School of Public Health, Southern Medical University, Guangzhou 510515, China.
Dermatology Hospital, Southern Medical University, Guangzhou 510095, China.
J Public Health (Oxf). 2024 Feb 23;46(1):72-82. doi: 10.1093/pubmed/fdad222.
Female sex workers (FSW) are particularly vulnerable to chlamydia and gonorrhea infections. However, there were few studies that detail the evolving patterns of chlamydia and gonorrhea among Chinese FSW. Therefore, our study endeavors to assess the prevalence of chlamydia and gonorrhea epidemics within FSW, investigate their changing trends and scrutinize associated factors.
In 2019, China instituted a sentinel surveillance network focused on FSW in Guangdong Province. This network conducted an annual serial cross-sectional survey spanning from April to August. All analyses are predicated on surveillance data accumulated between 2019 and 2022.
The prevalence of chlamydia increased from 10.1 to 12.3%, exhibiting an annual percentage shift of 6.8%. Conversely, the prevalence of gonorrhea dwindled from 2.0 to 1.3%, marking an annual percentage decline of 13.4% (P < 0.001). After adjusting for covariates, chlamydia exhibited associations with having household registration in other provinces (adjusted odds ratio (aOR = 0.55)), displaying symptoms of sexually transmitted infections (STIs) (aOR = 1.65) and infected with gonorrhea (aOR = 5.68). In parallel, gonorrhea demonstrated associations with providing oral sex to clients (aOR = 3.74), manifesting STIs symptoms (aOR = 4.27) and those infected with chlamydia (aOR = 5.43).
Our observations underscore the imperative to implement a comprehensive intervention strategy concentrating on chlamydia, while simultaneously fortifying endeavors to expand the scope of gonorrhea prevention services.
性工作者（FSW）特别容易感染衣原体和淋病。然而，很少有研究详细描述中国 FSW 中衣原体和淋病的流行模式。因此，我们的研究旨在评估 FSW 中衣原体和淋病的流行率，调查其变化趋势，并分析相关因素。
2019 年，中国在广东省建立了一个针对 FSW 的哨点监测网络。该网络在 4 月至 8 月期间进行了年度连续横断面调查。所有分析均基于 2019 年至 2022 年期间积累的监测数据。
衣原体的流行率从 10.1%上升到 12.3%，呈每年 6.8%的百分比变化。相反，淋病的流行率从 2.0%下降到 1.3%，呈每年 13.4%的百分比下降（P<0.001）。在调整了协变量后，衣原体与在其他省份有户口（调整后的优势比[aOR] = 0.55）、有性传播感染（STIs）的症状（aOR = 1.65）和感染淋病（aOR = 5.68）有关。同时，淋病与为客户提供口交（aOR = 3.74）、出现 STIs 症状（aOR = 4.27）和感染衣原体（aOR = 5.43）有关。
我们的观察结果强调了实施综合干预策略的必要性，重点关注衣原体，并同时加强扩大淋病预防服务范围的努力。
