Abstract
Objectives To evaluate club drug use and its potential association with STI among female sex workers (FSWs) in China. Methods From November 2008 to January 2009, participants were recruited at sex work venues in five cities for a questionnaire survey. Free testing for syphilis, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) was provided. Logistic regression models were used to assess factors associated with club drug use and its association with STI. Results A total of 1604 eligible FSWs were included. The overall prevalence of any STI infection and club drug use in the past 12 months was 22.6% and 7.4%, respectively. STI prevalence was significantly higher among club drug users (33.1%) than among nonusers (21.7%, P < 0.05). Multivariable logistic regression found that club drug use was associated with younger age (AOR 2.4, 95% CI 1.0, 6.0), higher education, having injected drugs (AOR 24.4, 95% CI 6.2, 96.8), and having had STI symptoms (AOR 2.2, 95% CI 1.4, 3.4). Conclusions Club drug use and STI were highly prevalent among FSWs in China, especially among young FSWs. Club drug users had more risk behaviors and higher STI rates. A coordinated risk reduction framework is urgently needed to address the dual epidemic of drug use and STI.
Highlights
Abuse of club drugs which refer to a group of synthesized drugs like methamphetamine and ecstasy has been on the rise around the world [1, 2]
One available study conducted among female sex workers (FSWs) in a northeastern city in China found an association between club drug use and syphilis infection [13, 14]
The prevalence of club drug use and its correlation with sexual risk taking are important issues that have not been closely studied among FSWs in China
Summary
Abuse of club drugs which refer to a group of synthesized drugs like methamphetamine and ecstasy has been on the rise around the world [1, 2]. Studies in western countries showed that club drug use was associated with high-risk sexual behaviors and elevated risk of HIV and other sexually transmitted infections (STIs) among different risk groups [5, 6]. China has seen a boom of club drug use in the past two decades [7, 8]. Given the predominant contribution of sexual transmission to HIV/STI epidemic in China [10], the use of club drugs among female sex workers (FSWs) and other risk groups could potentially fuel the epidemic. One available study conducted among FSWs in a northeastern city in China found an association between club drug use and syphilis infection [13, 14]. The prevalence and patterns of club drug use differ across populations and regions, and studies assessing club drug use and its association with HIV/STI risk remain scarce in China
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