Wang C, Hawes S E, Gaye A, Sow P S, Ndoye I, Manhart L E, Wald A, Critchlow C W, Kiviat N B
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98103, USA.
Sex Transm Infect. 2007 Dec;83(7):534-40. doi: 10.1136/sti.2007.027151. Epub 2007 Oct 17.
To assess HIV prevalence and risk factors for HIV infection, to investigate condom use among registered female commercial sex workers (CSWs) in Senegal, West Africa, and to examine the association between previous HIV testing, knowledge of HIV serostatus and condom use with both regular sex partners and clients within this population.
A cross-sectional study was conducted at three sexually transmitted disease clinics among 1052 Senegalese registered CSWs between 2000 and 2004. Inperson interviews soliciting information concerning demographic characteristics, medical history, sexual behaviour with clients and regular partners, and previous HIV testing history were performed. Blood samples were collected for determination of HIV-1 and/or HIV-2 serostatus. Multivariable, Poisson and log-binomial models were used to calculate prevalence ratios.
The overall HIV prevalence was 19.8%. Over 95% of CSWs reported always using a condom with clients, but only 18% reported always using a condom with their regular partners. A history of previous HIV testing was not associated with condom use with clients (adjusted prevalence ratio (APR) = 0.98, 95% confidence intervals, CI: 0.90 to 1.06). However, prior HIV testing was associated with decreased condom use with their regular partners (APR = 0.44, 95% CI: 0.28 to 0.69), especially in women who tested HIV negative (APR = 0.17, 95% CI: 0.08 to 0.36).
CSWs in Senegal have a high HIV prevalence; therefore preventing HIV transmission from this population to the general population is important. Condom use with regular partners is low among registered CSWs in Senegal, and a prior HIV negative test is associated with even less condom use with regular partners. Intervention efforts to increase condom use with regular sexual partners are needed.
评估艾滋病毒感染率及艾滋病毒感染的风险因素，调查西非塞内加尔注册女性商业性工作者（CSW）使用避孕套的情况，并研究该人群中既往艾滋病毒检测、艾滋病毒血清学状态知晓情况与与固定性伴侣及客户使用避孕套之间的关联。
2000年至2004年期间，在三家性传播疾病诊所对1052名塞内加尔注册CSW进行了一项横断面研究。进行了面对面访谈，收集有关人口统计学特征、病史、与客户及固定伴侣的性行为以及既往艾滋病毒检测史的信息。采集血样以确定HIV-1和/或HIV-2血清学状态。使用多变量、泊松和对数二项式模型计算患病率比值。
艾滋病毒总体感染率为19.8%。超过95%的CSW报告在与客户发生性行为时总是使用避孕套，但只有18%的人报告在与固定伴侣发生性行为时总是使用避孕套。既往艾滋病毒检测史与与客户使用避孕套无关（调整患病率比值（APR）=0.98，95%置信区间，CI：0.90至1.06）。然而，既往艾滋病毒检测与与固定伴侣使用避孕套减少有关（APR = 0.44，95% CI：0.28至0.69），尤其是在艾滋病毒检测呈阴性的女性中（APR = 0.17，95% CI：0.08至0.36）。
塞内加尔的CSW艾滋病毒感染率很高；因此，防止艾滋病毒从该人群传播到普通人群很重要。塞内加尔注册CSW与固定伴侣使用避孕套的比例较低，既往艾滋病毒检测呈阴性与与固定伴侣使用避孕套的比例更低有关。需要采取干预措施，增加与固定性伴侣使用避孕套的比例。
