Thuy N T, Nhung V T, Thuc N V, Lien T X, Khiem H B
Pasteur Institute, Ho Chi Minh City, Vietnam.
AIDS. 1998 Mar 5;12(4):425-32. doi: 10.1097/00002030-199804000-00012.
To determine the extent of HIV infection among female commercial sex workers (CSW), to identify risk factors, and to provide baseline data for developing and targeting prevention measures.
A total of 968 female CSW were enrolled in a cross-sectional study from August 1995 to October 1996. Information was obtained from confidential face-to-face interview, physical examination, and laboratory testing.
A total of 65.5% of female CSW reported inconsistent condom use. Overall seroprevalence was 5.2%. The highest seroprevalence (9.5%) was detected in An Giang province, a border area adjacent to Cambodia. Out of seven HIV isolates in An Giang province, six were characterized as Thai subtype E and one as subtype B. Multiple logistic regression analysis showed an independent significant association between HIV seroprevalence and the following: age < or = 30 years [odds ratio (OR), 5.1; 95% confidence interval (CI), 1.7-15.2]; high frequency of sex (> 20 times per week; OR, 13.5; 95% CI, 3.6-50.2); inconsistent condom use (OR, 2.8; 95% CI, 1.01-8.0; sign of genital ulcers (OR, 18.1; 95% CI, 1.8-182); venereal warts (OR, 9.0; 95% CI, 2.5-33.0); brothels as sex venue (OR, 7.0; 95% CI, 2.0-24.3); and working at the border area (OR, 5.1; 95% CI, 2.4-11.0). Brothels as work-sites were significantly related to inconsistent condom use and the socioeconomic background of clients. Only 0.5% of CSW reported injecting drug use.
Female CSW at brothels who reported inconsistent condom use and ulcerous sexually transmitted disease, particularly in the border area with Cambodia, had greater risk of HIV infection. Brothels were more frequently used as sex venues in the border area and were more likely to be visited by occasional clients who were difficult to access. Drug use among female CSW in this region was rare. The development of prevention measures should be based on these results.
确定女性商业性工作者（CSW）中HIV感染的程度，识别危险因素，并为制定和针对性采取预防措施提供基线数据。
1995年8月至1996年10月，共有968名女性CSW纳入一项横断面研究。通过保密的面对面访谈、体格检查和实验室检测获取信息。
共有65.5%的女性CSW报告有不坚持使用避孕套的情况。总体血清阳性率为5.2%。在与柬埔寨接壤的边境地区安江省检测到最高的血清阳性率（9.5%）。在安江省的7株HIV分离株中，6株被鉴定为泰国E亚型，1株为B亚型。多因素logistic回归分析显示，HIV血清阳性率与以下因素之间存在独立的显著关联：年龄≤30岁[比值比（OR），5.1；95%置信区间（CI），1.7 - 15.2]；高性交频率（每周>20次；OR，13.5；95% CI，3.6 - 50.2）；不坚持使用避孕套（OR，2.8；95% CI，1.01 - 8.0）；生殖器溃疡体征（OR，18.1；95% CI，1.8 - 182）；尖锐湿疣（OR，9.0；95% CI，2.5 - 33.0）；妓院作为性场所（OR，7.0；95% CI，2.0 - 24.3）；以及在边境地区工作（OR，5.1；95% CI，2.4 - 11.）。妓院作为工作场所与不坚持使用避孕套以及嫖客的社会经济背景显著相关。只有0.5%的CSW报告有注射吸毒行为。
报告不坚持使用避孕套和患有溃疡性性传播疾病的妓院女性CSW，尤其是在与柬埔寨接壤的边境地区，感染HIV的风险更高。妓院在边境地区更常被用作性场所，且更有可能被难以接触到的临时嫖客光顾。该地区女性CSW中的吸毒情况罕见。应基于这些结果制定预防措施。
