Commercial sex plays an increasingly important role in
China's growing HIV and sexually transmitted infection (STI) epidemics. In
China, street-based sex workers (SSWs) are a subgroup of female sex workers
with a particularly high risk of HIV/STI infections but are neglected in responses
to HIV. This study assesses changes in HIV voluntary counseling and testing
(VCT) utilization and high-risk sexual behaviors following a three-month HIV
preventive intervention among SSWs in Chongqing, China.
A three-month intervention was conducted by a team of peer
educators, outreach workers from community-based organizations and health
professionals. It mainly included distribution of free pamphlets and condoms
and delivery of onsite and clinic-based VCT. Cross-sectional surveys were
conducted prior to (n = 100) and immediately following (n = 112) the
intervention to assess its impact. In-depth interviews were conducted among 12
SSWs after the intervention to further explore potential barriers to HIV prevention.
The intervention significantly increased SSWs' participation
in VCT (from 2.0%-15.2%). Despite participants' improved
HIV-related knowledge level (from 24.0%-73.2%), there were
minimal changes in the levels of condom use with clients. Qualitative research
revealed that fear of police arrest and stigma were the main barriers to VCT
utilization. Low condom use was associated with family financial constraints,
inadequate power in condom negotiation, low awareness and misconceptions of HIV
infection risks.
HIV intervention improved VCT utilization and knowledge but
we did not observe an increase in condom use after this short intervention.
SSWs faced substantial economic, social and environmental barriers to VCT utilization
and condom use.
Full article
at:
- 1School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China. zenghuan586@aliyun.com.
- 2School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China. zhaoyongzy3@sina.com.
- 3Department of Foreign Language, Chongqing Medical University, Chongqing 400016, China. mpsonia2003@163.com.
- 4School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China. tangxiaoj0726@qq.com.
- 5Institute of Health Policy, College of Human medicine, Michigan State University, Lansing, MI 48910, USA. Guohang@msu.edu.
- 6School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China. wangyang8289@163.com.
- 7Research Center for Public Health, School of Medicine, Tsinghua University, Beijing 100084, China. lzhang@kirby.unsw.edu.au.
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