HIV Infection and Sexually Transmitted Diseases in Female Commercial Sex Workers in China

A cross-sectional survey was conducted among female commercial sex workers (FSWs) in Zhengzhou, China, to estimate rates of HIV infection and sexually transmitted diseases (STDs) and to document their sexual behavior patterns from October 2000 to January 2001. FSWs were recruited by the snowball sampling technique and were interviewed at their working environments anonymously. This strategy resulted in high rates of response (92%) and concordance (98%) to sensitive questions. A total of 621 FSWs were enrolled. One direct FSW and 1 indirect FSW were positive for antibodies to HIV in oral fluids (prevalence of HIV infection, 1.4% and 0.2%, respectively). A history of STDs was reported by 49% of the FSWs. Most FSWs (87%) reported inconsistent condom use. Ten percent of FSWs recognized their clients as drug users. A few FSWs (2.2%) were injecting drug users, of whom 2 reported incidents of sharing needles/syringes with other injecting drug users. Direct FSWs had more risk characteristics and were more vulnerable to HIV infection and STDs than indirect FSWs. Inconsistent use of condoms and a high level of STDs underscore the urgent need to implement intervention strategies and condom promotion, particularly among direct sex workers in China.