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目的分析大龄女性性工作者(FSW)传播艾滋病的风险,为制定预防干预措施提供依据。方法采用两阶段分层抽样法抽取四川省16个项目区、县不同场所的11 550名FSW进行面对面问卷调查和艾滋病及梅毒血清学检测。结果初次卖淫年龄≥35岁的FSW中文化程度小学及以下比例为65.4%,71.1%为已婚女性,艾滋病知识知晓率为31.8%,从业场所72.7%为低档场所,性交易价格﹤50元的比例为51.4%,梅毒感染率为13.8%,最近1个月与商业性伴和固定性伴每次坚持使用安全套的比例分别为26.5%和7.4%,出现性病症状后均去正规医疗机构就诊的比例为31.1%;初次卖淫年龄≥35岁与<35岁的FSW在文化程度、艾滋病知识、梅毒感染率、近1个月与商业性伴和固定性伴坚持使用安全套、求医行为上差异均有统计学意义(P<0.05);多因素logistic回归结果显示,梅毒感染的影响因素为场所档次低(OR=1.715,95%CI=1.286~2.288),初次卖淫年龄大(OR=3.089,95%CI=2.105~4.533)和从业时间长(OR=1.351,95%CI=1.162~1.571)。结论大龄FSW人群传播艾滋病风险高,需要着重关注并进行有效的预防干预。
Objective To analyze the risk of transmitting AIDS among older female sex workers (FSWs) and provide the basis for making preventive interventions. Methods Two-stage stratified sampling method was used to extract 11 550 FSW from 16 sites and counties in Sichuan Province for face-to-face questionnaire and AIDS and syphilis serological tests. Results The primary literacy age of 35 or older was 65.4% in primary school with educational level of FSW, 71.1% were married women, the knowledge rate of AIDS was 31.8%, the place of employment was 72.7% low grade, the transaction price was less than 50 yuan Proportion of 51.4%, syphilis infection rate of 13.8%, the last month and commercial partners and fixed partners each insist on the use of condoms were 26.5% and 7.4%, respectively, after the onset of symptoms of venereal disease to the regular medical treatment (31.1%). The mean age at first prostitution was 35 years old and <35 years old. There was no significant difference in literacy, AIDS knowledge, syphilis infection rate, condom use in condom maintenance and medical treatment in nearly a month (OR = 1.715, 95% CI = 1.286 ~ 2.288). The age of first prostitution was high (OR = 3.089, 95% CI = % CI = 2.105 ~ 4.533) and working time (OR = 1.351, 95% CI = 1.162 ~ 1.571). Conclusion The risk of transmitting AIDS in older FSW population is high, which needs to pay attention to and carry out effective preventive intervention.