High prevalence of syphilis among street-based female sex workers in Nanchang, China.
BACKGROUND
Female sex workers (FSWs) play a critical role in the heterosexual transmission of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) in China. Several studies reported that street-based FSWs have higher risk behaviors than establishment-based FSWs. Therefore, street-based FSWs should be specifically targeted for HIV and STIs intervention programs.


OBJECTIVE
This study aims to investigate the prevalence rates and risk factors of HIV and syphilis among FSWs in Nanchang, China.


METHODS
Using convenience sampling methods, 361 street-based FSWs were recruited from August 2011 to February 2012. All participants completed an anonymous questionnaire on socioeconomic and sex behavioral information and were tested for HIV and syphilis. Risk for HIV and syphilis infection was assessed using univariate and multivariate logistic regression analyses.


RESULTS
No HIV infections were found. The prevalence rate of syphilis was 43.5%. Nearly 46.1% of street-based FSWs reported having education for no more than 6 years. Having reproductive tract infections at current visit, duration of sex work more than 5 years, indulgence in unprotected sex trade in the last time, unprotected sex trade in the last month, and unprotected sex with boyfriend or spouse in the last month were reported by 35.2%, 43.5%, 33.8%, 60.4%, and 93.1% street-based FSWs, respectively. In multivariate logistic regression analysis, having reproductive tract infections at current visit [odds ratio (OR), 12.10; 95% confidence interval (CI), 6.01-24.37], duration of sex work more than five years (OR, 4.26; 95% CI, 2.40-7.54), and unprotected sex trade in the last month (OR, 1.85; 95% CI, 1.06-3.22) were independently associated with syphilis infection.


CONCLUSIONS
The prevalence rate of syphilis among street-based FSWs is very high. Most street-based FSWs in our survey had low education, long experience of commercial sex, and high rate of inconsistent condom use. Comprehensive interventions targeting this high-risk group, especially scaling up screening and ensuring consistent use of condoms during sex are needed.
Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Xiao Hua
XH
Tao
Department of Gynaecology, The First People's Hospital of Jiujiang, Jiujiang, 332000, Jiangxi Province, China.
Tao
T
Jiang
Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Dan
D
Shao
Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Wei
W
Xue
Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Fa Shun
FS
Ye
Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Ming
M
Wang
Department of Dermatology and STD, Dermatology Hospital of Jiangxi Province, The Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Mei Hua
MH
He
Epidemiology; female sex worker; human immunodeficiency virus; prevalence; risk factor; syphilis