Abstract
ObjectivesFor migrant female sex workers (FSWs) at the Sino-Vietnamese border, the impact of work time in their current location on the spread of HIV/AIDS is not clear.MethodsData were collected from the Sino-Vietnamese border cities of Guangxi, China. Migrant FSWs working in these cities were studied. FSWs who worked less than 6 months in their current location were assigned to the short-term work group (ST FSWs), and FSWs who worked equal to or longer than 6 months in their current location were assigned to the long-term work group (LT FSWs). Logistic regression was performed to examine the impact of work time in the current location and factors associated with HIV infection.ResultsAmong the 1667 migrant FSWs, 586 (35.2%) and 1081 (64.9%) were assigned to the ST FSW and LT FSW groups, respectively. Compared to LT FSWs, ST FSWs were more likely to be of Vietnamese nationality, be less than 18 years old when they first engaged in commercial sex work, and have a low-level of HIV-related knowledge and had higher odds of using condoms inconsistently, having more male clients, having no regular male clients, and having a history of male clients who used aphrodisiacs but lower odds of receiving free condoms distribution and education/HIV counselling and testing programme. The analysis of factors associated with HIV infection revealed that Vietnamese FSWs, less than 18 years old when they first engaged in commercial sex work, having no regular male clients, and having lower average charge per sex transaction were correlated with HIV infection.ConclusionFSWs with short-term work at the Sino-Vietnamese border had a higher risk of risky sex and were correlated with HIV risk factors. Vietnamese FSWs were at higher risk of HIV infection, and they were more likely to have short-term work. More targeted HIV prevention should be designed for new FSWs who recently began working in a locality to further control the spread of HIV, particularly cross-border FSWs.
Highlights
Heterosexual behaviour has become the predominant mode of HIV transmission in China, and it accounts for greater than 60% of all HIV infections [1, 2]
Female sex workers (FSWs) with shortterm work in their current location were associated HIV risk factors, including being a Vietnamese FSW, being under 18 years when they first engaged in commercial sex work and having no regular male clients
Migrant FSWs with short-term work in their current location were more likely to be under 18 years old when they first engaged in commercial sex work, which was a risk factor for HIV infection in our study
Summary
Heterosexual behaviour has become the predominant mode of HIV transmission in China, and it accounts for greater than 60% of all HIV infections [1, 2]. Female sex workers (FSWs) are at a high risk of HIV infection via heterosexual behaviour, acting as the “bridge” population of HIV transmission among the general population. The prevalence of HIV is high in FSWs in the country’s border region [3,4,5]. Guangxi is a Vietnam-bordered province in China, and it has the secondhighest HIV infection rate in China [6]. A study conducted in other border provinces of Vietnam reported a high prevalence of sexually transmitted infections among FSWs [9]. Numerous Vietnamese female immigrants cross the border into Guangxi and engaged in sex work each year and become the workforce of the thriving sex industry in the border regions of China [10]
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