中国重庆地区女性性工作者中 HIV、梅毒、HCV 感染及行为因素的变化趋势：来自六项连续监测调查的结果。
Changing trends of HIV, syphilis, HCV infections and behavioural factors among female sex workers in Chongqing, China: findings from six serial surveillance surveys.
机构信息
Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China.
Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China.
出版信息
BMJ Open. 2020 Oct 12;10(10):e036654. doi: 10.1136/bmjopen-2019-036654.
OBJECTIVES
To explore the prevalence and changing trends of HIV, syphilis, hepatitis C virus (HCV) infections and risk behaviours among female sex workers (FSWs) and to provide reference and theoretical basis for formulating targeted interventions.
DESIGN
Six consecutive cross-sectional surveys.
SETTING
Chongqing, China.
PARTICIPANTS
FSWs were included if they (1) were aged ≥16 years, (2) provided commercial sex for money or goods during the previous month and (3) were willing to participate in the survey and could provide verbal informed consent. This study included 16 791 of 16 810 participants recruited between 2013 and 2018.
PRIMARY AND SECONDARY OUTCOME MEASURES
The prevalence of HIV/syphilis/HCV infection.
RESULTS
The HIV and HCV prevalence among FSWs in Chongqing was stable during the study period, but the prevalence of syphilis had an increasing trend, particularly among low-tier and middle-tier FSWs. Improvements in HIV-related knowledge, condom use, injecting drug use and participation in HIV-related services were observed. However, no change was found in the prevalence of drug use. HIV infection was correlated with no condom use in the last commercial sex (adjusted OR (aOR) 3.48, 95% CI 1.90 to 6.37) and syphilis infection (aOR 4.88, 95% CI 1.95 to 12.18). Syphilis infection was correlated with inconsistent condom use (aOR 1.30, 95% CI 1.02 to 1.65), HIV infection (aOR 5.88, 95% CI 2.40 to 14.41), HCV infection (aOR 7.68, 95% CI 4.37 to 13.49) and sexually transmitted infection (STI) diagnosis in the past year (aOR 3.81, 95% CI 2.40 to 6.03). HCV infection was associated with injecting drug use (aOR 8.91, 95% CI 4.45 to 17.86) and syphilis infection (aOR 7.88, 95% CI 4.49 to 13.83).
CONCLUSIONS
Comprehensive interventions targeting FSWs, particularly low-tier and middle-tier FSWs, should be increasingly implemented to prevent and control HIV, syphilis and other STIs.
目的
探讨女性性工作者（FSW）中 HIV、梅毒、丙型肝炎病毒（HCV）感染的流行情况和变化趋势，以及相关风险行为，为制定有针对性的干预措施提供参考和理论依据。
设计
连续 6 次横断面调查。
地点
中国重庆。
参与者
如果参与者（1）年龄≥16 岁，（2）在过去一个月内提供商业性性行为以获取金钱或物品，（3）愿意参与调查并能提供口头知情同意，则将其纳入 FSW。本研究共纳入了 2013 年至 2018 年期间招募的 16810 名参与者中的 16791 名。
主要和次要结局指标
HIV/梅毒/HCV 感染的流行率。
结果
在研究期间，重庆 FSW 中的 HIV 和 HCV 流行率保持稳定，但梅毒的流行率呈上升趋势，特别是在低级别和中级别 FSW 中。观察到与 HIV 相关的知识、安全套使用、注射吸毒和参与 HIV 相关服务有所改善。然而，药物使用的流行率没有变化。HIV 感染与最近一次商业性行为中未使用安全套（调整后的比值比[aOR]3.48，95%置信区间[CI]1.90 至 6.37）和梅毒感染（aOR 4.88，95%CI 1.95 至 12.18）相关。梅毒感染与安全套使用不一致（aOR 1.30，95%CI 1.02 至 1.65）、HIV 感染（aOR 5.88，95%CI 2.40 至 14.41）、HCV 感染（aOR 7.68，95%CI 4.37 至 13.49）和过去一年中性传播感染（STI）诊断（aOR 3.81，95%CI 2.40 至 6.03）相关。HCV 感染与注射吸毒（aOR 8.91，95%CI 4.45 至 17.86）和梅毒感染（aOR 7.88，95%CI 4.49 至 13.83）相关。
结论
应针对 FSW，特别是低级别和中级别 FSW，实施综合干预措施，以预防和控制 HIV、梅毒和其他 STI。
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