针对从事商业性交易的中国青春期女性的性暴力和基于性别的暴力的患病率及其相关因素：一项横断面研究。
Prevalence and correlates of sexual and gender-based violence against Chinese adolescent women who are involved in commercial sex: a cross-sectional study.
作者信息
Zhang Xu-Dong, Myers Sierra, Yang Hong-Juan, Li Yun, Li Ji-Hong, Luo Wei, Luchters Stanley
机构信息
Yunnan Research Centre for Hygiene and Health Management, School of Management and Economics, Kunming University of Science and Technology, Kunming, China.
Burnet Institute, Melbourne, Victoria, Australia.
出版信息
BMJ Open. 2016 Dec 19;6(12):e013409. doi: 10.1136/bmjopen-2016-013409.
OBJECTIVES
Despite the vast quantity of research among Chinese female sex workers (FSWs) to address concerns regarding HIV/sexually transmitted infection (STI) risk, there is a paucity of research on issues of sexual and gender-based violence (SGBV) and the missed opportunity for sexual and reproductive health (SRH) promotion among young FSWs. Our research aimed to assess the prevalence and correlates of SGBV among Chinese adolescent FSWs, and to explore SRH service utilisation.
DESIGN AND METHODS
A cross-sectional study using a one-stage cluster sampling method was employed. A semistructured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine individual and structural correlates of SGBV.
SETTING AND PARTICIPANTS
Between July and September 2012, 310 adolescent women aged 15-20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months were recruited and completed their interview in Kunming, Yunnan Province, China.
RESULTS
Findings confirm the high prevalence of SGBV against adolescent FSWs in China, with 38% (118/310) of participants affected in the past year. Moreover, our study demonstrated the low uptake of public health services and high rates of prior unwanted pregnancy (52%; 61/118), abortion (53%; 63/118) and self-reported STI symptoms (84%; 99/118) in participants who were exposed to SGBV. Forced sexual debut was reported by nearly a quarter of FSWs (23%; 70/310) and was independently associated with having had a drug-using intimate partner and younger age (<17 years old) at first abortion. When controlling for potential confounders, having experienced SGBV was associated with frequent alcohol use, having self-reported symptoms of STI, having an intimate partner and having an intimate partner with illicit drug use.
CONCLUSIONS
This study calls for effective and integrated interventions addressing adolescent FSWs' vulnerability to SGBV and broader SRH consequences.
目标
尽管针对中国女性性工作者（FSW）开展了大量研究以解决对艾滋病毒/性传播感染（STI）风险的担忧，但关于性暴力和基于性别的暴力（SGBV）问题以及年轻女性性工作者中错失的性与生殖健康（SRH）促进机会的研究却很少。我们的研究旨在评估中国青少年女性性工作者中性暴力和基于性别的暴力的患病率及其相关因素，并探索性与生殖健康服务的利用情况。
设计与方法
采用单阶段整群抽样方法进行横断面研究。由经过培训的同伴教育者或卫生工作者发放半结构化问卷。进行多变量逻辑回归以确定性暴力和基于性别的暴力的个体及结构相关因素。
背景与参与者
2012年7月至9月期间，在中国云南省昆明市招募了310名年龄在15 - 20岁之间、自我报告在过去6个月内曾以金钱或礼物换取性行为的青少年女性，并完成了访谈。
结果
研究结果证实中国青少年女性性工作者遭受性暴力和基于性别的暴力的患病率很高，在过去一年中，38%（118/310）的参与者受到影响。此外，我们的研究表明，遭受性暴力和基于性别的暴力的参与者对公共卫生服务的利用率较低，既往意外怀孕率（52%；61/118）、流产率（53%；63/118）和自我报告的性传播感染症状发生率（84%；99/118）较高。近四分之一的女性性工作者（23%；70/310）报告有被迫首次性行为，这与有吸毒的亲密伴侣以及首次流产时年龄较小（<17岁）独立相关。在控制潜在混杂因素后，经历过性暴力和基于性别的暴力与频繁饮酒、自我报告有性传播感染症状、有亲密伴侣以及有吸毒的亲密伴侣有关。
结论
本研究呼吁采取有效且综合的干预措施，解决青少年女性性工作者易遭受性暴力和基于性别的暴力的问题及其更广泛的性与生殖健康后果。
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