OBJECTIVES:This study assessed social and behavioural predictors for sexual risk taking and sexually transmitted infections (STIs) including HIV among adolescent female sex workers (FSWs) from Kunming, China. Additionally, health services needs and use were assessed. METHODS:A cross-sectional survey was conducted in 2010. Using snowball and convenience sampling, self-identified FSWs were recruited from four urban areas in Kunming. Women consenting to participate were administered a semi-structured questionnaire by trained interviewers identified from local peer-support organisations. Following interview, a gynaecological examination and biological sampling to identify potential STIs were undertaken. Descriptive and multivariable logistic regression analyses were performed. RESULTS:Adolescent FSWs had a mean age of 18.2 years and reported numerous non-paying sexual partners with very low rate of consistent condom use (22.2%). Half (50.3%) the respondents had sex while feeling drunk at least once in the past week, of whom 56.4% did not use condom protection. STI prevalence was high overall (30.4%) among this group. Younger age, early sexual debut, being isolated from schools and family, short duration in sex work, and use of illicit drugs were found to be strong predictors for unprotected sex and presence of an STI. Conversely, having access to condom promotion, free HIV counselling and testing, and peer education were associated with less unprotected sex. The majority reported a need for health knowledge, free condoms and low-cost STI diagnosis and treatment. CONCLUSIONS:There is an urgent need to improve coverage, accessibility and efficiency of existing interventions targeting adolescent FSWs.

译文

目的:本研究评估了来自中国昆明市的青春期女性性工作者(FSW)的性行为冒险和性传播感染(STI)(包括HIV)的社会和行为预测因素。此外,还评估了卫生服务的需求和使用。
方法:2010年进行了横断面调查。通过滚雪球和便利抽样,从昆明的四个市区招募了自我识别的FSW。从当地同支持组织确定的训练有素的访调员对同意参加的妇女进行半结构化问卷调查。采访之后,进行了妇科检查和生物采样以识别潜在的性传播感染。进行了描述性和多变量logistic回归分析。
结果:青少年FSW的平均年龄为18.2岁,并报告了许多无偿性伴侣,一致使用避孕套的比例很低(22.2%)。在过去的一周中,有一半(50.3%)的被调查者曾发生过至少一次醉酒的性行为,其中56.4%的人未使用安全套保护措施。在这一组中,性传播感染的患病率总体较高(30.4%)。人们发现,年龄较小,性行为初次出现,与学校和家庭隔离,性工作时间短以及使用非法药物是无保护性行为和性传播感染存在的强烈预测因素。相反,获得安全套宣传,免费的艾滋病毒咨询和检测以及同伴教育的机会与较少受到保护的性行为有关。大多数人报告需要健康知识,免费避孕套和低成本的STI诊断和治疗。
结论:迫切需要提高针对青少年FSW的现有干预措施的覆盖面,可及性和效率。

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