Impact evaluation of a community-based intervention to reduce risky sexual behaviour among female sex workers in Shanghai, China

BMC Public Health

Research Article

Xiaofeng Liu¹  Yinqing Ni²  Juan Liu³  Liviana Calzavara³  Robert S Remis³  Ted Myers³  Joshua B Mendelsohn³  Guozheng Shi⁴  Huili Fan⁵  Xiuhong Tian⁶  Qichao Pan⁷  Laiyi Kang⁷  Jinma Ren⁸  Yanfeng Cha⁹  Ann O’Leary^1,10 

[1] Baoshan District Centre for Disease Control and Prevention, Shanghai, China;Changning District Centre for Disease Control and Prevention, Shanghai, China;Dalla Lana School of Public Health, University of Toronto, Health Science Building, 155 College Street, Room 518, M5T 3M7, Toronto, ON, Canada;Jiading District Centre for Disease Control and Prevention, Shanghai, China;Luwan District Centre for Disease Control and Prevention, Shanghai, China;Minhang District Centre for Disease Control and Prevention, Shanghai, China;Shanghai Centre for Disease Control and Prevention, Shanghai, China;Shanghai Centre for Disease Control and Prevention, Shanghai, China;Centre for Outcomes Research, University of Illinois, College of Medicine, Peoria, IL, USA;Songjiang District Centre for Disease Control and Prevention, Shanghai, China;US Centres for Disease Control, Atlanta, GA, USA;

关键词: China;    Shanghai;    Female sex worker;    STI;    HIV;    Intervention;    Condom;    Risk perception;   

DOI  :  10.1186/s12889-015-1439-5

 received in 2014-07-24, accepted in 2015-01-15,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundFemale sex workers (FSWs) are at risk for sexually transmitted infections (STIs), including HIV. We implemented an HIV/STI preventive intervention among FSWs in Shanghai that aimed to increase condom use, improve HIV knowledge, and reduce STI and HIV incidence.MethodsFrom six districts in Shanghai, 750 randomly selected venue-based FSWs were allocated to either a behavioural intervention or control group. In the intervention and control groups, 221 and 278 participants, respectively, had at least one follow-up at three or six months. In analysis, we randomly selected 57 lost to follow-up cases in the intervention group and imputed baseline values to equalize the arms at n = 278 (74.1% follow-up rate in each group). The impacts of the intervention on condom use, HIV/STI risk perception and knowledge, and STI incidence were assessed using either a logistic or linear model, adjusting for the baseline measure of the outcome and venue type.ResultsThe intervention improved consistent condom use with any partner type in the previous month (AOR = 2.09, 95% CI, 1.43-3.04, p = 0.0001). Consistent condom use with clients in the three most recent sex acts increased in both arms, and with primary partners in the intervention arm, but there was no difference between groups after adjusting for baseline condom use and venue type. There were no differences in cumulative incidence of any STI (i.e., chlamydia, gonorrhoea, syphilis) between groups. HIV transmission knowledge (p = 0.0001), condom use skill (p = 0.0421), and self-efficacy for using condoms (p = 0.0071) were improved by the intervention. HIV-related stigma declined (p = 0.0119) and HIV and STI risk perception were improved (4.6 to 13.9%, and 9.4 to 20.0%, respectively). The intervention was associated with these improvements after adjusting for the baseline measure and venue type.ConclusionFollowing a preventive intervention among Shanghai FSWs, our findings demonstrate that a simple, community-based educational intervention improved overall condom use, HIV and STI knowledge, and attitudes in relation to HIV/AIDS. The intervention should be implemented widely after tailoring educational materials regarding condom negotiation with different partner types (i.e., commercial sex clients and primary partners).

【 授权许可】

Unknown   
© Liu et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.