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目的了解云南省昆明市中低收入女性性工作者(FSWs)无保护商业性行为状况及影响因素,为云南省该人群艾滋病(AIDS)综合防治提供建议。方法利用自制问卷对昆明市4个城区561名中低收入FSWs进行调查,拟合多因素logistic回归模型探讨不安全性行为的影响因素。结果 FSWs最近3个月与嫖客发生无保护性行为的比例为58.1%(326/561);单因素分析结果表明,FSWs与嫖客发生无保护性行为有统计学意义的变量为年龄(P=0.000)、月收入(P=0.044)、从事本行业年限(P=0.001)、对健康状况关心与否(P=0.000)、最担心的疾病(P=0.000)、是否遭受过职业侵害(P=0.016)、AIDS知识得分(P=0.010)、性服务场所(P=0.000)、每月平均工作天数(P=0.000);多因素logistic回归分析结果表明,年龄(OR=0.470,95%CI=0.313~0.704)、健康状况关心与否(OR=4.249,95%CI=2.680~6.735)、最担心的疾病(OR=0.231,95%CI=0.090~0.591)、AIDS知识得分(OR=2.371,95%CI=1.400~4.014)、性服务场所(OR=0.852,95%CI=0.728~0.998)、每月平均工作天数(OR=1.755,95%CI=1.099~2.801)是FSWs不安全性行为的独立影响因素。结论中低收入FSWs的无保护性行为更容易受到年龄、健康信念、从事本行业年限、性服务场所、每月平均工作天数以及是否受过职业侵害等因素的影响。
Objective To understand the status and influencing factors of unprotected commercial sex behavior among middle and low income female sex workers (FSWs) in Kunming, Yunnan Province, and to provide suggestions for comprehensive AIDS prevention and control of this population in Yunnan Province. Methods Self-made questionnaires were used to investigate 561 middle and low-income FSWs in four urban districts of Kunming. Multivariate logistic regression models were fitted to investigate the influencing factors of unsafe sex behavior. Results The proportion of unprotected sex workers who had FSWs with their clients in the last 3 months was 58.1% (326/561). The results of univariate analysis showed that the statistic variables of unprotected sex with FSWs and clients were age (P = 0.000 ), Monthly income (P = 0.044), occupational injury (P = 0.001), concern for health status (P = 0.000), most worried about disease (P = 0.000) (P = 0.016), AIDS knowledge score (P = 0.010), sex service place (P = 0.000), average monthly working days (P = 0.000) .Multivariate logistic regression analysis showed that the age (OR = 0.470, 95% CI = (OR = 2.249, 95% CI = 2.680-6.735), the most worried about disease (OR = 0.231, 95% CI = 0.090-0.591), AIDS knowledge score (OR = 2.371, (OR = 0.852, 95% CI = 0.728-0.998). The average number of working days per month (OR = 1.755, 95% CI = 1.099-2.801) was an unsafe behavior of FSWs Independent factors. Conclusions The unprotected behavior of low- and middle-income FSWs is more likely to be affected by factors such as age, health beliefs, length of service in the industry, sex service establishments, average number of working days per month, and occupational injury.