Gorbach Pamina M, Sopheab Heng, Chhorvann Chhea, Weiss Robert E, Vun Mean Chhi
Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA 900095, USA.
J Acquir Immune Defic Syndr. 2006 Jun;42(2):242-7. doi: 10.1097/01.qai.0000214817.03411.80.
Identify patterns and behaviors among direct and indirect female sex workers (DFSWs and IDFSWs, respectively) across Cambodia's 5 major cities from 1997 to 2003.
Interviews with DFSWs and IDFSWs followed random selection from clusters in 5 cities. Individual characteristics and condom use with clients and other partners were assessed in univariate and multivariate analyses.
From 1997 to 2003, consistent condom use with clients increased from 53% to 96% among DFSWs and from 30% to 84% among IDFSWs. DFSWs reported staying in their profession longer, had fewer clients per day, stayed longer in each brothel, were in increasingly larger brothels, and were tested more for HIV. For IDFSWs, there were significant changes: more reported practicing commercial sex and testing for HIV. In adjusted models, reported condom use with clients was significantly higher among DFSWs in later survey years (odds ratio [OR], 2.17) and who were never married (OR, 1.69), were in larger brothels (OR, 1.02), and charged more for sex (OR, 1.27), but lower for DFSWs with sweethearts (OR, 0.68) and who reported abnormal vaginal discharge (OR, 0.52). For IDFSWs, in the adjusted models, reported condom use with clients was higher in later years (OR, 1.77) and for those reporting abnormal vaginal discharge (OR, 1.34) and HIV testing (OR, 1.46), and lower for those with sweethearts (OR, 0.49).
From 1997 to 2003, Cambodian direct and indirect sex workers increased their use of condoms each year with commercial as well as noncommercial partners, contributing to the evidence that HIV prevention programs can produce significant changes in risk behaviors.
确定1997年至2003年期间柬埔寨5个主要城市的直接和间接女性性工作者（分别为DFSWs和IDFSWs）的模式和行为。
从5个城市的群组中随机选择DFSWs和IDFSWs进行访谈。在单变量和多变量分析中评估个体特征以及与客户和其他伴侣使用避孕套的情况。
1997年至2003年期间，DFSWs中与客户始终使用避孕套的比例从53%增至96%，IDFSWs中这一比例从30%增至84%。DFSWs报告称从事该职业的时间更长，每天的客户更少，在每家妓院停留的时间更长，所在妓院规模越来越大，接受艾滋病毒检测的次数更多。对于IDFSWs而言，有显著变化：更多人报告从事商业性行为并接受艾滋病毒检测。在调整模型中，在后期调查年份的DFSWs中，报告与客户使用避孕套的比例显著更高（优势比[OR]，2.17），从未结婚的DFSWs（OR，1.69）、所在妓院规模更大的DFSWs（OR，1.02）以及性交易收费更高的DFSWs（OR，1.27）也是如此，但有恋人的DFSWs（OR，0.68）以及报告有异常白带的DFSWs（OR，0.52）比例较低。对于IDFSWs，在调整模型中，后期年份报告与客户使用避孕套的比例更高（OR，1.77），报告有异常白带的IDFSWs（OR，1.34）和接受艾滋病毒检测的IDFSWs（OR，1.46）也是如此，有恋人的IDFSWs比例较低（OR，0.49）。
1997年至2003年期间，柬埔寨的直接和间接性工作者每年与商业及非商业伴侣使用避孕套的比例都有所增加，这证明了艾滋病毒预防项目能够使危险行为发生显著变化。
