Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., E4142, Baltimore, MD, 21205, USA,
AIDS Behav. 2014 Mar;18(3):562-72. doi: 10.1007/s10461-013-0577-y.
Within Eastern Europe/Central Asia's expanding HIV epidemic, relatively little is known about female sex workers (FSWs). Using mixed methods, we report on sex work context, HIV prevalence and contextual risk factors, and exposure to FSW-targeted prevention services among FSWs in Kazan, Krasnoyarsk, and Tomsk, Russia. Following a qualitative phase, FSWs (n = 754) were recruited via respondent-driven sampling for a cross-sectional survey with HIV screening in 2011. HIV was prevalent (3.9 %). In adjusted analyses, significant risk factors included injection drug use (IDU; AOR 5.85, 95 % CI 2.47, 14.43), client-perpetrated physical violence (AOR 2.52, 95 % CI 1.41, 4.51), and client-perpetrated sexual violence (vaginal AOR 3.77, 95 % CI 1.73, 8.22; anal AOR 4.80, 95 % CI 1.89, 12.19). FSW-targeted programming (reported by 75 %) was described as highly valuable, providing free, anonymous, and non-stigmatizing care. Findings confirm FSWs as a core HIV risk population in Russia, and demonstrate the need to support FSW-oriented HIV services. Such efforts should address violence against FSWs.
在东欧/中亚不断扩大的艾滋病毒流行中，对性工作者（FSWs）的了解相对较少。本研究采用混合方法，报告了俄罗斯喀山、克拉斯诺亚尔斯克和托姆斯克的性工作背景、艾滋病毒流行率和相关风险因素，以及性工作者获得以性工作者为目标的预防服务的情况。在定性阶段之后，通过应答者驱动抽样招募了 754 名性工作者，于 2011 年进行了横断面调查和艾滋病毒筛查。结果显示，HIV 的流行率为 3.9%。在调整后的分析中，显著的风险因素包括注射吸毒（AOR 5.85，95%CI 2.47,14.43）、嫖客造成的身体暴力（AOR 2.52，95%CI 1.41,4.51）和嫖客造成的性暴力（阴道 AOR 3.77，95%CI 1.73,8.22；肛门 AOR 4.80，95%CI 1.89,12.19）。性工作者为目标的规划（75%的人报告）被描述为非常有价值的，提供免费、匿名和非污名化的护理。研究结果证实了性工作者是俄罗斯核心艾滋病毒感染人群，并表明需要支持以性工作者为导向的艾滋病毒服务。这些努力应解决针对性工作者的暴力问题。
