女性性工作者无保护商业性行为及影响因素分析

Unprotected commercial sexual behavior and its influencing factors among female sex workers

目的了解云南省昆明市中低收入女性性工作者(FSWs)无保护商业性行为状况及影响因素,为云南省该人群艾滋病(AIDS)综合防治提供建议。方法利用自制问卷对昆明市4个城区561名中低收入FSWs进行调查,拟合多因素logistic回归模型探讨不安全性行为的影响因素。结果 FSWs最近3个月与嫖客发生无保护性行为的比例为58.1%(326/561);单因素分析结果表明,FSWs与嫖客发生无保护性行为有统计学意义的变量为年龄(P=0.000)、月收入(P=0.044)、从事本行业年限(P=0.001)、对健康状况关心与否(P=0.000)、最担心的疾病(P=0.000)、是否遭受过职业侵害(P=0.016)、AIDS知识得分(P=0.010)、性服务场所(P=0.000)、每月平均工作天数(P=0.000);多因素logistic回归分析结果表明,年龄(OR=0.470,95%CI=0.313～0.704)、健康状况关心与否(OR=4.249,95%CI=2.680～6.735)、最担心的疾病(OR=0.231,95%CI=0.090～0.591)、AIDS知识得分(OR=2.371,95%CI=1.400～4.014)、性服务场所(OR=0.852,95%CI=0.728～0.998)、每月平均工作天数(OR=1.755,95%CI=1.099～2.801)是FSWs不安全性行为的独立影响因素。结论中低收入FSWs的无保护性行为更容易受到年龄、健康信念、从事本行业年限、性服务场所、每月平均工作天数以及是否受过职业侵害等因素的影响。

Objective To examine unprotected commercial sexual behavior and its influencing factors among middle and low income female sex workers （FSWs） in Kunming city and to provide advice for developing comprehensive human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） prevention and treatment among FSWs. Methods Totally 561 FSWs with middle and low income from 4 districts of Kunming city were surveyed with a self-designed questionnaire. Logistic regression model was used to analyze influencing factors of unsafe sexual behavior. Results Among the FSWs ,58. 1% had unprotected sexual behaviors in the latest 3 months. Factors significantly related to unprotected sexual behavior were age （ P = 0.000）, monthly income （P = 0.044 ）, duration of sex work （P = 0.001）, care for health or not （ P = 0. 000 ）, the disease most worried about （P = 0.000）, experience of occupational abuse （P =0. 016） ,score of AIDS knowledge（P =0.010） ,place of sexual service（P =0. 000） ,and average working days in a month（ P = 0.000）. Multivariate logistic regression showed that age （odds ratiio[ OR] = 0.470,95 % confidence interval [ CI]：0.313 - 0.704 ）, care for health or not （ OR = 4. 249,95% CI： 2.680 - 6.735 ）, the disease most worded about （OR =0.231,95% CI：O. 090 -0. 591 ） ,score of AIDS knowledge（ OR =2. 371,95% CI：I. 400 -4. 014） ,place of sexual service（ OR = 0. 852,95% CI： 0.728 - 0.998 ）, and average working days in a month （OR = 1.755,95% CI： 1. 099 - 2. 801） were associated with the unsafe sexual behavior. Conclusion Unprotected commercial sexual behaviors among FSWs with middle and low income are influenced by the age, health attitude, duration of the work, place of sexual service, average working days in a month, and the experience of occupational abuse.