title: Condom use, intervention service utilization and HIV knowledge among female sex workers in China: results of three consecutive cross-sectional surveys in Shandong Province with historically low HIV prevalence.
abstract: Heterosexual transmission of HIV through contact with female sex workers (FSWs) is a growing concern for the HIV/AIDS epidemic in China. Using consecutive cross-sectional surveys, we examined the prevalence of HIV and sexually transmitted infections (STIs), risk behaviours, HIV knowledge and the utilization of intervention services among FSWs in Shandong Province. Of 3460 participants, half reported ever having STI-related symptoms, 57.8% had ≥7 clients in the last week, half reported inconsistent use of condoms with clients and 11.2% reported ever using illicit drugs. Consistent use of condoms with clients was associated with higher education, being 20-24 years of age, being recruited from hotels, having ever received free condoms and was inversely associated with STI-related symptoms. HIV-related knowledge was associated with higher education, ever testing for HIV and inversely associated with self-reported STI-related symptoms. The low rates of condom use, high number and frequent turnover of clients, high prevalence of self-reported STIs and drug use highlight the urgency for more effective intervention in these FSWs.
authors.affiliation: Institute for AIDS/STD Control and Prevention, Shandong CDC, Jinan, Shandong Province,  People's Republic of China.
authors.forename: M
authors.initials: M
authors.lastname: Liao
authors.forename: Z
authors.initials: Z
authors.lastname: Bi
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.forename: D
authors.initials: D
authors.lastname: Kang
authors.forename: J
authors.initials: J
authors.lastname: Fu
authors.forename: Q
authors.initials: Q
authors.lastname: Song
authors.forename: J
authors.initials: J
authors.lastname: Freeman
authors.forename: B
authors.initials: B
authors.lastname: Jiang
authors.forename: Y
authors.initials: Y
authors.lastname: Jia
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012309:Risk-Taking; D060386:Sex Workers; D055815:Young Adult