Abstract
BackgroundFemale sex workers (FSW) are highly susceptible to chlamydia and gonorrhea infection. However, there is limited literature examining their testing uptake to date. This study aimed to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China.MethodsA cross-sectional study with convenience sampling was performed in five cities in Southern China. Data on socio-demographic characteristics, sexual behaviors, chlamydia and gonorrhea testing, and the utilization of health care services from participants were collected through face-to-face interviews. Univariate and multivariable logistic regressions were used to determine factors associated with chlamydia and gonorrhea testing, respectively.ResultsOverall, 1207 FSWs were recruited, with the mean age of 30.7 ± 6.8 years and an average number of clients of 7.0 (4.0–10.0) per week. 65.4% participants constantly used condoms with clients during the past month. Only 7.5 and 10.4% had been tested for chlamydia and gonorrhea in the last year, respectively. Multivariable analysis indicated that FSW who worked at low tiers (adjusted Odds Ratio (aOR) = 2.36, 95%CI:1.23–10.14), had more clients in the last month (aOR = 1.03, 95%CI:1.01–1.05), used condoms consistently (aOR = 1.79, 95%CI:1.12–2.86), had STD symptoms (aOR = 4.09,95%CI:2.62–6.40), had been tested for HIV (aOR = 5.16, 95%CI:3.21–8.30) or syphilis (aOR = 6.90, 95%CI:4.21–11.22) in the last year were more likely to have chlamydia testing. In addition, FSW who had more clients in the past month (aOR = 1.02,95%CI:1.00–1.04), had STD symptoms (aOR = 3.33, 95%CI:2.03–5.46), had been tested for HIV (aOR = 3.94, 95%CI:2.34–6.65) and syphilis (aOR = 3.27, 95%CI:1.96–5.46) in the last year were more likely to have gonorrhea testing.ConclusionsThe testing rates of chlamydia and gonorrhea are low among Chinese FSW. Integrating chlamydia and gonorrhea testing into HIV testing promotion programs may help bridge the gap among FSW.
Highlights
Female sex workers (FSW) are highly susceptible to chlamydia and gonorrhea infection
Previous studies in the United States and Vietnam indicated that the asymptomatic infection of chlamydia and gonorrhea [13], low levels of knowledge [14], misperceptions of risk, stigma around sexually transmitted disease (STD) [15], and cost [16] are the main barriers for improving testing uptake of chlamydia and gonorrhea among women who are actively engaged in sex
Discussion testing is an effective strategy to prevent the transmission of chlamydia and gonorrhea, our findings suggest that chlamydia and gonorrhea testing rates remain low among Chinese FSW
Summary
Female sex workers (FSW) are highly susceptible to chlamydia and gonorrhea infection. The current sexually transmitted disease (STD) prevention services in the low- and middle- income countries (LMIC) mainly focused on controlling HIV and syphilis [11],including China, while to date, limited studies are examining the chlamydia and gonorrhea testing uptake among FSW [7, 12]. Previous studies in the United States and Vietnam indicated that the asymptomatic infection of chlamydia and gonorrhea [13], low levels of knowledge [14], misperceptions of risk, stigma around STD [15], and cost [16] are the main barriers for improving testing uptake of chlamydia and gonorrhea among women who are actively engaged in sex.
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