Background
Methods
Study sites
Study participants
Data collection
Measurements
Social-demographic and behavioral variables
Characteristics of online commercial sex-seeking
Statistical analysis
Results
Sociodemographic characteristics
Characteristics | Total n (%) | Online sex-seeking | P | |
---|---|---|---|---|
Yes n (%) | No n (%) | |||
Demographics | 1155 | 386(33.42) | 769(66.58) | |
Age (Year) | < 0.001 | |||
Mean ± SD | 33.17 ± 9.89 | 34.86 ± 10.56 | 32.32 ± 9.43 | |
<=30 | 465(40.26) | 130(33.68) | 335(43.56) | |
30–40 | 434(37.58) | 145(37.56) | 289(37.58) | |
> 40 | 256(22.16) | 111(28.76) | 145(18.86) | |
Ethnicity | 0.147 | |||
Han | 1059(91.69) | 347(89.90) | 712(92.59) | |
Non-Han | 96(8.31) | 39(10.10) | 57(7.41) | |
Marital status | 0.620 | |||
Married | 504(43.64) | 164(42.49) | 340(44.21) | |
Unmarried | 651(56.36) | 222(57.51) | 429(55.79) | |
Highest education | 0.125 | |||
Primary school or less | 250(21.65) | 77(19.95) | 173(22.49) | |
Junior high School | 623(53.94) | 201(52.07) | 422(54.88) | |
Senior high school and above | 282(24.42) | 108(27.98) | 174(22.63) | |
Annual income ($) | < 0.001 | |||
< 5000 | 177(15.32) | 39(10.10) | 138(17.95) | |
5000–10,000 | 386(33.42) | 103(26.68) | 283(36.80) | |
10,001–15,000 | 345(29.87) | 120(31.09) | 225(29.26) | |
> 15,000 | 247(21.39) | 124(32.12) | 123(15.99) | |
Workplace | 0.073 | |||
Middle tier | 690(59.74) | 216(55.96) | 474(61.64) | |
Low tier | 465(40.26) | 170(44.04) | 295(38.36) | |
Length of time working in current location (month) | 0.221 | |||
< 6 | 356(30.82) | 107(27.72) | 249(32.38) | |
6–12 | 327(28.31) | 110(28.50) | 217(28.22) | |
> 12 | 472(40.87) | 169(43.78) | 303(39.40) | |
Vaginal discomfort | 0.951 | |||
No | 739(63.98) | 246(63.73) | 493(64.11) | |
Yes | 416(36.02) | 140(36.27) | 276(35.89) | |
Received health services locally | < 0.001 | |||
No | 275(23.81) | 49(12.69) | 226(29.39) | |
Yes | 880(76.19) | 337(87.31) | 543(70.61) | |
Sexual Behavior | ||||
Number of clients in the last week | < 0.001 | |||
Mean ± SD | 7.92 ± 7.23 | 10.06 ± 8.50 | 6.84 ± 6.24 | |
<=7 | 667(57.75) | 161(41.71) | 506(65.80) | |
8–14 | 307(26.58) | 144(37.31) | 163(21.20) | |
>=15 | 181(15.67) | 81(20.98) | 100(13.00) | |
Consistent condom uses in the last month | 0.970 | |||
No | 315(27.27) | 105(27.20) | 210(27.31) | |
Yes | 840(72.73) | 281(72.80) | 559(72.69) | |
Reproductive health | ||||
Ever had an unintended pregnancy due to commercial sex | 0.004 | |||
No | 1024(88.66) | 327(84.72) | 697(90.64) | |
Yes | 131(11.34) | 59(15.28) | 72(9.36) | |
Ever have been diagnosed as infertile | < 0.001 | |||
No | 880(76.19) | 317(82.12) | 563(73.21) | |
Yes | 30(2.60) | 15(3.89) | 15(1.95) | |
Unknown | 245(21.21) | 54(13.99) | 191(24.84) | |
Ever abortions | < 0.001 | |||
No | 767(66.41) | 223(57.77) | 544(70.74) | |
Yes | 388(33.59) | 163(42.23) | 225(29.26) | |
STD testing results | ||||
HIV positive | ||||
No | 1154(99.91) | 385(99.74) | 769(100.00) | |
Yes | 1(0.09) | 1(0.26) | 0(0.00) | |
Syphilis positive | 0.436 | |||
No | 1145(99.13) | 381(98.70) | 764(99.35) | |
Yes | 10(0.87) | 5(1.30) | 5(0.65) | |
Gonorrhea positive | 0.143 | |||
No | 1118(96.80) | 369(95.60) | 749(97.40) | |
Yes | 37(3.20) | 17(4.40) | 20(2.60) | |
Chlamydia positive | 0.061 | |||
No | 1007(87.19) | 326(84.46) | 681(88.56) | |
Yes | 148(12.81) | 60(15.54) | 88(11.44) | |
STD positive | 0.019 | |||
No | 984(85.19) | 315(81.61) | 669(87.00) | |
Yes | 171(14.81) | 71(18.39) | 100(13.00) | |
Lifetime history of testing | ||||
Ever tested for chlamydia | 0.001 | |||
No | 1051(91.00) | 333(86.27) | 718(93.37) | |
Yes | 104(9.00) | 53(13.73) | 51(6.63) | |
Ever tested for gonorrhea | 0.001 | |||
No | 1071(92.73) | 344(89.12) | 727(94.54) | |
Yes | 84(7.27) | 42(10.88) | 42(5.46) |
Use of online commercial sex-seeking
Variables | n | % |
---|---|---|
Length of time since started to find sexual partners online | ||
< 6 months | 107 | 27.72 |
6 months-1 year | 148 | 38.34 |
1–3 years | 114 | 29.53 |
> 3 years | 17 | 4.40 |
Engaged in finding sexual partners online in the last weeks | ||
No | 80 | 20.73 |
Yes | 306 | 79.27 |
Number of sexual partners seeking online in the last week | ||
0–3 | 259 | 67.10 |
4–6 | 99 | 25.65 |
7–10 | 16 | 4.15 |
> 10 | 12 | 3.11 |
Length of time since met the last sexual partner online (days) | ||
< 1 | 65 | 16.84 |
1–2 | 142 | 36.79 |
3–4 | 81 | 20.98 |
5–7 | 55 | 14.25 |
8–30 | 24 | 6.22 |
> 30 | 19 | 4.92 |
The time taken from the first interaction to meeting in reality (hours) | ||
< 1 | 49 | 12.69 |
1–12 | 188 | 48.70 |
13–24 | 100 | 25.91 |
> 24 | 49 | 12.69 |
Used condoms during last sex with the last online partner | ||
No | 61 | 15.80 |
Yes | 325 | 84.20 |
Discussed about condom use before met | ||
No | 195 | 50.52 |
Yes | 191 | 49.48 |
Being asked about your STD status before meeting up | ||
No | 251 | 65.03 |
Yes | 135 | 34.97 |
Sexual behaviors, reproductive health and prevalence of HIV/STD
Factors associated with online sex-seeking usage
Characteristics | cOR(95%CI) | P-value | aOR(95%CI) # | P-value |
---|---|---|---|---|
Demographics | ||||
Age (Year) | ||||
<=30 | Ref | - | Ref | - |
30–40 | 1.29(0.97,1.72) | 0.077 | 1.51(1.09,2.08) | 0.018* |
> 40 | 1.97(1.43,2.72) | < 0.001* | 2.55(1.79,3.65) | < 0.001* |
Marital status | ||||
Married | Ref | - | Ref | - |
Unmarried | 1.07(0.84,1.37) | 0.577 | 1.15(0.87,1.52) | 0.322 |
Highest education | ||||
Primary school or less | Ref | - | Ref | - |
Junior high school | 1.07(0.78,1.47) | 0.675 | 0.93(0.66,1.32) | 0.692 |
Senior high school and above | 1.40(0.97,2.00) | 0.070 | 1.09(0.72,1.65) | 0.690 |
Annual income ($) | ||||
< 5000 | Ref | - | Ref | - |
5000–10,000 | 1.29(0.85,1.96) | 0.239 | 1.25(0.81,1.91) | 0.309 |
10,001–15,000 | 1.89(1.24,2.87) | 0.003* | 1.71(1.10,2.67) | 0.018* |
> 15,000 | 3.57(2.31,5.51) | < 0.001* | 3.92(2.47,6.23) | < 0.001* |
Workplace | ||||
Middle tier | Ref | - | Ref | - |
Low tier | 1.27(0.99,1.62) | 0.064 | 1.36(1.04,1.79) | 0.093 |
Ethnicity | ||||
Han | Ref | - | Ref | - |
Non-Han | 1.40(0.91,2.14) | 0.119 | 1.12(0.72,1.75) | 0.614 |
Length of time working in current location (month) | ||||
< 6 | Ref | - | Ref | - |
6–12 | 1.18(0.86,1.63) | 0.315 | 1.11(0.79,1.56) | 0.541 |
> 12 | 1.30(0.97,1.74) | 0.083 | 1.15(0.83,1.59) | 0.405 |
Vaginal discomfort | ||||
Yes | Ref | - | Ref | - |
No | 0.98(0.76,1.27) | 0.900 | 0.83(0.63,1.08) | 0.169 |
Received health services locally | ||||
No | Ref | - | Ref | - |
Yes | 2.86(2.04,4.01) | < 0.001* | 2.57(1.80,3.67) | < 0.001* |
Sexual Behavior | ||||
Number of clients in the last week | ||||
<=7 | Ref | - | Ref | - |
8–14 | 2.78(2.09,3.70) | < 0.001* | 2.25(1.66,3.06) | < 0.001* |
>=15 | 2.55(1.81,3.59) | < 0.001* | 2.09(1.46,3.00) | < 0.001* |
Consistent condom uses in the last month | ||||
No | Ref | - | Ref | - |
Yes | 1.01(0.76,1.32) | 0.970 | 0.75(0.56,1.01) | 0.058 |
Reproductive health | ||||
Ever had an unintended pregnancy due to commercial sex | ||||
No | Ref | - | Ref | - |
Yes | 1.75(1.21,2.53) | 0.003* | 1.78(1.21,2.62) | 0.003* |
Have been diagnosed as infertile | ||||
No | 1.99(1.43,2.78) | < 0.001* | 1.57(1.10,2.23) | 0.013* |
Yes | 3.54(1.63,7.69) | 0.001* | 3.20(1.42,7.21) | 0.005* |
Unknown | Ref | - | Ref | - |
Ever abortions | ||||
No | Ref | - | Ref | - |
Yes | 1.77(1.37,2.28) | < 0.001* | 1.69(1.29,2.20) | < 0.001* |
STD testing results | ||||
Syphilis positive | ||||
No | Ref | - | Ref | - |
Yes | 2.01(0.58,9.67) | 0.274 | 2.67(0.75,9.52) | 0.131 |
Gonorrhea positive | ||||
No | Ref | - | Ref | - |
Yes | 1.73(0.89,3.33) | 0.104 | 1.38(0.69,2.76) | 0.361 |
Chlamydia positive | ||||
No | Ref | - | Ref | - |
Yes | 1.42(1.00,2.03) | 0.050 | 1.37(0.95,1.97) | 0.096 |
STD positive | ||||
No | Ref | - | Ref | - |
Yes | 1.51(1.08,2.10) | 0.015* | 1.48(1.05,2.09) | 0.026* |
Lifetime history of testing | ||||
Ever tested for chlamydia | ||||
No | Ref | - | Ref | - |
Yes | 2.24(1.49,3.36) | < 0.001* | 2.42(1.58,3.70) | < 0.001* |
Ever tested for gonorrhea | ||||
No | Ref | - | Ref | - |
Yes | 2.11(1.35,3.30) | 0.001* | 2.60(1.63,4.15) | < 0.001* |
Factors associated with long-term online sex-seeking usage
Characteristics | Total n (%) | Short term use n (%) | Long-term use n (%) | cOR(95%CI) | aOR(95%CI) # |
---|---|---|---|---|---|
Demographics | 386 | 255(66.06) | 131(33.94) | ||
Age (Year) | |||||
<=30 | 130(33.68) | 94(36.86) | 36(27.48) | Ref | Ref |
30–40 | 145(37.56) | 85(33.33) | 60(45.80) | 1.84(1.11,3.06) * | 1.62(0.88,3.00) |
> 40 | 111(28.76) | 76(29.80) | 35(26.72) | 1.20(0.69,2.09) | 1.63(0.83,3.19) |
Marital status | |||||
Married | 164(42.49) | 93(36.47) | 71(54.20) | Ref | Ref |
Unmarried | 222(57.51) | 162(63.53) | 60(45.80) | 0.49(0.32,0.74) * | 0.78(0.47,1.30) |
Highest education | |||||
Primary school or less | 77(19.95) | 65(25.49) | 12(9.16) | Ref | Ref |
Junior high school | 201(52.07) | 146(57.25) | 55(41.98) | 2.04(1.02,4.07) * | 1.73(0.82,3.64) |
Senior high school and above | 108(27.98) | 44(17.25) | 64(48.85) | 7.88(3.81,16.28) * | 7.94(3.47,18.18) * |
Annual income ($) | |||||
< 5000 | 39(10.10) | 26(10.20) | 13(9.92) | Ref | Ref |
5000–10,000 | 103(26.68) | 86(33.73) | 17(12.98) | 0.40(0.17,0.92) * | 0.36(0.14,0.88) * |
10,001–15,000 | 120(31.09) | 57(22.35) | 63(48.09) | 2.21(1.04,4.71) * | 1.64(0.73,3.70) |
> 15,000 | 124(32.12) | 86(33.73) | 38(29.01) | 0.88(0.41,1.90) | 0.60(0.25,1.46) |
Workplace | |||||
Middle tier | 216(55.96) | 157(61.57) | 59(45.04) | Ref | Ref |
Low tier | 170(44.04) | 98(38.43) | 72(54.96) | 1.96(1.28,3.00) * | 2.35(1.37,4.03) * |
Ethnicity | |||||
Han | 347(89.90) | 236(92.55) | 111(84.73) | Ref | Ref |
Non-Han | 39(10.10) | 19(7.45) | 20(15.27) | 2.24(1.15,4.36) * | 2.11(1.01,4.42) * |
Length of time working in current location (month) | |||||
< 6 | 107(27.72) | 98(38.43) | 9(6.87) | Ref | Ref |
6–12 | 110(28.50) | 88(34.51) | 22(16.79) | 2.72(1.19,6.23) * | 2.89(1.18,7.07) * |
> 12 | 169(43.78) | 69(27.06) | 100(76.34) | 15.78(7.47,33.36) * | 13.25(5.89,29.81) * |
Vaginal discomfort | |||||
Yes | 140(36.27) | 112(43.92) | 28(21.37) | Ref | Ref |
No | 246(63.73) | 143(56.08) | 103(78.63) | 2.88(1.77,4.68) * | 3.29(1.89,5.74) * |
Received health services locally | |||||
No | 49(12.69) | 36(14.12) | 13(9.92) | Ref | Ref |
Yes | 337(87.31) | 219(85.88) | 118(90.08) | 1.49(0.76,2.92) | 1.01(0.46,2.20) |
Sexual Behavior | |||||
Number of clients in the last week | |||||
<=7 | 161(41.71) | 83(32.55) | 78(59.54) | Ref | Ref |
8–14 | 144(37.31) | 106(41.57) | 38(29.01) | 0.38(0.24,0.62) * | 0.49(0.28,0.86) * |
>=15 | 81(20.98) | 66(25.88) | 15(11.45) | 0.24(0.13,0.46) * | 0.27(0.13,0.55) * |
Consistent condom uses in the last month | |||||
No | 105(27.20) | 90(35.29) | 15(11.45) | Ref | Ref |
Yes | 281(72.80) | 165(64.71) | 116(88.55) | 4.22(2.32,7.65) * | 3.83(2.00,7.34) * |
Reproductive health | |||||
Ever had an unintended pregnancy due to commercial sex | |||||
No | 327(84.72) | 212(83.14) | 115(87.79) | Ref | Ref |
Yes | 59(15.28) | 43(16.86) | 16(12.21) | 0.69(0.37,1.27) | 0.86(0.43,1.69) |
Have been diagnosed as infertile | |||||
No | 317(82.12) | 193(75.69) | 124(94.66) | 8.03(3.18,27.06) * | 8.55(3.25,29.58) * |
Yes | 15(3.89) | 12(4.71) | 3(2.29) | 3.12(0.56,16.09) | 3.73(0.61,21.03) |
Unknown | 54(13.99) | 50(19.61) | 4(3.05) | Ref | Ref |
Ever abortions | |||||
No | 223(57.77) | 157(61.57) | 66(50.38) | Ref | Ref |
Yes | 163(42.23) | 98(38.43) | 65(49.62) | 1.58(1.03,2.42) * | 1.93(1.18,3.16) * |
STD testing results | |||||
HIV positive | |||||
No | 385(99.74) | 254(99.61) | 131(100.0) | - | - |
Yes | 1(0.26) | 1(0.39) | 0(0.0) | - | - |
Syphilis positive | |||||
No | 381(98.70) | 250(98.04) | 131(100.0) | - | - |
Yes | 5(1.30) | 5(1.96) | 0(0.0) | - | - |
Gonorrhea positive | |||||
No | 369(95.6) | 242(94.90) | 127(96.95) | Ref | Ref |
Yes | 17(4.40) | 13(5.10) | 4(3.05) | 0.59(0.19,1.84) | 0.77(0.22,2.62) |
Chlamydia positive | |||||
No | 326(84.46) | 219(85.88) | 107(81.68) | Ref | Ref |
Yes | 60(15.54) | 36(14.12) | 24(18.32) | 1.36(0.78,2.40) | 1.67(0.87,3.20) |
STD positive | |||||
No | 315(81.61) | 209(81.96) | 106(80.92) | Ref | Ref |
Yes | 71(18.39) | 46(18.04) | 25(19.08) | 1.07(0.62,1.84) | 1.27(0.68,2.37) |
Lifetime history of testing | |||||
Ever tested for chlamydia | |||||
No | 333(86.27) | 211(82.75) | 122(93.13) | Ref | Ref |
Yes | 53(13.73) | 44(17.25) | 9(6.87) | 0.35(0.17,0.75) * | 0.40(0.18,0.91) * |
Ever tested for gonorrhea | |||||
No | 344(89.12) | 221(86.67) | 123(93.89) | Ref | Ref |
Yes | 42(10.88) | 34(13.33) | 8(6.11) | 0.42(0.19,0.94) * | 0.60(0.25,1.45) * |