Abstract
Chinese female entertainment workers are at high risk for HIV. We assessed the impact of healthcare access on HIV knowledge, condom use, and their willingness to receive HIV testing. We surveyed 257 entertainment workers in a cross-sectional study. Demographic, knowledge, and behavioral risk factors were examined. Of 257 women, 107 (42.1 %) reported inconsistent condom use. Only 9 % had prior HIV testing. Their HIV knowledge was generally poor. Having access to healthcare, being able to obtain condoms, and managers providing health information were associated with consistent condom use (all P < 0.01). Having access to healthcare was related to previous HIV testing (P < 0.01). Our study showed that having a doctor and access to healthcare had positive effects on HIV knowledge and likelihood of condom use and previous HIV testing. Chinese medical providers can play a significant role in encouraging HIV testing and outreach in migrant women employed at entertainment venues.
Similar content being viewed by others
References
Zhang KL, Detels R, Liao S, Cohen M, Yu DB. China’s HIV/AIDS epidemic: continuing challenges. Lancet. 2008;372:1791–3.
Lu L, Jia M, Ma Y, et al. The changing face of HIV in China. Nature. 2008;455:609–11.
Sheng L, Cao WK. HIV/AIDS epidemiology and prevention in China. Chin Med J. 2008;121:1230–6.
2005 Update on the HIV/AIDS Epidemic and Response in China. Joint United Nations Programme on HIV/AIDS, World Health Organization, 2006. http://data.unaids.org/publications/External-Documents/rp_2005chinaestimation_25jan06_en.pdf. Accessed 9 Aug 2014.
Wu Z, Rou K, Cui H. The HIV/AIDS epidemic in China: history, current strategies and future challenges. AIDS Educ Prev. 2004;16:7–17.
Wu Z, Sun X, Sullivan SG, Detels R. Public health. HIV testing in China. Science. 2006;312:1475–6.
Yang H, Li X, Stanton B, et al. Workplace and HIV-related sexual behaviours and perceptions among female migrant workers. AIDS Care. 2005;17:819–33.
Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007;97:1762–74.
Li L, Wu Z, Zhao Y, Lin C, Detels R, Wu S. Using case vignettes to measure HIV-related stigma among health professionals in China. Int J Epidemiol. 2007;36:178–84.
Li L, Wu Z, Wu S, Zhaoc Y, Jia M, Yan Z. HIV-related stigma in health care settings: a survey of service providers in China. AIDS Patient Care STDS. 2007;21:753–62.
Chapman J, Estcourt CS, Hua Z. Saving ‘face’ and ‘othering’: getting to the root of barriers to condom use among Chinese female sex workers. Sex Health. 2008;5:291–8.
Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39:446–53.
Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342:921–9.
Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. Am J Public Health. 1999;89:1397–405.
Liao SS, Schensul J, Wolffers I. Sex-related health risks and implications for interventions with hospitality women in Hainan, China. AIDS Educ Prev. 2003;15:109–21.
Xia G, Yang X. Risky sexual behavior among female entertainment workers in China: implications for HIV/STD prevention intervention. AIDS Educ Prev. 2005;17:143–56.
Zhao P, Yu H. Study on sexual and drug use behaviors of high risk among sex workers in entertainment in establishments in Shanghai. Zhonghua Liu Xing Bing Xue Za Zhi. 2001;22:341–3.
Yang X, Xia G. Gender, work, and HIV risk: determinants of risky sexual behavior among female entertainment workers in China. AIDS Educ Prev. 2006;18:333–47.
Chong MY, Wilkinson G. Validation of 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) in patients admitted for general health screening. Psychol Med. 1989;19:495–505.
Yang H, Li X, Stanton B, et al. HIV-related risk factors associated with commercial sex among female migrants in China. Health Care Women Int. 2005;26:134–48.
Li L, Lin C, Wu Z, et al. Stigmatization and shame: consequences of caring for HIV/AIDS patients in China. AIDS Care. 2007;19:258–63.
Sun X, Lu F, Wu Z, et al. Evolution of information-driven HIV/AIDS policies in China. Int J Epidemiol. 2010;39:4–13.
Wang D, Operario D, Hong Q, Zhang H, Coates TJ. Intervention to train physicians in rural China on HIV/STI knowledge and risk reduction counseling: preliminary findings. AIDS Care. 2009;21:468–72.
Tucker JD, Jia C, Henderson GE, Cohen MS, Davis JA, Wang XC. Online HIV/STI Chinese clinician training. Sex Transm Infect. 2004;80(2):154.
Grimes DA, Schulz KF. Bias and causal associations in observational research. Lancet. 2002;359:248–52.
Acknowledgments and Financial Support
This work was supported in part by the Petersen Educational Enhancement Fund of Brown Medical School for community-based research; Foreign Studies Fellowship Program of the International Health Institute, Brown University; the International Travel Fellowship of Luke Charitable Foundation; and the Grant Number P30-AI-42853 from the National Institutes of Health, Lifespan-Tufts-Brown Center for AIDS Research (NIH/CFAR).
Conflict of interest
The authors declare no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
Terence T. Sio and Kenneth Chang are co-first authors.
Rights and permissions
About this article
Cite this article
Sio, T.T., Chang, K., Jayakrishnan, R. et al. The Impact of Healthcare Access on Knowledge and Willingness for HIV Testing in Chinese Female Entertainment Workers. J Immigrant Minority Health 17, 1322–1329 (2015). https://doi.org/10.1007/s10903-014-0087-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10903-014-0087-7