Abstract
BackgroundThe mobility of female sex workers (FSWs) is a factor in the geographic spread of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). This study describes FSW mobility patterns in a high risk area of China to identify factors associated with increased mobility, and to study the incidence and prevalence of HIV/STIs in this group.Methods270 FSWs recruited from a baseline cross-sectional study were invited to participate in a one-year monthly follow-up cohort study in Kaiyuan City, Yunnan Province, China from 2006 to 2007. Laboratory tests were conducted for HIV/STIs at baseline, 6 and 12 months.ResultsA total of 117 (43.3%) FSWs moved to another city during the year. Risk factors for increased mobility included being from another city within Yunnan (adjusted hazard ratio [AHR] 1.67, 95% confidence interval [CI] 1.09-2.56), being from outside Yunnan (AHR 1.58, 95% CI 1.04-2.54), and working in lower risk entertainment establishments (AHR 1.55, 95% CI 1.03-2.35). HIV-positive subjects, drug users and FSWs in higher risk venue were less likely to change residence, less likely to use condoms with clients, and earned less per client, but had more working locations and more clients each month.ConclusionsThe least mobile FSWs were from Kaiyuan, worked in higher risk venues, were more likely to use drugs and be HIV-infected. Because FSWs characteristics differ according to the venue at which they work, future prevention work should tailor programs according to venue with a particular focus on FSWs in higher risk venues.
Highlights
The mobility of female sex workers (FSWs) is a factor in the geographic spread of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs)
Baseline characteristics of the study population Among the 737 FSWs who participated in the baseline cross-sectional survey, 270 (37%) were recruited into the cohort study, including 27 HIV-positive drug users, 20 HIV-positive non-drug users, 36 HIV-negative drug users, and 187 HIV-negative non-drug users
In this study, in which a cohort of 270 FSWs were followed monthly for one year to understand mobility, risk patterns, and HIV/STI rates, we found that, in general, FSWs were highly mobile with 43% of subjects moving between cities over the course of the year
Summary
The mobility of female sex workers (FSWs) is a factor in the geographic spread of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Female sex workers (FSWs) in developing countries often relocate to places with greater numbers of potential clients, such as military camps, mining towns and roadside truck stops [2,3]. Such mobility can facilitate the spread of the human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) from higher prevalence areas to lower prevalence areas. Research into FSW mobility is important because of its role in facilitating the transmission of HIV/STIs
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