Carter K H, Harry B P, Jeune M, Nicholson D
Pan American Health Organization, Georgetown, Guyana.
Rev Panam Salud Publica. 1997 Jun;1(6):451-9. doi: 10.1590/s1020-49891997000600005.
A study of 108 female sex workers engaged in prostitution in Georgetown, Guyana, was made in April 1993. Based on interviews and procurement of blood samples, the study investigated relationships between HIV seroprevalences and AIDS knowledge, risk behaviors, client characteristics, and condom use. Street-walkers-as distinct from sex workers in bars, hotels, and Port Georgetown-tended to charge less, be worse off socioeconomically, and have clients who were similarly disadvantaged; they were therefore classified as belonging to a "lower" socio-economic stratum, while the other workers were classified as belonging to a "higher" stratum. The overall HIV seroprevalence found among the sex workers was 25% (95% CI: 17%-33%). But the 50 subjects in the lower stratum had a relatively high seroprevalence (42%, as compared to 10% among those in the higher stratum), accounting for 21 of the 27 HIV-seropositive subjects. Reported patterns of client origins (Guyanese or foreign), worker willingness to have sex without a condom, and condom use by clients differed by stratum. Participants in the higher stratum were more disposed to having sex without a condom. The workers' knowledge of what causes AIDS and how HIV is transmitted was low in both strata; substantial numbers of workers said they had contracted a sexually transmitted disease within the past two years or were users of illicit drugs. Condom use is reportedly less common among Guyanese than foreign clients, suggesting a greater risk of contracting HIV from Guyanese clients or infecting Guyanese clients with it. The HIV seroprevalence among workers who said they had only Guyanese clients was statistically greater than the rate among those who said they had only foreign clients. The HIV seroprevalence among those reporting more than five clients per week was statistically greater than among those reporting fewer. HIV seropositivity was relatively high among the 12 workers who said they used cocaine. Overall, the findings supported the view that interventions targeted at female sex workers and their clients should be strengthened-more specifically, that concerted efforts should be made to intensity condom promotion, distribution, and social marketing; to improve STD services that provide treatment and counseling for female sex workers; and to increase educational activities among the workers' Guyanese clients.
1993年4月，对圭亚那乔治敦108名从事卖淫活动的女性性工作者进行了一项研究。该研究基于访谈和血液样本采集，调查了艾滋病毒血清阳性率与艾滋病知识、风险行为、嫖客特征及避孕套使用之间的关系。街头拉客者（与酒吧、酒店及乔治敦港的性工作者不同）收费较低，社会经济状况较差，其嫖客也同样处于不利地位；因此，他们被归类为“较低”社会经济阶层，而其他工作者则被归类为“较高”阶层。在这些性工作者中发现的总体艾滋病毒血清阳性率为25%（95%置信区间：17%-33%）。但较低阶层的50名受试者血清阳性率相对较高（42%，而较高阶层为10%），27名艾滋病毒血清阳性受试者中有21名来自该阶层。报告的嫖客来源模式（圭亚那人或外国人）、性工作者在无避孕套情况下发生性行为的意愿以及嫖客使用避孕套的情况因阶层而异。较高阶层的参与者更倾向于无避孕套性行为。两个阶层的性工作者对艾滋病病因及艾滋病毒传播方式的了解都很少；大量性工作者表示，她们在过去两年内感染过性传播疾病或吸食过非法毒品。据报道，圭亚那嫖客使用避孕套的情况比外国嫖客少，这表明从圭亚那嫖客感染艾滋病毒或感染圭亚那嫖客的风险更大。称只有圭亚那嫖客的性工作者中艾滋病毒血清阳性率在统计学上高于称只有外国嫖客的性工作者。每周接待超过五名嫖客的性工作者中艾滋病毒血清阳性率在统计学上高于接待较少嫖客的性工作者。在称使用可卡因的12名性工作者中，艾滋病毒血清阳性率相对较高。总体而言，研究结果支持这样一种观点，即应加强针对女性性工作者及其嫖客的干预措施——更具体地说，应齐心协力加强避孕套的推广、分发和社会营销；改善为女性性工作者提供治疗和咨询的性传播疾病服务；并增加对性工作者的圭亚那嫖客的教育活动。
