Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia.
Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia.
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DOI：
10.1136/bmjopen-2013-003095
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发表时间：
2013-09-10
期刊：
影响因子：
2.9
通讯作者：
Young Women's Health Study Collaborative*
中科院分区：
文献类型：
--
作者：
Page K;Stein E;Sansothy N;Evans J;Couture MC;Sichan K;Cockroft M;Mooney-Somers J;Phlong P;Kaldor J;Maher L;Young Women's Health Study Collaborative*
柬埔寨女性性工作者（FSW）的艾滋病毒感染率是东南亚最高的之一。我们描述了旨在打击人口贩运和性剥削的新法律实施前后，在柬埔寨金边连续采样的 FSW 中的艾滋病毒感染率和相关风险暴露（年轻女性健康研究 (YWHS)）。对两个前瞻性队列的基线数据进行横断面分析。在柬埔寨金边进行的社区研究。 2007 年（N=161；YWHS-1）和 2009 年（N=220；YWHS-2）在分别有 285 名和 345 名妇女参加的信息会议之后，年龄在 15-29 岁之间、报告上个月有 ≥ 2 名性伴侣和/或在过去 3 个月内从事过性交易的女性被纳入研究。比较了新法实施前后两组的艾滋病毒感染率、性危险行为、安非他明类兴奋剂（ATS）和酒精使用以及工作相关因素。两个队列的参与者年龄相似（中位 25 岁），但 YWHS-2 女性报告性伴侣较少，饮酒较多，苯丙胺类兴奋剂使用较少。与 YWHS-1 相比，YWHS-2 中女性在娱乐场所工作的比例更高（分别为 68% 和 31%）。最近抽样的女性的艾滋病毒感染率明显较低：9.2%（95% CI 4.5% 至 13.8%）vs 23%（95% CI 16.5% 至 29.7%）。随着反卖淫和反人口贩运法律的实施，金边年轻的 FSW 的性工作背景和风险发生了变化。虽然这两个队列都是使用相同的资格标准招募的，但最近抽样的女性的性风险和艾滋病毒感染率较低。更直接参与性交易的女性变得更难取样和接触。未来的预防研究和计划需要考虑 FSW 的新政策和人口变化如何影响艾滋病毒传播。
HIV prevalence among Cambodian female sex workers (FSW) is among the highest in Southeast Asia. We describe HIV prevalence and associated risk exposures in FSW sampled serially in Phnom Penh, Cambodia (Young Women's Health Study (YWHS)), before and after the implementation of a new law designed to combat human trafficking and sexual exploitation. Cross-sectional analysis of baseline data from two prospective cohorts. Community-based study in Phnom Penh, Cambodia. Women aged 15–29 years, reporting ≥2 sexual partners in the last month and/or engaged in transactional sex in the last 3 months, were enrolled in the studies in 2007 (N=161; YWHS-1), and 2009 (N=220; YWHS-2) following information sessions where 285 and 345 women attended. HIV prevalence, sexual risk behaviour, amphetamine-type stimulant (ATS) and alcohol use, and work-related factors were compared in the two groups, enrolled before and after implementation of the new law. Participants in the two cohorts were similar in age (median 25 years), but YWHS-2 women reported fewer sex partners, more alcohol use and less ATS use. A higher proportion of YWHS-2 compared with YWHS-1 women worked in entertainment-based venues (68% vs 31%, respectively). HIV prevalence was significantly lower in the more recently sampled women: 9.2% (95% CI 4.5% to 13.8%) vs 23% (95% CI 16.5% to 29.7%). Sex work context and risk have shifted among young FSW in Phnom Penh, following implementation of anti-prostitution and anti-trafficking laws. While both cohorts were recruited using the same eligibility criteria, more recently sampled women had lower prevalence of sexual risk and HIV infection. Women engaging more directly in transactional sex have become harder to sample and access. Future prevention research and programmes need to consider how new policies and demographic changes in FSW impact HIV transmission.
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