浙江省艾滋病综合防治示范区低档暗娼肛交行为调查

Situation of anal sex among low-tier female sex workers in the Demonstration Areas of Comprehensive AIDS Responses in Zhejiang province

目的分析浙江省艾滋病综合防治示范区低档暗娼与嫖客发生肛交行为的相关情况及影响因素。方法2013年在浙江省21个艾滋病综合防治示范区开展低档暗娼调查。以最近1个月是否与嫖客发生过肛交为因变量,其他行为感知、行为特征等为自变量,采用logistic回归模型分析低档暗娼肛交行为发生的相关因素。结果共调查低档暗娼2645人,≥26岁占67.9%(1796/2645)、初中及以下文化程度占89.9%(2378/2645)、已婚占58.4%(1546/2645)、外省籍占78.2%(2068/2645)、月均收入≤4000元的占68.6%(1814/2645);最近1个月与嫖客肛交发生率为5.03%(133/2645)。多因素logistic回归分析结果显示,低档暗娼最近1个月与嫖客发生肛交的影响因素包括:性服务类型为发廊/按摩店、路边店和其他场所服务,分别是站街服务的7.31倍(95%CI:2.27~23.59)、7.89倍(95%CI:2.27~27.40)和4.65倍(95%CI:1.23~17.53);性服务地区数量≥4个县(区)是性服务仅固定在1个县(区)的1.68倍(95%CI:1.01~2.81);最近1个月嫖客年龄段仅为中年及以上是青年和中年及以上嫖客的0.45倍(95%CI:0.30~0.66);有STD感染风险意识者是无STD感染风险意识者的2.00倍(95%CI:1.20~3.32);最近1个月与嫖客发生口交者是与未发生口交者的7.29倍(95%CI:4.78~11.12)。结论浙江省艾滋病综合防治示范区的低档暗娼与嫖客的商业性行为存在肛交现象,发生口交的低档暗娼更容易发生肛交。应重点关注低档暗娼的肛交及危险行为干预。

Objective To analyze the prevalence of anal sex and related factors in low-tier female sex workers(FSWs)in the demonstration areas of comprehensive AIDS responses(DACAR)in Zhejiang province.Method In 2013,a survey on low-tier FSWs was carried out in 21 Demonstration Areas of AIDS Responses in Zhejiang.Experience of having anal sex with clients in the last month was taken as dependent variable while independent variables would include perception and characteristics related to behavior of the FSWs.The multivariate logistic regression analyses were conducted to identify the factors related to anal sex in low-tier FSWs.Results A total of 2645 low-tier FSWs were interviewed.Among these FSWs,67.9%(1796/2645)were over 26 years old,89.9%(2378/2645)were with education level of junior high school or below,58.4%(1546/2645)were married,78.2%(2068/2645)were from other provinces,68.6%(1814/2645)had income level less than 4000 Yuan,and rates of anal sex with client in the last month were 5.03%(133/2645).Results from the multivariate logistic regression analysis of related factors of anal sex with client in the last month showed that among the low-tier FSWs,the venues of having commercial sex were in hair salons/massage parlors(OR=7.31,95%CI:2.27-23.59),roadside shops(OR=7.89,95%CI:2.27-27.40)or other places(OR=4.65,95%CI:1.23-17.53),when compared with the street-women service.FSWs often engaged in commercial sex business in three or more counties(OR=1.68,95%CI:1.01-2.81),when compared with FSWs often engaged in commercial sex business just one county.FSWs had sex with only middle-aged and the elderly clients(OR=0.45,95%CI:0.30-0.66),when compared with FSWs had sex with young or middle-aged and the elderly clients.FSWs had risk perception for sexually transmitted disease(STD)(OR=2.00,95%CI:1.20-3.32),when compared with FSWs with no risk perception.FSWs had oral sex experience with their clients in the last month(OR=7.29,95%CI:4.78-11.12),when compared with the ones without oral sex.The above said factors were all related to the incidence of anal sex.Conclusions Certain numbers of low-tier FSWs had anal sex experiences with their clients,especially those who had oral sex were more likely to have anal sex in DACAR in Zhejiang province.Attention should be paid to anal sex behavior when conducting behavior-related intervention programs,targeting on the low-tier FSWs.