Hladik Wolfgang, Baughman Andrew L, Serwadda David, Tappero Jordan W, Kwezi Rachel, Nakato Namakula D, Barker Joseph
Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA.
Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda.
BMC Public Health. 2017 Jun 10;17(1):565. doi: 10.1186/s12889-017-4428-z.
Sex workers in Uganda are at significant risk for HIV infection. We characterized the HIV epidemic among Kampala female sex workers (FSW).
We used respondent-driven sampling to sample FSW aged 15+ years who reported having sold sex to men in the preceding 30 days; collected data through audio-computer assisted self-interviews, and tested blood, vaginal and rectal swabs for HIV, syphilis, neisseria gonorrhea, chlamydia trachomatis, and trichomonas vaginalis.
A total of 942 FSW were enrolled from June 2008 through April 2009. The overall estimated HIV prevalence was 33% (95% confidence intervals [CI] 30%-37%) and among FSW 25 years or older was 44%. HIV infection is associated with low levels of schooling, having no other work, never having tested for HIV, self-reported genital ulcers or sores, and testing positive for neisseria gonorrhea or any sexually transmitted infections (STI). Two thirds (65%) of commercial sex acts reportedly were protected by condoms; one in five (19%) FSW reported having had anal sex. Gender-based violence was frequent; 34% reported having been raped and 24% reported having been beaten by clients in the preceding 30 days.
One in three FSW in Kampala is HIV-infected, suggesting a severe HIV epidemic in this population. Intensified interventions are warranted to increase condom use, HIV testing, STI screening, as well as antiretroviral treatment and pre-exposure prophylaxis along with measures to overcome gender-based violence.
乌干达的性工作者面临着感染艾滋病毒的重大风险。我们对坎帕拉女性性工作者（FSW）中的艾滋病毒流行情况进行了特征描述。
我们采用应答驱动抽样方法，对年龄在15岁及以上、报告在过去30天内与男性发生过性交易的女性性工作者进行抽样；通过音频计算机辅助自我访谈收集数据，并对血液、阴道和直肠拭子进行艾滋病毒、梅毒、淋病奈瑟菌、沙眼衣原体和阴道毛滴虫检测。
从2008年6月至2009年4月，共招募了942名女性性工作者。总体估计艾滋病毒流行率为33%（95%置信区间[CI] 30%-37%），25岁及以上的女性性工作者中流行率为44%。艾滋病毒感染与低教育水平、没有其他工作、从未进行过艾滋病毒检测、自我报告有生殖器溃疡或疮、淋病奈瑟菌或任何性传播感染（STI）检测呈阳性有关。据报告，三分之二（65%）的商业性行为使用了安全套；五分之一（19%）的女性性工作者报告有过肛交。基于性别的暴力行为很常见；34%的人报告在过去30天内曾被强奸，24%的人报告曾被客户殴打。
坎帕拉三分之一的女性性工作者感染了艾滋病毒，这表明该人群中存在严重的艾滋病毒流行。有必要加强干预措施，以增加安全套的使用、艾滋病毒检测、性传播感染筛查，以及抗逆转录病毒治疗和暴露前预防，同时采取措施克服基于性别的暴力。
