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HIV, syphilis and HCV rates vary among female sex workers in China
The overall prevalence of HIV, syphilis and hepatitis C virus among female sex workers in China decreased between 2008 and 2012, but there appears to be a disparity in disease prevalence between high- and low-tier sex workers, according to recent findings.
In the serial cross-sectional study, researchers evaluated 827,079 female sex workers (FSWs) in all 31 provinces, municipalities and regions of China. They mapped 500 study sites and classified the locations as high tier or low tier based on the socioeconomic status of the sex workers at these locations. High-tier locations included karaoke bars and hotels, whereas low-tier establishments included salons, foot-bathing shops, massage parlors and public outdoor locations. All study participants were older than 15 years.
Participants filled out questionnaires and provided information about age, marital status, residence, level of education, and length of time working at the given location. Behavior questions addressed condom use during commercial sex during the past month and use of injection drugs during the participant’s lifetime. The investigators also collected blood samples from each participant that were screened for HIV, syphilis and HCV.
The researchers found that there was a significant decrease in the overall incidence of HIV in FSWs during the study period. However, higher HIV prevalence was seen in lower-tier FSWs vs. higher-tier (0.8% lower-tier vs. 0.4% higher-tier in 2008, and 0.6% vs lower-tier vs. 0.1% higher-tier in 2012). Additionally, although the prevalence of syphilis was significantly reduced among high-tier FSWs during the study period, it showed a nonsignificant upward trend in the lower-tier FSWs. Similarly, the prevalence of HCV was significantly decreased in the high-tier FSWs (0.8% in 2009, 0.6% in 2012), but this trend was not consistent in the low-tier group.
The rate of consistent condom use was slightly lower among low-tier FSWs compared with high-tier FSWs, but this rate increased in both groups during the study.
According to the researchers, older FSWs also had relatively higher rates of disease prevalence and high-risk behaviors.
“The HIV and HCV prevalence among all FSWs and syphilis among high-tier FSWs in China was relatively decreased during the study period,” the researchers wrote. “However, low-tier and older FSWs had relatively higher disease prevalence and higher risk behaviors. Thus, comprehensive intervention strategies, particularly focusing on low-tier and older FSWs are needed in order to bring down the disease burden in this high-risk population.”
Disclosure: The researchers report no relevant financial disclosures.