Review of HIV and other sexually transmitted infections among female sex workers in China

Abstract

Female sex workers (FSW) are at greater risk for HIV and STIs. A systematic literature review of HIV and STI prevalence and incidence data for FSW in China was conducted to assess current trends. Studies between 1996 and 2010 detailing seroprevalence or incidence data, other laboratory-based tests, and clinical diagnoses of infections among FSW were reviewed. Select articles from Chinese literature around street-based and drug-abusing FSW were also reviewed. Results revealed high median prevalence for a variety of STIs among FSW: active syphilis range 0.8-12.5% (median = 6.9%), herpes range 29.7-70.8% (median = 56.2%), chlamydia range 3.9-58.6% (median = 25.7%), gonorrhea range 2.0-85.4% (median = 16.4%), and trichomoniasis range 7.1-43.2% (median = 12.5%). HIV prevalence has remained relatively low and stable with a range of 0-10.3% (median = 0.6%), with the exception of higher prevalence in several areas of Yunnan and some areas of Guangxi. The FSW who are injecting drug users may be at even greater risk for HIV infection with 12-49% found to be HIV positive and 7-25% self-reporting positive status. A number of gaps in the literature remain, especially in the number of studies that detail prevalence confirmed by laboratory testing or that collect incidence data. Assessment of incidence and prevalence according to sampling methodology appropriate for the population, behavioral risks such as injecting drug use, and diverse venues especially those at the lower end are needed. Theory-based interventions to reduce the incidence and prevalence of HIV/STIs need to be piloted with successful models scaled-up.

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

“…The proportion of reported cases in China resulting from heterosexual transmission has increased steadily over time: 8.7 % in 2004, 30.6 % in 2006, 40.9 % in 2008,58.4 % in 2010 and 69.4 % in 2013 [5]. Meanwhile, the prevalence of HIV and syphilis has been consistently low among FSWs in China [6][7][8].…”

A systematic review and meta-analysis of the prevalence, trends, and geographical distribution of HIV among Chinese female sex workers (2000–2011): implications for preventing sexually transmitted HIV

“…13 The sex work tier is often a key determinant of socio-economic status, work environment, type of client, and risk behavioural patterns of FSWs in China. 14 The prevalence of sexually transmitted infections (STIs) among Chinese FSWs was high during the period of the present investigation and review (during 2000-2011: Chlamydia trachomatis, 17-46%; [15][16][17][18][19][20] gonorrhoea, 8-39%; [15][16][17][18]20 herpes simplex virus 2, 33-71%; 15,19,21,22 syphilis, 4-16% [15][16][17]20,[23][24][25][26].…”

Awareness and acceptance of human papillomavirus (HPV) vaccination among males attending a major sexual health clinic in Wuxi, China: A cross-sectional study

“…A systematic review found that among female sex workers in China, the prevalence of active syphilis ranged 0.8-12.5% (median=6.9%), herpes 29.7-70.8% (medianD56.2%), chlamydia 3.9-58.6% (median=25.7%), gonorrhea 2.0-85.4% (medianD16.4%), trichomoniasis 7.1-43.2% (median=12.5%) and HIV 0-10.3% (medianD0.6%). 30 HPV vaccine, like other vaccines against infections that could be sexually transmitted, such as hepatitis A vaccine and hepatitis B vaccine, should best be given to people before their 3) in some cultures discrimination and stigma against homosexuality and bisexuality is prevalent which lays a barrier for MSM to come out of the closet, even to their doctors. These issues need to be addressed in the HPV vaccination program targeting MSM.…”