Neisseria gonorrhoeae prevalence, incidence and associated risk factors among female sex workers in a high HIV-prevalence area of China

• An open cohort study was conducted.
• The incidence was 5.9 per 100 person-years.
• Higher risk venue, inconsistently used condom, and C. trachomatis were risk factors.

SummaryBackgroundNeisseria gonorrhoeae (N. gonorrhoeae) is one of the most prevalent non-ulcerative sexually transmitted infections (STIs) in China, however, the data about N. gonorrhoeae infections are limited in this population. The objective of this study is to determine N. gonorrheae incidence and associated risk factors among female sex workers (FSWs) in China.MethodsThis serial cross-sectional study was conducted semi-annually among FSWs in a City of Yunnan Province, which constituted an open cohort study. Participants were interviewed and tested for N. gonorrhoeae every 6 months.ResultsDuring 3 years of follow-up, 64 incident cases of N. gonorrhoeae infection were diagnosed, yielding an overall incidence of 5.9 per 100 person years (PY) (95% confidence interval (CI), 4.53-7.41). Working in higher risk commercial sex venue (adjusted hazard ratio (AHR)=2.7, 95% CI, 1.56-4.55), inconsistently used condoms with clients in previous week (AHR=1.9, 95% CI, 1.07-3.35) and being infected with C. trachomatis (AHR=1.9, 95% CI, 1.06-3.26) were independent risk factors for incident N. gonorrhoeae infection.ConclusionsA relatively high prevalence and incidence of N. gonorrhoeae among a prospective cohort of FSWs underscore the urgency for traditional HIV/STIs prevention methods among FSWs, such as condom promotion, screening and treatment of STIs, considering the high prevalence of STIs. Significant attention should focus on FSWs working in higher risk commercial sex venues as they are at higher risk for N. gonorrhoeae and transmission than those in lower risk commercial sex venues.