Background Female sex workers (FSW) is an important population in sexually transmitted infection (STI) epidemiology because of their extended partnership pattern that possibly leads to rapid STI spread. Prompt STI diagnosis, treatment and surveillance among FSW is therefore necessary for effective control of STI in the community, and public STI clinics remain the key platform for such. Yet, much is unknown about the pattern of health-seeking behaviour including STI clinic attendance of the FSW.
Methods A cross-sectional survey of 986 FSWs sampled from one-woman brothels, bars, clubs and streets in Hong Kong were conducted in 2009. Questions on last year attendance at public STI clinics, NGO testing centres, prior 6-month self-reported STI, STI symptoms and the subsequent actions regarding the symptoms were asked. Descriptive analysis was performed to show these frequencies. Self-reported rate among those with or withot symptoms were calculated. Self-reported STI and STI symptoms among those STI clinic and NGO attendees and non-attendees were compared using χ2 test.
Results Overall, 7.8% respondents reported having at least one episode of STI in the last 6 month. About one-third reported either having abnormal vaginal discharge, growth or ulcer in recent 6 months. Strikingly, about two-thirds would either self-medicate or adopt wait and see approach and about one-third attended private doctor or doctor across the border. Altogether less than 5% would attend NGO/STI clinic. Only 26% reported attendance at public STI clinic and 25% in NGO testing centre in the past 1 year. Self-reported STI was reported by 4% of those asymptomatic respondents, and 14% among those reported having any genital symptoms (p<0.05). The self-reported STI rate and STI symptom pattern did not differ significantly between the public STI and NGO attendees and the non-attendees see Abstract P1-S2.16 Figure 1.
Conclusions STI are three times more commonly reported among FSWs who reported genital complains. However, majority of them would not seek appropriate medical care when symptoms occur indicating that treatment might have been delayed. Self-medication is common and remain a challenge for health promotion in FSW. Although no significant difference is found between clinic attendees and non-attendees on STI symptoms, STI clinic data only captures a fraction of STI burden in FSW.
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