Asamoah-Adu C, Khonde N, Avorkliah M, Bekoe V, Alary M, Mondor M, Frost E, Deceuninck G, Asamoah-Adu A, Pépin J
STD/AIDS Regional Coordination Unit, Greater Accra Region, Ministry of Health, Accra, Ghana.
J Acquir Immune Defic Syndr. 2001 Dec 1;28(4):358-66. doi: 10.1097/00126334-200112010-00009.
Description of the epidemiology of HIV infection among sex workers (SW) in Accra, Ghana.
In all, 1013 SW working out of their homes ( seaters ) or finding customers in bars, hotels, brothels or on the street ( roamers ) were interviewed and tested for HIV.
Overall, prevalence of HIV infection was nearly 50% (506 of 1013), varying from 26% (133 of 507) among the roamers to 74% (368 of 496) among the seaters. Profound differences were noted between these two categories of SW with regard to age, number of clients per day, price per instance of intercourse, condom use, and other characteristics. Respectively, 27% and 58% of roamers and seaters were infected with HIV within their first 6 months of sex work, despite a limited number of unprotected sex acts with seropositive clients. Independent risk factors for HIV infection varied between types of SW: age among the roamers; region of origin and duration of sex work among the seaters; number of clients per day, and presence of current or past genital ulcer and gonococcal cervicitis in both groups.
In Accra, considerable heterogeneity exists in the population of SWs. In both categories of SW, new recruits become rapidly infected with HIV after entering the trade. The 25-fold higher prevalence of HIV among SWs than in the general adult population suggests that in Accra, as in many cities of West Africa, a high fraction of new cases of HIV infection continue to be acquired from SWs. Intervention programs targeting SW should be an essential component of national AIDS control strategies. Special efforts should be made to identify and offer preventive services to new sex workers.
描述加纳阿克拉性工作者中艾滋病毒感染的流行病学情况。
总共对1013名在家工作（坐台者）或在酒吧、酒店、妓院或街头寻找客户（流动者）的性工作者进行了访谈并检测艾滋病毒。
总体而言，艾滋病毒感染率接近50%（1013人中的506人），流动者中的感染率为26%（507人中的133人），坐台者中的感染率为74%（496人中的368人）。这两类性工作者在年龄、每日客户数量、每次性行为价格、避孕套使用情况及其他特征方面存在显著差异。尽管与血清阳性客户发生的无保护性行为数量有限，但分别有27%的流动者和58%的坐台者在从事性工作的头6个月内感染了艾滋病毒。艾滋病毒感染的独立危险因素因性工作者类型而异：流动者为年龄；坐台者为原籍地区和性工作时长；两组的每日客户数量以及当前或过去患有生殖器溃疡和淋菌性宫颈炎情况。
在阿克拉，性工作者群体存在相当大的异质性。在这两类性工作者中，新入行人员入行后很快就会感染艾滋病毒。性工作者中艾滋病毒感染率比一般成年人群高25倍，这表明在阿克拉，与西非许多城市一样，很大一部分新的艾滋病毒感染病例仍来自性工作者。针对性工作者的干预项目应成为国家艾滋病控制策略的重要组成部分。应特别努力识别新的性工作者并为其提供预防服务。
