Prevalence, Trends and Correlates of HIV, Syphilis and HCV Infection Among Chinese Local and Cross-border Migrant Female Sex Workers in the Sino-Vietnam Border Area of Guangxi, 2016-2021.

Female sex workers (FSWs) are considered a high-risk group for sexually transmitted infections (STIs). However, limited data exist on the prevalence and trends of HIV, syphilis and HCV among FSWs in the Sino-Vietnam border area. To determine the prevalence, trends and correlates of STIs among Chinese local FSWs (CL-FSWs) and cross-border migrant FSWs (CM-FSWs), we conducted consecutive cross-sectional surveys from 2016 to 2021, recruiting 7747 CL-FSWs and 932 CM-FSWs. The overall HIV, syphilis and HCV prevalence declined from 1.0%, 8.8% and 1.7% to 0.1%, 0.9% and 0.3%, respectively. There was no significant downward trend in the overall HIV and syphilis prevalence. However, HCV prevalence showed a decreasing trend among CL-FSWs. CM-FSWs had higher HIV prevalence (2.5% vs. 0.6%). Similarities and differences in STIs-related factors existed between CM-FSWs and CL-FSWs. For instance, receiving HIV-related services in the last year reduced the risk of HIV infection (for CM-FSWs: aOR = 0.234, 95% CI: 0.055-0.993; for CL-FSWs: aOR = 0.182, 95% CI: 0.058-0.567). Serving male clients at least 50 years old increased the risk of syphilis infection (for CM-FSWs: aOR = 4.277, 95% CI: 1.535-11.917; for CL-FSWs: aOR = 1.404, 95% CI: 1.087-1.815). Moreover, CM-FSWs with past-year STIs history had a higher risk of HIV (aOR = 34.976, 95% CI: 5.338-229.176) and HCV infection (aOR = 17.649, 95% CI: 1.846-168.846), both of which were associated with multiple factors in CL-FSWs. It is therefore necessary to develop effective, accessible, high-quality and targeted interventions for CM-FSWs and CL-FSWs.

Trends and associated factors in the uptake of HIV testing among female sex workers in Sino-Vietnam border areas in Guangxi, China: a cross-sectional study.

BACKGROUND: HIV testing is a primary prevention strategy against the HIV epidemic and an entry point for HIV/AIDS-related care, prevention and treatment. This study aimed to estimate the uptake of HIV testing among Sino-Vietnam female sex workers (FSWs) in Guangxi, China, from 2016 to 2018, and to identify the factors influencing HIV testing uptake. METHODS: A cross-sectional survey was conducted among FSWs in two Sino-Vietnam border cities of Guangxi, China. The survey was conducted through face-to-face interview, the data were collected by a structured questionnaire, and HIV-1 infection was detected simultaneously. Logistic regression analysis was used to determine the factors associated with uptake of HIV testing. RESULTS: In total, 4565 Chinese local FSWs (CL-FSWs) and 636 cross-border migrant Vietnamese FSWs (CMV-FSWs) were recruited into this study. HIV-1 prevalence in CL-FSWs and CMV-FSWs was 0.70% and 3.14%, respectively. The rate of self-reported uptake of HIV testing in CL-FSWs and CMV-FSWs was 54.56% and 45.44%, respectively. The rates of self-reported uptake of HIV testing declined in both groups from 2016 to 2018. Logistic regression analysis indicated that a number of factors, including socio-demographic characteristics (age < 35 years, higher education, location in Chongzuo City), behaviour factors (having received free AIDS education, condom distribution services and peer education services, high risk sexual behaviours such as inconsistent condom use, having regular commercial sexual partners, etc.), psychological factors (perception of vulnerability to HIV/STIs, perception of risk for HIV infection) were the factors significantly related to uptake of HIV testing. CONCLUSION: In recent years, the rate of HIV testing uptake among Sino-Vietnam border FSWs in Guangxi, China was low, which may be an important reason for the high HIV-1 prevalence among FSWs in the region. A number of factors were identified to be associated with HIV-1 testing uptake, suggesting that HIV testing prevention strategies in this region could include accelerating AIDS education training, raising personal awareness of HIV testing, and improving accessibility of HIV testing.

Migrant female sex workers working at the Sino-Vietnamese border for a short time have a higher risk of HIV transmission: a consecutive cross-sectional study.

OBJECTIVES: For migrant female sex workers (FSWs) at the Sino-Vietnamese border, the impact of work time in their current location on the spread of HIV/AIDS is not clear. METHODS: Data were collected from the Sino-Vietnamese border cities of Guangxi, China. Migrant FSWs working in these cities were studied. FSWs who worked less than 6 months in their current location were assigned to the short-term work group (ST FSWs), and FSWs who worked equal to or longer than 6 months in their current location were assigned to the long-term work group (LT FSWs). Logistic regression was performed to examine the impact of work time in the current location and factors associated with HIV infection. RESULTS: Among the 1667 migrant FSWs, 586 (35.2%) and 1081 (64.9%) were assigned to the ST FSW and LT FSW groups, respectively. Compared to LT FSWs, ST FSWs were more likely to be of Vietnamese nationality, be less than 18 years old when they first engaged in commercial sex work, and have a low-level of HIV-related knowledge and had higher odds of using condoms inconsistently, having more male clients, having no regular male clients, and having a history of male clients who used aphrodisiacs but lower odds of receiving free condoms distribution and education/HIV counselling and testing programme. The analysis of factors associated with HIV infection revealed that Vietnamese FSWs, less than 18 years old when they first engaged in commercial sex work, having no regular male clients, and having lower average charge per sex transaction were correlated with HIV infection. CONCLUSION: FSWs with short-term work at the Sino-Vietnamese border had a higher risk of risky sex and were correlated with HIV risk factors. Vietnamese FSWs were at higher risk of HIV infection, and they were more likely to have short-term work. More targeted HIV prevention should be designed for new FSWs who recently began working in a locality to further control the spread of HIV, particularly cross-border FSWs.