Buzingo T, Alary M, Sokal D C, Saidel T
Faculté de médecine, Département de médecine sociale et préventive, Université Laval, Québec, Canada.
Sante. 1997 Nov-Dec;7(6):355-60.
This study was designed to determine the prevalence of HIV infection and associated high-risk behavior in female sex workers in two areas of Bujumbura (Bwiza and Musanga), Burundi. Between June 15th and July 15th 1993, 320 female sex workers responded to an anonymous questionnaire and gave a blood sample on filter paper for detection of HIV antibodies. The mean age of the prostitutes was 24.6 (+/- 5.9) years (range 15 to 46). The HIV infection rate was 42.2% (135 of the 320). Univariate analysis showed that the proportion of HIV-infected female sex workers was higher in the Musaga area than in Bwiza (48.3% versus 34.3%; p = 0.012). The prevalence of HIV infection increased with age (24.3% for those aged between 15 and 19; 40.8% for those aged between 20 and 24 and more than 51.4% infected in the over 25 age-group; p < 0.001). The median number of sexual partners in the preceding month was 3 (range 1 to 50) and was not correlated with HIV infection (Wilcoxon's test: p = 0.516). HIV infection was highly correlated with a previous history of STDs (62.7% versus 32.7%; p < 0.001) and was also correlated with STD symptoms (87.5% versus 51.7%; p = 0.01). The only factors correlated with HIV infection in multivariate analysis were age (p = 0.008; Trend's test) and previous history of STDs (p < 0.001). Only 40.2% (127 of 316) of the female sex workers had used condoms with their clients during the preceding month. Intervention strategies to combat HIV transmission among individuals with high levels of sexual activity in Burundi should focus on the female sex workers and their clients, particularly the manual laborers, drivers, soldiers, prisoners and other men who regularly use prostitutes. The prevention of HIV infection in individuals of high-risk groups is the best strategy to reduce HIV transmission in the general population of developing countries.
本研究旨在确定布隆迪布琼布拉两个地区（布维扎和穆桑加）女性性工作者中艾滋病毒感染率及相关高危行为。1993年6月15日至7月15日期间，320名女性性工作者回答了一份匿名问卷，并在滤纸上提供血样以检测艾滋病毒抗体。妓女的平均年龄为24.6（±5.9）岁（范围15至46岁）。艾滋病毒感染率为42.2%（320人中135人）。单因素分析显示，穆桑加地区艾滋病毒感染的女性性工作者比例高于布维扎地区（48.3%对34.3%；p = 0.012）。艾滋病毒感染率随年龄增加而上升（15至19岁年龄组为24.3%；20至24岁年龄组为40.8%，25岁以上年龄组感染率超过51.4%；p < 0.001）。前一个月性伴侣的中位数为3（范围1至50），与艾滋病毒感染无相关性（威尔科克森检验：p = 0.516）。艾滋病毒感染与既往性传播疾病史高度相关（62.7%对32.7%；p < 0.001），也与性传播疾病症状相关（87.5%对51.7%；p = 0.01）。多因素分析中与艾滋病毒感染相关的唯一因素是年龄（p = 0.008；趋势检验）和既往性传播疾病史（p < 0.001）。前一个月只有40.2%（316人中127人）的女性性工作者与客户使用了避孕套。布隆迪针对性活动频繁人群防治艾滋病毒传播的干预策略应侧重于女性性工作者及其客户，特别是体力劳动者、司机、士兵、囚犯以及其他经常光顾妓女的男性。预防高危人群中的艾滋病毒感染是发展中国家普通人群减少艾滋病毒传播的最佳策略。
