Background Introduction of the point-of-care tests (rapid tests) for sexually transmitted infections (STIs) presents an opportunity to expand screening and treatment services in non-clinical settings, such as commercial sex venues where individuals who do not access standard healthcare services can be reached. A free syphilis screening with the rapid test was implemented in two southern Chinese cities (LZ and JM) to assess the feasibility of integrating rapid syphilis testing into existing outreach services for female sex workers (FSWs).
Methods Commercial sex venues in the study sites were systematically mapped, and free rapid syphilis testing using whole blood from fingerstick was provided to the target population as a component of routine outreach services at those venues.
Results From April 2009 to February 2010, a total of 2821 FSWs were approached by outreach workers and offered invitation to accept an onsite rapid syphilis testing, 95.1% of which accepted the test. Test acceptance rate varied a bit across different types of commercial sex venues, ranging from 91.5% among FSWs working at nightclubs to 97.6% among those on streets. Most (99.5%) preferred immediate onsite results notification or through cellphone rather than receiving it at a designated referral clinic. 182 (6.8%) respondents had a positive result, among whom 63.7% visited designated referral clinics for confirmatory test and treatment. Test uptake was positively correlated with JM (AOR 2.4, 95% CI 1.4 to 4.2), age 30–44 years old (AOR 1.9, 95% CI 1.1 to 3.3), no prior syphilis infection (AOR 2.7, 95% CI 1.3 to 5.5), or unknown history of syphilis infection (AOR 4.5, 95% CI 1.5 to 13.3), and negatively associated with working in roadside restaurants (AOR 0.3, 95% CI 0.1 to 0.9) or sauna/bathing centers (AOR 0.5, 95% CI 0.3 to 0.9) compared to FSWs working on streets.
Conclusions It concludes that integration of a rapid and onsite syphilis testing into routine outreach services at sex work venues is feasible and well received at the study areas. However, linkage between onsite testing and referral services should be improved with further efforts to maximise the impact of onsite testing.
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