Dermatology Hospital of Southern Medical University, Guangzhou, China.
Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China.
Front Public Health. 2022 Apr 13;10:744240. doi: 10.3389/fpubh.2022.744240. eCollection 2022.
Syphilis self-testing (SST) may help expand syphilis test uptake among female sex workers. However, there has been no studies on examining SST among female sex workers. We aim to examine SST experience and its determinants among female sex workers in China.
A venue-based, cross-sectional study of female sex workers was conducted in eight Chinese cities in 2019. Participants completed a survey including socio-demographic characteristics, sexual behaviors, and SST history. Multivariable logistic regression was conducted to evaluate the associated factors with SST.
Among 1,287 Chinese female sex workers, 72.1% (928/1,287) had ever tested for syphilis, and 5.9% (76/1,287) had ever used syphilis self-testing. Among syphilis self-testers, more than half (57.9%, 44/76) reported that the self-test was their first syphilis test, around one-fifth (18.4%, 14/76) reported that syphilis self-testing results influenced the price of commercial sex. After adjusting for covariates, female sex workers who received anal sex in the past month (adjusted odds ratio [aOR]: 2.6, 95%CI: 1.5-4.3, < 0.001), used drugs before or during sex (aOR: 3.8, 95%CI: 2.3-6.4, < 0.001), tested for other sexually transmitted infections (STIs) in the past 6 months (aOR: 3.4, 95%CI: 1.9-6.0), ever tested in the hospital (aOR: 5.1, 95%CI: 2.5-10.4, < 0.001), and ever tested in the community (aOR: 1.7, 95%CI: 1.3-2.2, < 0.001) were more likely to perform syphilis self-testing.
Syphilis self-testing has the potential to expand testing coverage, and increase testing frequency with limited potential harms among FSW. Further evaluation on the intervention effects based on syphilis self-testing among FSW are needed.
梅毒自检（SST）可能有助于扩大梅毒检测的覆盖面，尤其对女性性工作者而言。然而，目前尚无关于中国女性性工作者进行 SST 的研究。我们旨在调查中国女性性工作者的 SST 经历及其决定因素。
本研究采用基于地点的横断面研究，于 2019 年在中国 8 个城市进行。参与者完成了一份包括社会人口统计学特征、性行为和 SST 史在内的调查问卷。采用多变量 logistic 回归分析评估与 SST 相关的因素。
在 1287 名中国女性性工作者中，72.1%（928/1287）曾接受过梅毒检测，5.9%（76/1287）曾使用过梅毒自检。在梅毒自检者中，超过一半（57.9%，44/76）表示该自检是他们首次进行的梅毒检测，约五分之一（18.4%，14/76）表示梅毒自检结果影响了商业性行为的价格。调整混杂因素后，最近一个月有过肛交的女性性工作者（调整后的优势比[aOR]：2.6，95%置信区间[CI]：1.5-4.3，<0.001）、有过性前或性过程中使用药物的女性性工作者（aOR：3.8，95%CI：2.3-6.4，<0.001）、过去 6 个月内检测过其他性传播感染（STI）的女性性工作者（aOR：3.4，95%CI：1.9-6.0）、曾在医院检测过的女性性工作者（aOR：5.1，95%CI：2.5-10.4，<0.001）和曾在社区检测过的女性性工作者（aOR：1.7，95%CI：1.3-2.2，<0.001）更有可能进行梅毒自检。
梅毒自检有可能扩大检测覆盖面，增加检测频率，且对女性性工作者的潜在危害有限。需要进一步评估基于女性性工作者梅毒自检的干预效果。
