昭通市不同场所暗娼梅毒感染情况及其影响因素分析

Analysis of Syphilis Prevalence and Impact Factors in Female Sex Worker in Zhaotong City

目的了解昭通市暗娼人群（FSW）梅毒感染及其影响因素，为制定防制策略提供依据。方法采用普查法抽取1330名A类、B类和c类不同场所FSW进行问卷调查，抽取静脉血进行梅毒检测，采用SPSS19．0进行卡方检验、倾向分数的Logistic回归、单因素和多因素Logistic回归分析。结果c类、B类和A类Fsw分别为375例（28．20％），611例（45．94％）和344例（25．86％）；FSW梅毒抗体阳性率3．68％（49／1330），C类、B类和A类FSW的梅毒抗体阳性率分别是5．87％，3．27％和2．03％，采用倾向分数的Logistic回归分析显示，c类FSW梅毒抗体阳性率高于B类（OR=2．95，95％C11．23～6．99，P=0．01）和A类（OR=1．65，95％凹0．69～3．94，P=0．26）。多因素Logistic回归分析显示，上一个工作地点为外省（OR=2．07，95％CI1．12～3．81）、第一次与客人发生性行为年龄为40岁以上（OR：2．77，95％c，1．12～6．81）以及最近一个月与客人发生性行为未坚持使用安全套（OR=3．89，95％C11．97～7．67）均能增加FSW感染梅毒的风险。结论昭通市c类FSW梅毒抗体阳性率高于B类和A类FSW，应根据不同场所FSW提供针对性行为干预的同时，开展梅毒的普查普治工作，控制传染源，遏制梅毒在昭通市的流行。

Objective To understand the prevalence and influence factors of syphilis in female sex workers （FSW） to provide a basis for developing strategies for preventing sexually transmitted disease （STDs）. Methods Questionnaires and serological testing were conducted in 1 330 FSW of various types （type A, type B and type C）. For statistical analysis, chi-square test, propensity score Logistic regression, univariate and multivari- ate Logistic regression were performed using SPSS19.0 software. Results The numbers of type C, type B and type A FSW were 375 （28.20%） ,611 （45.94%） and 344 （25.86%） ,respectively. The total syphilis anti- body positive rate in FSW was 3.68% （49/1 330）. The syphilis antibody positive rate in type C FSW was 5.87% while positive rates in type B and type A FSW were 3.27% and 2. 03% , respectively. Logistic re- gression with propensity score analysis showed that the syphilis antibody positive rate was higher in type C FSW than in type B（ OR =2. 95,95% CI 1.23 - 6.99 ,P --- 0. 01 ） and type A（ OR = 1.65,95% CI O. 69 3.94 ,P = O. 26 ）FSW. Multivariate logistic regression analysis showed that syphilis infection risk was in- creased in FSW whose last working place was in other province （ OR =2. 07,95% CI 1.12 -3.81 ） ,and first commercial sex with clients was over 40 years old （OR = 2. 77,95% C1 1.12 - 6. 81 ） ,and who did not con- sistently use condoms while having sex with clients in the last month （ OR = 3.89,95% CI 1.97 - 7.67 ）. Conclusion Syphilis antibody positive rate was higher in type C than in type B and type A FSW. In order to control syphilis prevalence in Zhaotong city in Yunnan, it was necessary to provide interventions for sexual practices of various types FSW, syphilis test and treatment.