Organizational policy recommendations for control of STI/HIV among female sex workers in China: regular examination of workers in social hygiene clinics

Abstract

This article aims to address female sex workers at high risk for contracting HIV in China by recommending evidence-based socio-structural interventions and policies at the national level that have yielded effective outcomes in other countries. National governments such as the Philippines and Hong Kong have utilized the Social Hygiene Clinic (SHC) model. A similar national policy can be highly effective in China. Evidence-based research study results indicate significant reductions in STI and consistent condom use among female sex workers in both China and the Philippines. Consistent condom use in both countries continues to be significantly associated with interpersonal- and venue-level factors. Individuals who had higher appointment-keeping ratios in the Philippines had higher rates of consistent condom use (OR = 2.7, 95% CI = 1.6–3.7) and significantly lower rates of STI (OR = 0.43, 95% CI = 0.26–0.57). By beginning with provinces, which already have a good relationship between establishment venues and the local Health Department, China can develop city ordinances and establishment regulations that begin to require regular examinations of female sex workers and entertainers in the local STI clinic.

Keywords:

• China
• female sex worker
• HIV prevention
• social hygiene clinic
• national policy

Acknowledgements

This research was supported by Grant R01-AI33845 from the National Institute of Allergy and Infectious Diseases to Donald E. Morisky, and by the UCLA Graduate Division Doctoral Training Programme in the Social and Behavioral Determinants of HIV/AIDS Prevention and the University of California Office of the Pacific Rim Research Grant to Lianne Urada. We extend appreciation to our co-investigator Dr. Teodora Tiglao; research manager, Charlie Mendoza; site coordinators, Dorcas Romen, Grace Carungay, Angelica Mallari, Mildred Publico, and Grace Ong for the southern Philippines study; and to co-investigators Dr. Nymia Pimentel-Simbulan, Laufred I. Hernandez, and Benilda deGuia and the Philippine Rural Reconstruction Movement, Inc. team for the study in Quezon City, Metro Manila.