Abstract
BackgroundLimited data suggested that the prevalence of Human Papillomavirus (HPV) among female sex workers (FSW) is much higher than in the general female population. The current study aimed to examine the HPV and cervical cancer related awareness, knowledge, and behaviors among FSW in China.MethodsA total of 360 FSW recruited from entertainment establishments in Beijing completed a self-administered survey including demographics, HPV related knowledge, and health-seeking and cervical cancer preventive behaviors.ResultsApproximately 70.8% of the participants ever heard of cervical cancer, and as few as 22.1% and 13.3% ever heard of HPV and HPV vaccine, respectively. The mean score on a 7-item knowledge scale was 2.2 (SD = 2.4). Less than 10% of FSW perceived any risk of cervical cancer, and only 15.3% ever had a Pap smear. About 40.8% of FSW would accept HPV vaccine if it is free, and 21.8% would accept it even with a charge. Multivariate regression suggested that women with better knowledge of cervical cancer were more likely to have a Pap smear (aOR = 1.35); women who had tested for HIV were 11 times more likely to have a Pap smear, and women who had worked longer in commercial sex (aOR = 1.01) and had regular health check-ups (aOR = 1.95) were more likely to accept HPV vaccine.ConclusionsOur study underscores the needs for effective cervical cancer prevention programs for FSW in China and other resource-limited countries. We specifically call for cervical cancer and HPV knowledge and awareness programs and regular screening as well as HPV risk-reduction programs for these vulnerable women.
Highlights
Limited data suggested that the prevalence of Human Papillomavirus (HPV) among female sex workers (FSW) is much higher than in the general female population
The current study aims to fill the gaps in the literature by answering the following research questions: 1) What is the level of awareness of cervical cancer, HPV, HPV vaccine among FSW? 2) What is the level of knowledge of HPV and cervical cancer among FSW? and 3) What are the factors associated with cervical cancer preventive behaviors (i.e., Pap smear behavior and acceptance of the HPV vaccine)?
The mean age of the FSW was 25.1 years (SD = 3.5, range:18–36 years old), a majority (91.1%) of them were ethnic Han, 64.2% came from rural areas, 61.9% were currently not married, and 58.1% had less than nine years of schooling
Summary
Limited data suggested that the prevalence of Human Papillomavirus (HPV) among female sex workers (FSW) is much higher than in the general female population. As the most populous country, China has observed an increase in the cervical cancer incidence rate in younger females (25–44 years of age) within a context of a growing cancer burden [1,2]. In some developed countries, health professionals have implemented screening programs among general women and HPV vaccination programs among schoolbased adolescent girls and found cervical cancer as well as HPV-related diseases have been markedly prevented [3,20,21,22,23,24], but programs targeting FSW have been very limited [25,26]
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