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Open Access Research article

HPV and cervical cancer related knowledge, awareness and testing behaviors in a community sample of female sex workers in China

Yan Hong1, Chen Zhang2, Xiaoming Li3*, Danhua Lin4 and Yingjie Liu5

Author Affiliations

1 Department of Social and Behavioral Health, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA

2 Rollins School of Public Health, Emory University, Atlanta, GA, USA

3 Carman and Ann Adams Department of Pediatrics, Prevention Research Center, Wayne State University School of Medicine, 4707 St. Antoine, Suite W534, Detroit, MI, USA

4 School of Psychology, Beijing Normal University, Beijing, China

5 Chaoyang District Center for Disease Control and Prevention, Beijing, China

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BMC Public Health 2013, 13:696  doi:10.1186/1471-2458-13-696

Published: 30 July 2013

Abstract

Background

Limited data suggested that the prevalence of Human Papillomavirus (HPV) among female sex workers (FSW) is much higher than in the general female population. The current study aimed to examine the HPV and cervical cancer related awareness, knowledge, and behaviors among FSW in China.

Methods

A total of 360 FSW recruited from entertainment establishments in Beijing completed a self-administered survey including demographics, HPV related knowledge, and health-seeking and cervical cancer preventive behaviors.

Results

Approximately 70.8% of the participants ever heard of cervical cancer, and as few as 22.1% and 13.3% ever heard of HPV and HPV vaccine, respectively. The mean score on a 7-item knowledge scale was 2.2 (SD = 2.4). Less than 10% of FSW perceived any risk of cervical cancer, and only 15.3% ever had a Pap smear. About 40.8% of FSW would accept HPV vaccine if it is free, and 21.8% would accept it even with a charge. Multivariate regression suggested that women with better knowledge of cervical cancer were more likely to have a Pap smear (aOR = 1.35); women who had tested for HIV were 11 times more likely to have a Pap smear, and women who had worked longer in commercial sex (aOR = 1.01) and had regular health check-ups (aOR = 1.95) were more likely to accept HPV vaccine.

Conclusions

Our study underscores the needs for effective cervical cancer prevention programs for FSW in China and other resource-limited countries. We specifically call for cervical cancer and HPV knowledge and awareness programs and regular screening as well as HPV risk-reduction programs for these vulnerable women.

Keywords:
Cervical cancer; HPV; Female sex workers; Prevention