Pan Rong, Mao Limin, He Na, Zhang Jing, Chen Kun, Liao Cuiqin, Tang Xian, Gong Xiangzhen, Blaxland Megan, de Wit John
a Department of Epidemiology, School of Public Health , Fudan University , Shanghai , China.
AIDS Care. 2015;27(6):688-92. doi: 10.1080/09540121.2015.1005004. Epub 2015 Jan 29.
Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18-52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32-4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84-7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21-0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20-0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05-0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers.
在中国，女性性工作者是艾滋病预防和健康促进的重点人群。本文研究了上海虹口区以场所为基础的性工作者利用艾滋病相关及一般健康服务的模式和相关因素。通过三阶段抽样策略招募参与者，并邀请她们在2012年自行完成一份简短的调查问卷。纳入分析的400名参与者的年龄中位数为33岁（范围 = 18 - 52岁），超过四分之三的人在调查时已婚。参与者大多是外来务工人员，一半以上在上海居住了六个月或更长时间，近三分之二在一个女性性工作者总数少于五人的场所工作。常规体检和艾滋病检测是过去12个月中最常使用的健康服务。在过去12个月中，共有347名女性（86.8%）积极寻求免费健康服务，其中157名女性获得了这些服务，主要来自当地社区卫生服务中心（CHSCs）。积极寻求主要由社区卫生服务中心提供的免费健康服务与在上海居住时间较长有关（调整后的优势比[AOR] = 2.55，95%置信区间[CI] = 1.32 - 4.93；p < 0.01）以及在过去12个月中进行过艾滋病检测（AOR = 3.68，95% CI = 1.84 - 7.38；p < 0.001）。相反，年收入较高（AOR = 0.41，95% CI = 0.21 - 0.80；p < 0.01）、在较大场所工作（AOR = 0.40，95% CI = 0.20 - 0.79；p < 0.01）以及知道艾滋病可通过输入未经筛查的血液传播（AOR = 0.21，95% CI = 0.05 - 0.91；p < 0.05）与不积极寻求此类服务有关。上海以场所为基础的女性性工作者对免费的社区健康服务有很高的需求。在中国及其他地区的大城市，扩大社区卫生服务提供者提供的免费和综合健康服务有望促进女性性工作者的健康和福祉。
