中国江苏地区性工作者梅毒和沙眼衣原体感染的流行率：一项多中心横断面和基于场所的研究结果。
Prevalence of syphilis and chlamydia trachomatis infection among female sex workers in Jiangsu, China: Results from a multicenter cross-sectional and venue-based study.
机构信息
Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.
出版信息
Front Public Health. 2022 Oct 31;10:1018724. doi: 10.3389/fpubh.2022.1018724. eCollection 2022.
BACKGROUND
Female sex workers (FSWs) are considered highly vulnerable to sexually transmitted infections (STIs), but available data on the prevalence of STIs among FSWs in China is limited at a provincial level. This study aimed to evaluate the prevalence of STIs and risk factors among FSWs in Jiangsu, China.
METHODS
We conducted a multicenter cross-sectional study in seven cities of Jiangsu to investigate the prevalence and risk factors associated with HIV and other STIs. Blood and urine were collected to test for HIV, syphilis, Hepatitis C (HCV), Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections.
RESULTS
We enrolled 3,580 FSWs. The overall prevalence of bacterial STIs was 6.2% (5.4%-7.0%). The prevalence of HIV, syphilis infection, HCV, NG and CT were 0.1% (95%CI, 0.0-0.2), 1.8% (95%CI, 1.4-2.3), 0.3% (95%CI, 0.1-0.5), 0.3% (95%CI, 0.2-0.5) and 4.3% (95%CI, 3.6-5.0), respectively. Most FSWs (85.6%) reported consistent condom use with clients in the past month. Only 10.6% of FSWs reported group sex, and 68.3% self-reported HIV testing in the previous year. According to the multivariable model, having group sex in the past year (aOR, 2.521, 95%CI: 1.366-4.651) and HIV infection (aOR, 26.260, 95%CI: 2.432-283.563) were associated with a higher risk of syphilis infection. Migrants (aOR, 1.669, 95%CI: 1.163-2.395), having a history of STIs in the past year (aOR, 4.601, 95%CI: 1.003-21.118), and NG infection (aOR, 38.549, 95%CI: 11.214-132.514) were associated with a higher risk of CT infection. On the contrary, FSWs aged older than 25 were associated with lower risk of syphilis infection (25-34: aOR, 0.339, 95%CI: 0.151-0.763) and CT infection (25-34: aOR, 0.503, 95%CI: 0.316-0.802; ≥35: aOR, 0.578, 95%CI: 0.362-0.925).
CONCLUSION
This study's prevalence rates of syphilis and CT infections show the need to promote comprehensive STIs control and prevention strategies, including behavioral intervention and STIs screening, especially in younger high-risk populations. With the increasing coverage of HIV testing, integrating other STIs screening with HIV testing may be a reasonable way to implement comprehensive STIs control and prevention.
背景
性工作者（FSWs）被认为极易感染性传播感染（STIs），但中国省级层面关于 FSWs 中 STIs 流行率的现有数据有限。本研究旨在评估中国江苏省 FSWs 中 STIs 的流行率及其相关风险因素。
方法
我们在江苏省七个城市进行了一项多中心横断面研究，调查了 HIV 和其他 STIs 相关的流行率及风险因素。采集血样和尿样检测 HIV、梅毒、丙型肝炎（HCV）、淋病奈瑟菌（NG）和沙眼衣原体（CT）感染。
结果
我们共纳入了 3580 名 FSWs。细菌 STIs 的总流行率为 6.2%（5.4%-7.0%）。HIV、梅毒感染、HCV、NG 和 CT 的流行率分别为 0.1%（95%CI，0.0-0.2）、1.8%（95%CI，1.4-2.3）、0.3%（95%CI，0.1-0.5）、0.3%（95%CI，0.2-0.5）和 4.3%（95%CI，3.6-5.0）。大多数 FSWs（85.6%）报告过去一个月与客户坚持使用安全套。仅有 10.6%的 FSWs报告有过群交行为，68.3%的 FSWs报告过去一年进行过 HIV 检测。根据多变量模型，过去一年有过群交行为（OR，2.521，95%CI：1.366-4.651）和 HIV 感染（OR，26.260，95%CI：2.432-283.563）与梅毒感染风险增加相关。流动人口（OR，1.669，95%CI：1.163-2.395）、过去一年有 STIs 史（OR，4.601，95%CI：1.003-21.118）和 NG 感染（OR，38.549，95%CI：11.214-132.514）与 CT 感染风险增加相关。相反，年龄大于 25 岁的 FSWs 与梅毒感染风险降低相关（25-34 岁：OR，0.339，95%CI：0.151-0.763）和 CT 感染风险降低相关（25-34 岁：OR，0.503，95%CI：0.316-0.802；≥35 岁：OR，0.578，95%CI：0.362-0.925）。
结论
本研究中梅毒和 CT 感染的流行率表明，需要推行全面的 STIs 防控策略，包括行为干预和 STIs 筛查，尤其是针对年轻高危人群。随着 HIV 检测覆盖率的提高，将其他 STIs 筛查与 HIV 检测相结合可能是实施全面 STIs 防控的合理方式。
Zotero 插件