Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA.
AIDS. 2010 Jul;24 Suppl 2(0 2):S69-75. doi: 10.1097/01.aids.0000386736.25296.8d.
To assess prevalence of HIV, syphilis, and hepatitis B (HBV) and C virus (HCV) and associated risk behaviors among female sex workers (FSWs) in three Afghan cities.
Cross-sectional prevalence assessment.
Consented FSWs from Jalalabad, Kabul, and Mazar-i-Sharif completed an interviewer-administered questionnaire, pretest and posttest counseling, and rapid and confirmatory testing for HIV, HCV, HBV, and syphilis. Logistic regression was used to detect correlates associated with HBV infection.
Of 520 participants, median age and age of initiating sex work were 29 and 23 years, respectively, and the median number of monthly clients was 12. Few FSWs reported ever having used illicit drugs (6.9%) or alcohol (4.7%). Demographic and risk behaviors varied significantly by enrollment site, with Kabul FSWs more likely to report sexually transmitted infection symptoms, longer sex work duration, and sex work in other cities. Prevalence of HIV was 0.19%, HCV was 1.92%, and HBV was 6.54%, with no cases of syphilis detected. HBV was independently associated with at least 12 clients monthly [adjusted odds ratio (AOR) = 3.15, 95% confidence interval (CI) 1.38-7.17], ever using alcohol (AOR = 2.61, 95%CI 1.45-4.69), anal sex (AOR = 2.42, 95%CI 1.15-5.08), and having children (AOR = 2.12, 95%CI 1.72-2.63) in site-controlled multivariable analysis.
Although prevalence of HIV, HCV, and syphilis is currently low in these three Afghan cities, risky sexual practices were common and associated with HBV. Programming inclusive of voluntary testing for HIV, viral hepatitis, and sexually transmitted infections, hepatitis vaccination, substance abuse prevention, and condom promotion for both FSWs and clients should be pursued in Afghanistan.
评估三个阿富汗城市中女性性工作者（FSW）中 HIV、梅毒和乙型肝炎（HBV）和丙型肝炎（HCV）的流行情况以及相关的风险行为。
横断面流行率评估。
来自贾拉拉巴德、喀布尔和马扎里沙里夫的同意 FSW 完成了一份由调查员管理的问卷、预测试和后测试咨询，以及 HIV、HCV、HBV 和梅毒的快速和确认测试。逻辑回归用于检测与 HBV 感染相关的相关性。
在 520 名参与者中，中位年龄和开始性工作的年龄分别为 29 岁和 23 岁，每月客户中位数为 12 人。很少有 FSW 报告曾使用过非法药物（6.9%）或酒精（4.7%）。人口统计学和风险行为因招募地点而异，喀布尔 FSW 更有可能报告性传播感染症状、性工作时间更长以及在其他城市从事性工作。HIV 的流行率为 0.19%，HCV 为 1.92%，HBV 为 6.54%，未发现梅毒病例。HBV 与每月至少有 12 名客户独立相关[调整后的优势比（AOR）=3.15，95%置信区间（CI）1.38-7.17]，曾使用酒精（AOR=2.61，95%CI 1.45-4.69）、肛交（AOR=2.42，95%CI 1.15-5.08）和有孩子（AOR=2.12，95%CI 1.72-2.63）在地点控制的多变量分析中。
尽管目前这三个阿富汗城市的 HIV、HCV 和梅毒的流行率较低，但危险的性行为很常见，并与 HBV 相关。应在阿富汗开展包括 HIV、病毒性肝炎和性传播感染自愿检测、乙肝疫苗接种、预防药物滥用以及为 FSW 和客户推广安全套在内的规划。
