Prevalence of HIV and STIs and Associated Risk Factors Among Female Sex Workers in Guangdong Province, China

Objectives: To assess the prevalence of HIV and sexually transmitted infections (STIs) and associated factors among female sex workers (FSWs) in Guangdong, China. Methods: Respondent-driven sampling was used to recruit 320 FSWs. The recruited participants were interviewed face-to-face using a structured questionnaire and tested for HIV, syphilis, gonorrhea, and Chlamydia. Results: The prevalence of syphilis, gonorrhea, and Chlamydia were 8.0% (4.6%-12.2%), 9.5% (5.6%-14.3%), and 3.9% (1.7%-6.2%), respectively, and of any STIs was 19.7% (13.9%-26.2%). None of the participants were HIV positive. The median number of clients during the previous week was 5. The proportion of consistent condom use with the clients during the previous week was 58.0% (50.4%-65.5%), use with regular nonpaying partners and nonregular nonpaying partners were much lower than that with clients. Multivariate analysis indicated that years of education and perception of HIV risk were protective factors. Awareness of HIV/AIDS; regular sex partners deciding about condom use when having sex; recruiting clients at hotels, hair/beauty salons, or streets instead of massage parlors; and higher charge for last sexual service were associated with STI infection. Conclusions: Future intervention programs should not only address personal risk factors but also empower FSWs to require condom use by both clients and nonpaying partners.