How likely are HIV-positive female sex workers in China to transmit HIV to others?
Joseph T. F. Lau A B E , Jing Gu C , Hiyi Tsui A , Hongyao Chen D , Renfan Wang D and Xianyou Hu D
+ Author Affiliations
- Author Affiliations
A Centre for Health Behaviours Research, School of Public Health and Primary Care, the Chinese University of Hong Kong, 5/F., School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong, China.
B Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, Guangdong, 510275, China.
C Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.
D Dazhou Center for Disease Control and Prevention, Dazhou, Sichuan, 635002, China.
E Corresponding author. Email: jlau@cuhk.edu.hk
Sexual Health 8(3) 399-406 https://doi.org/10.1071/SH10106
Submitted: 30 August 2010 Accepted: 31 January 2011 Published: 17 August 2011
Abstract
Background: Female sex workers (FSW) are highly marginalised and HIV-positive FSW are under a double stigma. No study has assessed the likelihood of secondary transmission via HIV-positive FSW in China. Methods: A total of 199 FSW who injected drugs were recruited by snowball sampling, and 158 non-injecting FSW were recruited from sex service establishments by convenience sampling in Dazhou, China. All participants were interviewed anonymously using a structured questionnaire. Results: If found to be HIV-positive, 11.7% of the participants would continue working as FSW, 24.6% would not care about transmitting HIV to others, 18.8% believed that they would eventually spread HIV to others and 9% would take revenge by spreading HIV to others. In multivariate models, factors associated with ≥1 of the four aforementioned perceptions (42.0%) included drug use (odds ratio (OR) = 1.82–3.26, P < 0.01), perceived discrimination towards people living with HIV and AIDS in China (OR = 2.03, P < 0.05) and perceived inaccessibility to medical treatments if diagnosed as HIV-positive (OR = 2.30, P < 0.01); the reverse was true for use of HIV-related services (OR = 0.53, P < 0.05) and suicidal intentions if found to be HIV-positive (OR = 0.42, P < 0.05). Conclusions: Improvement of the social, care and medical environment of HIV-positive FSW is likely to reduce secondary transmission via HIV-positive FSW. Special attention should be given to FSW who inject drugs.
Additional keywords: injecting drug use, secondary transmission, STI.
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