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目的了解上海市闵行区商业性女性性服务者(FSWs)II型单纯疱疹病毒(HSV-2)感染现状及其影响因素、阳性感染者性行为及其性网络特征。方法运用横断面研究设计和以场所为基础的抽样方法,从上海市闵行区江川、颛桥、古美、莘庄4个街道招募478名FSWs,通过问卷调查了解该人群特征及性行为情况并进行HSV-2和艾滋病病毒(HIV)抗体检测,运用SPSS 17.0软件进行数据统计分析。采用logistic单因素和多因素回归分析HSV-2感染相关的社会人口学特征,HSV-2感染者性行为比较采用χ2检验,P<0.05为差异有统计学意义。结果 139名研究对象HSV-2抗体检测阳性,HSV-2感染率为29.1%。多因素logistic回归分析显示“三小场所”(服务人员20人以下提供商业性性服务的小场所,例如:小发廊、小足浴室、小浴室等)(OR=1.91,95%CI:1.12~3.25)、现住址居住时间≤6个月(OR=1.99,95%CI:1.24~3.19)及月收入≥3 001元(OR=3.90,95%CI:1.30~11.65)为FSWs人群HSV-2感染的关联因素。未发现HIV阳性者。HSV-2感染者过去一个月的性关系网络较广,安全套使用率较低,其中C型性关系网络(无固定性伴,但有商业性伴或非固定非商业性伴)商业性行为平均联结度4.50,非固定非商业性行为平均联结度4.11。D型性关系网络(既有固定性伴,也有商业性或非固定非商业性伴)的商业性行为平均联结度7.94,非固定非商业性行为平均联结度5.32。结论上海市闵行区FSWs人群尤其是“三小场所”、流动性大及收入高的FSWs中HSV-2感染率较高。应加强对FSWs的宣传教育和防治工作,控制HSV-2感染及传播。
Objective To investigate the status and influencing factors of HSV-2 infection in commercial female sex workers (FSWs) in Shanghai and its sexual behavior and sexual network characteristics. Methods Using cross-sectional design and place-based sampling methods, 478 FSWs were recruited from 4 streets of Jiangchuan, Zhuanqiao, Gumei and Xinzhuang in Minhang District of Shanghai. The questionnaire was used to investigate the characteristics of the population and the sexual behavior of HSV -2 and HIV antibody testing, using SPSS 17.0 software for statistical analysis of data. The socio-demographic characteristics associated with HSV-2 infection were analyzed by logistic univariate and multivariate regression analysis. Chi-square test was used to compare the sexual behaviors of HSV-2 infected patients. P <0.05 was considered statistically significant. Results 139 subjects were positive for HSV-2 antibody test, the HSV-2 infection rate was 29.1%. Multivariate logistic regression analysis showed that “three small places” (small places for commercial sexual services such as small hair salons, small foot baths, small bathrooms, etc.) with less than 20 attendants (OR = 1.91, 95% CI: (OR = 1.99, 95% CI: 1.24-3.19) and monthly income ≥3001 (OR = 3.90, 95% CI: 1.30-11.65) for the current residence time of HSV -2 infection related factors. No HIV positive person found. In the past month, people with HSV-2 had a wider network of sexual relationships and a lower rate of condom use, with a C-type sex network (without sex partners, but with commercial sex or non-regular non-sex partners) 4.50 for the degree of union, 4.11 for the average degree of non-commercial non-commercial behavior. D-type sexual relations network (both fixed partners, but also commercial or non-fixed non-commercial sexual partners) the average degree of commercial engagement of 7.94, non-commercial non-commercial behavior of the average degree of 5.32. Conclusions FSWs in Minhang District of Shanghai, especially in “three small places”, have high prevalence of HSV-2 in FSWs with high liquidity and high income. Publicity, education and prevention and treatment of FSWs should be strengthened to control HSV-2 infection and transmission.