Ojeda V D, Strathdee S A, Lozada R, Rusch M L A, Fraga M, Orozovich P, Magis-Rodriguez C, De La Torre A, Amaro H, Cornelius W, Patterson T L
Department of Psychiatry (0680), University of California San Diego, La Jolla, CA 92093-0680, USA.
Sex Transm Infect. 2009 Oct;85(6):420-6. doi: 10.1136/sti.2008.032979. Epub 2009 Feb 2.
OBJECTIVE: To examine associations between migration and sexually transmitted infection (STI) prevalence among Mexican female sex workers (FSW). METHODS: FSW aged 18 years and older in Tijuana, Baja California (BC) underwent interviews and testing for HIV, syphilis, gonorrhoea and chlamydia. Multivariate logistic regressions identified correlates of STI. RESULTS: Of 471 FSW, 79% were migrants to BC. Among migrant FSW, prevalence of HIV, syphilis, gonorrhoea, chlamydia and any STI was 6.6%, 13.2%, 7.8%, 16.3% and 31.1% compared with 10.9%, 18.2%, 13.0%, 19.0% and 42.4% among FSW born in BC. A greater proportion of migrant FSW were registered with local health services and were ever tested for HIV. Migrant status was protective for any STI in unadjusted models (unadjusted odds ratio 0.61, 95% CI 0.39 to 0.97). In multivariate models controlling for confounders, migrant status was not associated with an elevated odds of STI acquisition and trended towards a protective association. CONCLUSIONS: Unexpectedly, migrant status (vs native-born status) appeared protective for any STI acquisition. It is unclear which social or economic conditions may protect against STI and whether these erode over time in migrants. Additional research is needed to inform our understanding of whether or how geography, variations in health capital, or social network composition and information-sharing attributes can contribute to health protective behaviours in migrant FSW. By capitalising on such mechanisms, efforts to preserve protective health behaviours in migrant FSW will help control STI in the population and may lead to the identification of strategies that are generalisable to other FSW.
目的:研究墨西哥女性性工作者(FSW)的移民身份与性传播感染(STI)患病率之间的关联。 方法:对墨西哥下加利福尼亚州蒂华纳市18岁及以上的女性性工作者进行访谈,并检测其是否感染艾滋病毒、梅毒、淋病和衣原体。多因素逻辑回归分析确定性传播感染的相关因素。 结果:在471名女性性工作者中,79%是移民至下加利福尼亚州的。在移民女性性工作者中,艾滋病毒、梅毒、淋病、衣原体及任何性传播感染的患病率分别为6.6%、13.2%、7.8%、16.3%和31.1%,而在下加利福尼亚州出生的女性性工作者中这一比例分别为10.9%、18.2%、13.0%、19.0%和42.4%。有更大比例的移民女性性工作者在当地卫生服务机构登记,并曾接受过艾滋病毒检测。在未调整的模型中,移民身份对任何性传播感染都具有保护作用(未调整优势比为0.61,95%置信区间为0.39至0.97)。在控制混杂因素的多因素模型中,移民身份与感染性传播感染的较高几率无关,且有呈现保护关联的趋势。 结论:出乎意料的是,移民身份(相对于本地出生身份)似乎对感染任何性传播感染具有保护作用。尚不清楚哪些社会或经济条件可能预防性传播感染,以及这些条件在移民中是否会随着时间推移而消失。需要进一步研究,以帮助我们理解地理因素、健康资本差异、社会网络构成及信息共享属性是否以及如何能促进移民女性性工作者的健康保护行为。通过利用这些机制,努力保持移民女性性工作者的保护性健康行为将有助于控制该人群中的性传播感染,并可能有助于确定可推广至其他女性性工作者的策略。
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