 35.2%, 43.5%, 33.8%, 60.4%, and 93.1% street-based FSWs, respectively. 

In multivariate logistic regression analysis, having reproductive tract infections at current visit, duration of sex work more than five years, and unprotected sex trade in the last month were independently associated with syphilis infection.

The prevalence rate of syphilis among street-based FSWs is very high. Most street-based FSWs in our survey had low education, long experience of commercial sex, and high rate of inconsistent condom use. Comprehensive interventions targeting this high-risk group, especially scaling up screening and ensuring consistent use of condoms during sex are needed.

Table 2

Association of sexual behavioral factors with syphilis infection among street-based female sex workers in Nanchang, Jiangxi province

Table 3

Factors associated with syphilis infection among street-based female sex workers in Nanchang, Jiangxi Province, as predicted by a multiple logistic regression model

Full article at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228639/

By: Xiao Hua Tao, Tao Jiang,1 Dan Shao, Wei Xue, Fa Shun Ye, Ming Wang, and Mei Hua He

1Department of Gynaecology, The First People's Hospital of Jiujiang, Jiujiang, 332000, Jiangxi Province, China

More at:  https://twitter.com/hiv_insight

Access to Healthcare for Long-Term Conditions in Women Involved in Street-Based Prostitution: A Qualitative Study

Background

Women involved in street-based prostitution (SBP) have well-documented health problems specific to their occupation, but access to care for other chronic health problems has not been explored. Primary care is seen as the optimal context to deliver care for people with long-term conditions because it is accessible, efficient, and can tackle inequalities related to socioeconomic deprivation. We aimed to explore the perspectives of women involved in SBP about access to health care for their long-term conditions.

Methods

This was a qualitative study with women accessing a third sector organization in North West England. Semi-structured interviews were conducted with sixteen women involved in SBP and accessing support. Data were analysed using the principles of constant comparison and a framework approach.

Results

Women described how they were living with ill health, which they found difficult to manage, and often impacted on their work. Women reported poor access to care and viewed any ensuing consultations in primary care as unsatisfactory.

Conclusion

This study highlights the unmet health needs of women who work in SBP, not just related to their occupation, but due to their co-morbid long-term conditions. Access to primary care was reported to be problematic and interactions with general practitioners not fulfilling their expectations, which impacted on future consultation behaviour. Understanding the health-seeking behaviours and self-management strategies of women involved in SBP with chronic health problems is essential in the design and commissioning of services and may reduce unscheduled care in this under-served group.

Read more at:  http://ht.ly/RPObY HT https://twitter.com/BristolUni

More at:  https://twitter.com/hiv_insight