Reported Willingness and Associated Factors Related to Utilization of Voluntary Counseling and Testing Services by Female Sex Workers in Shandong Province, China

Objective To explore reported willingness and factors associated with utilization of voluntary counseling and testing services by female sex workers (FSWs) in China and to offer recommendations to optimize use of such services. Methods A questionnaire to explore willingness to use VCT was designed based on social ecological theory and formative qualitative research. A cross-sectional survey was conducted among FSWs from entertainment venues. Single and multiple logistic regression analyses were employed to examine factors associated with reported willingness to utilize VCT. Results A total of 970 FSWs provided valid questionnaires, with 69% (669) expressing willingness to utilize VCT. Factors at the interpersonal level associated with reported willingness included knowledge about VCT, desire to get help if diagnosed as HIV positive, ability to imagine life after an HIV positive diagnosis, and perceived support for VCT from peers, managers, and family members. Availability of free antiretroviral (ARV) treatment represented a factor at policy level. Other factors included intention to leave sex work in the near future, having had a previous HIV test, and lack of a suspected STD history. Conclusions The rate of reported willingness to use VCT among FSWs was substantially higher than that of actual VCT utilization (11%). The next step is to explore the connection between reported willingness and actual use. Based on these Findings, peer education, VCT knowledge dissemination, and free ARV treatment should be emphasized to increase FSWs' willingness to use VCT.