Prevalence of sexually transmitted infections and HIV and associated risk factors among female sex workers in Guangdong Province, China.

Female sex workers (FSWs) play an important potential bridging role in the epidemic of HIV from specific high-risk populations to the general population. A study was conducted to understand their risk behaviors, their HIV and STD infection status, and the related predictors for STD infection among FSWs in Guangdong Province, China. Qualitative quantitative studies were combined to elucidate risk behaviors among FSWs. In the quantitative study, respondent-driven sampling (RDS) was used to recruit 320 FSWs in a city in Guangdong Province, China. The recruited participants were interviewed face-to-face, using a structured questionnaire, then tested for HIV, syphilis, gonorrhea, and Chlamydia. The median number of clients in the past week among FSWs was five. The rate of consistent condom use with the clients during the last week was 58.0% (50.4, 65.5%), but and much lower regular non-paying and non-regular non-paying partners. Street-based FSWs had more risk behaviors for HIV and STD infection. The proportion of inconsistent condom use with clients and with regular non-paying partners was lower than that for establishment-based sex workers. None of the participants was found to be HIV-positive. The prevalence of syphilis, gonorrhea, and Chlamydia was 8.0% (4.6-12.2%), 9.5% (5.6-14.3%) and 3.9% (1.7-6.2%), respectively. The prevalence of having at least one of these infections was 19.7% (13.9-26.2%). The multivariate logistic regression model showed that years of education, awareness of HIV/AIDS, risk of oneself for HIV infection, amount last charged for commercial sex, regular sex partners making the decision about condom use, and the venues where the participants met clients were independently associated with STD infection. The future intervention program should target street-based FSWs.