Background HIV testing is a primary prevention strategy against the HIV epidemic and an entry point for HIV/AIDS-related care, prevention and treatment. This study aimed to estimate the uptake of HIV testing among Sino-Vietnam female sex workers (FSWs) in Guangxi, China, from 2016 to 2018, and to identify the factors influencing HIV testing uptake. Methods A cross-sectional survey was conducted among FSWs in two Sino-Vietnam border cities of Guangxi, China. The survey was conducted through face-to-face interview, the data were collected by a structured questionnaire, and HIV-1 infection was detected simultaneously. Logistic regression analysis was used to determine the factors associated with uptake of HIV testing. Results In total, 4565 Chinese local FSWs (CL-FSWs) and 636 cross-border migrant Vietnamese FSWs (CMV-FSWs) were recruited into this study. HIV-1 prevalence in CL-FSWs and CMV-FSWs was 0.70% and 3.14%, respectively. The rate of self-reported uptake of HIV testing in CL-FSWs and CMV-FSWs was 54.56% and 45.44%, respectively. The rates of self-reported uptake of HIV testing declined in both groups from 2016 to 2018. Logistic regression analysis indicated that a number of factors, including socio-demographic characteristics (age < 35 years, higher education, location in Chongzuo City), behaviour factors (having received free AIDS education, condom distribution services and peer education services, high risk sexual behaviours such as inconsistent condom use, having regular commercial sexual partners, etc.), psychological factors (perception of vulnerability to HIV/STIs, perception of risk for HIV infection) were the factors significantly related to uptake of HIV testing. Conclusion In recent years, the rate of HIV testing uptake among Sino-Vietnam border FSWs in Guangxi, China was low, which may be an important reason for the high HIV-1 prevalence among FSWs in the region. A number of factors were identified to be associated with HIV-1 testing uptake, suggesting that HIV testing prevention strategies in this region could include accelerating AIDS education training, raising personal awareness of HIV testing, and improving accessibility of HIV testing.

Objective This study investigated prevalence trends and identified the associated factors of HIV, syphilis and hepatitis C virus (HCV) among pregnant women in the Guangxi Zhuang Autonomous Region (Guangxi), Southwest China. Methods Serial cross-sectional surveys were performed annually among pregnant women in Guangxi from 2009 to 2018. Blood specimens were collected to test the prevalence of HIV, syphilis and HCV. Cochran–Armitage analysis was used to assess the trends of HIV, syphilis and HCV prevalence, as well as the sociodemographic and behavioural data. In this study, we used zero-inflated negative binomial (ZINB) regression models to identify factors associated with HIV, syphilis and HCV infection. Results A total of 23,879 pregnant women were included in the study. The prevalence of HIV, syphilis and HCV was 0.24%, 0.85% and 0.19%, respectively. There was a decrease in HIV prevalence from 0.54% to 0.10%, a decrease in HCV prevalence from 0.40% to 0.05% and a decrease in syphilis prevalence from 1.53% to 0.30%. The findings based on the ZINB model revealed that pregnant women who had a history of STI had significantly increased risks of HIV (OR 6.63; 95% CI 1.33–32.90) and syphilis (OR 9.06; 95% CI 3.85–21.30) infection, while pregnant women who were unmarried/widowed/divorced were more likely to have HIV (OR 2.81; 95% CI 1.20–6.54) and HCV (OR 58.12; 95% CI, 3.14–1076.99) infection. Furthermore, pregnant women whose husband had a history of STI (OR 5.62; 95% CI 1.24–25.38) or drug use (OR 7.36; 95% CI 1.25–43.43) showed an increased risk of HIV infection. Conclusions There was a relatively low prevalence of HIV, syphilis and HCV among pregnant women. Although decreasing trends in HIV, syphilis and HCV infections were observed, effort is needed to promote STI testing in both premarital medical check-ups and antenatal care, especially targeting couples with a history of STI or drug use.

Background Data on recent human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis prevalence among drug users in the Southwest China are sparse despite the high burden of drug use. This study aims at assessing the prevalence trends and related factors of HIV, HCV and syphilis infection among different drug users in the China–Vietnam border area. Methods A consecutive cross-sectional survey was conducted among drug users from 2010 to 2020 in the China–Vietnam border area. Results A total of 24,543 (84.77%) heroin-only users, 2062 (7.12%) synthetic drug-only (SD-only) users and 2346 (8.10%) poly-drug users participated in this study. From 2010 to 2020, the proportion of heroin-only users decreased from 87.79–75.46%, whereas SD-only users and poly-drug users increased from 5.16–16.03%, and from 7.05–8.52%, respectively. The prevalence of HIV, HCV, and syphilis during the study period declined from 12.76%, 60.37% and 5.72–4.35%, 53.29% and 4.53%, respectively, among heroin-only users and declined from 18.30%, 66.67% and 15.69–6.95%, 27.81% and 5.35%, respectively, among poly-drug users; however, the prevalence of HIV and HCV among SD-only users increased from 0.89% and 8.93–2.84% and 18.75%, respectively. Having ever injected drugs and needle sharing were common risk factors for both HIV and HCV infection among poly-drug users and heroin-only users. Aged ≥ 35 years old was a risk factor for HIV, HCV and syphilis infection among the SD-only users. Female drug users were at high risk of contracting syphilis among three different drug users. Conclusions The prevalence of HIV, HCV, and syphilis among heroin-only users and poly-drug users decreased during the study period. However, the prevalence of HIV and HCV among SD-only users increased. Comprehensive intervention strategies, particularly focusing on the SD-only users are needed in order to bring down the disease burden in this population in the China–Vietnam border areas.

Background To analyze the trends of HIV-1 and syphilis prevalence as well as associated factors among local Chinese female sex workers (LCFSWs) and cross-border migrant female sex workers (CMFSWs) in Sino-Vietnam border cities in Guangxi, China. Methods A consecutive cross-sectional study was conducted from 2010 to 2018 in three border cities in Guangxi. The survey was conducted through face-to-face interview with a structured questionnaire. HIV-1 and syphilis infections were tested simultaneously. Cochran-Armitage analysis was used to assess the trends of HIV-1, syphilis and HCV prevalence, as well as the trend of risk behaviors, HIV/AIDS knowledge and prevention services. Multivariate logistics regression analysis was used to identify factors associated with HIV-1 and syphilis infection.Results Totally, 19873 LCFSWs and 1723 CMFSWs were enrolled. The overall prevalence of HIV-1 and syphilis infection was 0.91% and 5.14%, respectively. The HIV-1 prevalence among CMFSWs was higher than that among LCFSWs, without a declined trend. However, a downward trend was observed among LCFSWs. Overall, the main associated factors of HIV-1 infection among CMFSWs shifted from age >35 years old, staying in current residence for >12 months, self-reporting sexually transmitted infections (STIs) in the last year during 2010-2015 to inconsistent condoms use in commercial sex in last month, not receiving peer education and self-reporting STIs in the last year during 2016-2018. The main correlated factors of syphilis infection among CMFSWs changed from history of illicit drug use, staying in current residence for more than 12 months, self-reporting of STIs and inconsistent condoms use in commercial sex in the past month during 2010-2015 to working in low-tier venues, self-reporting of STIs in the last year, and sexing with commercial male clients who used aphrodisiac drugs during 2016-2018. For LCFSWs, the relative strong associated factors of HIV-1 infection shifted from receiving less than 6 years of education, illicit drugs use, and self-reporting STIs in the last year during 2010-2015 to sexing with commercial male clients who use aphrodisiac drugs and self-reporting of STIs during 2016-2018, while the main factors of syphilis infection changed from self-reporting STIs in the last year, history of illicit drug use and receiving less than 9 years of education during 2010-2015 to self-reporting of STIs in the last year, sexing with commercial male clients who use aphrodisiac drugs, and history of illicit drugs use during 2016-2018.Conclusions The relatively higher prevalence of HIV-1 infection and frequent risk behaviours among CMFSWs in border cities in Guangxi, indicating that CMFSWs is the high-risk population for HIV-1 infection and transmission in the region, and is the key population of HIV/AIDS prevention and control. Meanwhile, the change of HIV infection-associated risk factors over time suggests that HIV intervention strategies need to be changed accordingly.