title: Factors associated with utilization of a free HIV VCT clinic by female sex workers in Jinan City, Northern China.
abstract: Based on our previous qualitative exploration, this research presents the second phase in our study of factors associated with utilization of a free HIV VCT clinic in Jinan City, Northern China, by female sex workers (FSWs). A total of 970 FSWs from entertainment venues were interviewed and prospectively followed to determine who ultimately sought and received VCT at the clinic, compared to those who did not. Simple and multiple logistic regressions were performed on factors drawn from the Ecological Perspective, hypothesized to be associated with utilization of testing at the VCT clinic. Despite 69% of FSWs expressing willingness to attend the VCT clinic, only 11% were actually tested. The multiple logistic regression model that provided best goodness of fit included the covariates of willingness to attend the VCT clinic (Adjusted OR 3.13, 95% CI: 1.62-6.59), low perceived HIV infection risk (Adjusted OR 0.64, 95% CI: 0.35-1.11), low fear of FSWs status disclosure in the clinic (Adjusted OR 0.55, 95% CI: 0.31-0.94) and influence of acquaintances (Adjusted OR 0.52, 95% CI: 0.29-0.89) and peers (Adjusted OR 2.45, 95% CI: 1.40-4.50). This is the first study in China to follow FSWs longitudinally to measure factors related to VCT utilization. The low utilization of VCT services by participants in our study is similar to prior reports throughout China. FSWs' access to VCT service is associated with intrapersonal, institutional, and particularly, interpersonal factors. Based on these findings, we recommend emphasis on confidentiality of services, VCT education for influential peers, and introduction of HIV rapid testing on site.
authors.affiliation: Department of Diseases Control, National Institute of Viral Diseases Control and Prevention, Chinese CDC, Beijing, China. nihgrant@163.com
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Jingbin
authors.initials: J
authors.lastname: Pan
authors.forename: Sohini
authors.initials: S
authors.lastname: Sengupta
authors.forename: Catherine Boland
authors.initials: CB
authors.lastname: Emrick
authors.forename: Myron S
authors.initials: MS
authors.lastname: Cohen
authors.forename: Gail E
authors.initials: GE
authors.lastname: Henderson
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012309:Risk-Taking; D011477:Sex Work / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D035141:Voluntary Programs / Q000706:statistics & numerical data*; D055815:Young Adult
references.citation: AIDS Care. 2001 Oct;13(5):595-603
references.pmid: 11571006
references.citation: AIDS. 2005 Jan 3;19(1):77-84
references.pmid: 15627036
references.citation: Am J Public Health. 2007 Oct;97(10):1762-74
references.pmid: 17761565
references.citation: Retrovirology. 2006 Dec 01;3:87
references.pmid: 17140434
references.citation: AIDS Patient Care STDS. 2005 Dec;19(12):853-60
references.pmid: 16375618
references.citation: Sex Transm Dis. 2006 Dec;33(12):726-36
references.pmid: 16755273
references.citation: AIDS. 1996 Dec;10(14):1707-17
references.pmid: 8970692
references.citation: Sex Transm Infect. 2007 Dec;83(7):508-9
references.pmid: 18024710
references.citation: Sex Transm Dis. 2004 Nov;31(11):695-700
references.pmid: 15502679
references.citation: Sex Transm Dis. 2007 Sep;34(9):695-703
references.pmid: 17507838
references.citation: AIDS Behav. 2005 Dec;9(4):475-84
references.pmid: 16261266
references.citation: AIDS Behav. 2008 Jul;12(4):623-36
references.pmid: 17694431
references.citation: AIDS Behav. 2009 Oct;13(5):866-72
references.pmid: 18770027
references.citation: AIDS Care. 2004 May;16(4):411-25
references.pmid: 15203410
references.citation: AIDS Behav. 2005 Jun;9(2):233-42
references.pmid: 15933842
references.citation: J Obstet Gynaecol. 2003 Nov;23(6):632-6
references.pmid: 14617465
references.citation: Lancet. 2000 Jul 8;356(9224):103-12
references.pmid: 10963246
references.citation: Trop Med Int Health. 2004 May;9(5):566-72
references.pmid: 15117300
references.citation: AIDS. 2005 Mar 25;19(5):503-11
references.pmid: 15764856