Syphilis among female sex workers in southwestern China: potential for HIV transmission.
OBJECTIVE
The objective of this study was to investigate the prevalence and risk factors of syphilis infection among female sex workers in a southwestern Chinese city along a drug trafficking route.


METHODS
From December 2004 to January 2005, 343 female sex workers (FSWs) were recruited through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual and other sexually transmitted diseases/HIV risk behaviors. Cervical and blood samples were collected to test for syphilis and HIV antibodies and Neisseria gonorrhoeae infection; Condyloma acuminatum infection was diagnosed clinically.


RESULTS
Of 343 FSWs, 15.7% were infected with syphilis. The prevalence of HIV, gonorrhea, and C. acuminatum was 0.6%, 2.0%, and 1.5%, respectively. The subtype of 2 HIV-1 infections was both CRF 07BC. Nearly 10% of FSWs reported using illicit drugs. Consistent use, inconsistent use, and never use of condoms with commercial sex clients in the last month were reported by 53.9%, 38.5%, and 7.6% FSWs, respectively. Longer duration of sex work (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.08-3.62), working at low-end establishments (OR = 2.03; 95% CI = 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR = 2.06; 95% CI = 1.08-3.91) were independently associated with syphilis infection.


CONCLUSIONS
High prevalence of syphilis and overlapped unprotected commercial sex and drug using behaviors among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injection drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/sexually transmitted disease spread.
Ruan
Yuhua
Y
State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Cao
Xiaoyun
X
Qian
Han-Zhu
HZ
Zhang
Li
L
Qin
Guangming
G
Jiang
Zhengqing
Z
Song
Benli
B
Hu
Wei
W
Liang
Shu
S
Chen
Kanglin
K
Yang
Ye
Y
Li
Xinxu
X
Wang
Jun
J
Chen
Xi
X
Hao
Chun
C
Song
Yanhui
Y
Xing
Hui
H
Wang
Ning
N
Shao
Yiming
Y
D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious; D005260:Female; D015658:HIV Infections / Q000635:transmission* / Q000821:virology; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D047568:Unsafe Sex; D014626:Vaginal Smears