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A study of commercial sex and HIV/STI-related risk factors among hospitality girls in entertainment establishments in Wuhan, China.

BACKGROUND
Commercial sex is illegal in China but there are still many hospitality girls (HGs) working at licenced entertainment establishments in many places in the country. Hospitality girls can be categorised as sex-HGs and non-sex-HGs.


OBJECTIVE
To understand the proportion of sex-HGs and non-sex-HGs, the prevalence of HIV and sexually transmitted infections, and the high-risk behaviours among HGs.


METHODS
A total of 257 HGs at 29 entertainment establishments (13 sauna/massage parlors, 10 dancing/karaoke bars and six barbershops) from seven urban districts in Wuhan were investigated and studied with a two-step sampling frame during November and December 1999. Information on sexual practices, drug abuse, condom use and other related factors were collected by anonymous interviewer-administered questionnaires. Anonymous laboratory testing was performed on 185 (72%) serum samples obtained for HIV-1 and HSV-2 by enzyme-linked immunosorbent assay.


RESULTS
Of the 257 HGs, the mean age was 22.7 years (range 16-36 years); 147 (57.2%) stated they were sex-HGs, 15 (5.8%) were drug users, of whom 12 (80%) were injecting and 3 (20%) were inhaling. Sex-HGs was significantly correlated with drug abuse (P < 0.01, OR = 11.47). Among the 147 sex-HGs, 29 (19.7%) had sex with male clients more than seven times per week, 76 (51.7%) claimed to have used condoms consistently. The sero-prevalence survey of 185 HGs revealed that none tested HIV seropositive, and 40 (21.6%) were HSV-2 seropositive, which was positively correlated with sex-HGs (P < 0.01, OR = 3.13).


CONCLUSIONS
Although the HIV epidemic in Wuhan has not yet reached a high level, HIV/AIDS prevention and control must be taken into account in entertainment establishments because of the existing high risk-taking behaviours and high STI incidence among HGs. It is feasible to carry out epidemiological investigations, which are concerned with sensitive topics such as sex, drug abuse, etc, among community-based female sex workers if designed and implemented prudently.