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越南街头和场所性工作者中艾滋病毒感染的相关因素。

Correlates of HIV infection among street-based and venue-based sex workers in Vietnam.

作者信息

Le Thuy Tc, Nguyen Quoc C, Tran Ha Tt, Schwandt Michael, Lim Hyun J

机构信息

Department of Community Health and Epidemiology, College of Medicine University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

FHI 360 Vietnam, Hanoi, Vietnam.

出版信息

Int J STD AIDS. 2016 Oct;27(12):1093-1103. doi: 10.1177/0956462415608556. Epub 2015 Sep 29.

Abstract

Commercial sex work is one of the driving forces of the HIV epidemic across the world. In Vietnam, although female sex workers (FSWs) carry a disproportionate burden of HIV, little is known about the risk profile and associated factors for HIV infection among this population. There is a need for large-scale research to obtain reliable and representative estimates of the measures of association. This study involved secondary data analysis of the 'HIV/STI Integrated Biological and Behavioral Surveillance' study in Vietnam in 2009-2010 to examine the correlates of HIV among FSWs. Data collected from 5298 FSWs, including 2530 street-based sex workers and 2768 venue-based sex workers from 10 provinces in Vietnam, were analyzed using descriptive statistics and bivariate and multivariate logistic regression analyses. HIV prevalence among the overall FSW population was 8.6% (n = 453). However, when stratified by FSW subpopulations, HIV prevalence was 10.6% (n = 267) for street-based sex workers and 6.7% (n = 186) for venue-based sex workers. Factors independently associated with HIV infection in the multivariate analysis, regardless of sex work types, were injecting drug use, high self-perceived HIV risk, and age ≥ 25 years. Additional factors independently associated with HIV risk within each FSW subpopulation included having ever been married among street-based sex workers and inconsistent condom use with clients and having sex partners who injected drugs among venue-based sex workers. Apart from strategies addressing modifiable risk behaviours among all FSWs, targeted strategies to address specific risk behaviours within each FSW subpopulation should be adopted.

摘要

商业性工作是全球艾滋病流行的驱动因素之一。在越南,尽管女性性工作者承担着不成比例的艾滋病负担,但对于这一人群中艾滋病感染的风险特征及相关因素却知之甚少。需要开展大规模研究以获得关于关联度量的可靠且具有代表性的估计值。本研究对2009 - 2010年越南“艾滋病/性传播感染综合生物学与行为监测”研究的二手数据进行分析,以检验女性性工作者中艾滋病的相关因素。对从越南10个省份的5298名女性性工作者收集的数据进行了分析,其中包括2530名街头性工作者和2768名场所性工作者,分析方法包括描述性统计以及二元和多元逻辑回归分析。女性性工作者总体人群中的艾滋病患病率为8.6%(n = 453)。然而,按女性性工作者亚人群分层时,街头性工作者的艾滋病患病率为10.6%(n = 267),场所性工作者的艾滋病患病率为6.7%(n = 186)。在多变量分析中,无论性工作类型如何,与艾滋病感染独立相关的因素包括注射吸毒、自我感知的艾滋病高风险以及年龄≥25岁。在每个女性性工作者亚人群中,与艾滋病风险独立相关的其他因素包括街头性工作者曾结婚、与客户使用避孕套不一致,以及场所性工作者有注射吸毒的性伴侣。除了针对所有女性性工作者中可改变的风险行为的策略外,还应采用针对每个女性性工作者亚人群中特定风险行为的针对性策略。

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