巴西亚马逊地区某城市女性性工作者中人类免疫缺陷病毒感染的患病率及危险因素:性服务的不同形式

Prevalence and Risk Factors for Human Immunodeficiency Virus Infection Among Female Sex Workers: Distinct Offers of Sexual Services in a Municipality of the Brazilian Amazon.

作者信息

da Costa Luana Mota, Raiol Nairis Costa, Lisboa Brenda Luena A, Frade Paula Cristina R, Blandtt Lucinaldo da Silva, Silva-Oliveira Gláucia C, Machado Luiz Fernando A, Martins Luísa Caricio, Oliveira-Filho Aldemir B

机构信息

Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil.

Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, Brazil.

出版信息

AIDS Res Hum Retroviruses. 2019 Sep;35(9):826-832. doi: 10.1089/AID.2019.0032. Epub 2019 Jul 30.

Abstract

This study determined the prevalence of human immunodeficiency virus (HIV) infection and its associated factors in female sex workers (FSWs) from the municipality of Bragança in the state of Pará, Brazil. A cross-sectional study using a respondent-driven sampling method was used to investigate 137 FSWs. They were interviewed using a questionnaire for the collection of data on their characteristics and risk behavior. Blood samples were collected for serological and molecular testing for HIV. Poisson regression models were used to estimate the reasons of prevalence (RP). The majority was single, young, poorly educated, had a low monthly income, and had worked in the sex trade for more than 7 years. Sexual services were offered either directly (easy identification of FSWs in street markets, town squares, street corners, bars, and gas stations) or indirectly/discretely (more complex identification of FSWs, offering services through a cryptic approach or an intermediary). Overall, 22 (16.06%) FSWs had anti-HIV-1/2 antibodies, and 21 (15.33%) also had complementary DNA-HIV. The use of illicit drugs [adjusted RP (aRP) = 3.13; 95% confidence interval (CI) = 1.27-8.41], unprotected sex (aRP = 4.09; 95% CI = 1.34-11.62), anal sex (aRP = 4.01; 95% CI = 1.37-10.15), the exemption of condoms for clients paying extra (aRP = 4.71; 95% CI = 1.52-10.89), more than 7 years working as a sex worker (aRP = 6.04; 95% CI = 1.20-16.33), low levels of education (aRP = 3.55; 95% CI = 1.15-11.02), and a lack of regular medical or gynecological examinations were all associated with HIV infection (aRP = 5.87; 95% CI = 1.26-15.71). The FSWs who offered their services indirectly suffered significantly less physical and sexual aggression, charged more for encounters, had a significantly higher monthly income, and were more likely to have undergone a medical or gynecological examination within the preceding 12 months. This study identified information relevant to the control and prevention of HIV in FSWs.

摘要

本研究确定了巴西帕拉州布拉干萨市女性性工作者中人类免疫缺陷病毒(HIV)感染的流行情况及其相关因素。采用应答驱动抽样方法进行横断面研究,调查了137名女性性工作者。使用问卷对她们进行访谈,以收集有关其特征和风险行为的数据。采集血样进行HIV血清学和分子检测。采用泊松回归模型估计流行原因(RP)。大多数人单身、年轻、受教育程度低、月收入低,且从事性交易超过7年。性服务的提供方式有直接提供(在街市、城镇广场、街角、酒吧和加油站很容易识别女性性工作者)或间接/隐秘提供(更难识别女性性工作者,通过隐秘方式或中介提供服务)。总体而言,22名(16.06%)女性性工作者有抗HIV-1/2抗体,21名(15.33%)也有HIV互补DNA。使用非法药物[调整后RP(aRP)=3.13;95%置信区间(CI)=1.27-8.41]、无保护性行为(aRP=4.09;95%CI=1.34-11.62)、肛交(aRP=4.01;95%CI=1.37-10.15)、为额外付费的客户免除使用避孕套(aRP=4.71;95%CI=1.52-10.89)、从事性工作超过7年(aRP=6.04;95%CI=1.20-16.33)、低教育水平(aRP=3.55;95%CI=1.15-11.02)以及缺乏定期医疗或妇科检查均与HIV感染相关(aRP=5.87;95%CI=1.26-15.71)。间接提供服务的女性性工作者遭受的身体和性侵犯明显较少,每次交易收费更高,月收入明显更高,并且在过去12个月内更有可能接受过医疗或妇科检查。本研究确定了与女性性工作者中HIV控制和预防相关的信息。

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