Department of Diseases Control, National Institute of Viral Diseases Control and Prevention, Chinese CDC, Beijing, China.
AIDS Behav. 2011 May;15(4):702-10. doi: 10.1007/s10461-010-9703-2.
Based on our previous qualitative exploration, this research presents the second phase in our study of factors associated with utilization of a free HIV VCT clinic in Jinan City, Northern China, by female sex workers (FSWs). A total of 970 FSWs from entertainment venues were interviewed and prospectively followed to determine who ultimately sought and received VCT at the clinic, compared to those who did not. Simple and multiple logistic regressions were performed on factors drawn from the Ecological Perspective, hypothesized to be associated with utilization of testing at the VCT clinic. Despite 69% of FSWs expressing willingness to attend the VCT clinic, only 11% were actually tested. The multiple logistic regression model that provided best goodness of fit included the covariates of willingness to attend the VCT clinic (Adjusted OR 3.13, 95% CI: 1.62-6.59), low perceived HIV infection risk (Adjusted OR 0.64, 95% CI: 0.35-1.11), low fear of FSWs status disclosure in the clinic (Adjusted OR 0.55, 95% CI: 0.31-0.94) and influence of acquaintances (Adjusted OR 0.52, 95% CI: 0.29-0.89) and peers (Adjusted OR 2.45, 95% CI: 1.40-4.50). This is the first study in China to follow FSWs longitudinally to measure factors related to VCT utilization. The low utilization of VCT services by participants in our study is similar to prior reports throughout China. FSWs' access to VCT service is associated with intrapersonal, institutional, and particularly, interpersonal factors. Based on these findings, we recommend emphasis on confidentiality of services, VCT education for influential peers, and introduction of HIV rapid testing on site.
基于我们之前的定性探索，本研究展示了我们在中国北方城市济南研究与女性性工作者（FSW）利用免费艾滋病毒 VCT 诊所相关因素的第二阶段。我们对来自娱乐场所的 970 名 FSW 进行了访谈和前瞻性随访，以确定最终在诊所寻求和接受 VCT 的人与那些没有寻求 VCT 的人相比，哪些因素与他们利用 VCT 诊所进行检测相关。我们对来自生态视角的假设因素进行了简单和多元逻辑回归分析，这些因素被认为与在 VCT 诊所进行检测利用相关。尽管 69%的 FSW 表示愿意参加 VCT 诊所，但实际上只有 11%接受了检测。提供最佳拟合度的多元逻辑回归模型包括愿意参加 VCT 诊所的协变量（调整后的比值比 3.13，95%置信区间：1.62-6.59）、低感知艾滋病毒感染风险（调整后的比值比 0.64，95%置信区间：0.35-1.11）、低担心在诊所中公开 FSW 身份（调整后的比值比 0.55，95%置信区间：0.31-0.94）、熟人（调整后的比值比 0.52，95%置信区间：0.29-0.89）和同伴（调整后的比值比 2.45，95%置信区间：1.40-4.50）的影响。这是中国首例对 FSW 进行纵向随访以衡量与 VCT 利用相关的因素的研究。我们研究中的参与者对 VCT 服务的低利用率与中国之前的报告相似。FSW 获得 VCT 服务与个人内在因素、机构因素，特别是人际因素有关。基于这些发现，我们建议强调服务的保密性、对有影响力的同伴进行 VCT 教育，并引入现场快速艾滋病毒检测。
