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首页> 外文期刊>AIDS care. >Successes and gaps in uptake of regular, voluntary HIV testing for hidden street- and off-street sex workers in Vancouver, Canada
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Successes and gaps in uptake of regular, voluntary HIV testing for hidden street- and off-street sex workers in Vancouver, Canada

机译：在加拿大温哥华，针对隐藏的街头和街头无性工作者，定期进行自愿性HIV检测的成功与差距

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Despite evidence globally of the heavy HIV burden among sex workers (SWs) as well as other poor health outcomes, including violence, SWs are often excluded from accessing voluntary, confidential and non-coercive health services, including HIV prevention, treatment, care and support. This study therefore assessed the prevalence and association with regular HIV testing among street- and off-street SWs in Vancouver, Canada. Cross-sectional baseline data were used from a longitudinal cohort known as "An Evaluation of Sex Worker's Health Access" (AESHA; January 2010-July 2012). This cohort included youth and adult SWs (aged 14+ years). We used multivariable logistic regression to assess the relationship between explanatory variables and having a recent HIV test (in the last year). Of the 435 seronegative SWs included, 67.1% reported having a recent HIV test. In multivariable logistic regression analysis, having a recent HIV test remained significantly independently associated with elevated odds of inconsistent condom use with clients [adjusted (multivariable) odds ratios, AOR: 2.59, 95% confidence intervals [95% CIs]: 1.17-5.78], injecting drugs (AOR: 2.33, 95% CIs: 1.17-4.18) and contact with a mobile HIV prevention programme (AOR: 1.76, 95% CIs: 1.09-2.84) within the last six months. Reduced odds of having a recent HIV test was also significantly associated with being a migrantew immigrant to Canada (AOR: 0.33, 95% CIs: 0.19-0.56) and having a language barrier to health care access (AOR: 0.26, 95% CIs: 0.09-0.73). Our results highlight successes of reaching SWs at high risk of HIV through drug and sexual pathways. To maximize the effectiveness of including HIV testing as part of comprehensive HIV prevention and care to SWs, increased mobile outreach and safer-environment interventions that facilitate access to voluntary, confidential and non-coercive HIV testing remain a critical priority, in addition to culturally safe services with language support.
机译：尽管全球范围内有证据表明性工作者和其他不良健康后果（包括暴力）中艾滋病毒负担沉重，但性工作者通常无法获得自愿，保密和非强制性的医疗服务，包括艾滋病毒的预防，治疗，护理和支持。因此，这项研究评估了加拿大温哥华街道和街道外的西南妇女的患病率和与常规HIV检测的相关性。横断面基线数据来自一个纵向队列，即“性工作者健康状况评估”（AESHA; 2010年1月至2012年7月）。该队列包括青年和成年西南偏头痛（14岁以上）。我们使用多变量logistic回归来评估解释变量与最近一次HIV检测（在去年）之间的关系。在包括的435名血清阴性的SW中，有67.1％报告最近进行了HIV检测。在多变量logistic回归分析中，最近进行的HIV检测仍然与与客户使用安全套不一致的几率显着相关[调整后的（多变量）几率，AOR：2.59，95％置信区间[95％CI]：1.17-5.78] ，在过去六个月内注射药物（AOR：2.33，95％CI：1.17-4.18），并与流动性HIV预防计划联系（AOR：1.76，95％CI：1.09-2.84）。近期接受艾滋病毒检测的几率降低，也与成为加拿大移民/新移民（AOR：0.33，95％CI：0.19-0.56）和语言障碍（AOR：0.26，95％）显着相关CI：0.09-0.73）。我们的结果强调了通过毒品和性途径达到具有高HIV感染风险的SW的成功。为了最大程度地将艾滋病毒检测作为对性工作者的全面艾滋病毒预防和护理的一部分，除文化安全外，增加流动范围和更安全的环境干预措施仍是至关重要的优先事项，以促进获得自愿，保密和非强制性艾滋病毒检测提供语言支持的服务。

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