The aim of this study was to estimate the prevalence of depression among female sex workers (FSW) in an urban coastal city in South Africa, and to explore the relationship between depression and HIV-related social and biobehavioral determinants. A cross-sectional respondent-driven sampling study was conducted with FSW (n = 410), including a sociobehavioral questionnaire, PHQ-9 (Patient Health Questionnaire-9) based assessment of depression, and biological testing for HIV and syphilis. The prevalence of HIV in the sample was 64.1%. The estimated prevalence of depression was 28.8%. Depression was associated with social vulnerability such as living alone [adjusted prevalence ratio 1.82, 95% confidence interval (CI) 1.15–2.90] and food insecurity (aPR 2.19, 95% CI 1.42–3.38). A positive syphilis test result (aPR 1.46, 95% CI 1.02–2.09) and self-reported sexually transmitted disease symptoms (aPR 1.78, 95% CI 1.29–2.46) was associated with depression, but self-reported condom use and HIV status was not. FSW were also less likely to disclose their occupational status to health care providers (aPR 0.61, 95% CI 0.42–0.89) or undergo sexually transmitted infection screening in the last 12 months if they are depressed (aPR 0.64, 95% CI 0.43–0.95). The results demonstrate that the prevalence of depression is high among FSW and that depressive symptoms are associated with social covariates and biobehavioral HIV risk factors.

中文翻译：

---

探索南非纳尔逊曼德拉湾市女性性工作者的抑郁与社会和生物行为 HIV 风险因素之间的关联

本研究的目的是估计南非沿海城市女性性工作者 (FSW) 的抑郁症患病率，并探讨抑郁症与 HIV 相关的社会和生物行为决定因素之间的关系。使用 FSW ( n = 410），包括社会行为问卷、基于 PHQ-9（患者健康问卷-9）的抑郁评估以及 HIV 和梅毒的生物检测。样本中的 HIV 感染率为 64.1%。抑郁症的估计患病率为 28.8%。抑郁症与社会脆弱性有关，例如独居 [调整后的患病率 1.82, 95% 置信区间 (CI) 1.15–2.90] 和粮食不安全 (aPR 2.19, 95% CI 1.42–3.38)。梅毒检测结果呈阳性 (aPR 1.46, 95% CI 1.02–2.09) 和自我报告的性传播疾病症状 (aPR 1.78, 95% CI 1.29–2.46) 与抑郁症相关，但自我报告的安全套使用和 HIV 状况与抑郁症相关。不是。FSW 也不太可能向医疗保健提供者披露其职业状况（aPR 0.61, 95% CI 0.42–0. 89）或在过去 12 个月内接受过性传播感染筛查（aPR 0.64, 95% CI 0.43–0.95）。结果表明，FSW 中抑郁症的患病率很高，并且抑郁症状与社会协变量和生物行为 HIV 危险因素有关。