中越边境地区女性性工作者艾滋病风险经历的主题分析。
A thematic analysis of experiences of HIV risks among female sex workers in the Yunnan-Vietnam Chinese border region.
机构信息
Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
出版信息
BMC Womens Health. 2021 Jan 6;21(1):7. doi: 10.1186/s12905-020-01143-x.
BACKGROUND
The Yunnan province is located near the "Golden Triangle" border region between China, Myanmar and Thailand, which has the highest HIV/AIDS prevalence in China. Female sex workers (FSWs) in the Yunnan province are highly vulnerable to HIV infection. The objective of this study was to examine the experiences of FSWs in the Yunnan to better understand the risk of infection and the potential for transmission of HIV.
METHODS
Semi-structured interviews were conducted between May 2018 and June 2018 with 20 FSWs recruited in Hekou County, Yunnan Province, China. Thematic analysis was conducted to identify themes that highlighted increased exposure of FSWs to the risk of HIV infection and transmission.
RESULTS
The findings showed that FSWs' primary source for HIV information was gynecologists, with few visiting the local HIV charity Red Ribbon. FSWs reported infrequent visits for check-ups with some seeing a gynecologist once a year. FSWs felt that the onus was on them to prevent STI/HIV infection by using a condom during sex, regardless of their ability to negotiate use. FSWs were also reluctant to see a gynecologists for treatment. Instead, they resorted to douching as a way of preventing HIV/STIs and treating vaginal health problems, such as leucorrhea. Most FSWs worked without the influence of alcohol and drugs. A small number of FSWs reported heroin addiction and injecting drug use.
CONCLUSION
The findings suggest a need for innovative HIV prevention strategies among FSWs and their clients in the Chinese border region. Governmental agencies should continue to implement practical strategies in terms of HIV prevention education and condom use through tailored interventions that are localized. Such strategies should include localized tailored interventions that dispel myths about douching as a method of HIV/STI prevention and incorporate a mobile outreach approach, similar to the 'roadside restaurant' outreach that has been successful in rural China.
背景
云南省位于中国、缅甸和泰国之间的“金三角”边境地区附近，是中国艾滋病病毒感染率最高的地区。云南省的性工作者（FSWs）极易感染艾滋病毒。本研究的目的是研究云南省 FSWs 的经历，以更好地了解感染风险和 HIV 传播的潜力。
方法
2018 年 5 月至 6 月，在中国云南省河口县招募了 20 名性工作者进行半结构式访谈。采用主题分析方法，确定了突出性工作者感染艾滋病毒和传播艾滋病毒风险增加的主题。
结果
研究结果表明，FSWs 获取艾滋病毒信息的主要来源是妇科医生，很少有人去当地的红丝带艾滋病慈善机构。FSWs 报告说，她们很少去做检查，有些人一年只看一次妇科医生。FSWs 认为，防止性传播感染/艾滋病毒感染的责任在于她们自己，无论她们是否有能力协商使用安全套。FSWs 也不愿意去看妇科医生进行治疗。相反，她们倾向于使用冲洗来预防艾滋病毒/性传播感染和治疗阴道健康问题，如白带。大多数 FSWs 在工作中不受酒精和毒品的影响。少数 FSWs 报告说有海洛因成瘾和注射吸毒。
结论
研究结果表明，在中越边境地区，需要为 FSWs 及其客户制定创新性的艾滋病毒预防策略。政府机构应继续实施艾滋病毒预防教育和使用安全套的实用策略，通过针对当地情况的定制干预措施。这些策略应包括消除关于冲洗作为预防艾滋病毒/性传播感染方法的误解，并结合类似中国农村成功的“路边餐厅”外展的移动外展方法。
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