Bridging the Epidemic: a Comprehensive Analysis of Prevalence and Correlates of HIV, Hepatitis C, and Syphilis, and Infection Among Female Sex Workers in Guangxi Province, China

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Feb 28

PMID 25723548

Citations 24

Authors

Yi Chen

Zhiyong Shen

Jamie P Morano

Kaveh Khoshnood

Zunyou Wu

Guanghua Lan

Qiuying Zhu

Yuejiao Zhou

Shuai Tang

Wei Liu

Jie Chen

Zhenzhu Tang

Affiliations

Soon will be listed here.

Abstract

Introduction: Female sex workers (FSWs) are at highest risk for contracting HIV and facilitating the current heterosexual HIV epidemic in Guangxi, China, yet little is known of the impact of recent harm reduction campaigns in the province. We analyzed sentinel surveillance data collected between 2010 and 2012 in Guangxi to explore correlations between the prevalence of HIV, hepatitis C (HCV), and syphilis and risk behaviors of different categories of FSWs in Guangxi.

Methods: The sentinel surveillance data for 5,1790 FSWs in all 14 prefectures and 64 city/county regions of Guangxi, China from 2010 to 2012 were collected. Differences between three categories of FSWs (grouped by venue) and disease trends (HIV, HCV, and syphilis) by year were analyzed using bivariate and multivariate logistic regression analyses as to evaluate risk factors correlated with HIV, HCV, or syphilis infection.

Results: HIV and HCV prevalence remained constant across the three FSW categories; however, syphilis prevalence showed a significant increase from 5.7% to 7.3% for low-tier FSWs. Most cases with HIV, HCV, syphilis and intravenous drug use were seen in low-tier FSWs. Testing positive for HIV and syphilis were most correlated with being HCV positive (AOR 4.12 and AOR 4.36), only completing elementary school (AOR 3.71 and AOR 2.35), low tier venues (AOR 2.02 and AOR 2.00), and prior STI (AOR 1.40 and AOR 3.56), respectively. HCV infection was correlated with ever injecting drugs (AOR 60.65) and testing positive for syphilis (AOR 4.16) or HIV (AOR 3.74).

Conclusions: This study highlights that low tier FSWs with lower formal education levels are the most vulnerable population at risk for acquiring and transmitting HIV, HCV, and syphilis in Guangxi, China. Condom distribution with evolution to safer sex practices are the reasons to explain the non-increasing prevalence of HIV, HCV in Guangxi for 2010-2012.

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References

Chen Y, Tang Z, Shen Z, Lan G, Zhang H, Zhou Y . [Investigation on the risk factors for HIV infection among elderly male clients of the commercial female sex-workers in Guangxi Zhuang Autonomous Region, in 2012]. Zhonghua Liu Xing Bing Xue Za Zhi. 2014; 34(11):1086-90. View

Wang Y, Tao Q, Zhao H, Tsuda F, Nagayama R, Yamamoto K . Hepatitis C virus RNA and antibodies among blood donors in Beijing. J Hepatol. 1994; 21(4):634-40. DOI: 10.1016/s0168-8278(94)80112-6. View

Piyasirisilp S, McCutchan F, Carr J, Sanders-Buell E, Liu W, Chen J . A recent outbreak of human immunodeficiency virus type 1 infection in southern China was initiated by two highly homogeneous, geographically separated strains, circulating recombinant form AE and a novel BC recombinant. J Virol. 2000; 74(23):11286-95. PMC: 113233. DOI: 10.1128/jvi.74.23.11286-11295.2000. View

Li L, Chen L, Liang S, Liu W, Li T, Liu Y . Subtype CRF01_AE dominate the sexually transmitted human immunodeficiency virus type 1 epidemic in Guangxi, China. J Med Virol. 2013; 85(3):388-95. DOI: 10.1002/jmv.23360. View

Zou H, Xue H, Wang X, Lu D . Condom use in China: prevalence, policies, issues and barriers. Sex Health. 2012; 9(1):27-33. DOI: 10.1071/SH11021. View

Chen X, Wang Q, Yin Y, Liang G, Jiang N, Yang L . Prevalence of syphilis infection in different tiers of female sex workers in China: implications for surveillance and interventions. BMC Infect Dis. 2012; 12:84. PMC: 3352076. DOI: 10.1186/1471-2334-12-84. View

Tee K, Pybus O, Li X, Han X, Shang H, Kamarulzaman A . Temporal and spatial dynamics of human immunodeficiency virus type 1 circulating recombinant forms 08_BC and 07_BC in Asia. J Virol. 2008; 82(18):9206-15. PMC: 2546895. DOI: 10.1128/JVI.00399-08. View

Zhao K, Du J, Zheng W, Yu X . HIV-1 transmission among injection drug users leads to novel recombinants circulating in southern China. AIDS Res Hum Retroviruses. 2014; 30(10):1006-9. PMC: 4180304. DOI: 10.1089/AID.2014.0036. View

Wang H, Reilly K, Brown K, Jin X, Xu J, Ding G . HIV incidence and associated risk factors among female sex workers in a high HIV-prevalence area of China. Sex Transm Dis. 2012; 39(11):835-41. DOI: 10.1097/OLQ.0b013e318266b241. View

10.

Zhao S, Jiang T, Li R, Gao F, Lu L, Zheng H . HCV infection in voluntary donors and its influence on recruitment of donors in Chongqing area. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008; 16(3):676-80. View

11.

Ming Z, Liang S, Yap L, Liu W, Wu Z . [Qualitative study of drug-using and sexual behaviors of drug users in Guangxi]. Zhonghua Liu Xing Bing Xue Za Zhi. 2002; 23(2):111-3. View

12.

Deniaud F, MELMAN C . [From the apprehension of sexually transmissible diseases to the prevention of HIV]. Presse Med. 2002; 31(9):387-92. View

13.

Ruan Y, Cao X, Qian H, Zhang L, Qin G, Jiang Z . Syphilis among female sex workers in southwestern China: potential for HIV transmission. Sex Transm Dis. 2006; 33(12):719-23. DOI: 10.1097/01.olq.0000218881.01437.99. View

14.

Wang H, Chen R, Ding G, Ma Y, Ma J, Jiao J . Prevalence and predictors of HIV infection among female sex workers in Kaiyuan City, Yunnan Province, China. Int J Infect Dis. 2008; 13(2):162-9. PMC: 2650737. DOI: 10.1016/j.ijid.2008.05.1229. View

15.

Lu F, Jia Y, Sun X, Wang L, Liu W, Xiao Y . Prevalence of HIV infection and predictors for syphilis infection among female sex workers in southern China. Southeast Asian J Trop Med Public Health. 2009; 40(2):263-72. PMC: 2745968. View

16.

Ding Y, Detels R, Zhao Z, Zhu Y, Zhu G, Zhang B . HIV infection and sexually transmitted diseases in female commercial sex workers in China. J Acquir Immune Defic Syndr. 2005; 38(3):314-9. View

17.

Wang L, Li D, Ge L, Ding Z, Wang L, Cui Y . [HCV prevalence among the populations under the HIV sentinel surveillance data from 2009 to 2012 in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2013; 34(6):543-7. View

18.

Chu T, Levy J . Injection drug use and HIV/AIDS transmission in China. Cell Res. 2005; 15(11-12):865-9. DOI: 10.1038/sj.cr.7290360. View

19.

Wang H, Chen R, Sharp G, Brown K, Smith K, Ding G . Mobility, risk behavior and HIV/STI rates among female sex workers in Kaiyuan City, Yunnan Province, China. BMC Infect Dis. 2010; 10:198. PMC: 2914052. DOI: 10.1186/1471-2334-10-198. View

20.

Yu X, Chen J, Shao Y, Beyrer C, Liu B, Wang Z . Emerging HIV infections with distinct subtypes of HIV-1 infection among injection drug users from geographically separate locations in Guangxi Province, China. J Acquir Immune Defic Syndr. 2000; 22(2):180-8. DOI: 10.1097/00126334-199910010-00011. View