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Open Access Research article

High prevalence of HIV and syphilis and associated factors among low-fee female sex workers in mainland China: a cross-sectional study

Chu Zhou1, Keming Rou1, Willa M Dong1, Yu Wang1, Wei Dong1, Yuejiao Zhou2, Xi Chen3, Manhong Jia4, Wei Liu2, Jun Zheng3, Yanling Ma4, Youfang Li4, Zunyou Wu1* and for China National HIV Prevention Study Group

Author Affiliations

1 National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing, Changping District 102206, China

2 Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, China

3 Hunan Provincial Center for Disease Control and Prevention, Changsha, China

4 Yunnan Provincial Center for Disease Control and Prevention, Kunming, China

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BMC Infectious Diseases 2014, 14:225  doi:10.1186/1471-2334-14-225

Published: 26 April 2014

Abstract

Background

The prevalence of HIV and syphilis among middle and high-fee female sex workers (FSWs) has been widely reported but little is known among low-fee FSWs. This study aims to determine the prevalence and associated factors of HIV and syphilis among low-fee FSWs in China.

Methods

A cross-sectional study design was used. A convenience sample of low-fee FSWs was recruited from venues by outreach workers in 12 cities. Structured questionnaire interviews and blood sampling for HIV and syphilis were carried out. Univariate and multivariate logistic regression were used for assessing potential associated factors.

Results

This study enrolled 781 low-fee FSWs. There were 37 (4.7%) HIV positive participants and 117 (15.0%) participants were infected with syphilis. Final multivariate analysis identified five factors associated with HIV infection: older age (OR:2.6, 95% CI:1.1-6.1), local household registration (OR:3.3, 95% CI:1.5-6.9), employed in Yunnan province (OR:2.7, 95% CI:1.1-6.7), soliciting in self-rented rooms and “market day” buildings (OR:3.9, 95% CI:1.5-10.0), injection drug use in the past 6 months (OR:13.5, 95% CI:4.5-40.1); and four factors associated with syphilis infection: older age (OR:1.8, 95% CI:1.2-2.9), employed in Yunnan province (OR:2.1, 95% CI:1.2-3.6), soliciting in self-rented rooms and “market day” buildings (OR:2.3, 95% CI:1.4-3.7) , and no consistent condom use with clients in the past 30 days (OR:1.6, 95% CI:1.0-2.6).

Conclusions

A high prevalence of HIV and syphilis were found among low-fee FSWs. Those soliciting in self-rented rooms and “market day” buildings with the lowest income, and injection drug users (IDUs) in this population should take priority in further intervention strategies.

Keywords:
HIV; Syphilis; Sexually transmitted infections; Low-fee sex workers; China