Outreach Syphilis Testing Services by Different Health Providers to Female Sex Workers in Southern China

Abstract

Health providers have played important roles on delivering prevention and care services to control syphilis in China. The current study was aimed to evaluate the performance of different health providers in providing outreach syphilis testing services to female sex workers (FSWs). The current study carried out during April to August 2009 in Liuzhou was aimed to investigate the services delivered by two different types of clinics in China. A total of 1,808 FSWs recruited from sex work venues were included in the study. Prevalence of positive syphilis test (6.4%) among FSWs accessed by the local center for disease control outreach teams (CDC teams) was significantly lower than that (9.3%) among FSWs accessed by the local reproductive health hospital outreach teams (RHH teams). As compared with CDC teams, RHH teams had more FSWs to be successfully referred to the designated STD clinics for further syphilis confirmation and intervention (85.7% vs. 26.7%, P<0.001). These findings indicate that RHH teams may be more efficient than CDC teams to provide outreach-based services to FSWs. Participation of the reproductive health providers or other medical facilities in outreach services to FSWs should be considered in developing intervention programs in China.

Uptake of a women‐only, sex‐work‐specific drop‐in center and links with sexual and reproductive health care for sex workers

“…Most successful strategies to improve FSWs’ access to HIV prevention and care have been based on community empowerment models, including health and support services led by FSWs and tailored to their needs [6,12,13]. For example, the IMPACT project in Mombasa, Kenya, included a peer-mediated intervention to prevent HIV and STIs, which increased consistent condom use and access to SRH services [14].…”

A community-based comprehensive intervention to reduce syphilis infection among low-fee female sex workers in China: a matched-pair, community-based randomized study

“…On the other hand and perhaps most importantly, timely referral to treatment and higher treatment coverage for syphilis, as provided as a part of the intervention package, may have led to this decline and as such, have important advantages for public health [20]. Providing free or low-cost treatment and intervention services to patients infected with syphilis at clinics has been recommended as core components in syphilis control programs in China [21]. This study followed these guidelines in the development of the intervention package, which was found to be effective in reducing the prevalence of syphilis.…”

Psychological Fears among Low-Paid Female Sex Workers in Southwest China and Their Implications for HIV Prevention

“…Second, strengthening FSWs' trust in HIV-testing facilities and health care providers will be very important to promote FSWs' access to testing and other HIV prevention and treatment services. The severe stigma against both sex work and HIV/AIDS, the doubt about confidentiality of HIV clinics, and the distrust toward health care professionals or outreach workers may be sources of FSWs' fears of identity breaching and hesitation to access adequate and timely health care service [44] . In a study on utilization of VCT services among FSWs in northern China, 69% of the participants expressed their willingness to attend the VCT clinic, while only 11% were actually tested with fear of identity disclosure in the clinic being negatively related to actual HIV-testing [45] .…”

“…Stigma reduction among health care professionals and secured HIV-testing results notification procedure with an emphasis on confidentiality protection are needed to decrease fear of identity breaching among FSWs. HIV education and prevention activities can be combined with other health care services that FSWs need (e.g., reproductive health, family planning and women health) to increase rapport and trust between FSWs and health care professionals [44] .…”