Tounkara Fatoumata Korika, Téguété Ibrahima, Guédou Fernand A, Keita Bintou, Alary Michel
Centre Hospitalier Universitaire Gabriel Toure BP 267, Bamako, Mali.
Association de Recherche de Communication et d'Accompagnement à Domicile de personnes Vivant avec le VIH (ARCAD-SIDA), Bamako, Mali.
Sex Transm Dis. 2020 Oct;47(10):679-685. doi: 10.1097/OLQ.0000000000001231.
We aimed to (1) estimate the prevalence of HIV and other sexually transmitted infections (STIs) among female sex workers (FSWs) in Bamako, Mali, and (2) identify factors associated with STIs including HIV infection in this population.
We analyzed baseline data from a prospective observational cohort study on cervical cancer screening, human papillomavirus, and HIV infections among FSWs 18 years or older recruited in Bamako. Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios (APRs) with 95% confidence interval (95% CI) for HIV infection and STIs versus associated factors.
Among 353 women participating in the study, mean age was 26.8 (±7.6) years. HIV prevalence was 20.4%, whereas 35.1% of the FSWs had at least one STI. Factors significantly associated with HIV were older age (P < 0.0001, test for trend), duration of sex work ≥6 years (APR, 1.92; 95% CI, 1.22-3.02), uneducated status (APR, 2.24; 95% CI, 1.16-4.34), less than 10 clients in the last 7 days (APR, 1.55; 95% CI, 1.02-2.34), and gonococcal (APR, 1.85; 95% CI, 1.21-2.82) and chlamydial (APR, 2.58; 95% CI, 1.44-4.62) infections. Younger age (P = 0.018, test for trend), having ≥10 clients in the last week (APR, 1.47; 95% CI, 1.11-1.94), and HIV infection (APR, 2.00; 95% CI, 1.49-2.69) were significantly associated with STIs.
HIV and curable STI prevalence are high among FSWs in Bamako. There is thus a need to enhance the efficiency of interventions toward FSWs in Mali to reduce the burden of HIV and STIs among them and prevent HIV spread to the general population.
我们旨在（1）估计马里巴马科女性性工作者中艾滋病毒和其他性传播感染（STIs）的流行率，以及（2）确定该人群中与包括艾滋病毒感染在内的性传播感染相关的因素。
我们分析了一项前瞻性观察队列研究的基线数据，该研究针对在巴马科招募的18岁及以上女性性工作者的宫颈癌筛查、人乳头瘤病毒和艾滋病毒感染情况。多变量对数二项回归用于估计艾滋病毒感染和性传播感染与相关因素的调整患病率比（APRs）及95%置信区间（95%CI）。
在参与研究的353名女性中，平均年龄为26.8（±7.6）岁。艾滋病毒流行率为20.4%，而35.1%的女性性工作者至少患有一种性传播感染。与艾滋病毒显著相关的因素包括年龄较大（P<0.0001，趋势检验）、性工作时长≥6年（APR，1.92；95%CI，1.22 - 3.02）、未受过教育（APR，2.24；95%CI，1.16 - 4.34）、过去7天内客户少于10名（APR，1.55；95%CI，1.02 - 2.34），以及淋球菌（APR，1.85；95%CI，1.21 - 2.82）和衣原体（APR，2.58；95%CI，1.44 - 4.62）感染。年龄较小（P = 0.018，趋势检验）、过去一周内有≥10名客户（APR，1.47；95%CI，1.11 - 1.94）和艾滋病毒感染（APR，2.00；95%CI，1.49 - 2.69）与性传播感染显著相关。
巴马科女性性工作者中艾滋病毒和可治愈性传播感染的流行率很高。因此，有必要提高马里针对女性性工作者的干预措施的效率，以减轻她们中艾滋病毒和性传播感染的负担，并防止艾滋病毒传播到普通人群。
