Dual Epidemics of Drug Use and Syphilis Among Chinese Female Sex Workers: Results of Eight Consecutive Cross-Sectional Surveys from 2006 to 2013 in Qingdao, China

Abstract

Eight consecutive annual cross-sectional surveys were conducted to examine the trend of the prevalence of HIV, syphilis, drug use and their correlates among female sex workers (FSWs) in Qingdao, China. Among sampled FSWs over the 8 years, a higher proportion of older, married or cohabited, higher education levels and more on-call FSWs were observed in recent years. The syphilis prevalence increased significantly from 1.0 % in 2006 to 13.5 % in 2013, with illicit drug use rate ranging from 21.8 % in 2007 to 55.5 % in 2010. Multivariate logistic regression analyses showed that drug use, syphilis and unprotected vaginal sex predicted each other. The dual epidemics of illicit drug use and syphilis among FSWs underscore the urgency to implement a tailored intervention to curb the dual epidemics while also preventing an HIV epidemic in the context of diversified commercial sex dynamic.

Dual Epidemics of Club Drug Use and Sexually Transmitted Infections among Chinese Female Sex Workers: New Challenges to STI Prevention

“…This is consistent with findings of other studies conducted in China and abroad [13, 14, 17, 18]. Club drug use can elevate the risk of HIV/STI through unprotected sexual intercourse, trauma from prolonged intercourse, and less control of condom use under influence [3, 4].…”

“…It could also be due to the fact that club drug use was more prevalent among clients in these areas [9]. Club drug use was more prevalent among younger and better educated FSWs, which is consistent with national patterns and findings of other studies [9, 13, 14, 17, 18]. Club drug use was found to be associated with injecting drug use and history of STI.…”

“…The current study confirms that club drug use is common among FSWs in China. In our study, over 7% of FSWs reported club drug use during the past year, which is lower than life-time use among FSWs in Shandong province of China [13, 14]. This is probably due to the difference in study locations and design.…”

“…Club drug use was found to be associated with injecting drug use and history of STI. Other studies have also found that FSWs who used club drugs tend to have more risk behaviors [13, 14, 17, 18]. Prevention programs will need to account for club drug use in shaping risk patterns and design appropriate intervention measures.…”

“…Recently, several Chinese studies reported the extent of club drug use among men who have sex with men [11, 12]. And one available study conducted among FSWs in a northeastern city in China found an association between club drug use and syphilis infection [13, 14]. Nevertheless, the prevalence and patterns of club drug use differ across populations and regions, and studies assessing club drug use and its association with HIV/STI risk remain scarce in China.…”