不同档次娱乐场所暗娼的梅毒感染状况及高危行为特征

Syphilis prevalence and high risk behaviors among female sex workers in different settings

目的调查不同档次娱乐场所暗娼的行为学特征和梅毒感染率,为采取干预措施提供依据。方法对广东省和海南省3个城市的中、低、中低档娱乐场所的暗娼人群,进行行为学特征和梅毒感染率调查。结果共调查暗娼816人。梅毒感染率在低档场所暗娼为40.7%,中低档为21.7%,中档为11.1%。中低档场所暗娼中,发现3例艾滋病病毒(HIV)感染者。低档场所暗娼的年龄偏大(36.5岁),已婚者(92.4%)和低文化程度(80.1%)所占比例高,从业时间(5.5年)长,接客数相对较少(日均3.9个),既往人工流产史(70.2%)比例高,近1个月安全套每次(0.3%)和多数(42.1%)使用率低,与其他两组比较有显著性差异(P均<0.01)。低档和中低档场所暗娼对干预服务的需求明显。结论中、低、中低档场所暗娼的梅毒感染率高,危险行为的比例高,尤其是低档场所暗娼,她们是干预的重点对象。为这些人群提供包括梅毒治疗服务在内的综合干预措施十分必要。

Objective To investigate prevalence and high risk behaviors for syphilis among female sex workers in different settings,and provide reference data for target intervention. Methods Female sex workers （FSWs） from different settings, mainly, middle-, low-, or middle-low-class settings who agreed to participate in the investigation, were enrolled into the study. The information regarding demographic characteristics and risk behaviors were collect- ed. Blood samples were taken to test antibodies to syphilis and HIV. Results A total of 816 FSWs were surveyed. The prevalence of syphilis were 40.7 % in FSWs from low-class settings （based on rental houses, or streetbased）, 21.7% from middle-low-class settings （based on both low- and middle-class settings）,and 11.1 % from middie-class settings （based on small beauty centers,barber shpos,saunas,massage centers,foot care shops,etc. ）. HIV infection was found in 3 FSWs from middle-low-class settings. FSWs from low-class settings were older （mean agea 36.5 years） ,most of whom were married （92.4%） ,and they had lower educational level （80. 1% of them having elementary schooling or being illiterate）, longer history of engaging in sex trade （mean 5.5 years）, fewer clients per day （mean-3.9） ,higher proportion of previous abortion （70. 2%） ,lower rate of condom use in the last one month （persistent use- 0.3 % ;frequent use- 42.1% ） ,as compared with other two groups （all P〈0.01）. In addition,FSWs from both low- and low middle-class settings were in more urgent need for outreach service. Conclusion FSWs from different settings,especially from low-class settings, have high syphilis rate and high risk behaviors, which makes them become a key population for intervention and medical care service. It is important to provide intergrated intervention service, including screening and treatment of syphilis for this specific population group.