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Wang Q, Lin G. Sex Exchange and HIV-related Risk Behaviors among Female Heroin Users in China. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/002204260303300106] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examines differences in demographic characteristics and HIV-related risk behaviors between Chinese female heroin users who exchanged sex for drugs or money and those who were never involved in sex exchange. A sample of 171 female heroin users was recruited from a detoxification center in China. Female heroin users who exchanged sex for drugs or money were more likely to be unemployed and were at higher risk in both sexual behaviors and injection drug use. Number of sexual partners in the previous year, unemployment, and injection drug use were independently associated with exchange of sex for drugs or money; adjusted odds ratios were 1.2, 3.8, and 2.6, respectively. Findings show that HIV-related risk behaviors are common among female heroin users in China and that HIV harm reduction should be focused on female heroin users who exchange sex for drugs or money.
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Affiliation(s)
- Quanyi Wang
- Epidemiology in the Department of Epidemiology and Biostatistics, Peking Union Medical College and Chinese Academy of Medical Sciences
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Huang J, Jiang J, Li JZ, Yang X, Deng W, Abdullah AS, Qin B, Upur H, Zhong C, Wang Q, Wang Q, Ruan Y, Zou Y, Ye L, Xie P, Wei F, Xu N, Wei B, Liang H. Prevalence and correlates of sexual risk behaviors among drug users in western China: implications for HIV transmission. AIDS Res Hum Retroviruses 2013; 29:673-80. [PMID: 23210514 DOI: 10.1089/aid.2012.0272] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The prevalence and correlates of sexual risk behaviors among drug users in western China and the implications for HIV transmission in this population are described. A cross-sectional survey of male drug users was conducted in methadone maintenance therapy clinics and detoxification centers in three western provinces of China between September 2009 and December 2010. Participants in the study completed a questionnaire about demographics, HIV/AIDS knowledge, drug use history, sexual risk behaviors, and other psychosocial variables. Factors associated with HIV sexual risk behaviors were identified by multiple logistic regression analysis. Of 1,304 drug users surveyed, nearly 54% never used condoms during sexual intercourse with a spouse or cohabitant, and this behavior was associated with coming from Chongqing (OR=1.86, p<0.05), being aged 36 and older (OR=5.03, p<0.05), being married or cohabiting (OR=1.68, p<0.05), having first taken drugs at age 30 and above (OR=1.80, p<0.05), and having received AIDS advice or detection from authorities in the past year (OR=1.95, p<0.05). Twenty-six percent had had sex with casual sexual partners in the past year, and this behavior was associated with being married or cohabiting (OR=0.30, p<0.05), first taking drugs at age 31 and above (OR=0.42, p<0.05), and receiving AIDS advice or HIV detection from authorities in the past year (OR=0.70, p<0.05). About 34% never used a condom when having sex with casual sexual partners, and this behavior was associated with coming from Guangxi (OR=2.81, p<0.05) or Chongqing (OR=2.73, p<0.05). Almost 14% had had commercial sex in the past year, and this behavior was associated with coming from Guangxi (OR=6.26, p<0.05) or Chongqing (OR=5.44, p<0.05) and having exchanged needles or received clean needles from the Needle Exchange Centers in the past year (OR=2.76, p<0.05). Nearly 23% had never used condoms when having commercial sex, and this behavior was associated with having received free condoms from authorities in the past year (OR=0.26, p<0.05). Sexual risk behaviors among drug users in Guangxi, Chongqing, and Xinjiang are common. Additional intervention strategies are needed to control the spread of HIV in this population.
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Affiliation(s)
- Jiegang Huang
- School of Public Health, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory Cultivation Base of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, China
| | - Junjun Jiang
- School of Public Health, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory Cultivation Base of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, China
| | - Jonathan Z. Li
- Section of Retroviral Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts
| | - Xiaobo Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Wei Deng
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Abu S. Abdullah
- School of Public Health, Guangxi Medical University, Nanning, China
- Department of Medicine (MISU), Boston Medical Center, Boston, Massachusetts
| | - Bo Qin
- The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Halmurat Upur
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Chaohui Zhong
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qianqiu Wang
- National Center for STD Control, Chinese Center for Disease Control and Prevention, Nanjing, China
| | - Qian Wang
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Yuhua Ruan
- State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yunfeng Zou
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Li Ye
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Peiyan Xie
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Fumei Wei
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Na Xu
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Bo Wei
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Hao Liang
- School of Public Health, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory Cultivation Base of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, China
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Kelly BC, Liu T, Zhang G, Hao W, Wang J. Perceptions of HIV risk among methamphetamine users in China. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2013; 39:99-102. [PMID: 23421570 DOI: 10.3109/00952990.2012.762371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Methamphetamine use has emerged in China over the past decade. With the growth in methamphetamine use, it remains uncertain how users in China perceive its association with the HIV epidemic. METHODS The authors utilize qualitative and survey data from a mixed-methods study on methamphetamine use and HIV risk in China to assess the extent to which users perceive a risk for HIV transmission as well as how they conceive of the drug's links to HIV. RESULTS Data indicate that a considerable majority (82.2%) perceived themselves to have zero risk for HIV infection. Qualitative interviews highlight the lack of information about HIV possessed by methamphetamine users given the confusion and disbelief often expressed. Others acknowledged that while there was an intertwining of risk, they were not personally at risk. CONCLUSION Given the known association between methamphetamine use and HIV risk, health promotion initiatives in China should target methamphetamine users to build HIV-related knowledge and inhibit self-exempting beliefs. In particular, educational efforts regarding the association of methamphetamine use with HIV may inhibit risk behaviors.
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Affiliation(s)
- Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, IN 47907, USA.
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Syphilis and Methamphetamine Use Among Female Sex Workers in Shandong Province, China. Sex Transm Dis 2011; 38:57-62. [DOI: 10.1097/olq.0b013e3181ebb475] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Looking for a solution for drug addiction in China: exploring the challenges and opportunities in the way of China's new Drug Control Law. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2009; 21:149-54. [PMID: 19896818 DOI: 10.1016/j.drugpo.2009.10.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 10/05/2009] [Accepted: 10/08/2009] [Indexed: 11/22/2022]
Abstract
In the wake of the deteriorating situation of drug addiction and related infectious diseases among injecting drug users (IDUs) in China in recent years, the Standing Committee of the National People's Congress of China adopted the new Drug Control Law which came into force in June 1, 2008. This law is part of a broad reform movement in China where drug addiction is no longer understood as simply a legal or moral issue but rather, as a complicated medical condition requiring comprehensive therapeutic strategies. Although the Drug Control Law draws a distinct line from previous Drug Control regulations in the country, there have still been dilemmas along the implementation process. This paper is intended to elaborate on the general principles of China's latest Drug Control Law from the point of view of scholars who are involved in the field of drug addiction research and treatment in China. This paper will also discuss the challenges we are currently facing, based on the observations and practical experiences the authors have obtained in China. It is hoped that by addressing these issues, we will be able to implement the new Drug Control Law more successfully and ensure that we deal more effectively with drug addiction in China.
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Ebenstein AY, Jennings E. Bare Branches, Prostitution, and HIV in China: A~Demographic Analysis. GENDER POLICY AND HIV IN CHINA 2009. [DOI: 10.1007/978-1-4020-9900-7_5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Gu J, Wang R, Chen H, Lau JT, Zhang L, Hu X, Lei Z, Li Z, Cai H, Wang T, Tsui H. Prevalence of needle sharing, commercial sex behaviors and associated factors in Chinese male and female injecting drug user populations. AIDS Care 2008; 21:31-41. [DOI: 10.1080/09540120802068787] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jing Gu
- a Centre for Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine , The Chinese University of Hong Kong , Hong Kong , China
| | - Renfan Wang
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Hongyao Chen
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Joseph T.F. Lau
- a Centre for Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine , The Chinese University of Hong Kong , Hong Kong , China
| | - Linglin Zhang
- c Sichuan Provincial Center for Disease Control and Prevention , China
| | - Xianyou Hu
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Zhangquan Lei
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Zhenglin Li
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Hua Cai
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Tao Wang
- b Dazhou Center for Disease Control and Prevention , Dazhou , Sichuan , China
| | - Hiyi Tsui
- a Centre for Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine , The Chinese University of Hong Kong , Hong Kong , China
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Yao Y, Wang N, Chu J, Ding G, Jin X, Sun Y, Wang G, Xu J, Smith K. Sexual behavior and risks for HIV infection and transmission among male injecting drug users in Yunnan, China. Int J Infect Dis 2008; 13:154-61. [PMID: 18778963 DOI: 10.1016/j.ijid.2008.05.1228] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2008] [Accepted: 05/03/2008] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To analyze the risk factors, particularly sexual behaviors, associated with HIV infection, and to describe the risks for HIV transmission among male injecting drug users (IDUs) in China. METHODS A cross-sectional study of 314 IDUs in Yunnan Province was conducted. Information on demographics, HIV serostatus, and sexual and drug-using behaviors was collected. RESULTS HIV prevalence among the study subjects was 59.9%. HIV infection was associated with older age (> or = 27 years), early drug initiation (at < or = 20 years of age), and frequent injection (> or = once a day). Thirty-seven percent reported multiple sexual partners. Consistent condom use rates were lowest with regular partners (23.8%), followed by 42.5% with casual partners, and 57.3% with female sex workers. Ninety-eight percent of subjects received high 'HIV knowledge' scores. Few of the subjects who needed medical care sought it out. CONCLUSIONS Despite awareness of HIV, needle sharing and unprotected sex persist in the population, and the HIV prevalence is high. Further interventions should not only seek to educate but also to reduce high-risk behaviors.
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Affiliation(s)
- Yan Yao
- Department of Epidemiology and Medical Statistics, Jilin University School of Public Health, Changchun, PR China
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Client-Perpetuated Violence and Condom Failure Among Female Sex Workers in Southwestern China. Sex Transm Dis 2008; 35:141-6. [DOI: 10.1097/olq.0b013e31815407c3] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Evaluation of a needle social marketing strategy to control HIV among injecting drug users in China. AIDS 2007; 21 Suppl 8:S115-22. [PMID: 18172379 DOI: 10.1097/01.aids.0000304706.79541.ef] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a needle social marketing strategy to reduce needle sharing and hepatitis C Virus (HCV)/HIV transmission among injecting drug users (IDU) in China. DESIGN Two-armed, prospective, community-randomized prevention trial. SETTING Four counties/townships in Guangxi and Guangdong provinces; one randomized to intervention the other to control in each province. PARTICIPANTS Injecting drug users: 823 (443 intervention, 382 control) at baseline and 852 (415 intervention, 407 control) at the second cross-sectional survey 12 months later. INTERVENTION A needle social marketing programme, including promotion of safe injection norms and increased access to clean needles over a 12 month period. MAIN OUTCOME MEASURES Cross sectional surveys at baseline and follow-up compared changes in drug using behaviours and HIV and HCV rates in the intervention and control communities. RESULTS Needle sharing behaviours were similar in the two groups at baseline (68.4 vs. 67.8%), and dropped significantly to 35.3% in the intervention community and remained relatively stable in the control community (62.3%; P < 0.001). In a subset of cohort of new injectors, the incidence of HCV was significant lower in intervention than in control in both provinces (P < 0.001, P = 0.014) and overall (P < 0.001) but HIV was only significantly lower in intervention in Guangdong (P = 0.011). CONCLUSION Needle social marketing can reduce risky injecting behaviour and HIV/HCV transmission among injecting drug users in China and should be expanded.
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Sullivan SG, Wu Z. Rapid scale up of harm reduction in China. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2007; 18:118-28. [PMID: 17689354 DOI: 10.1016/j.drugpo.2006.11.014] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Revised: 11/10/2006] [Accepted: 11/15/2006] [Indexed: 10/23/2022]
Abstract
In the last 20 years, China has seen a resurgence in drug use, particularly heroin, and with it a growing epidemic of HIV/AIDS. Faced with this dual epidemic, the government has begun testing harm reduction strategies in recent years. These have included methadone maintenance treatment (MMT) programmes, needle-syringe programmes (NSP), outreach, and increasing access to HIV testing. MMT and NSP have moved from the pilot stage to scale-up, with 320 MMT clinics and 93 NSPs now open. Both will number more than 1000 by the end of 2008. There are some good examples of outreach programmes in some areas, however more needs to be done to facilitate greater involvement from non-government organizations. Similarly, HIV testing for drug users is widely available, but novel approaches to increasing its uptake need to be explored. Management of scale-up and reaching China's vast and dispersed drug-using population remain key challenges. The introduction of harm reduction has been a massive turn-around in thinking by the government, particularly law enforcement agencies, and achieving this has required considerable cooperation and understanding between the Ministries of Health, Public Security, and Justice, and the Food and Drug Administration. With their support, rapid scale-up to effectively reach a majority of drug users can be achieved in the coming years.
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Affiliation(s)
- Sheena G Sullivan
- National Center for AIDS, STD Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China
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Qian HZ, Schumacher JE, Chen HT, Ruan YH. Injection drug use and HIV/AIDS in China: review of current situation, prevention and policy implications. Harm Reduct J 2006; 3:4. [PMID: 16451717 PMCID: PMC1402269 DOI: 10.1186/1477-7517-3-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Accepted: 02/01/2006] [Indexed: 11/10/2022] Open
Abstract
Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem.
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Affiliation(s)
- Han-Zhu Qian
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Joseph E Schumacher
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Huey T Chen
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Alabama, USA
| | - Yu-Hua Ruan
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Liu H, Grusky O, Li X, Ma E. Drug Users: A Potentially Important Bridge Population in the Transmission of Sexually Transmitted Diseases, Including AIDS, in China. Sex Transm Dis 2006; 33:111-7. [PMID: 16432483 DOI: 10.1097/01.olq.0000199762.28231.ee] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to examine risk characteristics among bridge and nonbridge drug users. STUDY DESIGN A cross-sectional study was conducted among drug users. Drug users who shared needles and engaged in sex with both high-risk partners and low-risk partners were defined as bridgers. RESULTS A total of 312 drug users were recruited, among whom 49.4% (154) were bridgers. Among bridgers, 83.1% injected drugs and 35% shared needles in the past month. Eighty-seven percent (134) of bridgers had one or more commercial sex partners in the past year. Only 3.9% of the bridgers and 4.6% of nonbridgers consistently used condoms with regular sex partners. Fifty-eight percent of bridgers and 46.8% of nonbridgers tested positive for hepatitis C virus, whereas 15.6% of bridgers and 7% of nonbridgers tested positive for syphilis. CONCLUSIONS The pervasiveness of bridgers among drug users and their risky sexual behavior underscore their role in the spread of sexually transmitted diseases.
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Affiliation(s)
- Hongjie Liu
- Prevention Research Center, School of Medicine, Wayne State University, Detroit, Michigan 48201-2196, USA.
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Yang X, Latkin C, Celentano D, Luo H. Prevalence and correlates of HIV risk behaviors among drug users in China. AIDS Behav 2006; 10:71-81. [PMID: 16323036 DOI: 10.1007/s10461-005-9028-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined the prevalence and correlates of HIV risk behaviors among 1,153 current drug users in China. Chi-squared tests of differences were used to test if drug users differed from non-users; logistic regression was used to identify behavior-specific risk factors. Results indicate that 60% of drug users injected drugs and more than one third shared needles. Compared to non-users, drug users had higher rates of risky sexual behavior and HIV/STDs. Among drug users, ethnic minorities and migrants were most vulnerable to unprotected casual sex and needle sharing. Drug users who experienced social isolation were associated with lower odds of risk behaviors; those who had experiences of anti-social behaviors and commercial sex, poor HIV knowledge, and perceived greater vulnerability were more prone to unprotected casual sex and needle sharing. Additional correlates of unprotected casual sex included being single, depression, and taking drugs/alcohol during sex. Additional risk factors of needle sharing included education and initiated drug use at younger ages. It is imperative that HIV interventions in China target drug users and address behavior-specific risk factors.
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Affiliation(s)
- Xiushi Yang
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, Virginia 23529, USA.
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Yang H, Li X, Stanton B, Liu H, Liu H, Wang N, Fang X, Lin D, Chen X. Heterosexual Transmission of HIV in China: A Systematic Review of Behavioral Studies in the Past Two Decades. Sex Transm Dis 2005; 32:270-80. [PMID: 15849527 PMCID: PMC1791011 DOI: 10.1097/01.olq.0000162360.11910.5a] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to address the role of heterosexual transmission of HIV in China. GOAL The goal of this study was to explore the prevalence of unsafe sex and the likelihood of HIV spread heterosexually from core populations to others. STUDY The authors conducted a review of behavioral studies. RESULTS Drug users were more likely to be involved in higher-risk sexual behaviors than were those who abstained from using drugs. Most female drug users (52-98%) reported having engaged in commercial sex. Most female sex workers (FSWs) and individuals with sexually transmitted diseases (STDs) had concurrent sexual partners. Many continued to have unprotected sex after noticing STD symptoms in themselves or their sexual partners. From 5% to 26% of rural-to-urban migrants had multiple sexual partners and 10% of males patronized FSWs during migration. CONCLUSIONS Factors such as high rates of FSW patronage, low rates of condom use during commercial sex, having sex with both commercial and noncommercial sexual partners, and high rates of STD infection may promote a heterosexual epidemic in China.
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Affiliation(s)
- Hongmei Yang
- Prevention Research Center the Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, Michigan 48201, USA.
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