HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China

Zhu, Jing; Yuan, Rui; Hu, Dan; Zhu, Zhibin; Wang, Ning; Wang, Bei

doi:10.1177/0956462417730258

Cited by 23 publications

(19 citation statements)

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“…Female sex workers (FSWs) are at a high risk of HIV infection via heterosexual behaviour, acting as the "bridge" population of HIV transmission among the general population. The prevalence of HIV is high in FSWs in the country's border region [3][4][5]. Guangxi is a Vietnam-bordered province in China, and it has the secondhighest HIV infection rate in China [6].…”

Section: Introductionmentioning

confidence: 99%

Migrant female sex workers working at the Sino-Vietnamese border for a short time have a higher risk of HIV transmission: a consecutive cross-sectional study

et al. 2020

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Objectives: For migrant female sex workers (FSWs) at the Sino-Vietnamese border, the impact of work time in their current location on the spread of HIV/AIDS is not clear.Methods: Data were collected from the Sino-Vietnamese border cities of Guangxi, China. Migrant FSWs working in these cities were studied. FSWs who worked less than 6 months in their current location were assigned to the shortterm work group (ST FSWs), and FSWs who worked equal to or longer than 6 months in their current location were assigned to the long-term work group (LT FSWs). Logistic regression was performed to examine the impact of work time in the current location and factors associated with HIV infection. Results:Among the 1667 migrant FSWs, 586 (35.2%) and 1081 (64.9%) were assigned to the ST FSW and LT FSW groups, respectively. Compared to LT FSWs, ST FSWs were more likely to be of Vietnamese nationality, be less than 18 years old when they first engaged in commercial sex work, and have a low-level of HIV-related knowledge and had higher odds of using condoms inconsistently, having more male clients, having no regular male clients, and having a history of male clients who used aphrodisiacs but lower odds of receiving free condoms distribution and education/ HIV counselling and testing programme. The analysis of factors associated with HIV infection revealed that Vietnamese FSWs, less than 18 years old when they first engaged in commercial sex work, having no regular male clients, and having lower average charge per sex transaction were correlated with HIV infection. Conclusion:FSWs with short-term work at the Sino-Vietnamese border had a higher risk of risky sex and were correlated with HIV risk factors. Vietnamese FSWs were at higher risk of HIV infection, and they were more likely to have short-term work. More targeted HIV prevention should be designed for new FSWs who recently began working in a locality to further control the spread of HIV, particularly cross-border FSWs. © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article' s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article'

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Section: Introductionmentioning

confidence: 99%

Migrant female sex workers working at the Sino-Vietnamese border for a short time have a higher risk of HIV transmission: a consecutive cross-sectional study

et al. 2020

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“…Vaginal swabs from FSWs was collected in a FSW cross-sectional study conducted by the Chinese Center for Disease Control (CDC) from June to December 2015 in Hekou County, Yunnan Province, China. Elements of this program have been reported in previous studies (Reilly et al 2012;Wang et al 2015;Wang et al 2012;Zhu et al 2018). All eligible FSWs were over 16 years old and had reported they had provided sexual services in exchange for money within the past six months.…”

Section: Study Participantsmentioning

confidence: 87%

“…(Su et al 2016) Recent epidemiological investigations have observed unique characteristics in FSWs in the border region of Yunnan province, China, where the vast majority of FSWs come from Vietnam. (Wang et al 2012;Zhu et al 2018) It is believed, these cross-border FSWs play key roles in STI transmission, because of frequent travelling and their tendencies to hide work histories. (Zhu et al 2018) The prevalence of STIs and related complications among the general population in local areas is difficult to control.…”

Section: Introductionmentioning

confidence: 99%

“…(Wang et al 2012;Zhu et al 2018) It is believed, these cross-border FSWs play key roles in STI transmission, because of frequent travelling and their tendencies to hide work histories. (Zhu et al 2018) The prevalence of STIs and related complications among the general population in local areas is difficult to control. The cross-border sex industry is a complicated social problem, however it is important to understand and recognize STI or HIV risk factors to public health.…”

Section: Introductionmentioning

confidence: 99%

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Peer Review #2 of "Characteristics of the vaginal microbiome in cross-border female sex workers in China: a case-control study (v0.2)"

2019

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Background : The female sex workers (FSWs) are key groups in the transmission of sexual transmitted infections (STI) and vaginal microbiome variations play an important role for it. We aimed to explore the characteristics of vaginal microbiome among FSWs. Materials and Methods: 24 cross-border female sex workers were randomly selected from a crosssectional survey for female sex workers in southwest China. 37 female non-sex workers were randomly selected from the gynecology clinic and health examination center. Vaginal swabs were collected, bacterial DNA extracted and 16S rRNA genes were sequenced. Differences in the vaginal microbiome between both groups were compared using bioinformatics analysis. Results: One DNA sample was excluded due to unqualified concentration, therefore 60 samples were sequenced. Female sex workers had significantly different vaginal microbiota β diversity, but undifferentiated α diversity when compared with non-sex workers. The average relative abundance of Sneathia, Shigella, Neisseria, Chlamydia, Prevotella, Enterococcus and Ureaplasma among female sex workers was higher than female non-sex workers, and relative abundance of Atopobium in female sex workers was lower than female non-sex workers. The Lactobacillus genus was the major genus in both groups. At the species level, Lactobacllus crispatus, Lactobacllus gasseri and Lactobacllus jensenii, in female sex workers, were lower when compared to female non-sex workers. Conclusion: There were distinct differences in vaginal bacteria variety between female sex workers and female non-sex workers. Some disease-related genus were also more abundant in female sex workers. Based on these observations, further research is required to identify microbiome communities related to high STI risks and other diseases in these cohorts.

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“…Increasingly, sexual activity rather than injection drug use has become a major route for HIV/AIDS transmission [ 1 ]; heterosexual activity accounted for just 30% of new HIV cases in 2005 growing to over 66% in 2014 [ 1 – 3 ]. As with other countries, this shift to sexual transmission has led to the “feminization” of the virus with women comprising one of the fastest growing demographics among new infections [ 4 – 7 ]. At the same time, as new incidents of HIV decrease overall, other sexual transmitted infections (STI) rates have rapidly increased in China, following the same shift in transmission patterns [ 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Mitigating circumstances: A model-based analysis of associations between risk environment and infrequent condom use among Chinese street-based sex workers

Chang

Hail-Jares

Huang³

et al. 2018

PLoS ONE

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BackgroundLittle is known about how freelance street-based sex workers navigate condom use while soliciting. Traditional behavioural model may fail to account for the complex risk environment that most street-based sex workers work within. We examine first the association of self-efficacy and the infrequent condom use, then we investigated the roles of clients and venues frequented on this association.MethodUsing a purposive chain-referral sampling method, we surveyed 248 street-based sex workers in Shanghai. The survey focused on sex workers HIV risk factors, sex work patterns, HIV knowledge, and related HIV self-efficacy. Clients types and behaviours, and characteristics of the venues frequented by these commercial sex workers were also collected. We conducted a series of multiple logistic regression models to explore how the association between a sex worker’s self-efficacy with infrequent condom use change as client and venue characteristics were added to the models.ResultsWe find that within the basic model, low self-efficacy was marginally associated with infrequent condom use (54.9% vs. 45.1%, AOR = 1.70, 95% CI = 0.95–3.03). As client- and venue- characteristics were added, the associations between self-efficacy and condom use were strengthened (AOR = 2.10 95% CI = 1.12–3.91 and 2.54 95% CI = 1.24–5.19 respectively). Those who reported middle-tiered income were more likely to report infrequent condom use compared to their peers of high income (AOR = 3.92 95% CI = 1.32–11.70) whereas such difference was not found between low income and high income sex workers. Visiting multiple venues and having migrant workers as clients were also associated with infrequent condom use.ConclusionOur findings suggest sex worker’s self-efficacy matters in their HIV risk behaviours only when environment characteristics were adjusted. Risk environment for street-based sex workers are complex. Programming addressing behavioural changes among female sex workers should adopt holistic, multilevel models with the consideration of risk environments.

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HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China

Cited by 23 publications

References 35 publications

Migrant female sex workers working at the Sino-Vietnamese border for a short time have a higher risk of HIV transmission: a consecutive cross-sectional study

Migrant female sex workers working at the Sino-Vietnamese border for a short time have a higher risk of HIV transmission: a consecutive cross-sectional study

Peer Review #2 of "Characteristics of the vaginal microbiome in cross-border female sex workers in China: a case-control study (v0.2)"

Mitigating circumstances: A model-based analysis of associations between risk environment and infrequent condom use among Chinese street-based sex workers

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