Uptake and Correlates of Chlamydia and Gonorrhea Testing among Female Sex Workers in Southern China: A Cross-sectional Study

Background: Female sex workers (FSW) are at high risk of chlamydia and gonorrhea infection. However, there is a limited literature examining their testing uptake to date. The aim of this study was to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China. Methods: : A cross-sectional study with convenience sampling was conducted in five cities in Southern China. We collected data on socio-demographic characteristics, sex behaviors, chlamydia and gonorrhea testing in the past twelve months and the utilization of health care services from participants through face-to-face interviews. Multivariable logistic regression was performed to identify factors associated with chlamydia and gonorrhea testing, respectively. Results: : Overall, 1207 FSWs were recruited, with the mean age of 30.7±6.8 years old, and an average number of clients per week of 7.0(4.0-10.0). 65.4% participants consistently used condoms with clients in the past month. Only 7.5% and 10.4% had been tested for chlamydia and gonorrhea in the past twelve months, respectively. Multivariable analysis indicated that FSW who worked at low titers (adjusted Odds Ratio (a OR )=2.36, 95%CI:1.23-10.14), had more clients in past month (a OR =1.03, 95%CI:1.01-1.05), used condoms consistently (a OR =1.79, 95%CI:1.12-2.86), had STD symptoms (a OR =4.09,95%CI:2.62-6.40), had HIV testing (a OR =5.16, 95%CI:3.21-8.30) or syphilis testing (a OR =6.90, 95%CI:4.21-11.22) in the past year were more likely to have received chlamydia testing. In addition, FSW who had more clients in the past month (a OR =1.02,95%CI:1.00-1.04), had STD symptoms (a OR =3.33, 95%CI:2.03-5.46), had HIV (a OR =3.94, 95%CI:2.34-6.65) and syphilis testing (a OR =3.27, 95%CI:1.96-5.46) in the past year were more likely to have gonorrhea testing. Conclusions: : The chlamydia and gonorrhea testing uptake are low among Chinese FSW. Integrating chlamydia and gonorrhea testing promotion strategies into HIV testing promotion programs may help bridge the gap among FSW.