Correlates of chlamydia and gonorrhea infection among female sex workers: the untold story of Jiangsu, China.
OBJECTIVE
To estimate the prevalence of sexually transmitted infections (STIs) among female sex workers (FSWs) in the Jiangsu Province, China and measure the association of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections with their potential correlates.


METHODS
A cross-sectional study on a representative sample of FSWs in Yangzhou and Changzhou cities of Jiangsu was conducted.


METHODS
185 sex-work venues in Yangzhou and 174 in Changzhou were selected by stratified random sampling. 2972 FSWs (1108 in Yangzhou and 1864 in Changzhou), aged 15 years or more, who agreed to participate and provided blood sample for HIV and syphilis testing were interviewed in these venues. Cervical specimens from 849 randomly chosen participants were then tested for CT and NG.


RESULTS
Proportions of young, school-educated, currently married FSWs who were living alone, migrated from other provinces and engaged in unprotected vaginal intercourse in past 3 months (UVI) were relatively high. Prevalence of HIV, syphilis, CT and NG were 0.20%, 4.88%, 14.61% and 5.42% respectively. Younger age, living alone or with persons other than partners/family members, engaging in UVI and having other STIs seemed to be associated with higher risk of CT or NG infection. Being divorced/widowed and working in middle/low-level venues were identified as additional risk factors for NG.


CONCLUSIONS
Based on a representative sample, this initial effort to identify the correlates of CT/NG infections among FSWs of Jiangsu revealed that focused interventions targeting high-risk FSWs are urgently required for controlling STI epidemics in Yangzhou and Changzhou where substantial number of STI cases were identified.
Department of Epidemiology, School of Public Health, University of California, Los Angeles, California, United States of America ; Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, Jiangsu, China.
Weiming
W
Tang
Jiangsu Province Geriatric Institute, Nanjing, Jiangsu, China.
Jicheng
J
Pan
National Center for STD Control, China CDC, Nanjing, Jiangsu, China.
Ning
N
Jiang
Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, Jiangsu, China.
Hai-Yang
HY
Hu
Department of Epidemiology, School of Public Health, University of California, Los Angeles, California, United States of America.
Tanmay
T
Mahapatra
National Center for STD Control, China CDC, Nanjing, Jiangsu, China.
Yue-Ping
YP
Yin
Department of Epidemiology, School of Public Health, University of California, Los Angeles, California, United States of America.
Sanchita
S
Mahapatra
Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, Jiangsu, China.
Xiao-Liang
XL
Wang
National Center for STD Control, China CDC, Nanjing, Jiangsu, China.
Xiang-Sheng
XS
Chen
College of Ocean & Earth Science, Xiamen University, Xiamen, China.
Nan
N
Lin
Department of Molecular Pharmacology and Physiology, MCM, University of South Florida, Tampa, Florida, United States of America.
Xun
X
Zhang
National Center for STD Control, China CDC, Nanjing, Jiangsu, China.
Xi-Ping
XP
Huan
Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, Jiangsu, China.
Hai-Tao
HT
Yang
Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, Jiangsu, China.
Geng-Feng
GF
Fu
D000328:Adult; D002681:China / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D060386:Sex Workers; D013587:Syphilis / Q000453:epidemiology; D047568:Unsafe Sex; D055815:Young Adult