title: Comparing HIV-related syringe-sharing behaviors among female IDU engaging versus not engaging in commercial sex.
abstract: BACKGROUND
  To compare the prevalence of syringe-sharing behaviors and other HIV-related characteristics among female injecting drug users (IDU) engaging and not engaging in sex work and to identify factors associated with such risk behaviors in the two groups.
  
  
  METHODS
  Data were obtained from 1923 female respondents of behavioral surveillance studies conducted in Sichuan, China.
  
  
  RESULTS
  The prevalence of having at least one of the three syringe-sharing behaviors (borrowing, lending, or injecting from pre-filled syringes) was 45.3% in the female sex workers (FSW) group and 37.2% in the non-FSW group (adjusted OR=1.28, p<0.05). Compared with non-FSW, FSW were more likely to have injected drugs for 3 or more years, have non-regular sex partners, believe that condom use could prevent HIV, and have received free condoms/lubricants (OR=1.34-5.08, p<0.05); FSW were less likely to be older, better educated, and have attempted quitting drugs (OR=0.31-0.68, p<0.05). Being FSW, older, longer injecting drug use, higher drug injection frequency, and having regular sex partner were associated with injecting with others' used syringes (multivariate OR=1.26-1.92, p<0.05) while the reverse was true for education level and voluntary HIV antibody testing (multivariate OR=0.44-0.64, p<0.05). Of all sampled FSW, 39.3% did not use a condom in the last episode of sex work.
  
  
  CONCLUSIONS
  Female IDU involving in sex work are at high risk of HIV transmission and the risk may even be higher than their non-FSW counterparts. The bridging effect poses a threat to the HIV epidemic in China and effective preventive services are warranted.
authors.affiliation: Centre for Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, 5/F, School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong, China. jlau@cuhk.edu.hk <jlau@cuhk.edu.hk>
authors.forename: Joseph T F
authors.initials: JT
authors.lastname: Lau
authors.forename: Hi Yi
authors.initials: HY
authors.lastname: Tsui
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Feng
authors.initials: F
authors.lastname: Cheng
authors.forename: Linglin
authors.initials: L
authors.lastname: Zhang
authors.forename: Jianxin
authors.initials: J
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D019359:Knowledge; D016485:Needle Sharing / Q000523:psychology* / Q000706:statistics & numerical data; D012044:Regression Analysis; D011477:Sex Work / Q000523:psychology*; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D055815:Young Adult