Ruan Yuhua, Cao Xiaoyun, Qian Han-Zhu, Zhang Li, Qin Guangming, Jiang Zhengqing, Song Benli, Hu Wei, Liang Shu, Chen Kanglin, Yang Ye, Li Xinxu, Wang Jun, Chen Xi, Hao Chun, Song Yanhui, Xing Hui, Wang Ning, Shao Yiming
State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Sex Transm Dis. 2006 Dec;33(12):719-23. doi: 10.1097/01.olq.0000218881.01437.99.
The objective of this study was to investigate the prevalence and risk factors of syphilis infection among female sex workers in a southwestern Chinese city along a drug trafficking route.
From December 2004 to January 2005, 343 female sex workers (FSWs) were recruited through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual and other sexually transmitted diseases/HIV risk behaviors. Cervical and blood samples were collected to test for syphilis and HIV antibodies and Neisseria gonorrhoeae infection; Condyloma acuminatum infection was diagnosed clinically.
Of 343 FSWs, 15.7% were infected with syphilis. The prevalence of HIV, gonorrhea, and C. acuminatum was 0.6%, 2.0%, and 1.5%, respectively. The subtype of 2 HIV-1 infections was both CRF 07BC. Nearly 10% of FSWs reported using illicit drugs. Consistent use, inconsistent use, and never use of condoms with commercial sex clients in the last month were reported by 53.9%, 38.5%, and 7.6% FSWs, respectively. Longer duration of sex work (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.08-3.62), working at low-end establishments (OR = 2.03; 95% CI = 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR = 2.06; 95% CI = 1.08-3.91) were independently associated with syphilis infection.
High prevalence of syphilis and overlapped unprotected commercial sex and drug using behaviors among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injection drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/sexually transmitted disease spread.
本研究旨在调查中国西南部一个位于毒品贩运路线上的城市中女性性工作者梅毒感染的患病率及危险因素。
2004年12月至2005年1月，通过社区宣传和同伴推荐招募了343名女性性工作者（FSW）。进行保密问卷调查以收集有关性及其他性传播疾病/艾滋病毒风险行为的信息。采集宫颈和血液样本检测梅毒、艾滋病毒抗体及淋病奈瑟菌感染；尖锐湿疣感染通过临床诊断。
343名女性性工作者中，15.7%感染梅毒。艾滋病毒、淋病和尖锐湿疣的患病率分别为0.6%、2.0%和1.5%。2例艾滋病毒-1感染的亚型均为CRF 07BC。近10%的女性性工作者报告使用过非法药物。在过去一个月中，分别有53.9%、38.5%和7.6%的女性性工作者报告始终、偶尔和从未与商业性客户使用避孕套。性工作时间较长（优势比[OR]=1.98；95%置信区间[CI]=1.08 - 3.62）、在低端场所工作（OR = 2.03；95% CI = 1.10 - 3.76）以及主要性伴侣在过去6个月内与其他女性发生过性行为（OR = 2.06；95% CI = 1.08 - 3.91）与梅毒感染独立相关。
在毒品贩运路线沿线的女性性工作者中，梅毒患病率高，且无保护的商业性行为和吸毒行为重叠，这可能表明艾滋病毒有从注射吸毒者快速传播至女性性工作者然后再传播至普通人群的潜在风险，并突出了采取预防性干预措施以阻断女性性工作者这一艾滋病毒/性传播疾病传播桥梁的紧迫性。
