蒙自市女性性工作者HIV感染及其危险因素调查

Prevalence and risk factors associated with HIV infection among female sex workers in Mengzi City

目的了解云南省蒙自市女性性工作者（隅）艾滋病病毒（HIV）的感染情况及HIV感染相关危险因素，为制定艾滋病防控策略和行为干预提供依据。方法于2010年10—11月采用方便抽样的方法，招募云南省红河州蒙自市娱乐场所FSWs，调查其社会人口统计学、行为学、HIV／AIDS知识以及生殖健康状况，并采集静脉血进行HIV血清学检测，分析FSWs人群HIV感染率及其危险因素。结果本次共调查423名FSW，HIV抗体阳性19人，HIV抗体阳性率为4．5％。最近一个月与客人发生性行为时坚持使用安全套的比例为87．0％。多因素分析显示，与HIV感染相关的危险因素为在低档性服务场所服务（校正OR=10．0，95％CI：3．77～26．67，P〈0．001）和从事性服务时间≥2年（校正OR=3．8，95％CI：1．39～10．20，P=0．01）。结论蒙自市FSWs有较高的HIV感染率，在低档性服务场所服务及从事性服务时间长是HIV感染的危险因素，需针对低档和中高档FSWs的危险行为特征分别实施不同的干预措施，控制HIV的传播流行。

Objective To explore the prevalence and risk factors of HIV infection among female sex workers （FSWs） in Mengzi City, Yunnan Province, so as to provide scientific evidence for formulating HIV prevention and control strategy and be- havior intervention measures. Methods From October to November, 2010, the convenience sampling method was used to re- cruit FSWs in the entertainment venues in Mengzi City in Yurman Province to investigate their demographic information, sexual behavior, HIV/AIDS knowledge and reproductive health status. Venous blood was collected to test HIV. The prevalence and risk factors of HIV infection were analyzed. Results Totally, 423 FSWs were recruited, among whom 19 were confirmed to be HIV antibody positive and the prevalence rate of HIV was 4.5 %. The proportion of the FSWs with consistent condom use when having sex with clients in the last month was 87.0 %. Multivariate logistic analysis indicated that the factors associated with HIV infection were working in low level sex work venues （adjusted OR = 10.0, 95 % CI ： 3.77 - 26.67, P 〈 0. 001） and time engaged in sexual work for2 yearsor more （adjusted OR=3.8, 95%CI： 1.39-10.20, P=0.01）. Conclusions The prevalence of HIV is high among female sex workers in Mengzi City. FSWs who work in low - grade sex work venues and engage in sexual work for long time are at higher risk of HIV infection. Intervention measures targeted at dangerous behavior of FSWs working in different levels of sex work venues should be carried out to control the spread and prevalence of HIV/AIDS.