Abstract

Objective To compare the prevalence of HIV and associated factors for participating HIV voluntary counseling and testing (VCT) among older clients of female sex workers (CFSWs) in Liuzhou City and Fuyang City in China. Methods A cross-sectional study was conducted and the study employed 978 male CFSWs, aged 50 years and above from October 2016 to December 2017. All participants were required to complete a questionnaire and provide blood samples for HIV testing. Multivariate logistic regression analysis was used to analyze the influential factors of using VCT program and tested for HIV. Results The HIV infection prevalence rate was 1.2% and 0.5%, while 52.3% and 54.6% participants had ever utilized VCT service and tested for HIV in Liuzhou City and Fuyang City, respectively. The older CFSWs who ever heard of VCT program were more likely to uptake VCT program in both cities (ORLiuzhou = 2.224, ORFuyang = 2.421). Participants, whose marital status was married or cohabiting (ORLiuzhou = 0.548, ORFuyang = 0.495), who have stigma against individuals who are living with HIV/AIDS (ORLiuzhou = 0.273, ORFuyang = 0.371), whose monthly income is more than 500 yuan (ORLiuzhou = 0.622, ORFuyang = 0.600), and whose age is more than 60 years old (ORLiuzhou = 0.639, ORFuyang = 0.554), were less likely to visit VCT clinics. Those who are worried about HIV-infected participants were more likely to utilize VCT services in Fuyang City (AOR = 1.838, 95%CI : 1.146‐2.948). Conclusion Combine strategy will be needed to promote the utilization of VCT service, based on the socioeconomic characteristics of older male CFSWs in different cities of China.

Highlights

  • It has been reported that the number of people living with HIV/AIDS has reached 780,000 at the end of 2011 in China

  • According to the analysis report of the AIDS epidemic in Liuzhou City from 2010 to 2015, the elderly often gather in the low-grade CSWs, the number of HIV/AIDS infection increases year by year, and the infection rate is relatively high [20, 21]

  • Health workers from local Center for Disease Control and Prevention (CDC) introduced the research team to the owners of commercial sex venues; after obtaining permission of the owner, researchers were stationed at the commercial sex venues, after brief introduction the purpose of the study to female sex workers (FSWs) who work in the commercial sex venues and asked them to recruit eligible older male clients for this study

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Summary

Introduction

It has been reported that the number of people living with HIV/AIDS has reached 780,000 at the end of 2011 in China. The contribution of heterosexual transmission has increased from 11.3% in 2005 to 76.3% in 2011 [1, 2]. It is estimated the number of female sex workers (FSWs) in mainland China is 1.8-3.8 million and clients of female sex workers (CFSWs) are 17.7-37.1 million [3]. Due to lack of effective vaccines or cure for HIV, voluntary counseling and testing (VCT) has been regarded as an effective intervention for prevention of HIV infection. To provision of care and treatment, VCT services

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