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Sample records for american sex workers

  1. Risk behaviours among internet-facilitated sex workers: evidence from two new datasets.

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    Cunningham, Scott; Kendall, Todd D

    2010-12-01

    Sex workers have historically played a central role in STI outbreaks by forming a core group for transmission and due to their higher rates of concurrency and inconsistent condom usage. Over the past 15 years, North American commercial sex markets have been radically reorganised by internet technologies that channelled a sizeable share of the marketplace online. These changes may have had a meaningful impact on the role that sex workers play in STI epidemics. In this study, two new datasets documenting the characteristics and practices of internet-facilitated sex workers are presented and analysed. The first dataset comes from a ratings website where clients share detailed information on over 94,000 sex workers in over 40 cities between 1999 and 2008. The second dataset reflects a year-long field survey of 685 sex workers who advertise online. Evidence from these datasets suggests that internet-facilitated sex workers are dissimilar from the street-based workers who largely populated the marketplace in earlier eras. Differences in characteristics and practices were found which suggest a lower potential for the spread of STIs among internet-facilitated sex workers. The internet-facilitated population appears to include a high proportion of sex workers who are well-educated, hold health insurance and operate only part time. They also engage in relatively low levels of risky sexual practices.

  2. Increased and mistimed sex hormone production in night shift workers.

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    Papantoniou, Kyriaki; Pozo, Oscar J; Espinosa, Ana; Marcos, Josep; Castaño-Vinyals, Gemma; Basagaña, Xavier; Juanola Pagès, Elena; Mirabent, Joan; Martín, Jordi; Such Faro, Patricia; Gascó Aparici, Amparo; Middleton, Benita; Skene, Debra J; Kogevinas, Manolis

    2015-05-01

    Night shift work has been associated with an increased risk for breast and prostate cancer. The effect of circadian disruption on sex steroid production is a possible underlying mechanism, underinvestigated in humans. We have assessed daily rhythms of sex hormones and melatonin in night and day shift workers of both sexes. We recruited 75 night and 42 day workers, ages 22 to 64 years, in different working settings. Participants collected urine samples from all voids over 24 hours on a working day. Urinary concentrations of 16 sex steroid hormones and metabolites (estrogens, progestagens, and androgens) and 6-sulfatoxymelatonin were measured in all samples. Mean levels and peak time of total and individual metabolite production were compared between night and day workers. Night workers had higher levels of total progestagens [geometric mean ratio (GMR) 1.65; 95% confidence intervals (CI), 1.17-2.32] and androgens (GMR: 1.44; 95% CI, 1.03-2.00), compared with day workers, after adjusting for potential confounders. The increased sex hormone levels among night shift workers were not related to the observed suppression of 6-sulfatoxymelatonin. Peak time of androgens was significantly later among night workers, compared with day workers (testosterone: 12:14 hours; 10:06-14:48 vs. 08:35 hours; 06:52-10:46). We found increased levels of progestagens and androgens as well as delayed peak androgen production in night shift workers compared with day workers. The increase and mistiming of sex hormone production may explain part of the increased risk for hormone-related cancers observed in night shift workers. ©2015 American Association for Cancer Research.

  3. Sex workers, unite! (Litigating for sex workers' freedom of association in Russia).

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    Arps, F S E Freddie; Golichenko, Mikhail

    2014-12-11

    The existing legal framework in Russia makes sex work and related activities punishable offenses, leaving sex workers stigmatized, vulnerable to violence, and disproportionally affected by HIV and other sexually transmitted infections. In 2013, the Ministry of Justice, supported by the courts, refused registration and official recognition to the first all-Russia association of sex workers, referring to the fact that sex work is under administrative and criminal punitive bans and therefore the right of association for sex workers is unjustified. In light of international human rights standards, in particular the jurisprudence of the European Court of Human Rights, we examine in this paper whether the overall punitive legal ban on sex work in Russia is discriminatory. The government's positive obligations concerning discrimination against sex workers whose activities are consensual and between adults, and whose working conditions leave them among society's most vulnerable, should outweigh their punitive laws and policies around sex work. The scope of legal criminalization is narrow: it should apply only in exceptional cases where it is clearly justified. Copyright © 2014 Arps and Golichenko. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  4. Voices of Māori Sex Workers

    OpenAIRE

    Escaravage, Elise

    2016-01-01

    Aotearoa (New Zealand) is the only country in the world to have decriminalized sex work. The Prostitution Reform Act (PRA henceforth) was enacted in 2003 with the aim to safeguard the human rights of sex workers, and create a framework that is conducive to public health. Skeptics of this policy argue that the law reform was targeting indoor workers while the livelihood of street-based sex workers did not see significant improvements (Justice Acts, 2014). It is known that Māori sex workers are...

  5. An action agenda for HIV and sex workers.

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    Beyrer, Chris; Crago, Anna-Louise; Bekker, Linda-Gail; Butler, Jenny; Shannon, Kate; Kerrigan, Deanna; Decker, Michele R; Baral, Stefan D; Poteat, Tonia; Wirtz, Andrea L; Weir, Brian W; Barré-Sinoussi, Françoise; Kazatchkine, Michel; Sidibé, Michel; Dehne, Karl-Lorenz; Boily, Marie-Claude; Strathdee, Steffanie A

    2015-01-17

    The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Occupational health and safety among commercial sex workers.

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    Ross, Michael W; Crisp, Beth R; Månsson, Sven-Axel; Hawkes, Sarah

    2012-03-01

    The concept of occupational health and safety (OHS) for commercial sex workers has rarely been investigated, perhaps because of the often informal nature of the workplace, the associated stigma, and the frequently illegal nature of the activity. We reviewed the literature on health, occupational risks, and safety among commercial sex workers. Cultural and local variations and commonalities were identified. Dimensions of OHS that emerged included legal and policing risks, risks associated with particular business settings such as streets and brothels, violence from clients, mental health risks and protective factors, alcohol and drug use, repetitive strain injuries, sexually transmissible infections, risks associated with particular classes of clients, issues associated with male and transgender commercial sex workers, and issues of risk reduction that in many cases are associated with lack of agency or control, stigma, and legal barriers. We further discuss the impact and potential of OHS interventions for commercial sex workers. The OHS of commercial sex workers covers a range of domains, some potentially modifiable by OHS programs and workplace safety interventions targeted at this population. We argue that commercial sex work should be considered as an occupation overdue for interventions to reduce workplace risks and enhance worker safety.

  7. High burden of STI and HIV in male sex workers working as internet escorts for men in an observational study: a hidden key population compared with female sex workers and other men who have sex with men.

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    Verhaegh-Haasnoot, Amanja; Dukers-Muijrers, Nicole H T M; Hoebe, Christian J P A

    2015-07-29

    Male sex work in the western countries has changed, including now a subculture of male sex workers who have paid sex with men arranged for via the internet. The men involved in this subculture do not easily identify themselves as sex workers nor as homosexual, and are therefore missed by regular health care and public health interventions. These male sex workers may form a hidden key population for sexually transmitted infections (STIs) and HIV, bridging towards other persons outside this context. This clinic-based observational study included consultations by male sex workers (n = 212), female sex workers (n = 801) and in men having sex with men who did not report being paid for sexual contacts (MSM, n = 2703) who received STI and HIV testing and counselling at our clinic during the study period. In this study we compare the consultations in male sex workers to those in in female sex workers and MSM. Demographic characteristics and sexual behaviour of the male sex workers, female sex workers and MSM were compared using chi-square tests and non-parametric tests. Using univariate and multivariate regression analyses, determinants for STI positivity in male sex workers were evaluated. Male sex workers tested positive for STI (including HIV) in 40 % of the consultations; female sex workers and MSM respectively in 9 and 14 % of the consultations. A new HIV infection was found in 8 % of the consultations of male sex workers. Male sex workers were a young population of migrant sex workers from Eastern Europe. They reported more often to also have sex contacts with women and other sex workers. Male sex workers are at a higher risk for one or more new STI than female sex workers and other MSM, even after correction for age, ethnicity, known HIV positivity and behavioural variables. Male sex workers form a hidden key population that impacts the transmission of STI and HIV within the MSM population and, possibly, to the heterosexual population. They require specific targeted

  8. Combating human trafficking in the sex trade: can sex workers do it better?

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    Jana, Smarajit; Dey, Bharati; Reza-Paul, Sushena; Steen, Richard

    2014-12-01

    The dominant anti-trafficking paradigm conflates trafficking and sex work, denying evidence that most sex workers choose their profession and justifying police actions that disrupt communities, drive sex workers underground and increase vulnerability. We review an alternative response to combating human trafficking and child prostitution in the sex trade, the self-regulatory board (SRB) developed by Durbar Mahila Samanwaya Committee (DMSC, Sonagachi). DMSC-led interventions to remove minors and unwilling women from sex work account for over 80% of successful 'rescues' reported in West Bengal. From 2009 through 2011, 2195 women and girls were screened by SRBs: 170 (7.7%) minors and 45 (2.1%) unwilling adult women were assisted and followed up. The remaining 90.2% received counselling, health care and the option to join savings schemes and other community programmes designed to reduce sex worker vulnerability. Between 1992 and 2011 the proportion of minors in sex work in Sonagachi declined from 25 to 2%. With its universal surveillance of sex workers entering the profession, attention to rapid and confidential intervention and case management, and primary prevention of trafficking-including microcredit and educational programmes for children of sex workers-the SRB approach stands as a new model of success in anti-trafficking work. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. How sex work becomes an option: Experiences of female sex workers in Kerman, Iran.

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    Karamouzian, Mohammad; Foroozanfar, Zohre; Ahmadi, Azal; Haghdoost, Ali Akbar; Vogel, Joanna; Zolala, Farzaneh

    2016-01-01

    Sex work is rarely an occupation of choice for Iranian women and is often described as a last resort. While several factors play a role in creating an environment where individuals become involved in sex work, female sex workers' experiences regarding entry into sex work in Iran are poorly understood. In this qualitative study, a convenience sample of 24 participants was recruited from a drop-in centre for vulnerable women in Kerman, Iran. Through in-depth interviews, participants were asked about their personal lived experiences of initiating sex work. Grounded theory was used to analyse findings from this research. We learned that major factors impacting on women's initiation into sex work circulated around their vulnerability and chronic poverty. Participants continued to sell sex due to their limited opportunities, drug dependence and financial needs. Improving sex workers' economic status could be a vital intervention in providing vulnerable women with options other than sex work. Female sex workers should be provided with government support and educational programmes delivered through special centres. Despite the illegal status of their work, sex workers' needs should be recognised across all aspects of policy and legislation.

  10. ¿Mi cuerpo? ¡Mi vida! Voicing Latin American transgenders in Antwerp’s sex industry

    Directory of Open Access Journals (Sweden)

    Julie Rausenberger

    2016-12-01

    Full Text Available Prostitution is a well-known universal social phenomenon, from anywhere and at all times, that attracts many migrants. Yet sex work is clearly not evenly integrated into society. After all, there are still existing dominant conservative stigma that classify this sector as deviant. This causes sex work to exist further in the margins of contemporary societies while, in fact, prostitution is not more than a social construct which can differ in legal and moral terms. It goes without saying that sex workers often lead a double life. Latin American migrants selling sex furthermore live with two double stigma because they work in prostitution and are of foreign origin. If they are additionally transgendered, the stigma is even triple because they are also discriminated because of their sexual orientation and appearance. As an anthropologist, this asked for a broader understanding about the motives and effects of this activity in the sex industry as a Latin American transgender migrant. This consideration has led to this narrative study as a result by deploying the qualitative methods of participative observation and informal interviews. The purpose of this anthropological and phenomenological research project has been to find out who the Latin American transgender sex workers in Antwerp are, why they work in the sex industry, which journey brought them to Europe, how they experience life, how they feel about their bodies, identities and sexuality, and how art is used as a creative coping strategy to escape their remarkable reality.

  11. Client retention and health among sex workers in Nairobi, Kenya.

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    Izugbara, Chimaraoke O

    2012-12-01

    It is still a small body of research that directly addresses female sex workers' relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi's FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers' practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer.

  12. National sex work policy and HIV prevalence among sex workers: an ecological regression analysis of 27 European countries.

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    Reeves, Aaron; Steele, Sarah; Stuckler, David; McKee, Martin; Amato-Gauci, Andrew; Semenza, Jan C

    2017-03-01

    Sex workers are disproportionately affected by HIV compared with the general population. Most studies of HIV risk among sex workers have focused on individual-level risk factors, with few studies assessing potential structural determinants of HIV risk. In this Article, we examine whether criminal laws around sex work are associated with HIV prevalence among female sex workers. We estimate cross-sectional, ecological regression models with data from 27 European countries on HIV prevalence among sex workers from the European Centre for Disease Control; sex-work legislation from the US State Department's Country Reports on Human Rights Practices and country-specific legal documents; the rule of law and gross-domestic product per capita, adjusted for purchasing power, from the World Bank; and the prevalence of injecting drug use among sex workers. Although data from two countries include male sex workers, the numbers are so small that the findings here essentially pertain to prevalence in female sex workers. Countries that have legalised some aspects of sex work (n=17) have significantly lower HIV prevalence among sex workers than countries that criminalise all aspects of sex work (n=10; β=-2·09, 95% CI -0·80 to -3·37; p=0·003), even after controlling for the level of economic development (β=-1·86; p=0·038) and the proportion of sex workers who are injecting drug users (-1·93; p=0·026). We found that the relation between sex work policy and HIV among sex workers might be partly moderated by the effectiveness and fairness of enforcement, suggesting legalisation of some aspects of sex work could reduce HIV among sex workers to the greatest extent in countries where enforcement is fair and effective. Our findings suggest that the legalisation of some aspects of sex work might help reduce HIV prevalence in this high-risk group, particularly in countries where the judiciary is effective and fair. European Centre for Disease Prevention and Control. Copyright

  13. Stigma and sex work from the perspective of female sex workers in Hong Kong.

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    Wong, William C W; Holroyd, Eleanor; Bingham, Amie

    2011-01-01

    While the stigma surrounding sex work is both well documented and easily recognised, few studies examine stigma in this context from the perspective of the sex workers themselves. In this article we report on a study using a modified grounded theory approach to analyse a series of semi-structured interviews with 49 female sex workers in Hong Kong, in order to examine the ways in which this group experiences and negotiates the stigma which arises from their employment in the sex industry. Sex workers in Hong Kong were subject to various stigmatising forces in their daily lives in their interactions with the public, the police and their families. These processes could have a negative impact on the sex workers' health, both through obvious manifestations such as physical or verbal abuse and through more subtle processes such as those which generated or perpetuated vulnerability and those which compelled the sex workers to conceal their identities and withdraw themselves from social networks. These findings are situated in the context of broader research surrounding sex work, drawing attention to the consequences of stigma on health and their interaction with health-service providers, before briefly discussing possible means of overcoming stigma-related barriers to providing adequate healthcare for this marginalised group. © 2010 The Authors. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  14. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

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    Wilson, David

    2015-06-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  15. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

    Directory of Open Access Journals (Sweden)

    David Wilson

    2015-06-01

    Full Text Available There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  16. Sex workers talk about sex work: six contradictory characteristics of legalised sex work in Melbourne, Australia.

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    Begum, Sufia; Hocking, Jane S; Groves, Jan; Fairley, Christopher K; Keogh, Louise A

    2013-01-01

    Despite research suggesting that legal sex work is safe and that emotional risks and social stigma are of greater concern than health risks, much research on sex work has focused on health risks. Given the legalisation of sex work in Victoria, Australia, it is timely to look beyond health. Three focus groups were conducted with a total of 14 female sex workers on their experience of legal sex work, both positive and negative, and the social acceptability of their profession. Thematic analysis was used to identify the key ways that sex workers described sex work. Women saw legal sex work as safer than illegal sex work, but still not socially acceptable. However, they also described six contradictory elements of sex work, which was seen as: financially rewarding and entrapping; empowering and demeaning; increasing some opportunities while reducing others; flexible and demanding; offering both intimacy and competition; and leading to a 'double life'. While legalisation has improved the safety of sex work, stigma and discrimination persist.

  17. Male sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission.

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    Baral, Stefan David; Friedman, M Reuel; Geibel, Scott; Rebe, Kevin; Bozhinov, Borche; Diouf, Daouda; Sabin, Keith; Holland, Claire E; Chan, Roy; Cáceres, Carlos F

    2015-01-17

    Male sex workers who sell or exchange sex for money or goods encompass a very diverse population across and within countries worldwide. Information characterising their practices, contexts where they live, and their needs is limited, because these individuals are generally included as a subset of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. Male sex workers, irrespective of their sexual orientation, mostly offer sex to men and rarely identify as sex workers, using local or international terms instead. Growing evidence indicates a sustained or increasing burden of HIV among some male sex workers within the context of the slowing global HIV pandemic. Several synergistic facilitators could be potentiating HIV acquisition and transmission among male sex workers, including biological, behavioural, and structural determinants. Criminalisation and intersectional stigmas of same-sex practices, commercial sex, and HIV all augment risk for HIV and sexually transmitted infections among male sex workers and reduce the likelihood of these people accessing essential services. These contexts, taken together with complex sexual networks among male sex workers, define this group as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights. Evidence-based and human rights-affirming services dedicated specifically to male sex workers are needed to improve health outcomes for these men and the people within their sexual networks. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting.

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    Landsberg, Adina; Shannon, Kate; Krüsi, Andrea; DeBeck, Kora; Milloy, M-J; Nosova, Ekaterina; Kerr, Thomas; Hayashi, Kanna

    2017-08-01

    Previous research indicates that criminalization of sex work is associated with harms among sex workers. In 2013, the Vancouver Police Department changed their sex work policy to no longer target sex workers while continuing to target clients and third parties in an effort to increase the safety of sex workers (similar to "end-demand sex work" approaches being adopted in a number of countries globally). We sought to investigate the trends and correlates of rushing negotiations with clients due to police presence among 359 sex workers who use drugs in Vancouver before and after the guideline change. Data were derived from three prospective cohort studies of people who use drugs in Vancouver between 2008 and 2014. We used sex-stratified multivariable generalized estimating equation models. The crude percentages of sex workers who use drugs reporting rushing client negotiations changed from 8.9% before the guideline change to 14.8% after the guideline change among 259 women, and from 8.6 to 7.1% among 100 men. In multivariable analyses, there was a significant increase in reports of rushing client negotiation after the guideline change among women (p = 0.04). Other variables that were independently associated with increased odds of rushing client negotiation included experiencing client-perpetrated violence (among both men and women) and non-heterosexual orientation (among women) (all p sex workers who use drugs. It was also associated with client-perpetrated violence and other markers of vulnerability. These findings lend further evidence that criminalizing the purchase of sexual services does not protect the health and safety of sex workers.

  19. An assessment of sex work in Swaziland: barriers to and opportunities for HIV prevention among sex workers.

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    Chipamaunga, Shalote; Muula, Adamson S; Mataya, Ronald

    2010-10-01

    The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pleasure or "sensation seeking", and freedoms from the burden of marriage as perceived benefits of sex work. We also found that penile-vaginal sex was not universal in male-female sexual encounters; and motivation by sex workers for non-condom use included intention to earn more money from unprotected sex, desire for sexual pleasure, and not having time to use condoms. Many sex workers expressed doubts over an alternative lifestyle, even if that change afforded them money to meet their daily necessities. The findings from this study suggest that treating sex workers as a homogenous group that is driven into, or maintain sex work only because of poverty may be problematic, and could hamper HIV-relevant interventions aimed at reducing their vulnerability to sexually transmitted infections.

  20. Daily practices of health among sex workers

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    Elouyse Fernandes Leitão

    2012-09-01

    Full Text Available Objective: To describe the health practices adopted by sex workers in their daily lives. Methods: A qualitative study that took place at bars where sex workers of Maceió –AL, Brazil, work. The universe of participant subjects was integrated by 15 female sex workers, aged between 20 and 39 years, assisted by the team of a Street Clinic. The research took place between August and October 2011 and women were randomly selected. Data was collected through semi-structured interviews, which were all audio-recorded and transcribed for further analysis and interpretation. Results: Thematic analysis of the data produced and the theoretical framework of health promotion enabled the categorization of the health practices in daily life of these women, such as: prevention of sexually transmitted diseases, body care and aesthetics, physical activity, nutrition, leisure, interpersonal relationships, consumption of alcohol and others drugs, self-medication, and quest for health services. The ways they appropriate themselves of such practices are conditioned by the social vulnerability and economic and sociocultural context they are in. Conclusion: Despite the deficiencies found in the development of these practices, sex workers seek to preserve habits that improve their physical, social and mental health, as well as the pursuit of professional care and services to promote their health.

  1. Cervical cancer screening in rural South Africa among HIV-infected migrant farm workers and sex workers.

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    Afzal, Omara; Lieber, Molly; Dottino, Peter; Beddoe, Ann Marie

    2017-05-01

    At an HIV clinic in the Limpopo province of South Africa, chart reviews revealed long delays in addressing abnormal Pap smears, difficulty in referrals, poor quality and lost results, and increasing cases of cervical cancer. To address these barriers, a "see and treat" approach to screening was proposed. The objective was to integrate this method into current HIV care offered by local providers and to obtain demographic and risk factor data for use in future educational and intervention programs in the region. A cross sectional study of HIV farm workers and at-risk sex workers attending an HIV clinic was performed with visual inspection with acetic acid (VIA). Those with positive screens were offered cryotherapy. Clinic charts were reviewed retrospectively for Pap smear results for the previous year at the time of program initiation and at 12 and 18 months post-program. A total of 403 participants consented and underwent screening with VIA (306 Farm workers and 97 sex workers participated). 83.9% of participants (32.9% sex workers and 100% farm workers) were HIV +. VIA was positive in 30.5% of participants, necessitating cryotherapy. There was no significant difference in VIA positivity between HIV + farm workers and sex workers. There was a positive correlation between Pap smears and VIAs results. We demonstrate successful integration of cervical cancer screening using VIA for HIV + farm workers and sex workers into an existing HIV treatment and prevention clinic in rural South Africa, addressing and treating abnormal results promptly.

  2. Combination HIV prevention for female sex workers: what is the evidence?

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    Bekker, Linda-Gail; Johnson, Leigh; Cowan, Frances; Overs, Cheryl; Besada, Donela; Hillier, Sharon; Cates, Willard

    2015-01-03

    Sex work occurs in many forms and sex workers of all genders have been affected by HIV epidemics worldwide. The determinants of HIV risk associated with sex work occur at several levels, including individual biological and behavioural, dyadic and network, and community and social environmental levels. Evidence indicates that effective HIV prevention packages for sex workers should include combinations of biomedical, behavioural, and structural interventions tailored to local contexts, and be led and implemented by sex worker communities. A model simulation based on the South African heterosexual epidemic suggests that condom promotion and distribution programmes in South Africa have already reduced HIV incidence in sex workers and their clients by more than 70%. Under optimistic model assumptions, oral pre-exposure prophylaxis together with test and treat programmes could further reduce HIV incidence in South African sex workers and their clients by up to 40% over a 10-year period. Combining these biomedical approaches with a prevention package, including behavioural and structural components as part of a community-driven approach, will help to reduce HIV infection in sex workers in different settings worldwide. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Vulnerabilities and rights of migrant sex workers in Europe.

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    Brussa, Licia; Munk, Veronica

    2010-10-01

    In recent years, Europe has witnessed a rise in the number of migrant sex workers, in part because of increased mobility for citizens of European Union member states. However, migrant sex workers find themselves in a highly vulnerable position in regard to having their rights respected and accessing HIV prevention services. In this article, based on a presentation at AIDS 2010, Licia Brussa and Veronica Munk outline the current situation of migrant sex workers in Europe and the steps that need to be taken to ensure that their rights are respected.

  4. Criminalization, legalization or decriminalization of sex work: what female sex workers say in San Francisco, USA.

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    Lutnick, Alexandra; Cohan, Deborah

    2009-11-01

    Sex work is a criminal offence in San Francisco, USA, and sex work advocates have so far unsuccessfully campaigned for decriminalizing it. Some groups argue that the decriminalization movement does not represent the voices of marginalized sex workers. Using qualitative and quantitative data from the Sex Worker Environmental Assessment Team Study, we investigated the perspectives and experiences of a range of female sex workers regarding the legal status of sex work and the impact of criminal law on their work experiences. Forty women were enrolled in the qualitative phase in 2004 and 247 women in the quantitative phase in 2006-07. Overall, the women in this study seemed to prefer a hybrid of legalization and decriminalization. The majority voiced a preference for removing statutes that criminalize sex work in order to facilitate a social and political environment where they had legal rights and could seek help when they were victims of violence. Advocacy groups need to explore the compromises sex workers are willing to make to ensure safe working conditions and the same legal protections afforded to other workers, and with those who are most marginalized to better understand their immediate needs and how these can be met through decriminalization.

  5. "Wear Some Thick Socks If You Walk in My Shoes": Agency, Resilience, and Well-Being in Communities of North American Sex Workers.

    Science.gov (United States)

    Burnes, Theodore R; Rojas, Elizabeth M; Delgado, Irena; Watkins, Tianna E

    2018-07-01

    Using a participatory action research (PAR) paradigm, this study investigated how 35 individuals involved in the sex work industry exemplified aspects of agency and intentional well-being under harsh work environments. Using PAR and qualitative research, sex workers were asked to identify research questions and help to design a study investigating the relationship between well-being and sex worker agency. Participants in the study each completed one semi-structured individual interview to share their experiences in the sex work industry. Data from these interviews were analyzed using constructivist phenomenology; standards of trustworthiness were accounted for using multiple tools. Four themes emerged from the data that described how the participants understood their own resilience and areas of needed attention with respect to their mental health: (1) validating sex work and eliminating whorephobic oppression; (2) safety and mobility within practice environments; (3) sexual boundary setting; and (4) social support for sex workers. Implications of the findings on theory, research, practice, and advocacy are discussed.

  6. FEMALE SEX WORKERS’ ATTITUDES TOWARD HIV TESTING: A STUDY AMONG INDIRECT SEX WORKERS IN BANTUL, YOGYAKARTA, INDONESIA

    Directory of Open Access Journals (Sweden)

    Dhesi Ari Astuti

    2016-12-01

    Full Text Available Background: HIV prevalence among female sex workers in Indonesia is among the highest in Asia after Papua New Guinea and Malaysia. Indirect sex workers posed a heightened risk of HIV infection compared to direct sex workers because they usually earn less than their direct counterpart and have lower bargaining power in condom use. Objective: This study aims to examine the factors influencing indirect sex workers’ attitudes toward HIV testing. Methods: This study employed a quantitative method with a cross-sectional approach involved 67 indirect sex workers from massage parlors and beauty salons in Bantul district. Descriptive analysis of respondents’ attitude, perceive threat and expectation was drawn from Health Belief Model Theory. Results: The majority of indirect sex workers had positive attitude towards HIV testing. They are aware to the importance of condom in every commercial sex works, but the majority believe themselves were not susceptible to HIV-AIDS due to their preference to healthy-looking clients to serve sex. Personal expenses to visit the health center for HIV testing are less considered compared to public opinion and discrimination. Peers encouraged the workers to get tested. Disseminating HIV/AIDS information to sex workers through media and mobile phone are not successful. Conclusion: The findings of the study carrying an expectation that when individuals’ attitudes toward HIV testing are positive, the likelihood of getting themselves tested would also be higher. Since the perception is driven by information as stimulus, it is important to provide continuous information to create stimulus which eventually will influence their perception.

  7. Documenting human rights violations against sex workers in Kenya.

    Science.gov (United States)

    Lukera, MaryFrances

    2007-12-01

    The human rights of sex workers are an increasing concern for prominent women's rights organizations such as the Federation of Women Lawyers (FIDA). As FIDA-Kenya's MaryFrances Lukera writes, documenting human rights abuses against sex workers is critical to responding to Kenya's HIV epidemic.

  8. Vulnerability on the streets: female sex workers and HIV risk.

    Science.gov (United States)

    Pyett, P M; Warr, D J

    1997-10-01

    In-depth interviews were conducted with 24 purposively selected female sex workers who were perceived to be vulnerable to risks associated with their lifestyle and occupation. Brothel workers were found to be considerably less exposed to risk than the women working on the streets. Client resistance was the major obstacle to women maintaining safe sex practices. Physical threats and coercion from clients, the absence of legal protection for street workers, the workers' extreme social isolation and lack of community support added to the difficulties experienced by women in their attempts to insist on condoms for all sex services. Youth, homelessness and heavy drug use had contributed to women being at times even more vulnerable because they had less capacity to manage situations of potential violence or STD risk. Whether through sex work or in their private relationships, HIV remains a risk for some of these women. This study highlights the dangers associated with illegal sex work. While decriminalization of prostitution would reduce some of the dangers to which women were exposed and increase women's capacity to insist on safe sex practices, it is also important for community education programmes to address men's failure to accept responsibility for condom use when seeking the services of sex workers.

  9. Factors associated with condom use negotiation by female sex workers in Bangladesh.

    Science.gov (United States)

    Alam, Nazmul; Chowdhury, Mahbub Elahi; Mridha, Malay K; Ahmed, Anisuddin; Reichenbach, Laura J; Streatfield, Peter Kim; Azim, Tasnim

    2013-10-01

    Negotiation for condom use by female sex workers with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 female sex workers; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the 7 days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street-based female sex workers, respectively. Overall, 28.1% of female sex workers negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2-2.0) and self-perceived risk of human immunodeficiency virus infection (AOR, 1.8 95% CI, 1.6-2.1) were positive predictors for condom negotiation. Compared to the hotel-based female sex workers, street (AOR, 0.6; 95% CI, 0.4-0.9) and brothel-based female sex workers (AOR, 0.7; 95% CI, 0.5-0.9) were less likely to negotiate for condom use. Female sex workers in Bangladesh are at high risk for sexually transmitted infection / human immunodeficiency virus infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by female sex workers, and should be strengthened in commercial sex venues.

  10. Child rearing practices amongst brothel based commercial sex workers.

    Science.gov (United States)

    Pardeshi, Geeta; Bhattacharya, S

    2006-07-01

    The experiences of the commercial sex workers as they fulfill the role of being a parent, have rarely been reported. Considering their socioeconomic background, profession and work pattern, the women are bound to face major challenges. To describe child bearing, family support, dietary practices and various placement options for raising children. A cross-sectional descriptive study of brothel-based commercial sex workers. X2 test, Fisher's Exact test. Some commercial sex workers continued pregnancy with the hope of security and support, while others were compelled to do so, as they report late for medical termination of pregnancy. A group of sex workers (Devdasis) received support during pregnancy, delivery, puerperium and child-rearing. The role and responsibilities of raising the child, depended upon the kind of family support available to the mothers. Being a single parent, stigma of the profession, odd working hours and variable family support were major challenges, while the fact that the women were earning, availability of rehabilitation centers, the homogeneous groups within the brothels, supportive peers and local non governmental organizations were factors which helped them in the process of raising their children. Day care centers and night shelters should be opened up in the red light area where the children can be looked after, during the working hours. The sex workers should be educated about weaning and nutrition. The role of peer workers and NGOs was very important in helping the women raise their children.

  11. Adolescent female sex workers: invisibility, violence and HIV.

    Science.gov (United States)

    Silverman, Jay G

    2011-05-01

    A large number of female sex workers are children. Multiple studies demonstrate that up to 40% of women in prostitution started this work prior to age 18. In studies across India, Nepal, Thailand and Canada, young age at entry to sex work has been found to heighten vulnerability to physical and sexual violence victimisation in the context of prostitution, and relates to a two to fourfold increase in HIV infection. Although HIV risk reduction among adult female sex workers has been a major focus of HIV prevention efforts across the globe, no public health interventions, to date, have addressed the increased hazards and HIV risk faced by adolescent female sex workers. Beyond the structural barriers that limit access to this vulnerable group, historical tensions between HIV prevention and child protection agencies must be overcome in order to develop effective strategies to address this large scale yet little recognised human rights and HIV-related crisis.

  12. Condom utilization and sexual behavior of female sex workers in ...

    African Journals Online (AJOL)

    People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. Methods: A quantitative ...

  13. Male sex workers in Córdoba, Argentina: sociodemographic characteristics and sex work experiences

    Directory of Open Access Journals (Sweden)

    Mariño Rodrigo

    2003-01-01

    Full Text Available OBJECTIVE: To report on the sociodemographic characteristics and work experiences of 31 male sex workers (MSWs in the city of Córdoba, Argentina. METHODS: Information on each of the MSWs was collected using a questionnaire that covered his personal characteristics and his work background, self-assessed general health status, and use of health and social services. Scales were included in order to assess attitudes towards condom use, knowledge about safe sex, perceptions about the risk of getting HIV, individual self-efficacy, and locus of control. The questionnaire also asked each respondent to rank his level of agreement with interactive strategies for gaining client compliance with safe sex practices. RESULTS: In terms of their self-identity, out of the 30 MSWs who answered the question, 10 of them (33.3% self-identified as heterosexual and 9 (30% as bisexual. Alcohol and drug consumption and unsafe sexual practices were relatively low among the MSWs. Of the 31 MSWs responding, 21 of them (67.7% reported that they had been tested for HIV, but only 13 of them (41.9% said they had been vaccinated for either hepatitis A or hepatitis B. A variety of differences were found between the study's 17 street sex workers (sex workers who offer their services in public places such as streets and parks and the 14 independent sex workers (sex workers who are self-employed, advertise and manage their own business, and have an exclusive location for their commercial sex work. The street MSWs were younger and had less formal education. Independent MSWs were economically more settled, had been working longer in the sex industry, and were more comfortable about having sex with men. Independent MSWs were also more likely to report a gay sexual orientation and less likely to report using alcohol, marijuana, or other substances. CONCLUSIONS: The differences between street MSWs and independent MSWs are important since they could influence the negotiating of safer sex

  14. Female sex workers' empowerment strategies amid HIV-related socioeconomic vulnerabilities in Cameroon.

    Science.gov (United States)

    Cange, Charles W; LeBreton, Matthew; Saylors, Karen; Billong, Serge; Tamoufe, Ubald; Fokam, Pamella; Baral, Stefan

    2017-10-01

    Research has consistently demonstrated that female sex workers use a variety of empowerment strategies to protect one another and their families. This study examines the strategies Cameroonian sex workers employ to do so. In-depth interviews and focus-group discussions were conducted with 100 sex workers. Coded texts were analysed for recurring themes. Sex workers reported being concerned with physical violence and sexual assault and demands from authorities for bribes to avoid fines and/or imprisonment. Women described strategies such as 'looking out for' each other when faced with security threats. Many reported staying in sex work to provide for their children through education and other circumstances to allow them to lead a better life. Sex worker mothers reported not using condoms when clients offered higher pay, or with intimate partners, even when they understood the risk of HIV transmission to themselves. Concern for their children's quality of life took precedence over HIV-related risks, even when sex workers were the children's primary carers. A sex worker empowerment programme with a focus on family-oriented services could offer an effective and novel approach to increasing coverage of HIV prevention, treatment and care in Cameroon.

  15. From Client to Pimp: Male Violence against Female Sex Workers

    Science.gov (United States)

    Karandikar, Sharvari; Prospero, Moises

    2010-01-01

    The present study explores intimate partner violence (IPV) among female sex workers from the red-light area based in Mumbai, India. Using a grounded theory approach, in-depth interviews were conducted with ten sex workers to explore their experiences of IPV in the context of commercial sex work. Narratives were analyzed and themes constructed. A…

  16. Enabling Sex Workers to Document Violence (India and Cambodia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Digital advocacy techniques have been used to document human rights abuses and communicate these to people of influence, but these have yet to be systematically applied to sex worker-led advocacy. This project is based on the assumption that enabling sex workers to document violations and amplify their advocacy ...

  17. Female street sex workers in Hong Kong: moving beyond sexual health.

    Science.gov (United States)

    Wong, William C W; Holroyd, Eleanor A; Gray, Ann; Ling, Davina C

    2006-05-01

    For many years, the sex industry in Hong Kong has appeared to be an integral and ever-expanding component of the city's sociocultural and economic structure. Accordingly, the physical and psychological health of sex workers is becoming an increasing concern for the workers themselves, the public, and government policy. A cross-sectional survey on the quality of life (World Health Organization Quality of Life [WHOQOL]) of female sex workers (FSWs) in Hong Kong was used to investigate the physical and psychological well-being of street FSWs, and the results were compared with those of non-sex-working Hong Kong women after adjusting for age, educational level, marital status, and health status. The 89 FSWs surveyed scored significantly lower on QOL--WHOQOL-BREF (HK)--measures compared with the non-sex-working women. One common aspect among these sex workers was their negative view of themselves and of life. Many sex workers were at risk of being abused while at work, and many women worked without legal protection. Most of the women surveyed engaged in sex work to support their families. Because their income was often insufficient, some of their needs, especially those concerning health, were often neglected. The low WHOQOL-BREF (HK) scores in FSWs indicate feelings of helplessness and entrapment, which may well result in detrimental effects on sex workers' health, self-esteem, and confidence when asserting their basic rights, such as access to healthcare and safety. The conclusion highlights the vulnerability of this population to apparent weaknesses in Hong Kong's current healthcare system.

  18. Beyond Compassion: Children of Sex Workers in Kolkata's Sonagachi

    Science.gov (United States)

    Sircar, Oishik; Dutta, Debolina

    2011-01-01

    In 2005, children of sex workers from Kolkata's Sonagachi red-light district formed their own collective, Amra Padatik ("We are Foot Soldiers"), to work for gaining dignity for their mothers and claiming their own rights as children of sex workers. In this article the authors speak to AP's founder members to demystify the culture of fear…

  19. Exploring the Context and Implementation of Public Health Regulations Governing Sex Work: A Qualitative Study with Migrant Sex Workers in Guatemala.

    Science.gov (United States)

    Rocha-Jiménez, Teresita; Brouwer, Kimberly C; Silverman, Jay G; Morales-Miranda, Sonia; Goldenberg, Shira M

    2017-10-01

    Public health regulations practices surrounding sex work and their enforcement can have unintended consequences for HIV and sexually transmitted infection (STI) prevention and care among sex workers. This analysis was based on qualitative in-depth (n = 33) and focus groups interviews (n = 20) conducted with migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, and explored the implementation of sex work regulations and related consequences for HIV prevention and care among migrant sex workers. Sex work regulations were found to have health-related benefits (e.g., access to HIV/STI testing) as well as negative impacts, such as abuse by police and harassment, detention/deportation of migrant sex workers. Whereas public health regulations may improve access to HIV/STI testing, their implementation may inadvertently jeopardize sex workers' health through unintended negative consequences. Non-coercive, evidence-based public health and sex work policies and programs are needed to expand access to HIV/STI prevention and care among migrant sex workers, while protecting their dignity and human rights.

  20. Structure and agency: reflections from an exploratory study of Vancouver indoor sex workers.

    Science.gov (United States)

    Bungay, Vicky; Halpin, Michael; Atchison, Chris; Johnston, Caitlin

    2011-01-01

    Sex work research continues to be characterised by debates around decriminalization. Central to these debates are claims about the agency of those involved in the sex trade. Some researchers argue that individuals involved in the sex trade are victims of structural and interpersonal constraint, whilst others depict them as workers exercising choice. Drawing on structure-agency theory, a review of legal and media accounts of the sex trade and qualitative interviews with 21 indoor sex workers in Vancouver, Canada, we argue that both of these perspectives are insufficient. Rather than reducing the sex trade to part of a binary, we suggest that it is necessary to analyse sex work through the complex interplay of both structure and agency. Specifically, structural analyses undercover the numerous ways that sex workers are controlled, observed and influenced whilst agency perspectives elicit the means that sex workers continue to exercise control in spite of disadvantage. While we do not finalise decriminalisation debates, we do critique current Canadian laws for the lack of responsiveness to the lives of sex workers and their exploitative and contradictory stance on sex work.

  1. High burden of STI and HIV in male sex workers working as internet escorts for men in an observational study: a hidden key population compared with female sex workers and other men who have sex with men

    OpenAIRE

    Verhaegh-Haasnoot, Amanja; Dukers-Muijrers, Nicole H. T. M.; Hoebe, Christian J. P. A.

    2015-01-01

    Background Male sex work in the western countries has changed, including now a subculture of male sex workers who have paid sex with men arranged for via the internet. The men involved in this subculture do not easily identify themselves as sex workers nor as homosexual, and are therefore missed by regular health care and public health interventions. These male sex workers may form a hidden key population for sexually transmitted infections (STIs) and HIV, bridging towards other persons outsi...

  2. Sex Worker Political Development in Costa Rica: from Informal Solidarities to Formal Organizing

    OpenAIRE

    Koné, Mzilikazi

    2014-01-01

    While many accounts of sex workers presume they lack agency, this project studies how people framed as powerless assert positions of power through social interactions, friendships, and organizing. I examine sex workers' politics and power from the perspective of a subset of female Costa Rican sex workers. I engage specifically with sex workers who organize, in order to theorize everyday experiences of politics, including solidarity building and acts of accommodation or resistance vis-à-vis st...

  3. HIV frequency among female sex workers in Imbituba, Santa Catarina, Brazil

    Directory of Open Access Journals (Sweden)

    Fabiana Schuelter Trevisol

    Full Text Available We examined HIV frequency and probable risk factors among female sex workers in the port city of Imbituba, Southern Brazil. From December 2003 through February 2004, 90 female sex workers were interviewed in order to investigate demographic, socioeconomic and behavioral variables related to HIV infection. A blood sample of each woman was also collected to test for HIV antibodies. Six (6.7% of the sex workers were HIV-positive; the significantly-correlated risk factors were the daily number of clients (p = 0.008, the use of inhaled illicit drugs by the sex workers (P = 0.053 and by their clients (p = 0.005, and the lack of condom use in sexual relations (p = 0.015. The HIV infection rate in these sex workers was higher than that in the general population and similar to that found in other studies made with Brazilian populations presenting the same characteristics. This highlights the need for preventative measures, especially in this port area, in order to reduce transmission and to deter the introduction and dissemination of HIV.

  4. Access to and utilisation of healthcare services by sex workers at ...

    African Journals Online (AJOL)

    be very high in urban areas,[2] with overall odds of infection being ... North Star Alliance (North Star) is a public-private partnership ... To inform future service development for sex workers and describe North Star's ... workers at truck-stop clinics in South Africa: A case study ..... Global Network of Sex Workers Projects. Global ...

  5. Tuberculosis screening among Bolivian sex workers and their children.

    Science.gov (United States)

    Chiang, Silvia S; Paulus, Jessica K; Huang, Chi-Cheng; Newby, P K; Castellón Quiroga, Dora; Boynton-Jarrett, Renée; Antkowiak, Lara

    2015-06-01

    Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers' mandatory HIV screenings may be a cost-efficient disease-control strategy. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  6. Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

    Science.gov (United States)

    Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

    2012-01-01

    The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

  7. Male sex workers who sell sex to men also engage in anal intercourse with women: evidence from Mombasa, Kenya.

    Directory of Open Access Journals (Sweden)

    Priya Mannava

    Full Text Available To investigate self-report of heterosexual anal intercourse among male sex workers who sell sex to men, and to identify the socio-demographic characteristics associated with practice of the behavior.Two cross-sectional surveys of male sex workers who sell sex to men in Mombasa, Kenya.Male sex workers selling sex to men were invited to participate in surveys undertaken in 2006 and 2008. A structured questionnaire administered by trained interviewers was used to collect information on socio-demographic characteristics, sexual behaviors, HIV and STI knowledge, and health service usage. Data were analyzed through descriptive and inferential statistics. Bivariate logistic regression, after controlling for year of survey, was used to identify socio-demographic characteristics associated with heterosexual anal intercourse.From a sample of 867 male sex workers, 297 men had sex with a woman during the previous 30 days - of whom 45% did so with a female client and 86% with a non-paying female partner. Within these groups, 66% and 43% of male sex workers had anal intercourse with a female client and non-paying partner respectively. Factors associated with reporting recent heterosexual anal intercourse in bivariate logistic regression after controlling for year of survey participation were being Muslim, ever or currently married, living with wife only, living with a female partner only, living with more than one sexual partner, self-identifying as basha/king/bisexual, having one's own children, and lower education.We found unexpectedly high levels of self-reported anal sex with women by male sex workers, including selling sex to female clients as well as with their own partners. Further investigation among women in Mombasa is needed to understand heterosexual anal sex practices, and how HIV programming may respond.

  8. Risk practices and immunization against hepatitis B among female sex workers

    Directory of Open Access Journals (Sweden)

    Rosilane de Lima Brito Magalhães

    2016-01-01

    Full Text Available Objective: to identify the use of hepatitis B vaccine and risk practices among female sex workers. Methods: cross-sectional research using the Respondent Driven Sampling methodology. One-hundred and fifty-three sex workers were studied.Results: risk practices were related to the early onset of sexual activity, multiple partners with up to 17 clients per week 34 (22.2%, lack of use of condom 9 (5.9%, 124 (81.0% shared sharps and 53 (34.6% reported no vaccine against hepatitis B. Conclusion: sex workers found themselves exposed to various risk situations to the hepatitis B virus, due to the lack of immunization schedule, sexual precocity, multiple sex partners lack of use of condom, habit of sharing sharp objects. It is urgent to invest in health promotion with guidance on the importance of the vaccine, the adoption of protective measures and increased access of sex workers to health facilities.

  9. [Analysis of the risky behaviors among HIV positive female sex workers].

    Science.gov (United States)

    Wang, Jue; Jia, Manhong; Luo, Hongbing; Li, Youfang; Song, Lijun; Mei, Jingyuan; Ma, Yanling; Yang, Yanling; Lu, Ran; Wang, Ling; Zhang, Renzhong; Pan, Songfeng; Li, Zhiqing; Lu, Lin

    2015-11-01

    To analyze the characteristics of risky behaviors among different age groups of HIV positive female sex workers, and to explore the strengthening of their management. From January to June 2014, 22 814 female sex workers were investigated and tested HIV in 117 sentinel surveillance sites in Yunnan Province, and 181 were confirmed to be HIV antibody positive, who accepted questionnaire surveys. According to the age, the participants were divided into the HIV/AIDS and related risk behaviors characteristics of the two groups were obtained via questionnaire surveys among 181 HIV positive female sex workers, and in-depth qualitative interviews were conducted from among 12 HIV positive sex workers. HIV antibody positive rate was 0.8% (181), the age of the 181 subjects were (35.83 ± 9.17) years old, 76 cases (42.0%) were HIV, the proportion of AIDS awareness was 95.6% (173); the proportion of drug use among ≥ 35 years old age group was 51.4% (54), which was higher than that in HIV counseling and testing in the past year. The proportion of continuing to engage in sexual services over 5 years after HIV infection was 48.5% (51/105) and the proportion of receiving antiretroviral treatment was 69.5% (73/105) in ≥ 35 years old age group, which were higher than those in the HIV positive female sex workers found that regular clients, not consistent use of condoms were the main cause of no condom use. Economic and livelihood factors are important reasons for continuing to engage in sexual services among HIV positive sex workers. HIV positive sex workers still have high risk behaviors including continuing to engage in commercial sexual service and no condom use after knowing their HIV infection status, and the proportion of using drugs in the ≥ 35 years old group was higher than that in < 35 years old group.

  10. Increased and Mistimed Sex Hormone Production in Night Shift Workers

    OpenAIRE

    Papantoniou, K; Pozo, OJ; Espinosa, A; Marcos, J; Castano-Vinyals, G; Basagana, X; Juanola Pages, E; Mirabent, J; Martin, J; Such Faro, P; Gasco Aparici, A; Middleton, B; Skene, DJ; Kogevinas, M

    2015-01-01

    BACKGROUND: Night shift work has been associated with an increased risk for breast and prostate cancer. The effect of circadian disruption on sex steroid production is a possible underlying mechanism, underinvestigated in humans. We have assessed daily rhythms of sex hormones and melatonin in night and day shift workers of both sexes. METHODS: We recruited 75 night and 42 day workers, ages 22 to 64 years, in different working settings. Participants collected urine samples from all voids over ...

  11. The Typology of Female Sex Workers in Dar-es-Salaam ...

    African Journals Online (AJOL)

    Objective: To establish the categories of female sex workers in Dar es Salaam. Methods: We conducted in depth-interviews with 32 female sex workers (FSWs) in five geographic areas of Dar-es-Salaam known to be the primary residential and working places, three local government leaders in three of the five areas known ...

  12. Estimation of the size of the female sex worker population in Rwanda using three different methods.

    Science.gov (United States)

    Mutagoma, Mwumvaneza; Kayitesi, Catherine; Gwiza, Aimé; Ruton, Hinda; Koleros, Andrew; Gupta, Neil; Balisanga, Helene; Riedel, David J; Nsanzimana, Sabin

    2015-10-01

    HIV prevalence is disproportionately high among female sex workers compared to the general population. Many African countries lack useful data on the size of female sex worker populations to inform national HIV programmes. A female sex worker size estimation exercise using three different venue-based methodologies was conducted among female sex workers in all provinces of Rwanda in August 2010. The female sex worker national population size was estimated using capture-recapture and enumeration methods, and the multiplier method was used to estimate the size of the female sex worker population in Kigali. A structured questionnaire was also used to supplement the data. The estimated number of female sex workers by the capture-recapture method was 3205 (95% confidence interval: 2998-3412). The female sex worker size was estimated at 3348 using the enumeration method. In Kigali, the female sex worker size was estimated at 2253 (95% confidence interval: 1916-2524) using the multiplier method. Nearly 80% of all female sex workers in Rwanda were found to be based in the capital, Kigali. This study provided a first-time estimate of the female sex worker population size in Rwanda using capture-recapture, enumeration, and multiplier methods. The capture-recapture and enumeration methods provided similar estimates of female sex worker in Rwanda. Combination of such size estimation methods is feasible and productive in low-resource settings and should be considered vital to inform national HIV programmes. © The Author(s) 2015.

  13. Rates of advertised condomless sex in the online profiles of private sex workers: a cross-sectional study.

    Science.gov (United States)

    Blackledge, Edjoni; Thng, Caroline; McIver, Ruthy; McNulty, Anna

    2018-02-01

    This study aimed to assess the level of condomless sex advertised online by private sex workers (PSW) in Sydney. In 2015, 750 online profiles of PSW, including 339 female, 53 male and 39 transgender PSWs, were reviewed. It was found that PSWs advertise protected anal and vaginal sex. However, 50% of female PSW advertised condomless oral sex. Age less than 25 years was associated with advertised condomless oral sex (odds ratio 1.56; 95% confidence interval 1.03-2.37; P=0.037). Online platforms are widely used for advertising, especially by female PSWs. Levels of condom use advertised reflect that of other studies of sex workers in Sydney.

  14. Agency, lapse in condom use and relationship intimacy among female sex workers in Jamaica.

    Science.gov (United States)

    Bailey, Althea E; Figueroa, John Peter

    2018-05-01

    This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.

  15. Potential impact of pre-exposure prophylaxis for female sex workers and men who have sex with men in Bangalore, India: a mathematical modelling study.

    Science.gov (United States)

    Mitchell, Kate M; Prudden, Holly J; Washington, Reynold; Isac, Shajy; Rajaram, Subramanian P; Foss, Anna M; Terris-Prestholt, Fern; Boily, Marie-Claude; Vickerman, Peter

    2016-01-01

    In Bangalore, new HIV infections of female sex workers and men who have sex with men continue to occur, despite high condom use. Pre-exposure prophylaxis (PrEP) has high anti-HIV efficacy for men who have sex with men. PrEP demonstration projects are underway amongst Indian female sex workers. We estimated the impact and efficiency of prioritizing PrEP to female sex workers and/or men who have sex with men in Bangalore. A mathematical model of HIV transmission and treatment for female sex workers, clients, men who have sex with men and low-risk groups was parameterized and fitted to Bangalore data. The proportion of transmission attributable (population attributable fraction) to commercial sex and sex between men was calculated. PrEP impact (infections averted, life-years gained) and efficiency (life-years gained/infections averted per 100 person-years on PrEP) were estimated for different levels of PrEP adherence, coverage and prioritization strategies (female sex workers, high-risk men who have sex with men, both female sex workers and high-risk men who have sex with men, or female sex workers with lower condom use), under current conditions and in a scenario with lower baseline condom use amongst key populations. Population attributable fractions for commercial sex and sex between men have declined over time, and they are predicted to account for 19% of all new infections between 2016 and 2025. PrEP could prevent a substantial proportion of infections amongst female sex workers and men who have sex with men in this setting (23%/27% over 5/10 years, with 60% coverage and 50% adherence), which could avert 2.9%/4.3% of infections over 5/10 years in the whole Bangalore population. Impact and efficiency in the whole population was greater if female sex workers were prioritized. Efficiency increased, but impact decreased, if only female sex workers with lower condom use were given PrEP. Greater impact and efficiency was predicted for the scenario with lower condom use

  16. The job satisfaction of female sex workers working in licensed brothels in Victoria, Australia.

    Science.gov (United States)

    Bilardi, Jade E; Miller, Amanda; Hocking, Jane S; Keogh, Louise; Cummings, Rosey; Chen, Marcus Y; Bradshaw, Catriona S; Fairley, Christopher K

    2011-01-01

    Previous studies have examined sex workers' attitudes to work but not their levels of job satisfaction compared with other occupations. The job satisfaction levels and standards of living of sex workers in licensed brothels in Victoria were compared with Australian women. Responses to a questionnaire that included questions about sex work and their "most likely alternative job." Survey data was compared with identical questions from the Households, Income and Labour Dynamics in Australia Survey. A structured survey was undertaken with sex workers in Victoria attending a a sexual health service. Of the 112 sex workers who agreed to participate in the study, 85 (76%) completed the survey. The median years women had been working as sex workers was three (range 0.1-18). The main reasons women started sex work was because "they needed the money" (69%), were attracted to the flexible hours (44%) or had a particular goal in mind (43%). The two biggest concerns women had about sex work were their safety (65%) and the risk of sexually transmitted infections (65%). When compared with the median job satisfaction scores of Australian women working in sex workers' "most likely alternative jobs," 50% of sex workers reported a higher median satisfaction score for sex work in relation to hours worked, 47% in relation to flexibility, 43% in relation to total pay, 26% in relation to job security, 19% in relation to the work itself, and 25% in relation to overall job satisfaction. Women reported that they primarily do sex work for financial gain although a significant minority prefer it to other work they would be likely to do. These results should be interpreted in the context that the presence of personality disorders that are common among sex workers were not measured in this study. © 2010 International Society for Sexual Medicine.

  17. Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers.

    Science.gov (United States)

    Suryawanshi, Dipak; Bhatnagar, Tarun; Deshpande, Sucheta; Zhou, Weiwei; Singh, Pankaj; Collumbien, Martine

    2013-01-01

    It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients' consistent condom use with FSW. Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks.

  18. Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh.

    Science.gov (United States)

    Katz, Karen R; McDowell, Misti; Green, Mackenzie; Jahan, Shamim; Johnson, Laura; Chen, Mario

    2015-12-01

    Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.

  19. Social cohesion, social participation, and HIV related risk among female sex workers in Swaziland.

    Directory of Open Access Journals (Sweden)

    Virginia A Fonner

    Full Text Available Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317. Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR] = 2.25, 95% confidence interval [CI]: 1.30-3.90 and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36-4.03 and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13-3.51, and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33-0.91. Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland.

  20. Social Cohesion, Social Participation, and HIV Related Risk among Female Sex Workers in Swaziland

    Science.gov (United States)

    Fonner, Virginia A.; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E.; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR]  = 2.25, 95% confidence interval [CI]: 1.30–3.90) and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36–4.03) and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13–3.51), and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33–0.91). Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland. PMID:24498125

  1. Social cohesion, social participation, and HIV related risk among female sex workers in Swaziland.

    Science.gov (United States)

    Fonner, Virginia A; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR] = 2.25, 95% confidence interval [CI]: 1.30-3.90) and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36-4.03) and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13-3.51), and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33-0.91). Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland.

  2. Enabling Sex Workers to Document Violence (India and Cambodia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In most societies, sex work is highly stigmatized and sex workers are subject to blame, disapproval and discrimination. As a result, violence against individuals involved in sex work is seldom visible and, in some contexts, even condoned. Hence, there are few sources of reliable, ethical and confidential data on violence ...

  3. THE LANCET SERIES ON HIV IN SEX WORKERS; PAPER 4 BURDEN AND HIV IMPACT OF HUMAN RIGHTS VIOLATIONS AGAINST SEX WORKERS

    Science.gov (United States)

    Decker, Michele R.; Crago, Anna-Louise; Ka Hon Chu, Sandra; Sherman, Susan G.; Saraswathi Seshu, Meena; Buthelezi, Kholi; Dhaliwal, Mandeep; Beyrer, Chris

    2015-01-01

    We reviewed evidence from over 800 studies and reports on the burden and HIV impact of human rights abuses against sex workers across policy climates. Published research documents widespread abuses of human rights perpetrated by both state and non-state actors. Such violations facilitate HIV vulnerability, both directly and indirectly, and undermine effective HIV prevention and intervention efforts. Violations include homicide, physical and sexual violence from law enforcement, clients and intimate partners, unlawful arrest and detention, discrimination in accessing health services, and forced HIV testing. Abuses occur across all policy regimes, though most profoundly so where sex work is criminalized through punitive law. Protection of sex workers’ human rights is critical to respect, protect and fulfill human rights, and to improve their health and wellbeing. Findings affirm the value of rights-based HIV responses for sex workers, and underscore the obligation of states to uphold the rights of this marginalized population. PMID:25059943

  4. Modelling information exchange in worker-queen conflict over sex allocation

    NARCIS (Netherlands)

    Pen, I.R.; Taylor, P.D.

    2005-01-01

    We investigate the conflict between queen and worker over sex allocation, specifically the allocation of the queen's eggs between workers and reproductives and the allocation of the reproductive eggs between male and female. In contrast to previous models, we allow workers to observe and use

  5. Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers.

    Directory of Open Access Journals (Sweden)

    Dipak Suryawanshi

    Full Text Available BACKGROUND: It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. METHODS: The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040. The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM to estimate the average treatment effect on treated (ATT of intervention messages on clients' consistent condom use with FSW. RESULTS: Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%. Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%, and highest among men soliciting less visible sex workers (70%. Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001 and among men soliciting other more hidden FSW (ATT 17%; p=0.001. In Tamil Nadu no impact could be demonstrated. CONCLUSION: Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks.

  6. Innovative approaches to cervical cancer screening for sex trade workers: an international scoping review.

    Science.gov (United States)

    Thulien, Naomi S

    2014-03-01

    Female sex trade workers are among those at highest risk for developing and dying of cervical cancer, and yet many-particularly the most marginalized-are less likely than other women to be screened. This review summarizes global findings on innovative approaches to cervical cancer screening for female sex trade workers, highlights current gaps in the delivery of cervical cancer screening for female sex trade workers globally, and suggests areas for future research and policy development. A scoping review of peer-reviewed publications and grey literature was conducted. Medline (OVID), PubMed, EMBASE, and SCOPUS were searched for relevant studies written in English. There were no limitations placed on dates. Grey literature was identified by hand searching and through discussion with health care providers and community outreach workers currently working with sex trade workers. Twenty-five articles were deemed suitable for review. Articles detailing innovative ways for female sex trade workers to access cervical cancer screening were included. Articles about screening for sexually transmitted infections were also included if the findings could be generalized to screening for cervical cancer. Articles limited to exploring risk factors, knowledge, awareness, education, prevalence, and incidence of cervical cancer among sex trade workers were excluded from the review. Successful screening initiatives identified in the studies reviewed had unconventional hours of operation, understood the difference between street-based and venue-based sex trade workers, and/or used peers for outreach. Two significant gaps in health care service delivery were highlighted in this review: the limited use of unorthodox hours and the nearly exclusive practice of providing sexually transmitted infection screening for female sex trade workers without cervical cancer screening. In addition, although street-based (as opposed to venue-based) sex trade workers are likely at higher risk for

  7. Risk factors for sexually transmitted diseases among sex workers in the interior of Piaui, Brazil

    Directory of Open Access Journals (Sweden)

    Jardeliny Corrêa da Penha

    Full Text Available OBJECTIVE: To identify the risk factors for STD among female sex workers and the characteristics of this population, and to verify the association between condom use by their male partners and clients. METHOD: Cross-sectional and correlational study conducted with 73 sex workers registered at the Sex Workers´ Association of the municipality of Picos -PI, Brazil. Data were collected in September and October 2010 using a questionnaire to obtain sociodemographic information and the participants´ background in the sex industry. Ethical aspects were observed. RESULTS: There was no significant association between most of the sociodemographic variables and background in the sex industry and condom use by male partners or clients. However, there was a significant association with years in the sex industry (p = 0.029. Sex workers who had been in the industry for the longest used condoms for protection against sexually transmitted diseases. CONCLUSION: It is essential to create health promotion strategies that observe the real-life experiences of sex workers.

  8. The Loss of Boystown and Transition to Online Sex Work: Strategies and Barriers to Increase Safety Among Men Sex Workers and Clients of Men.

    Science.gov (United States)

    Argento, Elena; Taylor, Matthew; Jollimore, Jody; Taylor, Chrissy; Jennex, James; Krusi, Andrea; Shannon, Kate

    2016-06-28

    Men sex workers in Vancouver have largely transitioned from street to online solicitation coinciding with losing "Boystown," the main outdoor sex work stroll for men. This article explores strategies and barriers to increase safety among men and trans sex workers and clients of men in Vancouver, Canada. Qualitative interviews were conducted (2012-2013) with 61 self-identifed men who currently buy and/or sell sex in a community-based research project known as CHAPS (Community Health Assessment of Men Who Purchase and Sell Sex). Drawing on a socioecological framework, thematic analysis of interview transcripts was conducted utilizing ATLAS.ti 7 software among men (39 workers; 8 buyers). Narratives indicate that gentrification and urban planning led to social isolation and loss of social support networks among men in the sex industry. Concurrently, the restructuring of sex work to online increased workers' safety and control. Narratives reveal how the Internet can provide greater opportunities to negotiate terms of sex work and enhanced screening using webcams, reducing risks of violence, stigma, and police harassment for both workers and clients compared with the street. This study highlights how losing Boystown led to a loss of community and solidarity: key protective measures for sex workers. Online solicitation increased workers' capacity to screen prospective clients and prevent violence. Recent legal reforms in Canada to further criminalize sex work raise significant concern for human rights and health of individuals in the sex industry, and point to the critical need to include voices of men and trans sex workers and buyers in policy discussions. © The Author(s) 2016.

  9. Correlates of HIV infection among street-based and venue-based sex workers in Vietnam.

    Science.gov (United States)

    Le, Thuy Tc; Nguyen, Quoc C; Tran, Ha Tt; Schwandt, Michael; Lim, Hyun J

    2016-10-01

    Commercial sex work is one of the driving forces of the HIV epidemic across the world. In Vietnam, although female sex workers (FSWs) carry a disproportionate burden of HIV, little is known about the risk profile and associated factors for HIV infection among this population. There is a need for large-scale research to obtain reliable and representative estimates of the measures of association. This study involved secondary data analysis of the 'HIV/STI Integrated Biological and Behavioral Surveillance' study in Vietnam in 2009-2010 to examine the correlates of HIV among FSWs. Data collected from 5298 FSWs, including 2530 street-based sex workers and 2768 venue-based sex workers from 10 provinces in Vietnam, were analyzed using descriptive statistics and bivariate and multivariate logistic regression analyses. HIV prevalence among the overall FSW population was 8.6% (n = 453). However, when stratified by FSW subpopulations, HIV prevalence was 10.6% (n = 267) for street-based sex workers and 6.7% (n = 186) for venue-based sex workers. Factors independently associated with HIV infection in the multivariate analysis, regardless of sex work types, were injecting drug use, high self-perceived HIV risk, and age ≥ 25 years. Additional factors independently associated with HIV risk within each FSW subpopulation included having ever been married among street-based sex workers and inconsistent condom use with clients and having sex partners who injected drugs among venue-based sex workers. Apart from strategies addressing modifiable risk behaviours among all FSWs, targeted strategies to address specific risk behaviours within each FSW subpopulation should be adopted. © The Author(s) 2016.

  10. Drug use and risk behaviours among injecting drug users: a comparison between sex workers and non-sex workers in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Breen Courtney

    2005-06-01

    Full Text Available Abstract Background This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU who report engaging in sex work for money or drugs and regular injecting drug users who do not. Methods Cross sectional data collected from regular IDU interviewed as part of the New South Wales (NSW Illicit Drug Reporting System (IDRS in 2003 were analysed. Results IDU who reported engaging in sex work were more likely to be female, and identify as being of Aboriginal and/or Torres Strait Islander descent. They initiated injecting drug use at a significantly younger age and were more likely to report injection related problems than IDU who had not engaged in sex work. There were no differences in the drug classes used, but findings suggested that the sex workers tended to be more frequent users of crystalline methamphetamine (ice and benzodiazepines. Conclusion The similarities between these groups were more striking than the differences. Further research, examining a larger sample is needed to clarify whether injecting drug users who are sex workers have heavier use patterns.

  11. Sex-specific inhibition and stimulation of worker-reproductive transition in a termite

    Science.gov (United States)

    Sun, Qian; Haynes, Kenneth F.; Hampton, Jordan D.; Zhou, Xuguo

    2017-10-01

    In social insects, the postembryonic development of individuals exhibits strong phenotypic plasticity in response to the environment, thus generating the caste system. Different from eusocial Hymenoptera, in which queens dominate reproduction and inhibit worker fertility, the primary reproductive caste in termites (kings and queens) can be replaced by neotenic reproductives derived from functionally sterile individuals. Feedback regulation of nestmate differentiation into reproductives has been suggested, but the sex specificity remains inconclusive. In the eastern subterranean termite, Reticulitermes flavipes, we tested the hypothesis that neotenic reproductives regulate worker-reproductive transition in a sex-specific manner. With this R. flavipes system, we demonstrate a sex-specific regulatory mechanism with both inhibitory and stimulatory functions. Neotenics inhibit workers of the same sex from differentiating into additional reproductives but stimulate workers of the opposite sex to undergo this transition. Furthermore, this process is not affected by the presence of soldiers. Our results highlight the reproductive plasticity of termites in response to social cues and provide insights into the regulation of reproductive division of labor in a hemimetabolous social insect.

  12. Decreasing Human Trafficking through Sex Work Decriminalization.

    Science.gov (United States)

    Albright, Erin; D'Adamo, Kate

    2017-01-01

    In order to decrease human trafficking, health care workers should support the full decriminalization of prostitution. Similar to trafficking in other forms of labor, preventing trafficking in the sex trade requires addressing the different forms of marginalization that create vulnerable communities. By removing punitive laws that prevent reporting of exploitation and abuse, decriminalization allows sex workers to work more safely, thereby reducing marginalization and vulnerability. Decriminalization can also help destigmatize sex work and help resist political, social, and cultural marginalization of sex workers. © 2017 American Medical Association. All Rights Reserved.

  13. Poverty as a contextual factor affecting sexual health behavior among female sex workers in India.

    Science.gov (United States)

    Dasgupta, Satarupa

    2013-06-01

    A thorough understanding of the environmental and structural factors that precipitate unsafe sexual practices is necessary for HIV/AIDS-prevention research among high-risk population groups like commercial sex workers. I examined how poverty contextualizes sexual health behavior, including condom compliance among commercial female sex workers in a red light district in Calcutta, India. For my research I did an ethnographic study and conducted in-depth interviews of 37 commercial female sex workers. I found that poverty, instead of serving as a catalyst for poor health choices among sex workers, acted as an impetus for pursuing safe sex practices and remaining healthy. The results indicate that sex work, poverty, and health do not always have a paradoxical relationship.

  14. HIV prevention interventions for young male commercial sex workers.

    Science.gov (United States)

    Ballester-Arnal, R; Gil-Llario, M D; Salmeron-Sánchez, P; Giménez-García, C

    2014-03-01

    The sex industry, where men sell sexual services to other men or women, has grown in recent years. These men who offer sexual services are particularly vulnerable to HIV infection due to such factors as: frequency of risky sexual practices, number of sex partners, drug-taking, prevalence of sexually-transmitted infections (STI) and their specific situation of social exclusion which may hinder access to health services. These multi-faceted realities faced by sex workers explain the burgeoning interest in new avenues of scientific research. There are too few preventive programs however aimed at this population group and the studies that evaluate their effectiveness are fewer still. In this article we survey more recent studies on the difficulties of implementing programs for HIV prevention in male sex workers (MSW), as well as the studies that have gauged the impact of preventive programs in this group.

  15. Alcohol and condom use among HIV-positive and HIV-negative female sex workers in Nagaland, India.

    Science.gov (United States)

    Nuken, Amenla; Kermode, Michelle; Saggurti, Niranjan; Armstrong, Greg; Medhi, Gajendra Kumar

    2013-09-01

    This study examines the relationship between alcohol use, HIV status, and condom use among female sex workers in Nagaland, India. We analyzed data from a cross-sectional survey undertaken in 2009, using descriptive and multivariate statistics. Out of 417 female sex workers, one-fifth used alcohol daily and one-tenth were HIV-positive. HIV-positive female sex workers were more likely than HIV-negative female sex workers to consume alcohol daily (30.2% vs. 18.0%). HIV-positive daily alcohol users reported lower condom use at last sex with regular clients compared to HIV-positive non-daily alcohol users (46.2% vs. 79.3%), a relationship not evident among HIV-negative female sex workers. There is a need to promote awareness of synergies between alcohol use and HIV, and to screen for problematic alcohol use among female sex workers in order to reduce the spread of HIV.

  16. Cervical cancer screening in rural South Africa among HIV-infected migrant farm workers and sex workers

    Directory of Open Access Journals (Sweden)

    Omara Afzal

    2017-05-01

    We demonstrate successful integration of cervical cancer screening using VIA for HIV+ farm workers and sex workers into an existing HIV treatment and prevention clinic in rural South Africa, addressing and treating abnormal results promptly.

  17. Anal sexual experience and HIV risk awareness among female sex workers in Dire Dawa, eastern Ethiopia.

    Science.gov (United States)

    Mazeingia, Yohannes Teka; Olijjira, Lemessa; Dessie, Yadeta

    2017-01-01

    Female sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia. Qualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis. Female sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers' misperception and risk anal sexual experience. Female sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk

  18. Perspectives on condom breakage: a qualitative study of female sex workers in Bangalore, India.

    Science.gov (United States)

    Gurav, Kaveri; Bradley, Janet; Chandrashekhar Gowda, G; Alary, Michel

    2014-01-01

    A qualitative study was conducted to obtain a detailed understanding of two key determinants of condom breakage - 'rough sex' and poor condom fit - identified in a recent telephone survey of female sex workers, in Bangalore, India. Transcripts from six focus-group discussions involving 35 female sex workers who reported condom breakage during the telephone survey were analysed. Rough sex in different forms, from over-exuberance to violence, was often described by sex workers as a result of clients' inebriation and use of sexual stimulants, which, they report, cause tumescence, excessive thrusting and sex that lasts longer than usual, thereby increasing the risk of condom breakage. Condom breakage in this setting is the result of a complex set of social situations involving client behaviours and power dynamics that has the potential to put the health and personal lives of sex workers at risk. These findings and their implications for programme development are discussed.

  19. Senegal: where "card-carrying" sex workers are legal.

    Science.gov (United States)

    1995-06-01

    An estimated 1.5% of Senegal's 5 million adult population is HIV-seropositive, with 3000 people having already died of AIDS-related illnesses. Although 75% of those with AIDS are men, women comprise the majority of people infected with HIV. This latter phenomenon is most likely the result of men having become infected before women because of the former's greater degree of travel relative to women. Infection with HIV-2 accounts for 70% of those with HIV, but for only 30% of AIDS cases. HIV-1 is, however, becoming a growing problem since it seems to be transmitted more easily and develop into AIDS more quickly. 15% of prostitutes in Senegal are HIV-seropositive compared to more than 50% of comparable subgroups in most African countries. Experts cannot say for sure why Senegal has a comparatively low rate of HIV, but several factors have been posited as explanations. The comparatively low rate of infection could be related to the long distance between Senegal and the HIV-1 epicenters of east and central Africa, the ability of HIV-2 infection to help the body fight off HIV-1, the strong Islamic influence which has made male circumcision universal thus reducing the risk of contracting HIV, the provision of AIDS awareness and prevention early in the epidemic, and the government's permissive approach to commercial sex. This latter factor is probably the most important related to the current status of HIV/AIDS in Senegal. It has been legal since 1966 to sell sex as long as the sex worker is registered, over 21 years old, has a regular medical check-up, and can present an up-to-date medical report card to the police upon request. This approach was established by then-president Senghor to reduce the incidence and prevalence of sexually transmitted diseases (STD). Registered sex workers since 1986 have been tested for HIV, advised on how to avoid infection, and given free condoms. In anonymous questionnaires, 70-75% of all Dakar's official sex workers reported always using

  20. Social Support and Sexual Risk Among Establishment-Based Female Sex Workers in Tijuana.

    Science.gov (United States)

    Choudhury, Shonali Mona; Toller Erausquin, Jennifer; Park, Kyuwon; Anglade, Debbie

    2015-08-01

    Social support can affect health outcomes of female sex workers. In this inductive feminist grounded theory study based on 20 in-depth interviews, we explore how establishment-based female sex workers in Tijuana perceive the impact of the connections among women on their lives and health. Participants elected to discuss the importance of social support from mothers, sisters, friends, and co-workers, and the empowering and disempowering aspects of these relationships. In previous studies, scholars demonstrated the efficacy of formal organization of female sex workers in promoting the mitigation of sexual and HIV risk. We show the importance of informal ties with other women. Some participants mentioned competitive relationships, others talked about cooperation and the desire for a venue to learn from one another. Social interactions with other women are especially empowering when female sex workers can openly engage in "woman talk" that may contribute to the mitigation of sexual and HIV risk. © The Author(s) 2015.

  1. HIV and sexual risk behavior among commercial sex workers in the Netherlands

    NARCIS (Netherlands)

    van Veen, Maaike G.; Götz, Hannelore M.; van Leeuwen, Petra A.; Prins, Maria; van de Laar, Marita J. W.

    2010-01-01

    In 2002-2005, a cross-sectional study to assess the potential for HIV transmission was carried out among 557 female and male-to-female transgender commercial sex workers (CSW) in three cities in the Netherlands. Female CSW (F-CSW), drug-using female CSW (DU), and transgender sex workers were

  2. Female migrant sex workers in Moscow: gender and power factors and HIV risk.

    Science.gov (United States)

    Weine, Stevan; Golobof, Alexandra; Bahromov, Mahbat; Kashuba, Adrianna; Kalandarov, Tohir; Jonbekov, Jonbek; Loue, Sana

    2013-01-01

    This study aimed to build formative knowledge regarding HIV risks in female migrant sex workers in Moscow, focusing on gender and power. This was a collaborative ethnographic study, informed by the theory of gender and power, in which researchers conducted minimally structured interviews with 24 female sex workers who were migrants to Moscow and who provided sexual services to male migrant laborers. Overall, the female migrant sex workers engaged in HIV risk behaviors and practiced inadequate HIV protection with their clients. These behaviors were shaped by gender and power factors in the realms of labor, behavior, and cathexis. In the labor realm, because some female migrants were unable to earn enough money to support their families, they were pushed or pulled into sex work providing service to male migrants. In the behavior realm, many female migrant sex workers were intimidated by their male clients, feared violence, and lacked access to women's health care and prevention. In the cathexis realm, many had a sense of shame, social isolation, emotional distress, and lacked basic HIV knowledge and prevention skills. To prevent HIV transmission requires addressing the gender and power factors that shape HIV/AIDS risks among female migrant sex workers through multilevel intervention strategies.

  3. Sex Role Attributions of American-Indian Women.

    Science.gov (United States)

    Portman, Tarrell Awe Agahe

    2001-01-01

    Examines the sex role attributes of American-Indian women as compared to a predominately White normative group using the short form of the Bem Sex Role Inventory. Results indicate a significant difference on the masculine subscale between the two groups with American-Indian women having higher scores. Provides implications for mental health…

  4. Effects of government registration on unprotected sex among female sex workers in Tijuana, Mexico

    Science.gov (United States)

    Sirotin, Nicole; Strathdee, Steffanie A.; Lozada, Remedios; Abramovitz, Daniela; Semple, Shirley J.; Bucardo, Jesús; Patterson, Thomas L.

    2010-01-01

    Background Sex work is partially regulated in Tijuana, but little is known of its health effects. A recent behavioral intervention among female sex workers (FSWs) decreased incidence of HIV/STIs by 40%. We evaluated effects of sex worker regulation on condom use among FSWs randomized to this intervention. Methods FSWs aged ≥18 years who reported unprotected sex with ≥1 client in the last 2 months and whether they were registered with Tijuana’s Municipal Health Department underwent a brief, theory-based behavioral intervention to increase condom use. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, C. trachomatis and N. gonorrhoeae. Negative binomial regression was used to determine the effect of registration on numbers of unprotected sex acts and cumulative HIV/STI incidence. Results Of 187 women, 83 (44%) were registered. Lack of registration was associated with higher rates of unprotected sex (rate ratio: 1.7, 95% CI: 1.2–2.3), compared to FSWs who were registered, after controlling for potential confounders. Conclusions Registration predicted increased condom use among FSWs enrolled in a behavioral intervention. Public health programs designed to improve condom use among FSWs may benefit from understanding the impact of existing regulation systems on HIV risk behaviors. PMID:20956076

  5. Effects of government registration on unprotected sex amongst female sex workers in Tijuana; Mexico.

    Science.gov (United States)

    Sirotin, Nicole; Strathdee, Steffanie A; Lozada, Remedios; Abramovitz, Daniela; Semple, Shirley J; Bucardo, Jesús; Patterson, Thomas L

    2010-11-01

    Sex work is partially regulated in Tijuana, but little is known of its health effects. A recent behavioural intervention amongst female sex workers (FSWs) decreased incidence of HIV/STIs by 40%. We evaluated effects of sex worker regulation on condom use amongst FSWs randomized to this intervention. FSWs aged ≥18 years who reported unprotected sex with ≥1 client in the last 2 months and whether they were registered with Tijuana's Municipal Health Department underwent a brief, theory-based behavioural intervention to increase condom use. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, Chlamydia trachomatis and Neisseria gonorrhoeae. Negative binomial regression was used to determine the effect of registration on numbers of unprotected sex acts and cumulative HIV/STI incidence. Of 187 women, 83 (44%) were registered. Lack of registration was associated with higher rates of unprotected sex (rate ratio: 1.7, 95% CI: 1.2-2.3), compared to FSWs who were registered, after controlling for potential confounders. Registration predicted increased condom use amongst FSWs enrolled in a behavioural intervention. Public health programmes designed to improve condom use amongst FSWs may benefit from understanding the impact of existing regulation systems on HIV risk behaviours. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Human rights violations against sex workers: burden and effect on HIV.

    Science.gov (United States)

    Decker, Michele R; Crago, Anna-Louise; Chu, Sandra K H; Sherman, Susan G; Seshu, Meena S; Buthelezi, Kholi; Dhaliwal, Mandeep; Beyrer, Chris

    2015-01-10

    We reviewed evidence from more than 800 studies and reports on the burden and HIV implications of human rights violations against sex workers. Published research documents widespread abuses of human rights perpetrated by both state and non-state actors. Such violations directly and indirectly increase HIV susceptibility, and undermine effective HIV-prevention and intervention efforts. Violations include homicide; physical and sexual violence, from law enforcement, clients, and intimate partners; unlawful arrest and detention; discrimination in accessing health services; and forced HIV testing. Abuses occur across all policy regimes, although most profoundly where sex work is criminalised through punitive law. Protection of sex workers is essential to respect, protect, and meet their human rights, and to improve their health and wellbeing. Research findings affirm the value of rights-based HIV responses for sex workers, and underscore the obligation of states to uphold the rights of this marginalised population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Government crackdown of sex work in China: responses from female sex workers and implications for their health.

    Science.gov (United States)

    Huang, Yingying; Pan, Suiming

    2014-01-01

    The Chinese Government periodically enforces anti-prostitution laws through regular police presence in red light districts and through the arrests of brothel managers and sex workers. One of the most intense crackdowns on prostitution occurred throughout China in 2010. Using the 'structure-agency' framework and ethnographic approach, this paper examines the influence of the 2010 government anti-prostitution crackdown on female sex workers (FSWs). We observed 10 red light districts (6 cities and 2 counties) and interviewed 107 FSWs, 26 managers and 37 outreach workers working with FSWs. The findings describe variations in police practices and diverse strategies adopted by FSWs in response to police actions. The strategies include: soliciting sex outside of establishments in less visible channels, increasing the mobility and flexibility of sex work, changing sexual practices, sharing knowledge of how to identify policemen disguised as male clients and building personal relationships with local police. Our study suggests that, rather than disappearing as a result of crackdowns, the terms and content of sex work changed as a result of the FSWs' responses to police practices. Some of these responses potentially increased the health risks associated with sex work, but others laid the foundation for an effective response to police practices.

  8. Government crackdown of sex work in China: Responses from female sex workers and implications for their health

    Science.gov (United States)

    Huang, Yingying; Pan, Suiming

    2015-01-01

    The Chinese Government periodically enforces anti-prostitution laws through regular police presence in red light districts and through the arrests of brothel managers and sex workers. One of the most intense crackdowns on prostitution occurred throughout China in 2010. Using the ‘structure-agency’ framework and ethnographic approach, this paper examines the influence of the 2010 government anti-prostitution crackdown on female sex workers (FSWs). We observed 10 red light districts (6 cities and 2 counties) and interviewed 107 FSWs, 26 managers and 37 outreach workers working with FSWs. The findings describe variations in police practices and diverse strategies adopted by FSWs in response to police actions. The strategies include: soliciting sex outside of establishments in less visible channels, increasing the mobility and flexibility of sex work, changing sexual practices, sharing knowledge of how to identify policemen disguised as male clients and building personal relationships with local police. Our study suggests that, rather than disappearing as a result of crackdowns, the terms and content of sex work changed as a result of the FSWs’ responses to police practices. Some of these responses potentially increased the health risks associated with sex work, but others laid the foundation for an effective response to police practices. PMID:25226069

  9. Prevalence of Pthirus pubis (Anoplura: Pediculidae) among sex workers in urban Jos, Nigeria.

    Science.gov (United States)

    Imandeh, N G

    1993-11-01

    Between May and October 1992, 374 sex workers comprising of 372 prostitutes and 2 homosexuals were examined for Pthirus pubis infestation. While none of the homosexuals was found to be infested, 52.69% of the prostitutes were infested with the highest and lowest infestation in the 40-49 year old group and 20-29 year old group respectively. The educational level was found to determine the extent of disease awareness among the sex workers. Questions are raised about the role of Pthirus pubis is AIDS transmission among sex workers.

  10. Social Cohesion, Social Participation, and HIV Related Risk among Female Sex Workers in Swaziland

    OpenAIRE

    Fonner, Virginia A.; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E.; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social ...

  11. Speaking of sex workers: How suppression of research has distorted the United States' domestic HIV response.

    Science.gov (United States)

    Forbes, Anna

    2015-05-01

    Sex workers remain a vulnerable population at risk for HIV acquisition and transmission. Research suggests that interventions at the individual level, such as condom distribution, are less effective in preventing HIV among sex workers than structural changes such as allowing safer work settings and reducing the harassment and abuse of sex workers by clients and police. In the US, HIV incidence has not declined in the last decade. This may be due in part to its policy of wilful ignorance about sex work, but the data to resolve the question simply do not exist. Political actions such as PEPFAR's prostitution pledge and a congressional campaign against "waste, fraud and abuse" in research are products of an ideological environment that suppresses research on HIV prevention and treatment needs of sex workers. Even basic prevalence data are missing because there is no "sex worker" category in the US National HIV Behavior Surveillance System. However, international efforts are taking a public health approach and are calling for decriminalization of sex work, as the most effective public health strategy for reducing HIV incidence among sex workers. Although such an approach is not yet politically feasible in the US, some urgent practical policy changes can be implemented to improve data collection and generation of evidence to support HIV prevention and treatment programs targeting sex workers. Copyright © 2015. Published by Elsevier Ltd.

  12. Causes of maternal and child mortality among Cambodian sex workers and their children: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Brian Willis

    2016-11-01

    Full Text Available Abstract Background To reach global and national goals for maternal and child mortality, countries must identify vulnerable populations, which includes sex workers and their children. The objective of this study was to identify and describe maternal deaths of female sex workers in Cambodia and causes of death among their children. Methods A convenience sample of female sex workers were recruited by local NGOs that provide support to sex workers. We modified the maternal mortality section of the 2010 Cambodia Demographic and Health Survey and collected reports of all deaths of female sex workers. For each death we ask the ‘sisterhood’ methodology questions to identify maternal deaths. For child deaths we asked each mother who reported the death of a child about the cause of death. We also asked all participants about the cause of deaths of children of other female sex workers. Results We interviewed 271 female sex workers in the four largest Cambodian cities between May and September 2013. Participants reported 32 deaths of other female sex workers that met criteria for maternal death. The most common reported causes of maternal deaths were abortion (n = 13;40% and HIV (n = 5;16%. Participants report deaths of 8 of their children and 50 deaths of children of other female sex workers. HIV was the reported cause of death for 13 (36% children under age five. Conclusion This is the first report of maternal deaths of sex workers in Cambodia or any other country. This modification of the sisterhood methodology has not been validated and did not allow us to calculate maternal mortality rates so the results are not generalizable, however these deaths may represent unrecognized maternal deaths in Cambodia. The results also indicate that children of sex workers in Cambodia are at risk of HIV and may not be accessing treatment. These issues require additional studies but in the meantime we must assure that sex workers in Cambodia and their

  13. Factors associated with HIV-1 infection among sex workers of Addis Ababa, Ethiopia

    NARCIS (Netherlands)

    Aklilu, M.; Messele, T.; Tsegaye, A.; Biru, T.; Mariam, D. H.; van Benthem, B.; Coutinho, R.; Rinke de Wit, T.; Fontanet, A.

    2001-01-01

    OBJECTIVE: To study the prevalence and risk factors for HIV infection among sex workers of Addis Ababa, Ethiopia. Design and methods: Cross-sectional survey on socio-demographic characteristics, behaviours, and HIV serological status of sex workers attending two health centres of Addis Ababa.

  14. Violence prevention and municipal licensing of indoor sex work venues in the Greater Vancouver Area: narratives of migrant sex workers, managers and business owners.

    Science.gov (United States)

    Anderson, Solanna; Jia, Jessica Xi; Liu, Vivian; Chattier, Jill; Krüsi, Andrea; Allan, Sarah; Maher, Lisa; Shannon, Kate

    2015-01-01

    Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing practices and licensing requirements increase sex workers' risk of violence and conflict with clients and result in heightened stress, an inability to rely on police support, lost income and the displacement of sex workers to more hidden informal work venues. Prohibitive licensing and policing practices prevent sex workers, managers and owners from adopting safer workplace measures and exacerbate health and safety risks for sex workers. This study provides critical evidence of the negative public health implications of prohibitive municipal licensing in the context of a criminalised and enforcement-based approach to sex work. Workplace safety recommendations include the decriminalisation of sex work and the elimination of disproportionately high fees for licences, criminal record restrictions, door lock restrictions, employee registration requirements and the use of police as licensing inspectors.

  15. Predictive factors of unprotected sex for female sex workers: first study in French Guiana, the French territory with the highest HIV prevalence.

    Science.gov (United States)

    Parriault, Marie-Claire; Basurko, Célia; Melle, Astrid Van; Gaubert-Maréchal, Emilie; Rogier, Stéphanie; Couppié, Pierre; Nacher, Mathieu

    2015-07-01

    French Guiana is the French territory that is most affected by HIV. AIDS incidence is much higher than in mainland France and sex work seems to be an important driver of the epidemic. The objective of this study was to describe consistent condom use among female sex workers with their clients and their intimate partners and to identify determinants of non-use of condoms. An HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey was conducted in 2009-2010 among sex workers in French Guiana. A total of 477 sex workers were interviewed. Female sex workers were more likely to use condoms with their clients (97%) than with their intimate partners (45%). The factors associated with non-consistent condom use with the intimate partner were having had an abortion, feeling at risk for HIV, not evaluating one's own risk for HIV, living as a couple, being Dominican, and not feeling comfortable asking intimate partners to use condoms. Although a high proportion of female sex workers declared using condoms with commercial partners, there is still room for improvement in the prevention of transmission with both commercial and intimate partners. © The Author(s) 2014.

  16. Male Sex Workers: Practices, Contexts, and Vulnerabilities for HIV acquisition and transmission

    Science.gov (United States)

    Baral, Stefan David; Friedman, M. Reuel; Geibel, Scott; Rebe, Kevin; Bozhinov, Borche; Diouf, Daouda; Sabin, Keith; Holland, Claire E.; Chan, Roy; Caceres, Carlos

    2015-01-01

    Summary Male sex workers (MSW) who sell/exchange sex for money or goods comprise an extremely diverse population across and within countries worldwide. Information characterizing their practices, contexts where they live, and their needs is very limited, as these men are generally included as subsets of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. MSW, regardless of their sexual orientation, mostly offer sex to men, and rarely identify as sex workers, using local or international terms instead. There is growing evidence of a sustained or increasing burden of HIV among some MSW in the context of the slowing global HIV pandemic. There are several synergistic facilitator spotentiating HIV acquisition and transmission among MSW, including biological, behavioural, and structural determinants. The criminalization and intersectional stigmas of same-sex practices, commercial sex, and HIV all increase HIV and STI risk for MSW and decrease their likelihood of accessing essential services. These contexts, taken together with complex sexual networks among MSW, define them as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights. PMID:25059939

  17. The presence and absence of sex workers' mothering

    DEFF Research Database (Denmark)

    Spanger, Marlene

    A number of studies demonstrate that some migrants sell sexual services as a survival strategy that allows them to provide for their children and for the family they have left behind. The entanglement of familial intimate relationships and the organisation of female sex work have been largely...... neglected in the literature on sex for sale. This chapter therefore examines how female migrants selling sexual services organise their mothering and the various ways in which their identities as single mothers, migrants, and sex workers intersect. Drawing on the literature of transnational motherhood...

  18. Perception of HIV prevention programs among Ayoreo sex workers in Bolivia.

    Science.gov (United States)

    López-Entrambasaguas, Olga María; Fernández-Sola, Cayetano; Granero-Molina, José

    2015-11-01

    The Ayoreo population constitutes one of Bolivia's most vulnerable ethnic groups in terms of HIV/AIDS. Being a woman, indigenous, and a sex worker signifies belonging to a high-risk group. The aim of this study is to explore the Ayoreo sex workers' and health agents' perceptions of HIV/AIDS prevention programs in order to identify variables that could influence their success or failure. This study used an ethnographic methodology that included participant observation and semistructured interviews. In the data collection, participant observation and semistructured interviews with sex workers and key informants were conducted. Three themes emerged from the inductive data analysis: health prevention efforts, cultural inadequacy of prevention programs, and the eventuality of interventions. We conclude that nursing can develop culturally-adequate HIV/AIDS prevention interventions and programs as well as promote health within these populations. © The Author(s) 2014.

  19. Entamoeba histolytica Infection in Female Sex Workers: A Matched Case-Control Study in Durango, Mexico.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sanchez-Anguiano, Luis Francisco; Hernandez-Tinoco, Jesus; Estrada-Martinez, Sergio; Perez-Alamos, Alma Rosa; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

    2017-07-01

    Infection with Entamoeba histolytica ( E. histolytica ) can be potentially transmitted by sexual contact. The seroepidemiology of E. histolytica in female sex workers has not been studied. The aim of the study was to determine whether E. histolytica is associated with the occupation of female sex work. In addition, the correlates of E. histolytica seroprevalence in female sex workers were also investigated. We performed an age- and gender-matched case-control study of 187 female sex workers and 374 women without sex work. Cases and controls were tested for the presence of E. histolytica IgG antibodies using a commercially available enzyme-linked immunoassay. Seroprevalence association with the characteristics of female sex workers was determined by bivariate analysis. Anti- E. histolytica IgG antibodies were found in five (2.7%) of 187 female sex workers and in 16 (4.3%) of 374 controls (odds ratios (OR) = 0.61; 95% confidence intervals (CI): 0.22 - 1.70; P = 0.34). Mean optical density of the immunoassay in seropositive cases and controls was 1.35 ± 0.93 and 0.73 ± 0.45, respectively (P = 0.05). Seroprevalence of E. histolytica infection did not vary significantly with age, education, socioeconomic level, or health status of sex workers. Seropositivity to E. histolytica did not correlate with work characteristics such as duration in the occupation, condom use, type of sex, or a history of sexually transmitted diseases, or with behavioral variables such as washing hands before eating, or consumption of untreated water. Results indicate that female sex workers do not have an increased risk for E. histolytica infection in Durango City, Mexico. Further studies to determine the risk of infection with E. histolytica by sexual contact should be conducted.

  20. Migration, violence, and safety among migrant sex workers: a qualitative study in two Guatemalan communities.

    Science.gov (United States)

    Rocha-Jiménez, Teresita; Brouwer, Kimberly C; Silverman, Jay G; Morales-Miranda, Sonia; Goldenberg, Shira M

    2016-09-01

    Despite reports of high levels of violence among women migrants in Central America, limited evidence exists regarding the health and safety of migrant sex workers in Central America. This study is based on 16 months of field research (November 2012-February 2014), including ethnographic fieldwork, in-depth interviews, and focus groups conducted with 52 internal and international migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, key transit and destination communities for both international and internal migrants. The analysis explored migration-related determinants of susceptibility to violence experienced by migrant sex workers across different phases of migration. Violence in home communities and economic considerations were key drivers of migration. Unsafe transit experiences (eg undocumented border crossings) and negative interactions with authorities in destination settings (eg extortion) contributed to migrant sex workers' susceptibility to violence, while enhanced access to information on immigration policies and greater migration and sex work experience were found to enhance agency and resilience. Findings suggest the urgent need for actions that promote migrant sex workers' safety in communities of origin, transit, and destination, and programmes aimed at preventing and addressing human rights violations within the context of migration and sex work.

  1. High human immunodeficiency virus incidence in a cohort of Rwandan female sex workers

    NARCIS (Netherlands)

    Braunstein, Sarah L.; Ingabire, Chantal M.; Kestelyn, Evelyne; Uwizera, Aline Umutoni; Mwamarangwe, Lambert; Ntirushwa, Justin; Nash, Denis; Veldhuijzen, Nienke J.; Nel, Annalene; Vyankandondera, Joseph; van de Wijgert, Janneke H. H. M.

    2011-01-01

    Measurement of human immunodeficiency virus(HIV) incidence among female sex workers in Rwanda is a key part of preparing for HIV prevention trials. HIV-negative, nonpregnant female sex workers (N =397) were tested for HIV-1, sexually transmitted infections, and pregnancy quarterly for 12 months, and

  2. Tuberculosis screening among Bolivian sex workers and their children

    Directory of Open Access Journals (Sweden)

    Silvia S. Chiang

    2015-06-01

    Full Text Available Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers’ mandatory HIV screenings may be a cost-efficient disease-control strategy.

  3. Poz-itively Transformational: Sex Workers and HIV/AIDS Education

    Science.gov (United States)

    Hill, Robert J.

    2005-01-01

    HIV and AIDS are complex events that offer numerous opportunities for adult education. However, mainstream education on this issue has often not been relevant to a number of subpopulations, including sex workers. This chapter explores sources and content of HIV/AIDS education in the sex work industry (including art and the Internet) and suggests…

  4. Causes of maternal and child mortality among Cambodian sex workers and their children: a cross sectional study

    OpenAIRE

    Willis, Brian; Onda, Saki; Stoklosa, Hanni Marie

    2016-01-01

    Abstract Background To reach global and national goals for maternal and child mortality, countries must identify vulnerable populations, which includes sex workers and their children. The objective of this study was to identify and describe maternal deaths of female sex workers in Cambodia and causes of death among their children. Methods A convenience sample of female sex workers were recruited by local NGOs that provide support to sex workers. We modified the maternal mortality section of t...

  5. Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences.

    Science.gov (United States)

    Goldenberg, Shira M; Brouwer, Kimberly C; Jimenez, Teresita Rocha; Miranda, Sonia Morales; Mindt, Monica Rivera

    2016-01-01

    Migrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers. Focus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013-February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops. Key themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma) represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers. Results highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization and supports for migrant sex workers are

  6. Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences.

    Directory of Open Access Journals (Sweden)

    Shira M Goldenberg

    Full Text Available Migrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers.Focus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013-February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops.Key themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers.Results highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization and supports for migrant

  7. Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers.

    Science.gov (United States)

    Shannon, Kate; Kerr, T; Strathdee, S A; Shoveller, J; Montaner, J S; Tyndall, M W

    2009-08-11

    To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution. Prospective observational study. Vancouver, Canada during 2006-8. Female sex workers 14 years of age or older (inclusive of transgender women) who used illicit drugs (excluding marijuana) and engaged in street level sex work. Self reported gender based violence. Of 267 female sex workers invited to participate, 251 women returned to the study office and consented to participate (response rate of 94%). Analyses were based on 237 female sex workers who completed a baseline visit and at least one follow-up visit. Of these 237 female sex workers, 57% experienced gender based violence over an 18 month follow-up period. In multivariate models adjusted for individual and interpersonal risk practices, the following structural factors were independently correlated with violence against female sex workers: homelessness (adjusted odds ratio for physical violence (aOR(physicalviolence)) 2.14, 95% confidence interval 1.34 to 3.43; adjusted odds ratio for rape (aOR(rape)) 1.73, 1.09 to 3.12); inability to access drug treatment (adjusted odds ratio for client violence (aOR(clientviolence)) 2.13, 1.26 to 3.62; aOR(physicalviolence) 1.96, 1.03 to 3.43); servicing clients in cars or public spaces (aOR(clientviolence) 1.50, 1.08 to 2.57); prior assault by police (aOR(clientviolence) 3.45, 1.98 to 6.02; aOR(rape) 2.61, 1.32 to 5.16); confiscation of drug use paraphernalia by police without arrest (aOR(physicalviolence) 1.50, 1.02 to 2.41); and moving working areas away from main streets owing to policing (aOR(clientviolence) 2.13, 1.26 to 3.62). Our results demonstrate an alarming prevalence of gender based violence against female sex workers. The structural factors of criminalisation, homelessness, and poor availability of drug treatment independently correlated with gender based violence against street based female sex workers. Socio

  8. Determinants of condom breakage among female sex workers in Karnataka, India

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    Bradley Janet

    2011-12-01

    Full Text Available Abstract Background Condoms are effective in preventing the transmission of HIV and other sexually transmitted infections, when properly used. However, recent data from surveys of female sex workers (FSWs in Karnataka in south India, suggest that condom breakage rates may be quite high. It is important therefore to quantify condom breakage rates, and examine what factors might precipitate condom breakage, so that programmers can identify those at risk, and develop appropriate interventions. Methods We explored determinants of reported condom breakage in the previous month among 1,928 female sex workers in four districts of Karnataka using data from cross-sectional surveys undertaken from July 2008 to February 2009. Using stepwise multivariate logistic regression, we examined the possible determinants of condom breakage, controlling for several independent variables including the district and client load. Results Overall, 11.4% of FSWs reported at least one condom break in the previous month. FSWs were much more likely to report breakage if under 20 years of age (AOR 3.43, p = 0.005; if divorced/ separated/widowed (AOR 1.52, p = 0.012; if they were regular alcohol users (AOR 1.63, p = 0.005; if they mostly entertained clients in lodges/rented rooms (AOR 2.99, p = 0.029 or brothels (AOR 4.77, p = 0.003, compared to street based sex workers; if they had ever had anal sex (AOR 2.03, p = 0.006; if the sex worker herself (as opposed to the client applied the condom at last use (AOR 1.90, p Conclusions The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct condom use. More research is also needed on what specific situational parameters

  9. [Understanding and reaching young clandestine sex workers in Burkina Faso to improve response to HIV].

    Science.gov (United States)

    Berthé, Abdramane; Huygens, Pierre; Ouattara, Cécile; Sanon, Anselme; Ouédraogo, Abdoulaye; Nagot, Nicolas

    2008-01-01

    In 1998, researchers in Burkina Faso enrolled 300 women more or less involved in commercial sex work in an open cohort to determine whether adequate management of their sexually transmitted infections and exposure to well-designed, well-delivered, and plentiful communication for behaviour change (CBC) might reduce their vulnerability to HIV. In 2000, they observed that the non-professional sex workers (occasional or clandestine sex workers) were more difficult to reach, to mobilize and to keep involved in the project's different activities. This group was also infected at the same or higher rates than professional sex workers because they did not use condoms routinely. To accomplish the project objectives, they therefore chose to recruit more non-professional sex workers in the new cohort of 700 women. This social-anthropological study was conducted to help them to enrol young clandestine sex workers. The overall objective of this study was to understand the life of this category of sex workers and to identify strategic actors to reach them. Using a qualitative method, social anthropologists reviewed literature, identified and geo-referenced all local places suitable to encountering these women, obtained life stories from some of them and interviewed key informants and participants in the field. The results showed that in Bobo-Dioulasso (Burkina Faso): - most young women who are clandestine sex workers are Burkinabe, and girls entering the sex trade are increasingly young and increasingly uneducated; - most of them come from families with low capital (financial, cultural, or social). The parents' socioeconomic status (contextual poverty) results in unmet financial needs, which in turn exposes them to starting work early, including commercial sex work; - of all the income-generating activities available to unskilled young girls, commercial sex work is one of the most profitable and easily accessible; - in the three-fold context of an HIV epidemic, poverty, and

  10. Sex Workers, Fem Queens, and Cross-Dressers: Differential Marginalizations and HIV Vulnerabilities Among Three Ethnocultural Male-to-Female Transgender Communities in New York City.

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    Hwahng, Sel Julian; Nuttbrock, Larry

    2007-12-01

    This article describes 3 distinct ethnocultural male-to-female transgender communities in New York City: the low-income African American/Black and Latina(o) House Ball community; low-income, often undocumented immigrant Asian sex workers; and middle-class White cross-dressers. These communities are highly socially isolated from each other and are more connected to their ethnocultural contexts than to an abstract and shared transgender identity. Whereas previous research either has viewed male-to-female transgender people as one monolithic group or has separated them into abstract racial categories unconnected to their communities and lifestyles, this article positions them within specific social networks, cultures, neighborhoods, and lifestyles. With regard to HIV vulnerabilities, violence, and rape, House Ball community members seemed to engage in the riskiest form of survival sex work, whereas Asian sex workers seemed to engage in moderate-risk survival sex work. White cross-dressers seemed to engage in very low-risk recreational sex work.

  11. Preventing HIV Transmission Among Partners of HIV-Positive Male Sex Workers in Mexico City: A Modeling Study.

    Science.gov (United States)

    Monteiro, João Filipe G; Marshall, Brandon D L; Escudero, Daniel; Sosa-Rubí, Sandra G; González, Andrea; Flanigan, Timothy; Operario, Don; Mayer, Kenneth H; Lurie, Mark N; Galárraga, Omar

    2015-09-01

    Mexico has a concentrated HIV epidemic, with male sex workers constituting a key affected population. We estimated annual HIV cumulative incidence among male sex workers' partners, and then compared incidence under three hypothetical intervention scenarios: improving condom use; and scaling up HIV treatment as prevention, considering current viral suppression rates (CVS, 60.7 %) or full viral suppression among those treated (FVS, 100 %). Clinical and behavioral data to inform model parameterization were derived from a sample (n = 79) of male sex workers recruited from street locations and Clínica Condesa, an HIV clinic in Mexico City. We estimated annual HIV incidence among male sex workers' partners to be 8.0 % (95 % CI: 7.3-8.7). Simulation models demonstrated that increasing condom use by 10 %, and scaling up HIV treatment initiation by 50 % (from baseline values) would decrease the male sex workers-attributable annual incidence to 5.2, 4.4 % (CVS) and 3.2 % (FVS), respectively. Scaling up the number of male sex workers on ART and implementing interventions to ensure adherence is urgently required to decrease HIV incidence among male sex workers' partners in Mexico City.

  12. Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China.

    Science.gov (United States)

    Xiao, Zhiwen; Li, Xiaoming; Lin, Danhua; Tam, Cheuk Chi

    2015-01-01

    The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.

  13. Infection among Commercial Sex Workers in Jos

    African Journals Online (AJOL)

    A study of HHV8 seropositivity was conducted among commercial sex workers in Jos aimed at determining the prevalence in relation to history of STD, duration of prostitution, age and number of sexual partners per day. Antibodies to HHV8 were detected by enzyme linked - immunosorbent assay (ELISA) (Advanced ...

  14. HIV behavioural risks and the role of work environment among Chinese male sex workers in Hong Kong.

    Science.gov (United States)

    Wong, William C W; Leung, Phil W S; Li, C W

    2012-01-01

    Male sex workers are a highly marginalised group in Hong Kong and it is increasingly so with an influx of them travelling from mainland China to work as "freelance" sex workers. This study aimed to measure important work environment variables that might affect the likelihood of condom use among male sex workers working in Hong Kong. A cross-sectional survey of 161 participants recruited by snowball and convenience sampling methods through outreach workers of a local non-governmental organization was conducted in 2007-2008. Only 27.4%, 54.7% and 42.6% reported consistent condom use when engaging in oral, anal and vaginal sex, respectively. Logistic regression shows unsafe sex was nearly four times (OR=3.41; 95%CI 1.51-7.69) as common in institutionalised male sex workers as among their independent counterparts. Lack of condoms provided at workplaces was a major barrier in this socio-legal context and was strongly associated with condom non-use amongst institutionalised sex workers (OR= 10.86; 95%CI 2.94-40.17). The present study finds that when compared with independent Male sex workers (MSWs), institutionalised MSWs were older, less educated, earned a higher income but more likely to engage in unsafe sex with their clients and their partners. Public health physicians must work with law-enforcing authorities to provide clear guidelines to remove these HIV prevention barriers.

  15. Understanding Sociocultural Factors Contributing to HIV Risk Among Ayoreo Bolivian Sex Workers.

    Science.gov (United States)

    López Entrambasaguas, Olga María; Granero-Molina, José; Hernández-Padilla, Jose; Fernández-Sola, Cayetano

    2015-01-01

    The Bolivian indigenous Ayoreo ethnic people are vulnerable to sexually transmitted infections and HIV. Ayoreo women who also work in sex trades belong to an extremely high-risk group, and prevention programs are not delivering effective outcomes for them. The aim of our study was to explore, describe, and understand behavioral and cultural patterns related to sexual and reproductive health in Ayoreo sex workers. A qualitative-ethnographic study was designed; data were collected through participant observation and in-depth interviews with sex workers and key informants. Two fundamental themes contributing to HIV risk for female Ayoreo sex workers in Bolivia emerged: reproductive/sexual freedom and sociocultural risk determinants. We concluded that the in-depth examination of the sexual-reproductive culture amongst the Ayoreo has provided useful information, which might contribute to the cultural adaptation and design of future policies and prevention programs for sexually transmitted infections and HIV in this group. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  16. Considering risk contexts in explaining the paradoxical HIV increase among female sex workers in Mumbai and Thane, India.

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    Bandewar, Sunita V S; Bharat, Shalini; Kongelf, Anine; Pisal, Hemlata; Collumbien, Martine

    2016-01-28

    The period 2006-2009 saw intensive scale-up of HIV prevention efforts and an increase in reported safer sex among brothel and street-based sex workers in Mumbai and Thane (Maharashtra, India). Yet during the same period, the prevalence of HIV increased in these groups. A better understanding of sex workers' risk environment is needed to explain this paradox. In this qualitative study we conducted 36 individual interviews, 9 joint interviews, and 10 focus group discussions with people associated with HIV interventions between March and May 2012. Dramatic changes in Mumbai's urban landscape dominated participants' accounts, with dwindling sex worker numbers in traditional brothel areas attributed to urban restructuring. Gentrification and anti-trafficking efforts explained an escalation in police raids. This contributed to dispersal of sex work with the sex-trade management adapting by becoming more hidden and mobile, leading to increased vulnerability. Affordable mobile phone technology enabled independent sex workers to trade in more hidden ways and there was an increased dependence on lovers for support. The risk context has become ever more challenging, with animosity against sex work amplified since the scale up of targeted interventions. Focus on condom use with sex workers inadvertently contributed to the diversification of the sex trade as clients seek out women who are less visible. Sex workers and other marginalised women who sell sex all strictly prioritise anonymity. Power structures in the sex trade continue to pose insurmountable barriers to reaching young and new sex workers. Economic vulnerability shaped women's decisions to compromise on condom use. Surveys monitoring HIV prevalence among 'visible' street and brothel-bases sex workers are increasingly un-representative of all women selling sex and self-reported condom use is no longer a valid measure of risk reduction. Targeted harm reduction programmes with sex workers fail when implemented in

  17. HIV risk perception, risk behavior, and seroprevalence among female commercial sex workers in Georgetown, Guyana

    Directory of Open Access Journals (Sweden)

    Keith H. Carter

    1997-06-01

    Full Text Available A study of 108 female sex workers engaged in prostitution in Georgetown, Guyana, was made in April 1993. Based on interviews and procurement of blood samples, the study investigated relationships between HIV seroprevalences and AIDS knowledge, risk behaviors, client characteristics, and condom use. Street-walkers--as distinct from sex workers in bars, hotels, and Port Georgetown--tended to charge less, be worse off socioeconomically, and have clients who were similarly disadvantaged; they were therefore classified as belonging to a "lower" socioeconomic stratum, while the other workers were classified as belonging to a "higher" stratum. The overall HIV seroprevalence found among the sex workers was 25% (95%CI: 17%-33%. But the 50 subjects in the lower stratum had a relatively high seroprevalence (42%, as compared to 10% among those in the higher stratum, accounting for 21 of the 27 HIV-seropositive subjects. Reported patterns of client origins (Guyanese or foreign, worker willingness to have sex without a condom, and condom use by clients differed by stratum. Participants in the higher stratum were more disposed to having sex without a condom. The workers' knowledge of what causes AIDS and how HIV is transmitted was low in both strata; substantial numbers of workers said they had contracted a sexually transmitted disease within the past two years or were users of illicit drugs. Condom use is reportedly less common among Guyanese than foreign clients, suggesting a greater risk of contracting HIV from Guyanese clients or infecting Guyanese clients with it. The HIV seroprevalence among workers who said they had only Guyanese clients was statistically greater than the rate among those who said they had only foreign clients. The HIV seroprevalence among those reporting more than five clients per week was statistically greater than among those reporting fewer. HIV seropositivity was relatively high among the 12 workers who said they used cocaine

  18. Size estimation, HIV prevalence and risk behaviours of female sex workers in Pakistan

    International Nuclear Information System (INIS)

    Altaf, A.; Aga, A.; McKinizie, M.H.; Abbas, Q.; Jafri, S.B.

    2012-01-01

    Objective: To provide size estimation and to determine risky behaviours and HIV prevalence among female sex workers in Pakistan, which has progressed from a low to concentrated level of HIV epidemic. Methods: A cross-sectional study (geographic mapping and integrated behavioural and biological survey-IBBS) was conducted between August 2005 to January 2006 in Karachi, Hyderabad and Sukkur. A detailed questionnaire and dry blood spot (DBS) specimen for HIV testing were collected by trained interviewers after informed consent. The study was ethically approved by review boards in Canada and Pakistan. Results: About 14,900 female sex workers were estimated to be functional in Sindh. A total of 1158 of them were interviewed for the study. Average age of sex workers was 27.4+- 6.7 years, and the majority 787 (67.9%) were married, and uneducated 764 (65.9%). Sindhi (26.4%) was the predominant ethnicity. Mean number of paid clients was 2.1+-1.2. Three workers were confirmed HIV positive (0.75%, 95 percent CI 0.2-2.2%) from Karachi. Condom use at last sexual act was highest (68%) among brothel-based workers from Karachi, and the lowest in Sukkur where only 1.3% street-based workers reported using a condom at last sexual act. Overall use of illicit drugs through injections was negligible. Conclusion: HIV prevalence among female sex workers in Sindh, Pakistan is low but risky behaviours are present. Well organised service delivery programmes can help promoting safer practices. (author)

  19. Human rights abuses and collective resilience among sex workers in four African countries: a qualitative study.

    Science.gov (United States)

    Scorgie, Fiona; Vasey, Katie; Harper, Eric; Richter, Marlise; Nare, Prince; Maseko, Sian; Chersich, Matthew F

    2013-07-26

    Sex work is a criminal offence, virtually throughout Africa. This criminalisation and the intense stigma attached to the profession shapes interactions between sex workers and their clients, family, fellow community members, and societal structures such as the police and social services. We explore the impact of violence and related human rights abuses on the lives of sex workers, and how they have responded to these conditions, as individuals and within small collectives. These analyses are based on data from 55 in-depth interviews and 12 focus group discussions with female, male and transgender sex workers in Kenya, South Africa, Uganda and Zimbabwe. Data were collected by sex worker outreach workers trained to conduct qualitative research among their peers. In describing their experiences of unlawful arrests and detention, violence, extortion, vilification and exclusions, participants present a picture of profound exploitation and repeated human rights violations. This situation has had an extreme impact on the physical, mental and social wellbeing of this population. Overall, the article details the multiple effects of sex work criminalisation on the everyday lives of sex workers and on their social interactions and relationships. Underlying their stories, however, are narratives of resilience and resistance. Sex workers in our study draw on their own individual survival strategies and informal forms of support and very occasionally opt to seek recourse through formal channels. They generally recognize the benefits of unified actions in assisting them to counter risks in their environment and mobilise against human rights violations, but note how the fluctuant and stigmatised nature of their profession often undermines collective action. While criminal laws urgently need reform, supporting sex work self-organisation and community-building are key interim strategies for safeguarding sex workers' human rights and improving health outcomes in these communities. If

  20. Sex guilt and life satisfaction in Iranian-american women.

    Science.gov (United States)

    Abdolsalehi-Najafi, Emon; Beckman, Linda J

    2013-08-01

    Although the experience of sex guilt has been considered among a variety of ethnic groups, the area has not yet been empirically explored among Iranian American women. The present study investigated the relationship between sexual self-schema (i.e., beliefs about the sexual aspects of oneself), acculturation, and sex guilt, and it further examined the association between sex guilt and life satisfaction in Iranian American women. A total of 65 Iranian American women, with a mean age of 31.3 years (SD = 11.7), completed five self-administered questionnaires. Findings indicated a significant inverse correlation between sexual self-schema and sex guilt. More specifically, women who endorsed negative self-views regarding their sexual self reported higher levels sex guilt. Results revealed that acculturation was unrelated to sex guilt, when the effect of being Muslim or non-Muslim was controlled. Women with high sex guilt reported significantly lower levels of life satisfaction. Moreover, analyses for mediation effects supported sex guilt as a partially mediating variable between sexual self-schema and life satisfaction. Levels of sex guilt were higher among Muslim women when compared to women of other religious affiliations. Additionally, Muslim women appeared to be significantly less acculturated to Western ideals than other religious groups. The present findings suggest that mental health professionals who provide services to Iranian American women need to consider the negative effects of sex guilt, particularly among Muslim women.

  1. Correlates of Inconsistent Refusal of Unprotected Sex among Armenian Female Sex Workers

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    Karine Markosyan

    2014-01-01

    Full Text Available This cross-sectional study assessed the prevalence and correlates of inconsistent refusal of unprotected sex among female sex workers (FSWs in Armenia. One hundred and eighteen street-based FSWs between the ages of 20 and 52 completed a questionnaire assessing FSWs’ demographic, psychosocial, and behavioral characteristics. A total of 52.5% (n=62 of FSWs reported inconsistent refusal of unprotected sex with clients in the past 3 months. Logistic regression analysis controlling for participants’ age and education revealed that perceiving more barriers toward condom use (AOR = 1.1; P<0.01, reporting more types of abuse (AOR = 2.1; P<0.01, and setting lower fees for service (AOR = 0.9; P=0.02 significantly predicted inconsistent refusal of unprotected sex. HIV-risk-reduction behavioral interventions tailored to FSWs working in Yerevan Armenia should address the factors identified in this study toward the goal of enhancing refusal of unprotected sex and ultimately preventing acquisition of sexually transmitted infections (STIs including HIV.

  2. The representation of sex workers in South African media: Danger, morals and human rights

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    Sally Hunt

    2015-09-01

    Full Text Available The ideological construct of gender typically positions women below men, and “others” certain types of women even more, especially those distinguished from idealised femininity by aspects of their sexuality. This paper explores the representation of sex work and sex workers in the South African media in 2009 and 2010, a time during which there was an increase in news coverage of sex work during the 2010 FIFA World Cup. Analysis of the two data sets revealed that sex work is still often perceived as immoral and dangerous, and that sex workers – overwhelmingly represented as women – are criminalised for their actions while client agency is largely obscured, which is in line with previous studies of South African newspapers. However, a strong liberal representation of sex workers was also found in one data set, which advocates the decriminalisation of sex work in the context of human rights. The use of the term “sex work” and its derivatives, rather than “prostitution”, was found to index this progressive stance.

  3. Predictors of unprotected sexual intercourse among female commercial sex workers in Kano, North-Western Nigeria

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    U M Lawan

    2012-01-01

    Conclusion: Sex workers engage in unhealthy sex for social and economic reasons. They should be empowered through vocational training to acquire sustainable sources of income. Regulatory authorities should also work with development partners/Non-governmental organisations (NGOs to package and implement a formidable health strategy/intervention for the control of substance abuse and promotion of safer sex among both the sex workers and their clients.

  4. "One country, two systems": Sociopolitical implications for female migrant sex workers in Hong Kong

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    Griffiths Sian

    2008-12-01

    Full Text Available Abstract Background Under the "two countries, one system" policy implemented by China to manage the return of Hong Kong's sovereignty, Hong Kong has maintained a comparatively prosperous economy within the Asian region. This has resulted in an environment which fosters migration from the mainland to Hong Kong, due largely to proximity, higher earning potential, common language, and a relaxing of border control measures. However not all mainland China citizens are equally able to access these new migration schemes and indeed a number of women such as sex workers are either migrating and/or working illegally and without occupational, legal and health protection within Hong Kong. Discussion Female migrant sex workers are exposed to a number of significant threats to their health, however their illegal status contributes to even greater vulnerability. The prevailing discourses which view these women as either "trafficked women" or as "illegal immigrants" do not adequately account for the complex situations which result in such women's employment in Hong Kong's sex industry. Rather, their position can best be understood within the broader frameworks provided by migration literature and the concept of "structural violence". This allows for a greater understanding of the socio-political issues which are systematically denying migrant sex workers adequate access to health care and other opportunities for social advancement. When these issues are taken into account, it becomes clear that the current relevant legislation regarding both immigration and sex work is perpetuating the marginalised and vulnerable status of migrant sex workers. Unless changes are made, structural barriers will remain in place which impede the ability of migrant sex workers to manage their own health needs and status. Conclusion Female migrant sex workers in Hong Kong are extremely vulnerable to a number of occupational health and safety hazards which have significantly

  5. Strategies and Challenges in Preventing Violence Against Canadian Indoor Sex Workers

    Science.gov (United States)

    Guta, Adrian

    2018-01-01

    Objectives. To examine indoor sex workers’ strategies in preventing workplace violence and influential socio-structural conditions. Methods. Data included qualitative interviews with 85 sex workers in British Columbia, Canada, from 2014 through 2016. For analyses, we used interpretive thematic techniques informed by World Health Organization position statements on violence. Results. Robbery, nonpayment, financial exploitation, and privacy violations were frequent types of violence perpetrated by clients, landlords, and neighbors. We identified 2 themes that depicted how sex workers prevented violence and mitigated its effects: (1) navigating physical spaces and (2) navigating client relationships. Conclusions. Sex workers’ diverse strategies to prevent violence and mitigate its effects are creative and effective in many circumstances. These are limited, however, by the absence of legal and public health regulations governing occupational health and safety and stigma associated with sex work. Public Health Implications. Occupational health and safety regulatory policies that set conditions for clients’ substance and condom use within commercial sex transactions are required. Revisions to the current legal regulations governing prostitution are critical to support optimal work environments that reduce the likelihood of violence. These revisions must recognize sex work as a form of labor versus victimization. PMID:29346001

  6. Women's health and HIV: experience from a sex workers' project in Calcutta.

    Science.gov (United States)

    Nath, M B

    2000-03-01

    This article narrates an inspiring discovery for development professionals who are searching for ways to empower women to protect themselves, their partners and families from HIV infection. This was based on the experience of the author as she came across a movement of sex workers who successfully negotiated safe sex in the heart of Calcutta, India. Employing focus group discussions, informal interviews and home visits during 1999, the author discovered that a Sexually Transmitted Disease/HIV Intervention Project has been set up to promote disease control and condom distribution among these sex workers. Operating on three principles for its work--respect, recognition, and reliance, the program aims to create an impact on the sex workers themselves and their peers. Likewise, the need to build alliances with clients, training the police and forming the Durbar Mahila Samanvaya Committee were deemed as necessary. Several lessons were learned during the course of the research: use of stories and history to rally the community; retaining flexibility, meeting changing needs; using drama to promote communication; and negotiating with men and opposing patriarchy.

  7. Determinants of condom breakage among female sex workers in Karnataka, India.

    Science.gov (United States)

    Bradley, Janet; Rajaram, S; Alary, Michel; Isac, Shajy; Washington, Reynold; Moses, Stephen; Ramesh, B M

    2011-12-29

    Condoms are effective in preventing the transmission of HIV and other sexually transmitted infections, when properly used. However, recent data from surveys of female sex workers (FSWs) in Karnataka in south India, suggest that condom breakage rates may be quite high. It is important therefore to quantify condom breakage rates, and examine what factors might precipitate condom breakage, so that programmers can identify those at risk, and develop appropriate interventions. We explored determinants of reported condom breakage in the previous month among 1,928 female sex workers in four districts of Karnataka using data from cross-sectional surveys undertaken from July 2008 to February 2009. Using stepwise multivariate logistic regression, we examined the possible determinants of condom breakage, controlling for several independent variables including the district and client load. Overall, 11.4% of FSWs reported at least one condom break in the previous month. FSWs were much more likely to report breakage if under 20 years of age (AOR 3.43, p = 0.005); if divorced/ separated/widowed (AOR 1.52, p = 0.012); if they were regular alcohol users (AOR 1.63, p = 0.005); if they mostly entertained clients in lodges/rented rooms (AOR 2.99, p = 0.029) or brothels (AOR 4.77, p = 0.003), compared to street based sex workers; if they had ever had anal sex (AOR 2.03, p = 0.006); if the sex worker herself (as opposed to the client) applied the condom at last use (AOR 1.90, p < 0.001); if they were inconsistent condom users (AOR 2.77, p < 0.001); and if they had never seen a condom demonstration (AOR 2.37, p < 0.001). The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct

  8. Medical Students’ Knowledge and Attitudes Toward Female Sex Workers and Their Occupational Risk Factors

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    Jenna T. Nakagawa

    2014-10-01

    Full Text Available Background: The tendency for female sex workers to seek health care is highly influenced by physician attitudes and behavior. By identifying medical students' attitudes toward female sex workers and assessing their knowledge of barriers to seeking care, we can focus medical training and advocacy efforts to increase access to care and improve public health outcomes. Methods: In this cross-sectional study, medical students from various countries were invited to participate in an online survey with close-ended questions and Likert scale statements. Responses were quantified and knowledge and attitude scores were assigned based on knowledge of barriers to seeking care and agreement with positive and negative attitude statements. Results: A total of 292 medical students from 56 countries completed the survey, of whom 98.3% agreed that it will be their job to provide treatment to patients regardless of occupation. Self-identified religious students conveyed more negative attitudes toward female sex workers compared to those who did not identify themselves as religious (p<0.001. Students intending to practice in countries where prostitution is legal conveyed more positive attitudes compared to those intending to practice in countries where prostitution is illegal (p<0.001. Conclusion: Medical students largely agreed on the importance of providing care to female sex workers as a vulnerable group. In addition to addressing knowledge gaps in medical education, more localized studies are needed to understand the religious and legal influences on attitudes toward female sex workers. Such information can help focus the efforts in both medical education and communication training to achieve the desired behavioral impacts, reconciling the future generations of health care providers with the needs of female sex workers.

  9. Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India.

    Science.gov (United States)

    Bradley, Janet; Rajaram, Subramanian Potty; Isac, Shajy; Gurav, Kaveri; Ramesh, B M; Gowda, Chandrashekhar; Moses, Stephen; Alary, Michel

    2016-05-01

    Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8% reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions.

  10. Attrition and Rape Case Characteristics: A Profile and Comparison of Female Sex Workers and Non-Sex Workers.

    Science.gov (United States)

    Lea, Susan J; Callaghan, Lynne; Grafton, Iain; Falcone, M Aurora; Shaw, Steve

    2016-07-01

    The attrition of rape cases from the criminal justice system (CJS) remains high and there is a paucity of research in relation to marginalized groups. Sex workers (SWs) are vulnerable to sexual violence due to the nature of their work. They are also unlikely to report such violence to police for a range of reasons. Two stages of research sought to describe the victim, perpetrator, and offense characteristics of SW rape and to examine the attrition of these cases. All rapes and attempted rapes (N = 1,146) reported to police in a large city in the South West of England over a 21-year period were examined; 67 cases involved SWs. Data were extracted from police files in line with the variables of interest. Secondary analysis of the total number of SW rapes (n = 67) resulted in a profile of these cases. A matched pairs study revealed significant differences in victim, perpetrator, and assault characteristics between SW (n = 62) and non-sex-worker (NSW) samples (n = 62). Although no significant difference was found in terms of attrition from the CJS, SW cases were observed to secure more convictions for rape than NSW cases. The implications of the findings for practice and future research are discussed. © The Author(s) 2015.

  11. Motivational influences on the safer sex behavior of agency-based male sex workers.

    Science.gov (United States)

    Smith, Michael D; Seal, David W

    2008-10-01

    Although indoor male sex workers (MSWs) have been found to engage in lower rates of HIV risk behavior with clients than street-based MSWs, few studies have examined the motivations behind such practices. We interviewed 30 MSWs working for the same escort agency regarding their safer sex practices with clients and their reasons for these. As in other research, MSWs reported little risk behavior with clients. Five motivational themes related to safer sex on the job emerged: health concerns, emotional intimacy, client attractiveness, relationships, and structural work factors. Results suggest that participants engaged in rational decision-making relative to sex with clients, facilitated by reduced economic incentive for riskier behavior and a supportive social context. MSWs desired a safe sexual work place, personal integrity, and minimal negative consequences to personal relationships. Collaborating with sex work employers to study their role in encouraging a safer workplace may be important to future research.

  12. From violence to sex work: agency, escaping violence, and HIV risk among establishment-based female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Choudhury, Shonali M; Anglade, Debbie; Park, Kyuwon

    2013-01-01

    Violence experienced by female sex workers has been found to affect the HIV risk and quality of life of these women. Research on this topic has dealt with female sex workers and current experiences of violence with partners, clients, and in the workplace. In this study, we used feminist constructivist grounded theory to explore perceptions of violence among establishment-based female sex workers in Tijuana, Mexico. A key concept that emerged from 20 semi-structured in-depth interviews was "escaping violence with a romantic partner by becoming independent through sex work." The women also emphasized the negative impact of violence in the workplace but felt that achieving separation from a violent partner gave them strength to protect their lives and health. Interventions to help these women protect themselves from HIV infection and improve their quality of life should aim to build upon their strengths and the agency they have already achieved. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  13. Sex workers as peer health advocates: community empowerment and transformative learning through a Canadian pilot program.

    Science.gov (United States)

    Benoit, Cecilia; Belle-Isle, Lynne; Smith, Michaela; Phillips, Rachel; Shumka, Leah; Atchison, Chris; Jansson, Mikael; Loppie, Charlotte; Flagg, Jackson

    2017-08-30

    Social marginalization and criminalization create health and safety risks for sex workers and reduce their access to health promotion and prevention services compared to the general population. Community empowerment-based interventions that prioritize the engagement of sex workers show promising results. Peer-to-peer interventions, wherein sex workers act as educators of their colleagues, managers, clients and romantic partners, foster community mobilization and critical consciousness among sex workers and equip them to exercise agency in their work and personal lives. A pilot peer health education program was developed and implemented, with and for sex workers in one urban centre in Canada. To explore how the training program contributed to community empowerment and transformative learning among participants, the authors conducted qualitative interviews, asked participants to keep personal journals and to fill out feedback forms after each session. Thematic analysis was conducted on these three data sources, with emerging themes identified, organized and presented in the findings. Five themes emerged from the analysis. Our findings show that the pilot program led to reduced internalized stigma and increased self-esteem in participants. Participants' critical consciousness increased concerning issues of diversity in cultural background, sexual orientation, work experiences and gender identity. Participants gained knowledge about how sex work stigma is enacted and perpetuated. They also became increasingly comfortable challenging negative judgments from others, including frontline service providers. Participants were encouraged to actively shape the training program, which fostered positive relationships and solidarity among them, as well as with colleagues in their social network and with the local sex worker organization housing the program. Resources were also mobilized within the sex worker community through skills building and knowledge acquisition. The peer

  14. Torque teno virus infection in male commercial sex workers in Surakarta Indonesia

    Science.gov (United States)

    Prasetyo, Afiono Agung; Luvi, Sabrina Damara; Hartono, Sari, Yulia

    2017-02-01

    The molecular epidemiology data of torque teno virus (TTV) in Indonesia is very rare. This study evaluated the prevalence of TTV in male commercial sex workers, as one of the high risk community for blood borne viruses pathogens in Surakarta, Indonesia. All blood samples collected from male commercial sex workers in Surakarta in 2009-2013 were tested by nested polymerase chain reaction (PCR). The amplified PCR products were molecularly cloned and subjected to sequence analysis. TTV DNA was detected in 80.9% (72/89) samples. Furthermore, the molecular characterization revealed that the most prevalent was genogroup 3, followed by genogroup 2 and l, respectively. TTV was detected in male commercial sex workers in Surakarta with high infection rate. Further investigation about TTV circulation in Indonesian population is needed in order to provide additional information about the genetic variability and TTV epidemiology in Indonesia, especially in the high risk communities.

  15. Depression and key associated factors in female sex workers and women living with HIV/AIDS in the Dominican Republic.

    Science.gov (United States)

    Rael, Christine T; Davis, Alissa

    2017-04-01

    Little is known about the mental health of female sex workers and women living with HIV/AIDS in the Dominican Republic, which impedes HIV prevention, testing, and treatment. This project estimates the prevalence of depression and identifies key contributing factors to this outcome in female sex workers, women living with HIV/AIDS, and a comparison group. Participants were female sex workers (N = 349), women living with HIV/AIDS (N = 213), and a comparison group of HIV-negative women who were not sex workers (N = 314) from the Dominican Republic. Participants completed questionnaires assessing demographic characteristics and depression. Female sex workers and women living with HIV/AIDS completed additional questionnaires ascertaining HIV or sex work-related internalized stigma. Depression was prevalent among female sex workers (70.2%), women living with HIV/AIDS (81.1%), and the comparison group (52.2%). Adjusted logistic regressions showed that internalized stigma was associated with depression for female sex workers (OR = 2.73; 95% CI = 1.95-3.84) and women living with HIV/AIDS (OR = 3.06; 95% CI = 1.86-5.05). Permanent income was associated with this outcome for female sex workers (OR = 0.08; 95% CI = 0.01-0.80) and the comparison group (OR = 0.04; 95% CI = 0.00-0.45).

  16. Violence against sex workers by police and military in Democratic Republic of Congo.

    Science.gov (United States)

    Ombeni, Alphonse Mihigo; Crago, Anna Louise

    2008-12-01

    Sex workers in the Sud-Kivu district of the Democratic Republic of Congo (DRC) are regularly subjected to sexual and other forms of violence. In this article, based on a presentation at a concurrent session at the conference, Alphonse Mihigo Ombeni and Anna Louise Crago describe the negative impacts of this violence on the sex workers' health and working conditions. Many have become HIV-positive.

  17. Prevalence and correlates of sexual risk among male and female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Katsulis, Yasmina; Durfee, Alesha

    2012-01-01

    We investigated prevalence and correlates of sexual risk behaviours among male and female sex workers in Tijuana, Mexico, the busiest border crossing area on the US - Mexico border, analysing survey data from a purposive, cross-sectional sample of male and female sex workers who worked in a range of indoor and outdoor settings. Logistic regression was used to determine factors that were associated with sexual risk-taking, defined as failing to use a condom with last client. In bivariate regression models, gender, work setting (e.g., indoor vs. outdoor), poverty, engaging in survival sex, marital status and perceived drug addiction were correlated with sexual risk. When controlling for work location, housing insecurity, poverty, survival sex, marital status and perceived drug addiction, male sex workers were still 10 times more likely than female sex workers (FSW) to engage in sex without a condom during their last encounter with a client. And, although FSW were significantly more likely than males to have used a condom with a client, they were significantly less likely than males to have used a condom with their regular partner. Future research should further examine how gender shapes sexual risk activities in both commercial and non-commercial relationships.

  18. Social participation and drug use in a cohort of Brazilian sex workers.

    Science.gov (United States)

    Leslie, Hannah Hogan; Ahern, Jennifer; Chinaglia, Magda; Kerrigan, Deanna; Lippman, Sheri A

    2013-06-01

    Structural interventions focused on community mobilisation to engender an enabling social context have reduced sexual risk behaviours among sex workers. Interventions to date have increased social participation and shown an association between participation and safer sex. Social participation could modify risk for other health behaviours, particularly drug use. We assessed social participation and drug use before and after implementation of a clinical, social and structural intervention with sex workers intended to prevent sexually transmitted infections/HIV infection. We followed 420 sex workers participating in the Encontros intervention in Corumbá, Brazil, between 2003 and 2005. We estimated the association of participation in external social groups with drug use at baseline and follow-up using logistic regression and marginal modelling. Follow-up analyses of preintervention/postintervention change in drug use employed inverse probability weighting to account for censoring and were stratified by exposure to the intervention. Social participation showed a protective association with drug use at baseline (1 SD higher level of social participation associated with 3.8% lower prevalence of drug use, 95% CI -0.1 to 8.3). Among individuals exposed to Encontros, higher social participation was associated with an 8.6% lower level of drug use (95% CI 0.1 to 23.3). No significant association was found among the unexposed. A structural intervention that modified sex workers' social environment, specifically participation in external social groups, was associated with reduced drug use. These findings suggest that sexual risk prevention initiatives that enhance social integration among marginalised populations can produce broad health impacts, including reductions in drug use.

  19. Developing human rights-based strategies to improve health among female sex workers in Rwanda.

    Science.gov (United States)

    Binagwaho, Agnès; Agbonyitor, Mawuena; Mwananawe, Aimable; Mugwaneza, Placidie; Irwin, Alec; Karema, Corine

    2010-12-15

    How governments should address sex work is a topic of current debate in Rwanda and other countries. Some constituencies propose harsher punishment of sex workers as the cornerstone of an improved policy. We argue that an adequate policy response to sex work in the Rwandan context must prioritize public health and reflect current knowledge of the social determinants of health. This does not imply intensified repression, but a comprehensive agenda of medical and social support to improve sex workers' access to health care, reduce their social isolation, and expand their economic options. Evidence from social epidemiology converges with rights-based arguments in this approach. Recent field interviews with current and former sex workers strengthen the case, while highlighting the need for further social scientific and epidemiological analysis of sex work in Rwanda. Rwanda has implemented some measures that reflect a rights-based perspective in addressing sex work. For example, recent policies seek to expand access to education for girls and support sex workers in the transition to alternative livelihoods. These policies reinforce the model of solidarity-based public health action for which Rwanda has been recognized. Whether such measures can maintain traction in the face of economic austerity and ideological resistance remains to be seen. Copyright © 2010 Binagwaho, Agbonyitor, Mwananawe, Mugwaneza, Irwin, and Karema. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  20. Time to unsafe sexual practice among cross-border female sex workers in Metemma Yohannes, North West Ethiopia.

    Science.gov (United States)

    Gezie, Lemma Derseh; Taye, Belaynew Wassie; Ayele, Tadesse Awoke

    2015-07-28

    Because of the nature of their work, female sex workers are at risk of sexually transmitted diseases. Cross-border areas are places where this situation becomes worse. In Ethiopia, there has been a serious scarcity of studies on the time at which unsafe sexual practice starts and on factors which determine the practice among female sex workers there. Therefore, this study aimed to fill this identified gap. A total of 467 women who had been sex workers at least for three months prior to the resumption of the study were included. A structured and pre-tested questionnaire was used to collect data from July-August, 2010. Descriptive statistics was used to explore the data, and the Extended Cox-Regression model was employed to identify the predictors of time-to-unsafe sexual practice. The study participants were followed for 6, 643 person-months. The overall incidence density of unsafe sexual practice was 44.71 persons per 1000 persons-months. The hazard of unsafe sexual practice increased by 3.0 % every month (p-value =0.040) due to problem-drinking. Those female sex workers with familiarized clients had a two-fold hazard of practicing unsafe sex compared to their counterparts (AHR = 1.94 95 % CI 1.49, 2.53). The predominant sexual client type and the work place of sex workers were the other significant predictors of unsafe sexual practice. The incidence of unsafe sexual practice was found to be high among sex workers in the cross-border area. Time-to-unsafe sexual practice was significantly associated with female sex workers' status of familiarity with their clients, predominant sexual client type, their work place, and the interaction term of time and problem-drinking. Interventions need to be made on these controllable social and behavioral characteristics to help sex workers extend the duration of their safe sexual practice beyond the time they will quit sex work.

  1. Commercial sex venues, syphilis and methamphetamine use among female sex workers.

    Science.gov (United States)

    Kang, Dianming; Liao, Meizhen; Jiang, Zhenxia; Zhang, Xijiang; Mao, Wenwen; Zhang, Ning; Tao, Xiaorun; Huang, Tao; Bi, Zhenqiang; Aliyu, Muktar; Wu, Pingsheng; Jiang, Baofa; Jia, Yujiang

    2011-06-01

    The objective of this study was to assess the factors associated with methamphetamine (MA) use, syphilis, and unprotected sex among female sex workers from different type of venues in Qingdao City, Shandong Province of China. Three consecutive cross-sectional surveys provided information on demographics, sexual and drug use behaviors, and HIV-related services. Of 1187 participants, 3.0% were infected with syphilis; 30.2% ever used MA; 58.3% ever had unprotected commercial sex in the past month. The prevalence rates of syphilis and MA use were 2.5% and 33.0% for participants recruited from saunas, night clubs, bars or hotels; 2.7% and 28.3% for hair/beauty salon-based participants; and 4.5% and 15.8% for street-based participants. Street-based MA users were more likely to be single, non-Shandong residents, have first lifetime sex act at younger age, and recruited in 2008 (vs. 2006). Saunas, night clubs, bars, or hotels-based MA users were more likely to be younger, sex debut at younger age, have longer duration of sex work, have unprotected commercial sex, and be syphilis-infected. Hair/beauty salon-based MA users were more likely to be non-Shandong residents, younger, and to have unprotected commercial sex. Syphilis among the sauna-, night club-, bar-, or hotel-based participants was associated with MA use and ever receipt of HIV testing. Syphilis among the hair/beauty salon-based participants was associated with longer duration of sex work. MA users who frequent commercial sex venues are engaging in high-risk behaviors and are at risk for syphilis/other sexually transmitted diseases. Better-targeted intervention efforts to curtail the epidemics of MA use and HIV/syphilis should therefore take cognizance of the role of commercial sex venues as focal points of MA use and syphilis/sexually transmitted disease transmission.

  2. A qualitative exploration of barriers to condom use among female sex workers in China.

    Directory of Open Access Journals (Sweden)

    Wu Jie

    Full Text Available BACKGROUND: Sex workers in China continue to engage in unprotected sex acts that put them at risk for contracting HIV (Human Immunodeficiency Virus and other STIs (Sexually Transmitted Infections. The purpose of this study was to explore women's work history, the context of sex work, condom use, HIV testing services, and potential barriers to condom use in a sample of FSWs (female sex workers in Guangzhou, China. METHODOLOGY/PRINCIPAL FINDINGS: In-depth, semi-structured, face-to-face interviews were conducted with 24 FSWs in Guangzhou, China. Informants were recruited using a purposive sampling technique. Qualitative data were coded and analyzed using NVivo 8.0. The majority of respondents were internal economic migrants who had entered the sex industry in pursuit of greater financial reward. Most women in the study were married or had steady boyfriends, and were young, with secondary education and limited knowledge about HIV and STIs. Most were not satisfied with their current living conditions and expressed a desire to leave the sex industry. Women reported that they were more likely to use condoms during sex acts with commercial partners than with non-commercial partners. The potential stigma of being seen as a sex worker prevented many from accessing HIV testing. Three key factors put these FSWs at risk for HIV and STIs: unreasonable trust toward clients, stereotypes and assumptions about customers, and financial incentives. CONCLUSIONS/SIGNIFICANCE: These findings suggest that social and economic factors play an important role in shaping sexual decision-making among female sex workers in Guangzhou. We argue that greater insight into and attention to these factors could enhance the success of HIV prevention efforts.

  3. Resilience in work-related stress among female sex workers in Hong Kong.

    Science.gov (United States)

    Yuen, Winnie Wing-Yan; Wong, William Chi-Wai; Holroyd, Eleanor; Tang, Catherine So-Kum

    2014-09-01

    The literature on positive psychology and resilience demonstrates that individuals utilize their personal strengths and environmental resources to facilitate positive adaptation. Using a qualitative approach, we investigated how these frameworks operated as self-protective strategies for female sex workers to maintain their psychological and physical well-being under stressful socioeconomic and work-related conditions. Twenty-three female sex workers in Hong Kong participated in in-depth interviews. We used the grounded theory approach for data analysis. The informants reported negative feelings in response to financial burden, clients' demands, threats to physical health, and stigma. Some female sex workers showed their resilience by being able to rationalize their role, believe their ability to make a change in life, and stay optimistic. They adopted strategies including emotional regulation and acceptance of their responsibility and limits to cope with stressful life events. The results help us understand the role of positive psychology and resilience in this vulnerable population. © The Author(s) 2014.

  4. Condom utilization and sexual behavior of female sex workers in Northwest Ethiopia: A cross-sectional study.

    Science.gov (United States)

    Tamene, Masresha Molla; Tessema, Gizachew Assefa; Beyera, Getahun Kebede

    2015-01-01

    Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers.

  5. Unmet need for contraception among sex workers in Madagascar☆,☆☆

    Science.gov (United States)

    Khan, Maria R.; Turner, Abigail Norris; Pettifor, Audrey; Van Damme, Kathleen; Rabenja, Ny Lovaniaina; Ravelomanana, Noro; Swezey, Teresa; Williams, D’Nyce; Jamieson, Denise; Behets, Frieda

    2018-01-01

    Background The study was conducted to investigate past and future pregnancy preferences and contraceptive need among Malagasy sex workers. Study Design We analyzed data on pregnancy and contraceptive use collected during the baseline visit of a randomized, prospective formative trial which assessed diaphragm and microbicide acceptability among sex workers. To be eligible, women could not be pregnant or planning pregnancy for the next 2 months. Results Women (N=192) from four cities (Antananarivo, Antsiranana, Mahajanga and Toamasina) reported a median of 10 sex acts per week. Fifty-two percent reported a prior unwanted pregnancy, 45% at least one induced abortion and 86% that preventing future pregnancy was moderately to very important. During the last sex act, 24% used a hormonal method, 36% used a male condom, 2% used a traditional method and 38% used no method. Nearly 30% of participants reported that pregnancy prevention was moderately or very important but used no contraception at last sex; these women were categorized as having “unmet need” for contraception. In multivariable binomial regression analyses, factors associated with unmet need included low knowledge of contraceptive effectiveness [age- and site-adjusted prevalence ratio (PR): 2.1; 95% confidence interval (CI): 1.4–3.0] and low self-efficacy to negotiate condom use (age- and site-adjusted PR: 2.0; 95% CI: 1.4–3.0). Conclusions Among these women, prior unwanted pregnancy and induced abortion were common and preventing future pregnancy was important, yet gaps in contraceptive use were substantial. Contraceptive knowledge and self-efficacy should be improved to promote contraceptive use by sex workers. PMID:19185677

  6. A cross-sectional study of HIV and STIs among male sex workers attending Australian sexual health clinics.

    Science.gov (United States)

    Callander, Denton; Read, Phillip; Prestage, Garrett; Minichiello, Victor; Chow, Eric P F; Lewis, David A; McNulty, Anna; Ali, Hammad; Hellard, Margaret; Guy, Rebecca; Donovan, Basil

    2017-06-01

    Although sex work is frequently characterised as a practice with high risk for HIV and other STIs, little is known about the epidemiology of these infections among men who sell sex in Australia. This study reports the prevalence of chlamydia, gonorrhoea, infectious syphilis and HIV among men who have sex with men attending Australian publicly funded sexual health clinics and compares prevalence between sex workers and non-sex workers. From 2011 to 2014, de-identified patient data were extracted from 40 sexual health clinics in four Australian jurisdictions. The χ 2 and multiple logistic regression analyses were used to compare the prevalence of HIV and STIs among men attending these services who did and did not report sex work in the 12 months prior to consultation. All analyses were restricted to men who reported sex with other men and to each patient's first consultation at participating services. In total, 27 469 gay, bisexual and other men who have sex with men attended participating clinics; 443 (1.6%) reported sex work. At first consultation, 18% of sex workers and 17% of non-sex workers were diagnosed with HIV or an STI (p=0.4): 13% of sex workers were newly diagnosed with chlamydia, 15% with gonorrhoea, 0.5% with infectious syphilis and 0.6% with HIV. After controlling for demographic and behavioural factors, sex work was not independently associated with an HIV or STI diagnosis. These findings provide estimates of HIV and STI prevalence among men who sell sex in Australia and they challenge assumptions of sex work as inherently risky to the sexual health of gay bisexual and other men who have sex with men. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Oncogenic human papilloma virus and cervical pre-cancerous lesions in brothel-based sex workers in India

    Directory of Open Access Journals (Sweden)

    Kamalesh Sarkar

    Full Text Available Summary: A community-based cross-sectional study was conducted in brothel-based sex workers of West Bengal, Eastern India, to determine their oncogenic human papillomavirus (HPV status and the presence of pre-cancerous lesions. A total of 229 sex workers from three districts of West Bengal participated in the study. All the study participants were interviewed with the aid of a pre-tested questionnaire to determine their sociodemographics, risk behaviour and risk perceptions after obtaining informed verbal consent. The interview was followed by collection of cervical cells from all participants using a disposable vaginal speculum and cervical cytobrush. Oncogenic HPV DNA was detected by real-time polymerase chain reaction (PCR. A simultaneous Papanicolaou test (‘Pap smear’ was performed to detect cervical cytological abnormalities. Overall, the prevalence of oncogenic HPV was found to be 25% (58/229 among the studied population. A subset (n = 112 of the sample was tested separately to determine the existence and magnitude of HPV genotypes 16 and 18. The results showed that genotype 16 was prevalent in 10% (11/112, genotype 18 in 7% (8/112 and both genotype 16 and 18 in 7% (8/112. The HPV prevalence rate showed a decreasing trend with age, being 71.4% in the 10–19 years age group, 32.3% in the 20–29 years age group, 18.3% in the 30–39 years age group and 2.5% in the ≥40 years age group (statistically significant differences, P ≤ 0.00001. Considering the duration of sex work, oncogenic HPV prevalence was found to be 55% (n = 21 and 19% (n = 35 in sex workers with a sex working duration of ≤1 year and >1 year, respectively. This difference was found to be statistically significant both by univariate and multivariate analysis. In this study, it was observed that sex workers with an average number of daily clients of six or more had an HPV prevalence of 67% (n = 6, those with four to five clients had a prevalence of 45% (n

  8. Prevalence and Correlates of Non-Disclosure of HIV Serostatus to Sex partners among HIV-Infected Female Sex Workers and HIV-infected Male Clients of Female Sex Workers in India

    Science.gov (United States)

    Raj, Anita; Mahapatra, Bidhubhusan; Cheng, Debbie M.; Coleman, Sharon; Bridden, Carly; Battala, Madhusudana; Silverman, Jay G.; Pardeshi, Manoj H.; Samet, Jeffrey H.

    2013-01-01

    This study examines non-disclosure of HIV serostatus to sex partners among HIV-infected adults involved with transactional sex in Mumbai, India. Surveys were conducted with HIV-infected female sex workers (n = 211) and infected male clients (n = 205) regarding HIV knowledge, awareness of sex partners’ HIV serostatus, alcohol use, transactional sex involvement post-HIV diagnosis and non-disclosure of HIV serostatus. Gender-stratified multiple logistic regression models were used for analysis. Non-disclosure of one’s serostatus to all sex partners was reported by almost three-fifths of females and two-fifths of males. Predictors of non-disclosure included lack of correct knowledge about HIV and no knowledge of sex partners’ HIV serostatus. Among females, recent alcohol consumption also predicted non-disclosure. Among males, 10 + paid sexual partners in the year following HIV diagnosis predicted non-disclosure. Secondary HIV prevention efforts in India require greater focus on HIV disclosure communication and integrated alcohol and sexual risk reduction. PMID:22810892

  9. Social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia.

    Science.gov (United States)

    Wong, M L; Lubek, I; Dy, B C; Pen, S; Kros, S; Chhit, M

    2003-04-01

    To determine the social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia. Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap for HIV screening. Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91, 95% CI: 1.15 to 3.18) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51, 95% CI: 1.01 to 2.26), after adjustment for age, educational level, marital status, number of sexual encounters per week, and knowledge of AIDS/HIV and sexually transmitted infections. The most frequently reported reason for not using condoms with clients was not being able to persuade them (66.7%), while for non-paying partners, the reason was that they loved them (60.0%). To complement the government's current programme of client education, 100% condom policy and brothel administrative measures, additional strategies to increase condom use among clients and non-paying partners should be directed at (i) the social policy and community levels to address sex workers' economic and cultural barriers to condom use, and (ii) personal level empowerment through developing sex workers' condom negotiation skills.

  10. The Impact of Sex Work Interruption on Blood-Derived T Cells in Sex Workers from Nairobi, Kenya.

    Science.gov (United States)

    Omollo, Kenneth; Boily-Larouche, Geneviève; Lajoie, Julie; Kimani, Makobu; Cheruiyot, Julianna; Kimani, Joshua; Oyugi, Julius; Fowke, Keith Raymond

    Unprotected sexual intercourse exposes the female genital tract (FGT) to semen-derived antigens, which leads to a proinflammatory response. Studies have shown that this postcoital inflammatory response can lead to recruitment of activated T cells to the FGT, thereby increasing risk of HIV infection. The purpose of this study was to evaluate the impact of sex work on activation and memory phenotypes of peripheral T cells among female sex workers (FSW) from Nairobi, Kenya. Thirty FSW were recruited from the Pumwani Sex Workers Cohort, 10 in each of the following groups: HIV-exposed seronegative (at least 7 years in active sex work), HIV positive, and New Negative (HIV negative, less than 3 years in active sex work). Blood was obtained at three different phases (active sex work, abstinence from sex work-sex break, and following resumption of sex work). Peripheral blood mononuclear cells were isolated and stained for phenotypic markers (CD3, CD4, CD8, and CD161), memory phenotype markers (CD45RA and CCR7), activation markers (CD69, HLA-DR, and CD95), and the HIV coreceptor (CCR5). T-cell populations were compared between groups. In HIV-positive women, CD8+CCR5+ T cells declined at the sex break period, while CD4+CD161+ T cells increased when returning to sex work. All groups showed no significant changes in systemic T-cell activation markers following the interruption of sex work, however, significant reductions in naive CD8+ T cells were noted. For each of the study points, HIV positives had higher effector memory and CD8+CD95+ T cells and lower naive CD8+ T cells than the HIV-uninfected groups. Interruption of sex work had subtle effects on systemic T-cell memory phenotypes.

  11. Early Sex Work Initiation and Violence against Female Sex Workers in Mombasa, Kenya.

    Science.gov (United States)

    Parcesepe, Angela M; L'Engle, Kelly L; Martin, Sandra L; Green, Sherri; Suchindran, Chirayath; Mwarogo, Peter

    2016-12-01

    Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger. Logistic regression modeled recent violence as a function of early initiation, adjusting for drop-in center, age, education, HIV status, supporting others, and childhood abuse. Twenty percent of the sample reported early initiation of sex work. Although both early initiators and other FSWs reported commonly experiencing recent violence, early initiators were significantly more likely to experience recent physical and sexual violence and verbal abuse from paying partners. Early initiation was not associated with physical or sexual violence from non-paying partners. Many FSWs begin sex work before age 18. Effective interventions focused on preventing this are needed. In addition, interventions are needed to prevent violence against all FSWs, in particular, those who initiated sex work during childhood or adolescence.

  12. Assessing the Impact of Peer Educator Outreach on the Likelihood and Acceleration of Clinic Utilization among Sex Workers.

    Science.gov (United States)

    Krishnamurthy, Parthasarathy; Hui, Sam K; Shivkumar, Narayanan; Gowda, Chandrasekhar; Pushpalatha, R

    2016-01-01

    Peer-led outreach is a critical element of HIV and STI-reduction interventions aimed at sex workers. We study the association between peer-led outreach to sex workers and the time to utilize health facilities for timely STI syndromic-detection and treatment. Using data on the timing of peer-outreach interventions and clinic visits, we utilize an Extended Cox model to assess whether peer educator outreach intensity is associated with accelerated clinic utilization among sex workers. Our data comes from 2705 female sex workers registered into Pragati, a women-in-sex-work outreach program, and followed from 2008 through 2012. We analyze this data using an Extended Cox model with the density of peer educator visits in a 30-day rolling window as the key predictor, while controlling for the sex workers' age, client volume, location of sex work, and education level. The principal outcome of interest is the timing of the first voluntary clinic utilization. More frequent peer visit is associated with earlier first clinic visit (HR: 1.83, 95% CI, 1.75-1.91, p educator outreach. Peer outreach density is associated with increased likelihood of-and shortened duration to-clinic utilization among female sex workers, suggesting potential staff resourcing implications. Given the observational nature of our study, however, these findings should be interpreted as an association rather than as a causal relationship.

  13. Intimate relationships of Devadasi sex workers in South India: An exploration of risks of HIV/STI transmission.

    Science.gov (United States)

    Ramanaik, Satyanarayana; Thompson, Laura H; du Plessis, Elsabé; Pelto, Pertti; Annigeri, Vinod; Doddamane, Mahesh; Bhattacharjee, Parinita; Shaw, Souradet Y; Deering, Kathleen; Khan, Shamshad; Halli, Shiva S; Lorway, Robert

    2014-01-01

    Global literature on female sex workers suggests that being in an intimate relationship is associated with barriers to practising safe sex behaviours. Condom use within intimate relationships is often seen as a sign of infidelity and fosters mistrust which could affect longevity, trust and intimacy within partnerships. Using qualitative data from Devadasi sex workers and their intimate male partners in Bagalkot District, Karnataka, India, we examined both partners' perspectives to understand the quality and dynamics of these relationships and the factors that influence condom use in intimate relationships. Our thematic analysis of individual interviews conducted in May 2011 with 20 couples suggests that many Devadasi sex workers and their intimate partners define their relationships as 'like marriage' which reduced their motivation to use condoms. Evidence from this study suggests that active participation in sex workers' collectives (sanghas) can increase condom use, education and family planning services, among other things, and could be helpful for both Devadasis and their intimate partners to better understand and accept safer sexual practices. Our work has direct implications for designing couple-based health interventions for traditional Devadasi sex workers and their intimate partners in India.

  14. Can rights stop the wrongs? Exploring the connections between framings of sex workers' rights and sexual and reproductive health.

    Science.gov (United States)

    Overs, Cheryl; Hawkins, Kate

    2011-12-16

    There is growing interest in the ways in which legal and human rights issues related to sex work affect sex workers' vulnerability to HIV and abuses including human trafficking and sexual exploitation. International agencies, such as UNAIDS, have called for decriminalisation of sex work because the delivery of sexual and reproductive health services is affected by criminalisation and social exclusion as experienced by sex workers. The paper reflects on the connections in various actors' framings between sex workers sexual and reproductive health and rights (SRHR) and the ways that international law is interpreted in policing and regulatory practices. The literature review that informs this paper was carried out by the authors in the course of their work within the Paulo Longo Research Initiative. The review covered academic and grey literature such as resources generated by sex worker rights activists, UN policy positions and print and online media. The argument in this paper has been developed reflectively through long term involvement with key actors in the field of sex workers' rights. International legislation characterises sex work in various ways which do not always accord with moves toward decriminalisation. Law, policy and regulation at national level and law enforcement vary between settings. The demands of sex worker rights activists do relate to sexual and reproductive health but they place greater emphasis on efforts to remove the structural barriers that limit sex workers' ability to participate in society on an equal footing with other citizens. There is a tension between those who wish to uphold the rights of sex workers in order to reduce vulnerability to ill-health and those who insist that sex work is itself a violation of rights. This is reflected in contemporary narratives about sex workers' rights and the ways in which different actors interpret human rights law. The creation of regulatory frameworks around sex work that support health, safety

  15. Beliefs About Sex and Parent-Child-Church Sex Communication Among Church-Based African American Youth.

    Science.gov (United States)

    Moore, Erin; Berkley-Patton, Jannette; Bohn, Alexandria; Hawes, Starlyn; Bowe-Thompson, Carole

    2015-10-01

    Parent-child sex communication has been shown to be protective against sexual risk among African American youth. The current study sought to use the theory of planned behavior as a framework for focus group discussions (N = 54 youth participants aged 12-19 years) to explore church youths' (a) sex beliefs and values (attitudes), (b) sources and evaluation of sex communication and education (subjective norms), (c) facilitator/barriers to adolescent sexual risk reduction and communication behaviors (perceived behavioral control), and (d) intentions to engage in these behaviors. Additionally, participants identified strategies for consideration in developing tailored parent-child-church sex communication education programs for use in African American churches. Themes suggested both positive and negative attitudes toward premarital sex and parents and churches as key sources of sex education and communication. Strategies to enhance parent-child-church sex communication are discussed in the context of these findings.

  16. Assessing the Impact of Peer Educator Outreach on the Likelihood and Acceleration of Clinic Utilization among Sex Workers.

    Directory of Open Access Journals (Sweden)

    Parthasarathy Krishnamurthy

    Full Text Available Peer-led outreach is a critical element of HIV and STI-reduction interventions aimed at sex workers. We study the association between peer-led outreach to sex workers and the time to utilize health facilities for timely STI syndromic-detection and treatment. Using data on the timing of peer-outreach interventions and clinic visits, we utilize an Extended Cox model to assess whether peer educator outreach intensity is associated with accelerated clinic utilization among sex workers.Our data comes from 2705 female sex workers registered into Pragati, a women-in-sex-work outreach program, and followed from 2008 through 2012. We analyze this data using an Extended Cox model with the density of peer educator visits in a 30-day rolling window as the key predictor, while controlling for the sex workers' age, client volume, location of sex work, and education level. The principal outcome of interest is the timing of the first voluntary clinic utilization.More frequent peer visit is associated with earlier first clinic visit (HR: 1.83, 95% CI, 1.75-1.91, p < .001. In addition, 18% of all syndrome-based STI detected come from clinic visits in which the sex worker reports no symptoms, underscoring the importance of inducing clinic visits in the detection of STI. Additional models to test the robustness of these findings indicate consistent beneficial effect of peer educator outreach.Peer outreach density is associated with increased likelihood of-and shortened duration to-clinic utilization among female sex workers, suggesting potential staff resourcing implications. Given the observational nature of our study, however, these findings should be interpreted as an association rather than as a causal relationship.

  17. A comparison of male sex workers in Prague: Internet escorts versus men who work in specialized bars and clubs.

    Science.gov (United States)

    Bar-Johnson, Michael David; Weiss, Petr

    2015-01-01

    Prague, the Czech Republic, is a popular sex tourism destination where sex work is decriminalized and young men offer sexual services at low prices relative to countries in Western Europe. This quantitative survey aimed to identify some of the demographic characteristics of these young men and their experiences in the sex industry. Internet escorts (N = 20) and sex workers in bars and clubs (N = 20) completed the survey anonymously in spring 2011. The results showed that sex workers in clubs often had troubled pasts and were forced into sex work to survive. They also reported incidents of violence, serious alcohol and drug use, as well as frequent gambling. The larger group of sex workers in Prague is made up of Internet escorts who have backgrounds that are not atypical for the average Czech youth. They had fewer problems with drugs and alcohol but were twice as likely as sex workers in bars and clubs to be victims of violent crime. Plans for interventions to help those who would change their line of work, as well as the importance of sociocultural context in understanding sex workers, are discussed.

  18. Narratives of Violence, Pathology, and Empowerment: Mental Health Needs Assessment of Home-Based Female Sex Workers in Rural India.

    Science.gov (United States)

    Sardana, Srishti; Marcus, Marina; Verdeli, Helen

    2016-08-01

    This study explores the narratives of psychological distress and resilience among a group of female sex workers who use residential spaces to attend to clients in rural India. The narratives reflect the lived experiences of these women. They describe the women's reasons for opting into sex work; guilt, shame, and stigma related to their sex worker status; experiences with intimate partner and domestic violence; health-related problems; communication with their family members about their sex worker status; mental health referral practices among the women; and elements of resilience and strength that they experience within themselves and within their community of fellow sex workers. The article also offers elements of our own experiences of recruiting the women to participate in the focus group, training local outreach workers in conducting focus group discussions, and forging a collaboration with a local community-based organization to highlight important barriers, challenges, and strategies for planning a group-based discussion to explore the mental health needs of home-based sex workers. © 2016 Wiley Periodicals, Inc.

  19. The decriminalization of prostitution is associated with better coverage of health promotion programs for sex workers.

    Science.gov (United States)

    Harcourt, Christine; O'Connor, Jody; Egger, Sandra; Fairley, Christopher K; Wand, Handan; Chen, Marcus Y; Marshall, Lewis; Kaldor, John M; Donovan, Basil

    2010-10-01

    In order to assess whether the law has an impact on the delivery of health promotion services to sex workers, we compared health promotion programs in three Australian cities with different prostitution laws. The cities were Melbourne (brothels legalized if licensed, unlicensed brothels criminalized), Perth (criminalization of all forms of sex work) and Sydney (sex work largely decriminalized, without licensing). We interviewed key informants and gave questionnaires to representative samples of female sex workers in urban brothels. Despite the different laws, each city had a thriving and diverse sex industry and a government-funded sex worker health promotion program with shopfront, phone, online and outreach facilities. The Sydney program was the only one run by a community-based organisation and the only program employing multi-lingual staff with evening outreach to all brothels. The Melbourne program did not service the unlicensed sector, while the Perth program accessed the minority of brothels by invitation only. More Sydney workers reported a sexual health centre as a source of safer sex training and information (Sydney 52% v Melbourne 33% and Perth 35%; plegal context appeared to affect the conduct of health promotion programs targeting the sex industry. Brothel licensing and police-controlled illegal brothels can result in the unlicensed sector being isolated from peer-education and support. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

  20. Sexual relationship power and intimate partner violence among sex workers with non-commercial intimate partners in a Canadian setting.

    Science.gov (United States)

    Muldoon, Katherine A; Deering, Kathleen N; Feng, Cindy X; Shoveller, Jean A; Shannon, Kate

    2015-01-01

    There is little information on the private lives of women engaged in sex work, particularly how power dynamics within intimate relationships may affect intimate partner violence (IPV). Using baseline data of sex workers enrolled in a longitudinal cohort, "An Evaluation of Sex Workers' Health Access" (AESHA), the present study examined the association between sexual relationship power and IPV among sex workers in non-commercial partnerships in Vancouver, Canada. Pulweritz's Sexual Relationship Power Scale (SRPS) and The World Health Organization (WHO) Intimate Partner Violence against Women Scale (Version9.9) were used. Bivariable and multivariable logistic regression techniques were used to investigate the potential confounding effect of sexual relationship power on IPV among sex workers. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) were reported. Of 510 sex workers, 257 (50.4%) reported having an non-commercial intimate partner and were included in this analysis. In the past 6 months, 84 (32.7%) sex workers reported IPV (physical, sexual or emotional). The median age was 32 years, 39.3% were of Aboriginal ancestry, and 27.6% were migrants. After controlling for known confounders (e.g., age, Aboriginal ancestry, migrant status, childhood trauma, non-injection drug use), low relationship power was independently associated with 4.19 increased odds (95% CI: 1.93-9.10) and medium relationship power was associated 1.95 increased odds (95% CI: 0.89-4.25) of IPV. This analysis highlights how reduced control over sexual-decision making is plays a critical role in IPV among sex workers, and calls for innovation and inclusive programming tailored to sex workers and their non-commercial intimate partnerships.

  1. Dealing with the Margins of Law: Adult Sex Workers' Resistance in Everyday Life

    Directory of Open Access Journals (Sweden)

    Marisa Natalia Fassi

    2011-01-01

    Full Text Available This article looks at the way sex workers in Córdoba, Argentina, have dealt with legal marginalization, focusing on their understandings and associated practices of resistance. Sex workers position in law shows the group is on the margins of law, which means that their activity is not considered to be legal but is not illegal either. Since 2000 a group of sex workers started to organize to stop the constant detentions and humiliations by police officers. The organization called AMMAR (Asociación de Mujeres Meretrices Argentinas implied a major shift from an oppression of consciousness to a consciousness of oppression, modifying in this process the terms of their resistance from mere tactics of survival to a struggle for redefinition of their position in law and society. This article firstly explores the idea of margins of law, consciousness, power and resistance, and also describes the regulation of sex work in the city of Córdoba; secondly, it refers to sex workers experiences, perceptions and practices of resistance before the organization in relation to the police, the Judiciary, as well as with other institutions, and relates this experiences with their practices of resistance in that period; thirdly, it explains the process of organization and the way it has influenced their reflective awareness and practices of resistance, it describes as well the heterogeneity of understandings regarding law. Lastly, the Conclusion revisits the outcomes and literature to propose final reflections about dealing with the margins of law in everyday life.

  2. Motivators and barriers to HIV testing among street-based female sex workers in St. Petersburg, Russia.

    Science.gov (United States)

    King, Elizabeth J; Maman, Suzanne; Dudina, Victoria I; Moracco, Kathryn E; Bowling, J Michael

    2017-07-01

    Female sex workers are particularly susceptible to HIV-infection in Russia. However, a dearth of information exists on their utilisation of HIV services. A mixed-methods, cross-sectional study was conducted to examine motivators and barriers to HIV testing among street-based sex workers in St. Petersburg, Russia. The health belief model was the theoretical framework for the study. Twenty-nine sex workers participated in in-depth interviews, and 139 sex workers completed interviewer-administered surveys between February and September 2009. Barriers to getting an HIV test were fear of learning the results, worrying that other people would think they were sick, and the distance needed to travel to obtain services. Motivators for getting tested were protecting others from infection, wanting to know one's status and getting treatment if diagnosed. Logistic regression analysis demonstrated that knowing people living with HIV [aOR = 6.75, 95% CI (1.11, 41.10)] and length of time since start of injection drug use [aOR = 0.30, 95% CI (0.09, 0.97)] were significantly associated with recently getting tested. These results are important to consider when developing public health interventions to help female sex workers in Russia learn their HIV status and get linked to care and treatment services if needed.

  3. Risk Factors in Host and Environment for Cervicitis Among Commercial Sex Workers

    Directory of Open Access Journals (Sweden)

    Nazarwin Saputra

    2017-09-01

    Full Text Available sexually transmitted infection (STI remains a major health problem in some parts of the world. This study aimed to determine the host and environmental factors the effect on the incidence of cervicitis on sex workers. The study was observational case-control design with consecutive sampling technique. Risk factor for cervicitis is a history of sexually transmitted infections (p=0,0001, have couple (boy friend different gender (p=0,014, OR=4,4; CI95%=1,3-14,3, history of oral sex/cunnilingus (p=0,003, OR=6,8;CI95%=1,9-24,8, smokers (p=0,0001, CI95%=5,6; CI95%=2,4-13,1. Condom use last sex behavior is a protective factor affecting the incidence of cervicitis (p=0,0001, OR= 0,198; CI95 %=0,07- 0,5. The conclusion of this study is to prevent servisitis at-risk groups of commercial sex workers it should avoid from exposure of agents that cause sexually transmitted infections, does not have a spouse who is not authorized (girlfriend that leads to sex behavior, avoid behaviors oral sex / cunnilingus, no smoke. At-risk behavior should use condoms for prevention servisitis

  4. Hard-to-reach populations of men who have sex with men and sex workers: a systematic review on sampling methods.

    Science.gov (United States)

    Barros, Ana B; Dias, Sonia F; Martins, Maria Rosario O

    2015-10-30

    In public health, hard-to-reach populations are often recruited by non-probabilistic sampling methods that produce biased results. In order to overcome this, several sampling methods have been improved and developed in the last years. The aim of this systematic review was to identify all current methods used to survey most-at-risk populations of men who have sex with men and sex workers. The review also aimed to assess if there were any relations between the study populations and the sampling methods used to recruit them. Lastly, we wanted to assess if the number of publications originated in middle and low human development (MLHD) countries had been increasing in the last years. A systematic review was conducted using electronic databases and a total of 268 published studies were included in the analysis. In this review, 11 recruitment methods were identified. Semi-probabilistic methods were used most commonly to survey men who have sex with men, and the use of the Internet was the method that gathered more respondents. We found that female sex workers were more frequently recruited through non-probabilistic methods than men who have sex with men (odds = 2.2; p review identified 11 methods used to sample men who have sex with men and female sex workers. There is an association between the type of sampling method and the population being studied. The number of studies based in middle and low human development countries has increased in the last 6 years of this study.

  5. Condom negotiations among female sex workers in the Philippines: environmental influences.

    Directory of Open Access Journals (Sweden)

    Lianne A Urada

    Full Text Available Social and structural influences of condom negotiation among female sex workers (FSWs remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.Female bar/spa workers (N = 498, aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking associated with condom negotiation, adjusting for individuals nested within venues.Of 142 FSWs who traded sex in the previous 6 months (included in the analysis, 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment--trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34-49.90, economic environment--sex without a condom to make more money (AOR = 1.52, 95% CI 1.01-2.30, policy environment--sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49-4.48, and individual risk--substance use (AOR = 2.36, 95% CI = 1.28-4.35 were independently associated with FSWs' lack of condom negotiation with venue patrons.Factors in the physical, economic, and policy environments, over individual (excepting substance use and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation

  6. Engagement with HIV prevention treatment and care among female sex workers in Zimbabwe: a respondent driven sampling survey.

    Science.gov (United States)

    Cowan, Frances M; Mtetwa, Sibongile; Davey, Calum; Fearon, Elizabeth; Dirawo, Jeffrey; Wong-Gruenwald, Ramona; Ndikudze, Theresa; Chidiya, Samson; Benedikt, Clemens; Busza, Joanna; Hargreaves, James R

    2013-01-01

    To determine the HIV prevalence and extent of engagement with HIV prevention and care among a representative sample of Zimbabwean sex workers working in Victoria Falls, Hwange and Mutare. Respondent driven sampling (RDS) surveys conducted at each site. Sex workers were recruited using respondent driven sampling with each respondent limited to recruiting 2 peers. Participants completed an interviewer-administered questionnaire and provided a finger prick blood sample for HIV antibody testing. Statistical analysis took account of sampling method. 870 women were recruited from the three sites. HIV prevalence was between 50 and 70%. Around half of those confirmed HIV positive were aware of their HIV status and of those 50-70% reported being enrolled in HIV care programmes. Overall only 25-35% of those with laboratory-confirmed HIV were accessing antiretroviral therapy. Among those reporting they were HIV negative, 21-28% reported having an HIV test in the last 6 months. Of those tested HIV negative, most (65-82%) were unaware of their status. Around two-thirds of sex workers reported consistent condom use with their clients. As in other settings, sex workers reported high rates of gender based violence and police harassment. This survey suggests that prevalence of HIV is high among sex workers in Zimbabwe and that their engagement with prevention, treatment and care is sub-optimal. Intensifying prevention and care interventions for sex workers has the potential to markedly reduce HIV and social risks for sex workers, their clients and the general population in Zimbabwe and elsewhere in the region.

  7. Strengthening participation by young women sex workers in HIV programs: reflections on a study from Bangkok, Thailand.

    Science.gov (United States)

    Conn, Cath; Modderman, Kristel; Nayar, Shoba

    2017-01-01

    Participation is an accepted means of increasing the effectiveness of public health programs, and as such, it is considered an important component of HIV interventions targeting at-risk youth. The situation of young women sex workers in Thailand is alarming on many fronts, including that of HIV risk. As a result, HIV programs in Thailand are the key interventions undertaken in relation to young women sex workers' health. A small-scale study used semistructured interviews to explore the participation reports of five young women sex workers, as well as the related views of two community support workers, who lived and worked in Bangkok, Thailand. This study is considered in the light of current research on - as well as new opportunities and challenges offered for - participation by vulnerable groups in the context of digital society. Thematic analysis of the interview data identified barriers to participation, including the illegality of sex work, fear, and lack of trust of the authorities, as well as widespread social stigma. Such barriers resulted in young women seeking anonymity. Yet, promisingly, young women positioned themselves as experts; they are involved in peer education and are supportive of greater involvement in HIV programs, such as further educational initiatives and collective actions. There is a need for a more empowerment-oriented participation practice positioning young women sex workers as expert educators and codecision makers within a model of participation that is also accountable, such as including young women as members of program boards. Beyond current norms, there are new opportunities emerging because of the increasing availability of smartphone/Internet technology. These can support activist and codesign participation by young women sex workers in HIV programs. However, any developments in participation must maximize opportunities carefully, taking into consideration the difficult social environment faced by young women sex workers as well

  8. Prevalence of HIV Among U.S. Female Sex Workers: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Paz-Bailey, Gabriela; Noble, Meredith; Salo, Kathryn; Tregear, Stephen J

    2016-10-01

    Although female sex workers are known to be vulnerable to HIV infection, little is known about the epidemiology of HIV infection among this high-risk population in the United States. We systematically identified and critically assessed published studies reporting HIV prevalence among female sex workers in the United States. We searched for and included original English-language articles reporting data on the prevalence of HIV as determined by testing at least 50 females who exchanged sexual practices for money or drugs. We did not apply any restrictions on date of publication. We included 14 studies from 1987 to 2013 that reported HIV prevalence for a total of 3975 adult female sex workers. Only two of the 14 studies were conducted in the last 10 years. The pooled estimate of HIV prevalence was 17.3 % (95 % CI 13.5-21.9 %); however, the prevalence of HIV across individual studies varied considerably (ranging from 0.3 to 32 %) and statistical heterogeneity was substantial (I(2) = 0.89, Q = 123; p HIV among female sex workers in the United States; however, the available evidence does suggest that HIV prevalence among this vulnerable population is high.

  9. Measuring stigma affecting sex workers (SW) and men who have sex with men (MSM): A systematic review

    Science.gov (United States)

    Fitzgerald-Husek, Alanna; Van Wert, Michael J.; Ewing, Whitney F.; Holland, Claire E.; Katterl, Rachel; Rosman, Lori; Baral, Stefan D.

    2017-01-01

    Background Stigma involves discrediting a person or group based on a perceived attribute, behaviour or reputation associated with them. Sex workers (SW) and men who have sex with men (MSM) are key populations who are often at increased risk for the acquisition and transmission of HIV and who are affected by stigma that can negatively impact their health and well-being. Although stigma was included as an indicator in the US National HIV/AIDS Strategic Plan and there have been consultations focused on adding a stigma indicator within PEPFAR and the Global Fund in relation to potentiating HIV risks among key populations, there remains limited consensus on the appropriate measurement of SW- or MSM-associated stigma. Consequently, this systematic review summarizes studies using quantitative, qualitative, or mixed methods approaches to measure stigma affecting sex workers and men who have sex with men. Methods and findings This systematic review included English, French, and Spanish peer-reviewed research of any study design measuring SW- or MSM-associated stigma. Articles were published from January 1, 2004 to March 26, 2014 in PsycINFO, PubMed, EMBASE, CINAHL Plus, Global Health, and World Health Organization Global Health Library Regional Indexes. Of the 541 articles reviewed, the majority measured stigma toward MSM (over 97%), were conducted in North America, used quantitative methods, and focused on internalized stigma. Conclusions With the inclusion of addressing stigma in several domestic and international HIV strategies, there is a need to ensure the use of validated metrics for stigma. The field to date has completed limited measurement of stigma affecting sex workers, and limited measurement of stigma affecting MSM outside of higher income settings. Moving forward requires a concerted effort integrating validated metrics of stigma into health-related surveys and programs for key populations. PMID:29190642

  10. Measuring stigma affecting sex workers (SW and men who have sex with men (MSM: A systematic review.

    Directory of Open Access Journals (Sweden)

    Alanna Fitzgerald-Husek

    Full Text Available Stigma involves discrediting a person or group based on a perceived attribute, behaviour or reputation associated with them. Sex workers (SW and men who have sex with men (MSM are key populations who are often at increased risk for the acquisition and transmission of HIV and who are affected by stigma that can negatively impact their health and well-being. Although stigma was included as an indicator in the US National HIV/AIDS Strategic Plan and there have been consultations focused on adding a stigma indicator within PEPFAR and the Global Fund in relation to potentiating HIV risks among key populations, there remains limited consensus on the appropriate measurement of SW- or MSM-associated stigma. Consequently, this systematic review summarizes studies using quantitative, qualitative, or mixed methods approaches to measure stigma affecting sex workers and men who have sex with men.This systematic review included English, French, and Spanish peer-reviewed research of any study design measuring SW- or MSM-associated stigma. Articles were published from January 1, 2004 to March 26, 2014 in PsycINFO, PubMed, EMBASE, CINAHL Plus, Global Health, and World Health Organization Global Health Library Regional Indexes. Of the 541 articles reviewed, the majority measured stigma toward MSM (over 97%, were conducted in North America, used quantitative methods, and focused on internalized stigma.With the inclusion of addressing stigma in several domestic and international HIV strategies, there is a need to ensure the use of validated metrics for stigma. The field to date has completed limited measurement of stigma affecting sex workers, and limited measurement of stigma affecting MSM outside of higher income settings. Moving forward requires a concerted effort integrating validated metrics of stigma into health-related surveys and programs for key populations.

  11. Epidemic impacts of a community empowerment intervention for HIV prevention among female sex workers in generalized and concentrated epidemics.

    Science.gov (United States)

    Wirtz, Andrea L; Pretorius, Carel; Beyrer, Chris; Baral, Stefan; Decker, Michele R; Sherman, Susan G; Sweat, Michael; Poteat, Tonia; Butler, Jennifer; Oelrichs, Robert; Semini, Iris; Kerrigan, Deanna

    2014-01-01

    Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5-65% in Kenya and Ukraine; 10-70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012-2016 and, compared to status quo when all interventions are held constant. Optimistic but feasible coverage (65%-70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. A community empowerment approach to HIV prevention and access to universal ART for female sex workers is a

  12. Genital tract abnormalities among female sex workers who douche ...

    African Journals Online (AJOL)

    Vaginal douche products have been associated with cervical cancer. We examined female sex workers (FSWs) in Nigeria who douche with lemon or lime juice and compared the findings with that of nonusers. We obtained Pap smears and performed colposcopy of the vulva, vagina and cervix. A total of 374 FSWs ...

  13. Work-related violence and inconsistent condom use with non-paying partners among female sex workers in Adama City, Ethiopia.

    Science.gov (United States)

    Mooney, Alyssa; Kidanu, Aklilu; Bradley, Heather M; Kumoji, Evelyn Kuor; Kennedy, Caitlin E; Kerrigan, Deanna

    2013-08-23

    Although reported condom use between female sex workers and their clients is high in Ethiopia, condom use with regular, non-paying partners remains low, posing a substantial risk of HIV infection to sex workers, their partners and the general population. Previous studies have identified the synergistic effects of substance abuse, violence and HIV risk, but few have examined these inter-relationships among female sex workers and their regular, non-paying partners. This study explored the associations between work-related violence, alcohol abuse and inconsistent condom use among establishment-based female sex workers and their regular, non-paying partners in Adama City, Ethiopia. A cross-sectional survey was conducted with 350 establishment-based female sex workers, aged 15-35, at 63 bars, hotels and nightclubs. Multivariate logistic regression analysis was conducted to test the association between work-related violence and condom use with regular, non-paying partners, controlling for age, overall income, education and sex workers' total number of sexual partners in the past week. Alcohol abuse was explored as an effect modifier. Respondents reported a high prevalence of work-related violence (59%) and alcohol abuse (51%). Work-related violence was statistically significantly associated with unprotected sex with regular, non-paying partners among those who abused alcohol (OR: 6.34, 95% CI: 2.43-16.56) and among those who did not (OR: 2.98, 95% CI: 1.36-6.54). Alcohol abuse was not associated with inconsistent condom use within these partnerships, though it may strengthen the effect of work-related violence on unprotected sex. Findings suggest violence against establishment-based female sex workers is associated with HIV risk within regular, non-paying partnerships. Qualitative work is needed to better understand the links between a violent work environment and condom use with regular, non-paying partners and how interventions can be implemented in this context to

  14. Poor working conditions and work stress among Canadian sex workers.

    Science.gov (United States)

    Duff, P; Sou, J; Chapman, J; Dobrer, S; Braschel, M; Goldenberg, S; Shannon, K

    2017-10-01

    While sex work is often considered the world's oldest profession, there remains a dearth of research on work stress among sex workers (SWs) in occupational health epidemiological literature. A better understanding of the drivers of work stress among SWs is needed to inform sex work policy, workplace models and standards. To examine the factors that influence work stress among SWs in Metro Vancouver. Analyses drew from a longitudinal cohort of SWs, known as An Evaluation of Sex Workers' Health Access (AESHA) (2010-14). A modified standardized 'work stress' scale, multivariable linear regression with generalized estimating equations was used to longitudinally examine the factors associated with work stress. In multivariable analysis, poor working conditions were associated with increased work stress and included workplace physical/sexual violence (β = 0.18; 95% confidence interval (CI) 0.06, 0.29), displacement due to police (β = 0.26; 95% CI 0.14, 0.38), working in public spaces (β = 0.73; 95% CI 0.61, 0.84). Older (β = -0.02; 95% CI -0.03, -0.01) and Indigenous SWs experienced lower work stress (β = -0.25; 95% CI -0.43, -0.08), whereas non-injection (β = 0.32; 95% CI 0.14, 0.49) and injection drug users (β = 0.17; 95% CI 0.03, 0.31) had higher work stress. Vancouver-based SWs' work stress was largely shaped by poor work conditions, such as violence, policing, lack of safe workspaces. There is a need to move away from criminalized approaches which shape unsafe work conditions and increase work stress for SWs. Policies that promote SWs' access to the same occupational health, safety and human rights standards as workers in other labour sectors are also needed. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  15. Supervisors and accomplices: extra-marital sex among migrant construction workers in Ha Noi, Viet Nam.

    Science.gov (United States)

    Thuy, Bui Thi Thanh; Kretchmar, Joshua

    2008-06-01

    This study examines the influence of social networks on the sexual relations of migrant construction workers in Ha Noi, Viet Nam. Research included observation and interviews with members of two different groups of workers. The first group, together with their employer (cai), came from the same village; the second group came from different villages. Of interest in the present study was how social relationships among workers and their employers influence extra-marital sexual activity. In the group where workers and their cai came from the same village of origin, fear of acquiring a bad reputation made these workers reluctant to seek sex services, since accounts of their behaviour were transmitted quickly home. In contrast, workers from the group who came from different villages often went out together to purchase sex. The absence of direct links to their villages of origin made it easier for these latter workers to conceal their activity. The implication of these findings for sexual safety and risk are discussed.

  16. HIV, HBV, and HCV molecular epidemiology among trans (transvestites, transsexuals, and transgender) sex workers in Argentina.

    Science.gov (United States)

    Carobene, Mauricio; Bolcic, Federico; Farías, María Sol Dos Ramos; Quarleri, Jorge; Avila, María Mercedes

    2014-01-01

    Commercial sex work is frequent among male-to-female transvestites, transsexuals and transgenders in Argentina, leading to high susceptibility to HIV, HBV, and HCV among other sexually transmitted infections. In a global context of scarce data on the trans sex workers population, this study was aimed to study the genomic characterization of these viruses. Plasma presence of HIV, HBV, and HCV genomic material was evaluated in samples from 273 trans sex workers. Genomic sequences of HIV-gag, pol, and vif-vpu genes, HBV-S gene, and HCV-5'UT and NS5B genes were obtained. Molecular characterization involved phylogenetic analysis and several in silico tools. Resistance-associated mutations in HIV and HBV pol genes were also analyzed. The HIV genomic characterization in 62 trans sex workers samples showed that 54.8% of the isolates corresponded to BF intersubtype recombinants, and 38.7% to subtype B. The remaining were classified as subtypes C (4.8%) and A (1.6%). HBV and HCV co-infection prevalence among HIV positive trans sex workers yielded rates of 3.2% and 6.5% respectively. Drug resistance-associated mutations were found in 12/62 (19%) HIV pol sequences, but none among HBV. Based on phylogenetic relationships, HIV isolates characterized as subtypes BF and B appeared intermingled with those from other high-risk groups. Despite trans sex workers declared not to have received antiviral treatment, complex drug resistance-associated mutation patterns were found in several HIV isolates. Planned prevention, screening, and treatment are needed to reduce further transmission and morbidity. © 2013 Wiley Periodicals, Inc.

  17. Heavy Alcohol Use Among Migrant and Non-Migrant Male Sex Workers in Thailand: A Neglected HIV/STI Vulnerability.

    Science.gov (United States)

    Guadamuz, Thomas E; Clatts, Michael C; Goldsamt, Lloyd A

    2018-02-20

    There is scarce research on male sex workers in the context of alcohol use. While heavy alcohol use has been established as a risk factor for HIV and STI infections among men who have sex with men (MSM), men who engage in sex work with other men, particularly from the Global South, have not been included in these studies. Moreover, studies among male sex workers in Asia often do not explore migration contexts of these men. The objective of this exploratory study is to examine the prevalence and correlates of heavy alcohol use among migrant and non-migrant male sex workers in Bangkok and Pattaya, Central Thailand. Between August and October 2015, 18-24 year-old migrant and non-migrant male sex workers (n = 212) were recruited from various male sex work-identified venues (bars, clubs, massage parlors, and go-go bars) to take an interviewer-administered cross-sectional survey in Bangkok and Pattaya, Thailand. Measures were adapted from previous studies in similar populations and included structured questions across four domains, including demographic characteristics, alcohol use, stimulant use, and sexual behaviors. Multivariable logistic regression assessed the independent associations between heavy alcohol use (heavy versus not heavy) and demographic characteristics, stimulant use and sexual behavior. Heavy alcohol use was prevalent among one-third of participants. Heavy alcohol use was positively associated with male sex workers who were non-migrant and Thai, currently using stimulants, having 15 or more male clients in the past month and having first consumed alcohol at age 15 years or younger. Current HIV prevention efforts should consider subpopulations of MSM, including male sex workers and migrants, as well as other risk behaviors like alcohol, as important contexts for HIV and STI risks.

  18. A qualitative exploration of barriers to condom use among female sex workers in China

    NARCIS (Netherlands)

    Wu, J.; Zhou, X.; Lu, C.; Moyer, E.; Wang, H.; Hong, L.; Deng, X.

    2012-01-01

    Background: Sex workers in China continue to engage in unprotected sex acts that put them at risk for contracting HIV (Human Immunodeficiency Virus) and other STIs (Sexually Transmitted Infections). The purpose of this study was to explore women’s work history, the context of sex work, condom use,

  19. Differences between health-promoting lifestyle among sex worker with substance use and non-substance use women (Case study in Tehran

    Directory of Open Access Journals (Sweden)

    Fatemeh Damirchi

    2016-12-01

    Full Text Available Background and Objective: The high risks behaviors in sex worker women have a strong relationship with substance use. In addition, lifestyle has a key role in prevalence of social problems. Therefore, the aim of current study is to investigate the differences between health-promoting lifestyle among women sex workers with substance and non-substance use.Materials and Methods: This study is a descriptive correlation research. The 120 women including 60 sex worker with substance use and 60 non-substance use women who were selected by convenience sampling in Tehran in 2016. They completed the Health- Promoting Lifestyle Profile (HPLP. Data was analyzed by utilizing multivariate analysis of variance. SPSS software version 20 was used.Results: The results indicated that there was a the higher mean scores in nutrition and interpersonal sub-scales in non-substance use women than sex worker women (P=0.001. In addition, in spiritual level (P=0.001, responsibility (P=0.008 and Stress Management (P=0.015 in non-substance women had lower scores than substance use women sex-worker.Conclusion: These findings indicated that even though the life style in two group of sex worker women was unhealthy and unsafe but, in life style components in two women sex worker with and without substance abuse were different.

  20. Burden and correlates of mental health diagnoses among sex workers in an urban setting.

    Science.gov (United States)

    Puri, Nitasha; Shannon, Kate; Nguyen, Paul; Goldenberg, Shira M

    2017-12-19

    Women involved in both street-level and off-street sex work face disproportionate health and social inequities compared to the general population. While much research has focused on HIV and sexually transmitted infections (STIs) among sex workers, there remains a gap in evidence regarding the broader health issues faced by this population, including mental health. Given limited evidence describing the mental health of women in sex work, our objective was to evaluate the burden and correlates of mental health diagnoses among this population in Vancouver, Canada. An Evaluation of Sex Workers Health Access (AESHA) is a prospective, community-based cohort of on- and off-street women in sex work in Vancouver, Canada. Participants complete interviewer-administered questionnaires semi-annually. We analyzed the lifetime burden and correlates of self-reported mental health diagnoses using bivariate and multivariable logistic regression. Among 692 sex workers enrolled between January 2010 and February 2013, 338 (48.8%) reported ever being diagnosed with a mental health issue, with the most common diagnoses being depression (35.1%) and anxiety (19.9%). In multivariable analysis, women with mental health diagnoses were more likely to identify as a sexual/gender minority (LGBTQ) [AOR=2.56, 95% CI: 1.72-3.81], to use non-injection drugs [AOR=1.85, 95% CI: 1.12-3.08], to have experienced childhood physical/sexual trauma [AOR=2.90, 95% CI: 1.89-4.45], and work in informal indoor [AOR=1.94, 95% CI: 1.12 - 3.40] or street/public spaces [AOR=1.76, 95% CI: 1.03-2.99]. This analysis highlights the disproportionate mental health burden experienced by women in sex work, particularly among those identifying as a sexual/gender minority, those who use drugs, and those who work in informal indoor venues and street/public spaces. Evidence-informed interventions tailored to sex workers that address intersections between trauma and mental health should be further explored, alongside policies to

  1. Effects of implementing the act of prohibition on sex trafficking on female sex workers' sexually transmitted infections.

    Directory of Open Access Journals (Sweden)

    Minsoo Jung

    Full Text Available This study investigated the effect of implementing the act of prohibition on sex trafficking (PST on sexually transmitted disease (STD infections among South Korean female sex workers (FSWs working at prostitution blocks. Research data were collected twice through the Korean government-sanctioned survey for female sex workers (1st wave = 1,083; 2nd wave = 926. We examined the associations among health behavior, working conditions, and the effect of PST act via hierarchical logistic regression analyses using propensity score matching. After adjusted covariates, the risk probability was 0.288 times lower among FSWs who had remained in prostitute blocks after the PST act enforcement compared to FSWs who had worked before the PST. Similarly, the risk probability for a gonorrhea infection was 0.219 times lower among FSWs who had remained in prostitute blocks after the PST act compared to FSWs who had worked before the PST. Therefore, this study showed that, besides already known factors, the implementation and establishment of the PST Act was a strong factor that suppressed STD infections among FSWs.

  2. Sex Education Attitudes and Outcomes among North American Women

    Science.gov (United States)

    Williams, Monnica T.; Bonner, Laura

    2006-01-01

    Attitudes and outcomes of sex education received by North American women are examined via an Internet survey (N = 1,400). Mean age was 19.5, with 24% reporting one or more unplanned pregnancies. Women were more satisfied with sex education from informal sources than from parents, schools, and physicians. Those receiving sex education from parents…

  3. Social distance towards female sex workers and its relations to authoritarianism, social dominance orientation and self-respect

    Directory of Open Access Journals (Sweden)

    Karić Tijana

    2014-01-01

    Full Text Available In this paper, we explored the in-group and outer-group social distance towards sex workers and its relations to authoritarianism, social dominance orientation and self-respect. The sample consisted of 92 participants from the general population and 45 female sex workers (age 18-50. The instruments used were the Bogardus social distance scale, the Authoritarianism scale UPA-S, the Social dominance orientation scale and the Rosenberg self-respect scale. The results indicate a rather high social distance towards sex workers, including the distance by the general population being higher than the distance of the sex workers towards their own group. The correlation of authoritarianism and social distance was significant, as was the correlation between authoritarian aggressiveness and stoicism and social distance. The relationship between social dominance orientation and self-respect and social distance in our research has been statistically insignificant, however it demonstrates the expected trends. [Projekat Ministarstva nauke Republike Srbije, br. ON179002: Efekti egzistencijalne nesigurnosti na pojedinca i porodicu u Srbiji

  4. SEX WORK, LAW, AND VIOLENCE: BEDFORD V. CANADA AND THE HUMAN RIGHTS OF SEX WORKERS

    Directory of Open Access Journals (Sweden)

    Graham Hudson

    2013-02-01

    Full Text Available In Bedford v. Canada, two levels of Ontario courts ruled that a selection of criminal laws prohibiting prostitution-related activities unjustifiably deprive sex workers of their right to liberty and security of the person.The courts struck down or modified some of the offending provisions to ensure that sex workers are better able to take precautions against violence. While sex workers consider the Ontario Superior Court of Justice ruling a victory and the Ontario Court of Appeal ruling a partial victory, the government, some women’s rights groups, and other defenders of the provisions argue that courts ventured into a “policy thicket”, which is to suggest that they had stepped outside of their legitimate institutional role. Associated concerns include that the decisions effectively constitutionalize prostitution and will pre-empt or curtail Parliament’s consideration of legislative options.      In this paper, the authors clarify misconceptions about the constitutional foundations and implications of Bedford, and explore how the ruling might affect legal and policy-based interactions among various stakeholders. Approaching constitutional rights as discursive mechanisms, rather than as “trumps”, we argue that Bedford will not hinder the continuation of democratic debate about whether, how, and why aspects of sex work should be regulated. To the contrary, Bedford is more likely to enhance the quality of debates by making them more inclusive of the perspectives of sex workers as well as accommodative of growing empirical research that has hitherto been ignored or misrecognized.   Dans l’affaire Bedford v. Canada, deux tribunaux ontariens ont conclu que des dispositions législatives du droit criminel interdisant les activités liées à la prostitution privaient de façon injustifiée les travailleurs et travailleuses du sexe du droit à la liberté et à la sécurité de leur personne. Ces tribunaux ont d

  5. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

    Directory of Open Access Journals (Sweden)

    M Eugenia Socías

    Full Text Available Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC, sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC.Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access. Multivariable logistic regression analyses, using generalized estimating equations (GEE, were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013.In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4% women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%, limited hours of operation (36.5%, and perceived disrespect by health care providers (26.1%. In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10-1.94, workplace- (AOR = 1.31, 95% CI 1.05-1.63, and community-level violence (AOR = 1.41, 95% CI 1.04-1.92, as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03-1.69, a mental illness diagnosis (AOR = 1.66, 95% CI 1.34-2.06, and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59-7.57 emerged as independent correlates of institutional barriers to health services.Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex

  6. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

    Science.gov (United States)

    Socías, M Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10-1.94), workplace- (AOR = 1.31, 95% CI 1.05-1.63), and community-level violence (AOR = 1.41, 95% CI 1.04-1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03-1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34-2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59-7.57) emerged as independent correlates of institutional barriers to health services. Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex workers

  7. Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada—a qualitative study

    Science.gov (United States)

    Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

    2014-01-01

    Objectives To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers’ working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Design Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Setting Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers’ safety over arrest, while continuing to target clients. Participants 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Outcome measures Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers’ working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January–November 2013). Results Sex workers’ narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants’ accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. Conclusions These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in

  8. HIV knowledge, risk perception, and safer sex practices among female sex workers in Port Moresby, Papua New Guinea

    Science.gov (United States)

    Bruce, Eunice; Bauai, Ludwina; Sapuri, Mathias; Kaldor, John M; Fairley, Christopher K; Keogh, Louise A

    2011-01-01

    Sex workers are considered a high-risk group for sexually transmitted infections, including human immunodeficiency virus (HIV), and are often targeted by prevention interventions with safer sex messages. The purpose of this study was to explore the extent to which knowledge of HIV and perception of risk influence safer sex practices among female sex workers (FSWs) in Port Moresby, Papua New Guinea. FSWs (n = 174) were recruited from 19 sites to participate in the study. Qualitative data were collected using semistructured interviews with FSWs (n = 142) through focus group discussions and (n = 32) individual interviews. In addition, quantitative data were collected from all FSWs using a short structured, demographic questionnaire. Data were analyzed using recurring themes and calculations of confidence intervals. Despite some common misperceptions, overall, most FSWs were basically aware of the risks of HIV and informed about transmission and prevention modalities but used condoms inconsistently. Most reported using condoms ‘sometimes’, almost one-sixth ‘never’ used condoms, only a fraction used condoms ‘always’ with clients, and none used condoms ‘always’ with regular sexual partners (RSPs). Among these FSWs, being knowledgeable about the risks, transmission, and prevention of HIV did not translate into safe sex. The findings suggest that certain contextual barriers to safer sex practices exist. These barriers could heighten HIV vulnerability and possibly may be responsible for infection in FSWs. Specific interventions that focus on improving condom self-efficacy in FSWs and simultaneously target clients and RSPs with safer sex messages are recommended. PMID:21445375

  9. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    OpenAIRE

    Soc?as, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers? experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex worke...

  10. Complexities of short-term mobility for sex work and migration among sex workers: violence and sexual risks, barriers to care, and enhanced social and economic opportunities.

    Science.gov (United States)

    Goldenberg, Shira M; Chettiar, Jill; Nguyen, Paul; Dobrer, Sabina; Montaner, Julio; Shannon, Kate

    2014-08-01

    Despite research on the health and safety of mobile and migrant populations in the formal and informal sectors globally, limited information is available regarding the working conditions, health, and safety of sex workers who engage in short-term mobility and migration. The objective of this study was to longitudinally examine work environment, health, and safety experiences linked to short-term mobility/migration (i.e., worked or lived in another city, province, or country) among sex workers in Vancouver, Canada, over a 2.5-year study period (2010-2012). We examined longitudinal correlates of short-term mobility/migration (i.e., worked or lived in another city, province, or country over the 3-year follow-up period) among 646 street and off-street sex workers in a longitudinal community-based study (AESHA). Of 646 sex workers, 10.84 % (n = 70) worked or lived in another city, province, or country during the study. In a multivariate generalized estimating equations (GEE) model, short-term mobility/migration was independently correlated with older age (adjusted odds ratio (AOR) 0.95, 95 % confidence interval (CI) 0.92-0.98), soliciting clients in indoor (in-call) establishments (AOR 2.25, 95 % CI 1.27-3.96), intimate partner condom refusal (AOR 3.00, 1.02-8.84), and barriers to health care (AOR 1.77, 95 % CI 1.08-2.89). In a second multivariate GEE model, short-term mobility for sex work (i.e., worked in another city, province, or country) was correlated with client physical/sexual violence (AOR 1.92, 95 % CI 1.02-3.61). In this study, mobile/migrant sex workers were more likely to be younger, work in indoor sex work establishments, and earn higher income, suggesting that short-term mobility for sex work and migration increase social and economic opportunities. However, mobility and migration also correlated with reduced control over sexual negotiation with intimate partners and reduced health care access, and mobility for sex work was associated with

  11. Alcohol Use and HIV Risk Within Social Networks of MSM Sex Workers in the Dominican Republic.

    Science.gov (United States)

    Tan, Diane; Holloway, Ian W; Gildner, Jennifer; Jauregui, Juan C; Garcia Alvarez, Rafael; Guilamo-Ramos, Vincent

    2017-11-01

    To examine how alcohol-related HIV risk behaviors within MSM sex workers' social networks (SN) may be associated with individual risk behaviors, respondent-driven and venue-based sampling were used to collect demographic, behavioral and SN characteristics among MSM sex workers in Santo Domingo and Boca Chica (N = 220). The majority of participants reported problem drinking (71.0%) or alcohol use at their last sexual encounter (71.4%). Self-reported problem drinking was associated with SN characteristics (at least one member who recently got drunk aOR = 7.5, no religious/spiritual adviser aOR = 3.0, non-sexual network density aOR = 0.9), while self-reported alcohol use at last sex was associated with individual (drug use at last sex aOR = 4.4) and SN characteristics (at least one member with previous HIV/STI testing aOR = 4.7). Dominican MSM sex workers reported high alcohol use, which may increase their risk for HIV. A better understanding of SN factors associated with individual risk behaviors can help guide appropriate intervention development.

  12. Sex allocation in fungus-growing ants: worker or queen control without symbiont-induced female bias

    DEFF Research Database (Denmark)

    Dijkstra, Michiel B.; Boomsma, Jacobus Jan

    2008-01-01

    The fungal cultivars of fungus-growing ants are vertically transmitted by queens but not males. Selection would therefore favor cultivars that bias the ants' sex ratio towards gynes, beyond the gyne bias that is optimal for workers and queens. We measured sex allocation in 190 colonies of six...... sympatric fungus-growing ant species. As predicted from relatedness, female bias was greater in four singly mated Sericomyrmex and Trachymyrmex species than in two multiply mated Acromyrmex species. Colonies tended to raise mainly a single sex, which could be partly explained by variation in queen number......, colony fecundity, and fungal garden volume for Acromyrmex and Sericomyrmex, but not for Trachymyrmex. Year of collection, worker number and mating frequency of Acromyrmex queens did not affect the colony sex ratios. We used a novel sensitivity analysis to compare the population sex allocation ratios...

  13. Correlates of unprotected sex with female sex workers among male clients in Tijuana, Mexico.

    Science.gov (United States)

    Goldenberg, Shira M; Gallardo Cruz, Manuel; Strathdee, Steffanie A; Nguyen, Lucie; Semple, Shirley J; Patterson, Thomas L

    2010-05-01

    Tijuana, situated adjacent to San Diego, CA on the US-Mexico border, is experiencing an emerging HIV epidemic, with prevalence among female sex workers (FSWs) having risen in recent years from Tijuana. In 2008, males from San Diego (N = 189) and Tijuana (N = 211) aged 18 or older who had paid or traded for sex with a FSW in Tijuana during the past 4 months were recruited in Tijuana's red light district. Participants underwent psychosocial interviews, and were tested for HIV, syphilis (Treponema pallidum), gonorrhea (Neisseria gonorrhoeae), and Chlamydia (Chlamydia trachomatis). Of 394 men, median age was 36 years, 42.1% were married, and 39.3% were unemployed. Ethnic composition was 13.2% white, 79.4% Hispanic, and 7.4% black or other. Half (50.3%) reported unprotected vaginal or anal sex with FSWs in Tijuana in the past 4 months. High proportions reported using drugs during sex (66%), and 36% reported frequenting the same FSW. Factors independently associated with unprotected sex with FSWs were using drugs during sex, visiting the same FSW, being married, and being unemployed. FSWs' clients represent a sexually transmitted infections/HIV transmission "bridge" through unprotected sex with FSWs, wives, and other partners. Tailored interventions to promote consistent condom use are needed for clients, especially within the context of drug use and ongoing relations with particular FSWs.

  14. Burden of HIV and Syphilis: A Comparative Evaluation between Male Sex Workers and Non-Sex-Worker Men Who Have Sex with Men in Urban China.

    Directory of Open Access Journals (Sweden)

    Weiming Tang

    Full Text Available The increasing burden of sexually transmitted infections (STIs including HIV and syphilis among male sex workers (MSWs is a major global concern. The aim of our study was to evaluate the difference between MSWs and non-commercial MSMs in China.During 2008-09, in a cross-sectional study, 2618 adult MSM were recruited through respondent-driven and snowball sampling from seven cities of China. Information regarding socio-demographics, risk behaviors, HIV-related knowledge and STI-related symptoms were collected and participants were tested for HIV and syphilis.Among 2618 participating MSM, 9.97% sold sex to males. HIV prevalence was 7.45% (6.13% among MSWs and 7.59% among non-MSW MSM and syphilis prevalence was 14.32% (10.73% for MSWs and 14.72% for non-MSW MSM. Compared to non-MSW MSM, MSWs were more likely to be younger (adjusted odds ratio: aOR = 0.91, 95% confidence interval: 95%CI=0.88-0.93, never married (aOR = 4.38, 95% CI = 2.38-6.80, less educated, heterosexual (aOR = 13.04, 95% CI = 6.08-27.95, less knowledgeable regarding HIV (aOR = 0.70, 95% CI=0.51-0.96, experiencing symptoms of STI (aOR = 2.16, 95% CI = 1.47-3.19, engaging in condomless vaginal intercourse (aOR = 2.16, 95% CI = 1.47-3.19 and less likely to engage in condomless anal intercourse (aOR = 0.62, 95% CI = 0.46-0.85.High HIV and syphilis prevalence warranted urgent intervention targeting MSWs as a separate sentinel group for efficient surveillance owing to their different distribution from non-MSW MSM. Although male sex workers and non-commercial homosexuals have similar rates of HIV and syphilis, MSWs have different characteristics which should be considered in designing intervention programs targeting them.

  15. Policing practices as a structural determinant for HIV among sex workers: a systematic review of empirical findings.

    Science.gov (United States)

    Footer, Katherine Ha; Silberzahn, Bradley E; Tormohlen, Kayla N; Sherman, Susan G

    2016-01-01

    Sex workers are disproportionately infected with HIV worldwide. Significant focus has been placed on understanding the structural determinants of HIV and designing related interventions. Although there is growing international evidence that policing is an important structural HIV determinant among sex workers, the evidence has not been systematically reviewed. We conducted a systematic review of quantitative studies to examine the effects of policing on HIV and STI infection and HIV-related outcomes (condom use; syringe use; number of clients; HIV/STI testing and access) among cis and trans women sex workers. Databases included PubMed, Embase, Scopus, Sociological Abstracts, Popline, Global Health (OVID), Web of Science, IBSS, IndMed and WHOLIS. We searched for studies that included police practices as an exposure for HIV or STI infection or HIV-related outcomes. Of the 137 peer-reviewed articles identified for full text review, 14 were included, representing sex workers' experiences with police across five settings. Arrest was the most commonly explored measure with between 6 and 45% of sex workers reporting having ever been arrested. Sexual coercion was observed between 3 and 37% of the time and police extortion between 12 and 28% across studies. Half the studies used a single measure to capture police behaviours. Studies predominantly focused on "extra-legal policing practices," with insufficient attention to the role of "legal enforcement activities". All studies found an association between police behaviours and HIV or STI infection, or a related risk behaviour. The review points to a small body of evidence that confirms policing practices as an important structural HIV determinant for sex workers, but studies lack generalizability with respect to identifying those police behaviours most relevant to women's HIV risk environment.

  16. Migration, violence, and safety among migrant sex workers: A qualitative study in two Guatemalan communities

    OpenAIRE

    Rocha-Jiménez, Teresita; Brouwer, Kimberly C.; Silverman, Jay G.; Morales-Miranda, Sonia; Goldenberg, Shira M.

    2016-01-01

    Despite reports of high levels of violence among women migrants in Central America, limited evidence exists regarding the health and safety of migrant sex workers in Central America. This study is based on 16 months of field research (November 2012–February 2015), including ethnographic fieldwork, in-depth interviews, and focus groups conducted with 52 internal and international migrant female sex workers in Tecún Úman and Quetzaltenango, Guatemala, key transit and destination communities for...

  17. Demography and sex work characteristics of female sex workers in India

    Science.gov (United States)

    Dandona, Rakhi; Dandona, Lalit; Kumar, G Anil; Gutierrez, Juan Pablo; McPherson, Sam; Samuels, Fiona; Bertozzi, Stefano M

    2006-01-01

    Background The majority of sex work in India is clandestine due to unfavorable legal environment and discrimination against female sex workers (FSWs). We report data on who these women are and when they get involved with sex work that could assist in increasing the reach of HIV prevention activities for them. Methods Detailed documentation of demography and various aspects of sex work was done through confidential interviews of 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. The demography of FSWs was compared with that of women in the general population. Results A total of 5010 (75.4%), 1499 (22.5%), and 139 (2.1%) street-, home-, and brothel-based FSWs, respectively, participated. Comparison with women of Andhra Pradesh revealed that the proportion of those aged 20–34 years (75.6%), belonging to scheduled caste (35.3%) and scheduled tribe (10.5%), illiterate (74.7%), and of those separated/divorced (30.7%) was higher among FSWs (p 5 years were more likely to be non-street-based FSWs, illiterate, living in small urban towns, and to have started sex work between 12–15 years of age. The mean age at starting sex work (21.7 years) and gap between the first vaginal intercourse and the first sexual intercourse in exchange for money (6.6 years) was lower for FSWs in the rural areas as compared with those in large urban areas (23.9 years and 8.8 years, respectively). Conclusion These data highlight that women struggling with illiteracy, lower social status, and less economic opportunities are especially vulnerable to being infected by HIV, as sex work may be one of the few options available to them to earn money. Recommendations for actions are made for long-term impact on reducing the numbers of women being infected by HIV in addition to the current HIV prevention efforts in India. PMID:16615869

  18. Demography and sex work characteristics of female sex workers in India

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    McPherson Sam

    2006-04-01

    Full Text Available Abstract Background The majority of sex work in India is clandestine due to unfavorable legal environment and discrimination against female sex workers (FSWs. We report data on who these women are and when they get involved with sex work that could assist in increasing the reach of HIV prevention activities for them. Methods Detailed documentation of demography and various aspects of sex work was done through confidential interviews of 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. The demography of FSWs was compared with that of women in the general population. Results A total of 5010 (75.4%, 1499 (22.5%, and 139 (2.1% street-, home-, and brothel-based FSWs, respectively, participated. Comparison with women of Andhra Pradesh revealed that the proportion of those aged 20–34 years (75.6%, belonging to scheduled caste (35.3% and scheduled tribe (10.5%, illiterate (74.7%, and of those separated/divorced (30.7% was higher among FSWs (p 5 years were more likely to be non-street-based FSWs, illiterate, living in small urban towns, and to have started sex work between 12–15 years of age. The mean age at starting sex work (21.7 years and gap between the first vaginal intercourse and the first sexual intercourse in exchange for money (6.6 years was lower for FSWs in the rural areas as compared with those in large urban areas (23.9 years and 8.8 years, respectively. Conclusion These data highlight that women struggling with illiteracy, lower social status, and less economic opportunities are especially vulnerable to being infected by HIV, as sex work may be one of the few options available to them to earn money. Recommendations for actions are made for long-term impact on reducing the numbers of women being infected by HIV in addition to the current HIV prevention efforts in India.

  19. Non-Cationic Proteins Are Associated with HIV Neutralizing Activity in Genital Secretions of Female Sex Workers.

    Science.gov (United States)

    Birse, Kenzie D M; Cole, Amy L; Hirbod, Taha; McKinnon, Lyle; Ball, Terry B; Westmacott, Garrett R; Kimani, Joshua; Plummer, Frank; Cole, Alexander M; Burgener, Adam; Broliden, Kristina

    2015-01-01

    Cationic proteins found in cervicovaginal secretions (CVS) are known to contribute to the early antiviral immune response against HIV-infection in vitro. We here aimed to define additional antiviral factors that are over-expressed in CVS from female sex workers at high risk of infection. CVS were collected from Kenyan HIV-seronegative (n = 34) and HIV-seropositive (n = 12) female sex workers, and were compared with those from HIV-seronegative low-risk women (n = 12). The highly exposed seronegative (HESN) sex workers were further divided into those with less (n = 22) or more (n = 12) than three years of documented sex work. Cationic protein-depleted CVS were assessed for HIV-neutralizing activity by a PBMC-based HIV-neutralizing assay, and then characterized by proteomics. HIV neutralizing activity was detected in all unprocessed CVS, however only CVS from the female sex worker groups maintained its HIV neutralizing activity after cationic protein-depletion. Differentially abundant proteins were identified in the cationic protein-depleted secretions including 26, 42, and 11 in the HESN>3 yr, HESNHIV-positive groups, respectively. Gene ontology placed these proteins into functional categories including proteolysis, oxidation-reduction, and epidermal development. The proteins identified in this study include proteins previously associated with the HESN phenotype in other cohorts as well as novel proteins not yet associated with anti-HIV activities. While cationic proteins appear to contribute to the majority of the intrinsic HIV neutralizing activity in the CVS of low-risk women, a broader range of non-cationic proteins were associated with HIV neutralizing activity in HESN and HIV-positive female sex workers. These results indicate that novel protein factors found in CVS of women with high-risk sexual practices may have inherent antiviral activity, or are involved in other aspects of anti-HIV host defense, and warrant further exploration into their mode of action.

  20. Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in Singapore.

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    Junice Y S Ng

    Full Text Available We assessed the proportion of and socio-ecological factors associated with ever having had sex with female sex workers (FSWs among heterosexual adolescents. We also described the characteristics of the adolescents who reported inconsistent condom use with FSWs.This is a cross-sectional study (response rate: 73% of 300 heterosexually active male adolescents of 16 to 19 years attending a national STI clinic in Singapore between 2009 and 2014. We assessed the ecological factors (individual, parental, peer, school and medial influences and sexual risk behaviors using a self-reported questionnaire. Poisson regression was used to obtain the adjusted prevalence ratios (aPR and confidence intervals (CI.The proportion of heterosexual male adolescents who had ever had sex with FSWs was 39%. Multivariate analysis showed that significant factors associated with ever having had sex with FSWs were sex initiation before 16 years old (aPR 1.79 CI: 1.30-2.46, never had a sexually active girlfriend (aPR 1.75 CI 1.28-2.38, reported lower self-esteem score (aPR 0.96 CI: 0.93-0.98, higher rebelliousness score (aPR 1.03 CI: 1.00-1.07 and more frequent viewing of pornography (aPR 1.47 CI: 1.04-2.09. Lifetime inconsistent condom use with FSWs was 30%.A significant proportion of heterosexual male adolescents attending the public STI clinic had ever had sex with FSWs. A targeted intervention that addresses different levels of influence to this behavior is needed. This is even more so because a considerable proportion of adolescents reported inconsistent condom use with FSWs, who may serve as a bridge of STI transmission to the community. National surveys on adolescent health should include the assessment of frequency of commercial sex visits and condom use with FSWs for long-term monitoring and surveillance.

  1. Workplace violence among female sex workers who use drugs in Vancouver, Canada: does client-targeted policing increase safety?

    Science.gov (United States)

    Prangnell, Amy; Shannon, Kate; Nosova, Ekaterina; DeBeck, Kora; Milloy, M-J; Kerr, Thomas; Hayashi, Kanna

    2018-02-01

    Workplace violence, by clients or predators, poses serious negative health consequences for sex workers. In 2013, the Vancouver (British Columbia), Canada Police Department changed their guidelines with the goal of increasing safety for sex workers by focusing law enforcement on clients and third parties, but not sex workers. We sought to examine the trends and correlates of workplace violence among female sex workers (FSW) before and after the guideline change, using data collected from prospective cohorts of persons who use illicit drugs in Vancouver, Canada. Among 259 FSW, 21.0% reported workplace violence at least once during the study period between 2008 and 2014. There was no statistically significant change in rates of workplace violence after the guideline change. In our multivariable analysis, daily heroin use was independently associated with workplace violence. The 2013 policing guideline change did not appear to have resulted in decreased reports of workplace violence. Increased access to opioid agonist therapies may reduce workplace violence among drug-using FSW.

  2. Structural Barriers to Antiretroviral Therapy Among Sex Workers Living with HIV: Findings of a Longitudinal Study in Vancouver, Canada.

    Science.gov (United States)

    Goldenberg, Shira M; Montaner, Julio; Duff, Putu; Nguyen, Paul; Dobrer, Sabina; Guillemi, Silvia; Shannon, Kate

    2016-05-01

    In light of limited data on structural determinants of access and retention in antiretroviral therapy (ART) among sex workers, we examined structural correlates of ART use among sex workers living with HIV over time. Longitudinal data were drawn from a cohort of 646 female sex workers in Vancouver, Canada (2010-2012) and linked pharmacy records on ART dispensation. We used logistic regression with generalized estimating equations (GEE) to examine correlates of gaps in ART use (i.e., treatment interruptions or delayed ART initiation), among HIV seropositive participants (n = 74). Over a 2.5-year period, 37.8 % of participants experienced gaps in ART use (i.e., no ART dispensed in a 6-month period). In a multivariable GEE model, younger age, migration/mobility, incarceration, and non-injection drug use independently correlated with gaps in ART use. In spite of successes scaling-up ART in British Columbia, younger, mobile, or incarcerated sex workers face persistent gaps in access and retention irrespective of drug use. Community-based, tailored interventions to scale-up entry and retention in ART for sex workers should be further explored in this setting.

  3. The influence of power, poverty and agency in the negotiation of condom use for female sex workers in mainland China.

    Science.gov (United States)

    Choi, Susanne Y P; Holroyd, Eleanor

    2007-01-01

    This paper analyses barriers to consistent condom use in the context of transactional sex among female sex workers in mainland China. It reveals how differences in socioeconomic profile and organisational hierarchies amongst different groups of sex workers create different barriers to condom use. Data was collected by means of field observation of entertainment venues and in-depth interviews. Findings suggest that, compared with other sex workers, street-walkers are less likely to use condoms with their clients, hold highly disadvantaged socioeconomic profiles and work in isolation. Major barriers to condom use link to economic deprivation and threats of violence from clients. For the women working in entertainment venues, drunkenness of clients, pricing mechanisms and familiarity with clients pose barriers to condom use. Yet within all these constraints women are not powerless and instead find ways to exercise agency and gain personal protection and economic advantage. In the newly emerging China, both structural hierarchies of work and individual agency inform condom use by female sex workers. Future HIV intervention programmes need to take these factors into account in order to meet the needs of different groups of women sex workers.

  4. Overlapping HIV and sex-work stigma among female sex workers recruited to 14 respondent-driven sampling surveys across Zimbabwe, 2013.

    Science.gov (United States)

    Hargreaves, J R; Busza, J; Mushati, P; Fearon, E; Cowan, F M

    2017-06-01

    HIV stigma can inhibit uptake of HIV testing and antiretroviral therapy as well as negatively affect mental health. Efforts to reduce discrimination against people living with HIV (LWH) have contributed to greater acceptance of the infection. Female sex workers (FSW) LWH may experience overlapping stigma due to both their work and HIV status, although this is poorly understood. We examined HIV and sex-work stigma experienced by FSW LWH in Zimbabwe. Using the SAPPH-IRe cluster-randomised trial baseline survey, we analysed the data from 1039 FSW self-reporting HIV. The women were recruited in 14 sites using respondent-driven sampling. We asked five questions to assess internalised and experienced stigma related to working as a sex worker, and the same questions were asked in reference to HIV. Among all FSW, 91% reported some form of sex-work stigma. This was not associated with sociodemographic or sex-work characteristics. Rates of sex-work stigma were higher than those of HIV-related stigma. For example, 38% reported being "talked badly about" for LWH compared with 77% for their involvement in sex work. Those who reported any sex-work stigma also reported experiencing more HIV stigma compared to those who did not report sex-work stigma, suggesting a layering effect. FSW in Zimbabwe experience stigma for their role as "immoral" women and this appears more prevalent than HIV stigma. As HIV stigma attenuates, other forms of social stigma associated with the disease may persist and continue to pose barriers to effective care.

  5. The relationship between health worker stigma and uptake of HIV counseling and testing and utilization of non-HIV health services: the experience of male and female sex workers in Kenya.

    Science.gov (United States)

    Nyblade, Laura; Reddy, Aditi; Mbote, David; Kraemer, John; Stockton, Melissa; Kemunto, Caroline; Krotki, Karol; Morla, Javier; Njuguna, Stella; Dutta, Arin; Barker, Catherine

    2017-11-01

    The barrier HIV-stigma presents to the HIV treatment cascade is increasingly documented; however less is known about female and male sex worker engagement in and the influence of sex-work stigma on the HIV care continuum. While stigma occurs in all spheres of life, stigma within health services may be particularly detrimental to health seeking behaviors. Therefore, we present levels of sex-work stigma from healthcare workers (HCW) among male and female sex workers in Kenya, and explore the relationship between sex-work stigma and HIV counseling and testing. We also examine the relationship between sex-work stigma and utilization of non-HIV health services. A snowball sample of 497 female sex workers (FSW) and 232 male sex workers (MSW) across four sites was recruited through a modified respondent-driven sampling process. About 50% of both male and female sex workers reported anticipating verbal stigma from HCW while 72% of FSW and 54% of MSW reported experiencing at least one of seven measured forms of stigma from HCW. In general, stigma led to higher odds of reporting delay or avoidance of counseling and testing, as well as non-HIV specific services. Statistical significance of relationships varied across type of health service, type of stigma and gender. For example, anticipated stigma was not a significant predictor of delay or avoidance of health services for MSW; however, FSW who anticipated HCW stigma had significantly higher odds of avoiding (OR = 2.11) non-HIV services, compared to FSW who did not. This paper adds to the growing evidence of stigma as a roadblock in the HIV treatment cascade, as well as its undermining of the human right to health. While more attention is being paid to addressing HIV-stigma, it is equally important to address the key population stigma that often intersects with HIV-stigma.

  6. Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro

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    Laušević Dragan

    2016-01-01

    Full Text Available Introduction. Female sex workers (FSWs are a group at increased risk for human immunodeficiency virus (HIV infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0% of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR = 22.7, 95% confidence interval (CI = 2.3-228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4-118.9 towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0, and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5. Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.

  7. Reducing stigma in healthcare and law enforcement: a novel approach to service provision for street level sex workers.

    Science.gov (United States)

    Bodkin, Kate; Delahunty-Pike, Alannah; O'Shea, Tim

    2015-04-09

    Providing services for street level sex workers requires a multidisciplinary approach, addressing both health and safety concerns typical of their age and gender and those that arise specific to their line of work. Despite being a diverse population, studies have identified some specific health needs for sex workers including addictions treatment, mental health. Additionally, studies have shown a higher risk of physical and sexual assault for this population. The Persons at Risk program (PAR) in London, Ontario, Canada was started in 2005 to address the specific needs of street level sex workers by using a harm-reduction model for policing and healthcare provision. This qualitative study evaluated this model of care in terms of improving access to healthcare and essential police services for street level sex workers. A total of 14 semi-structured interviews were conducted with current and former female street level sex workers enrolled in the PAR program. In addition, 3 semi-structured interviews were conducted with health and law enforcement professionals. The research team then analyzed and coded the transcripts using qualitative description to identify key themes in the data. Results indicated that participants represent a vulnerable population with increased safety concerns and healthcare needs relating to addictions, mental health and infectious disease. Despite this, participants reported avoiding healthcare workers and police officers in the past because of fear of stigma or repercussions. All participants identified the harm reduction approach of the PAR program as being essential to their continued engagement with the program. Other important aspects included flexible hours, the location of the clinic, streamlined access to mental health and addictions treatment and the female gender of the police and healthcare worker. The PAR program provides sex workers access to much needed primary healthcare that is flexible and without judgment. In addition, they are

  8. Association between long work hours and poor self-reported general health among Latin American immigrant and native workers in the United States and Spain.

    Science.gov (United States)

    Conway, Sadie H; Cayuela, Ana; Delclos, George L; Pompeii, Lisa A; Ronda, Elena

    2016-12-01

    The relationship between hours worked per week and self-reported general health (SRGH) has not been assessed in Latin American immigrant and native workers across host countries. Cross-sectional study of the association between long work hours (LWH) (i.e., >51 hr per week) and poor SRGH using data from 2,626 workers in the United States (immigrants = 10.4%) and 8,306 workers in Spain (immigrants = 4.1%). Both countries' natives working >51 hr per week had increased odds of reporting poor SRGH compared to those working fewer hours (U.S.: OR = 1.59; 95%CI = 1.01-2.49; Spain: OR = 2.17; 95%CI = 1.71-2.75); when stratified by sex, increased odds also were observed among immigrant female workers in Spain (OR = 3.47; 95%CI = 1.15-10.5). LWH were associated with differential health outcomes in populations of native and Latin American immigrant workers in the United States and Spain, which may reflect social or occupational inequalities in general or resulting from the 2008 financial crisis. Am. J. Ind. Med. 59:1105-1111, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. Bedford v. Canada: a paradigmatic case toward ensuring the human and health rights of sex workers.

    Science.gov (United States)

    Galldin, Karin; Robertson, Leslie; Wiseman, Charlene

    2011-10-01

    The Criminal Code of Canada prohibits certain aspects of sex work: the keeping of a common bawdy-house, living off the avails of prostitution and communicating for the purposes of prostitution in a public place. These legal constraints impede sex workers' ability to practise their profession safely and without risk to their bodily integrity; they also impair their personal autonomy and can lead to their stigmatization. Bedford v. Canada is a groundbreaking case, since the applicants and intervening organizations seek to overturn aspects of Canadian law that specifically put the health and human rights of sex workers at risk.

  10. Estimating the Number of Male Sex Workers with the Capture- Re ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    (IDEA),Mobile Solutions group; 6Management Sciences for Health, Arlington, VA, USA. *For correspondence: Email: sadebajo@popcouncil.org; Phone: +234 806 887 9584. Abstract ... condom use among MSM and MSM sex workers is low as ... concurrent sexual relationships with women, are .... problematic situations.

  11. Reducing the risk of HIV infection among South African sex workers: socioeconomic and gender barriers.

    Science.gov (United States)

    Karim, Q A; Karim, S S; Soldan, K; Zondi, M

    1995-11-01

    The social context within which women engaged in sex work at a popular truck stop in South Africa are placed at risk of human immunodeficiency virus (HIV) infection and the factors that influence their ability to reduce their risk were assessed. Using qualitative and quantitative techniques, an elected sex worker from within the group collected all data. Given the various pressing needs for basic survival, the risk of HIV infection is viewed as one more burden imposed on these women by their lack of social, legal, and economic power. Violence, or the threat thereof, plays an important role in their disempowerment. In the few instances in which sex workers were able to insist on condom use, it resulted in a decrease in earnings, loss of clients, and physical abuse. Recommendations to reduce the sex workers' risk for HIV infection include negotiation and communication skills to enable them to persuade their clients to use condoms; development of strategies through which they can maximally use their group strength to facilitate unified action; and accessibility of protective methods they can use and control, such as intravaginal microbicides.

  12. Sex Workers, Fem Queens, and Cross-Dressers: Differential Marginalizations and HIV Vulnerabilities Among Three Ethnocultural Male-to-Female Transgender Communities in New York City

    OpenAIRE

    Hwahng, Sel Julian; Nuttbrock, Larry

    2007-01-01

    This article describes 3 distinct ethnocultural male-to-female transgender communities in New York City: the low-income African American/Black1 and Latina(o) House Ball community; low-income, often undocumented immigrant Asian sex workers; and middle-class White cross-dressers. These communities are highly socially isolated from each other and are more connected to their ethnocultural contexts than to an abstract and shared transgender identity. Whereas previous research either has viewed mal...

  13. Female commercial sex worker perspective on susceptibility of HIV-AIDS in Yogyakarta

    Science.gov (United States)

    Mahmudah, Nurul; Dasuki, Djaswadi; Kurniawati, Herlin Fitriani

    2017-08-01

    Commercial sex worker is one of the groups with the highest level of susceptibility against HIV infection. They are 13,5 fold more prone to a living with HIV infection than the female of non commercial sex workers. Moreover, these commercial sex workers are also stigmatized with social sanction and discrimination against people with HIV-AIDS. The society mostly avoid them, deject them, isolate them, insult them, despise them, distrust them, and even go against the existence of those suffering from or infected by HIV-AIDS. Thus, stigmatizing and discrimination are basicly highly prohibited since they can incur higher social problems. It is also vital to handle the spread of HIV-AIDS in the society as soon as possible in the attempt of fighting against the spread of the disease. Hence, being broad minded, tolerant, and caring towards them as well as working hand in hand with the community are expected to diminish, minimize, and even eradicate the outbreak of HIV-AIDS. Caring towards those suffering from the infection without stigmatizing them and discriminating them will be one of the first measurements to take to improve what is needed to prevent the prevalence and spread of the disease. Thus, the primary objective of this research is to know the perception of female commercial sex workers on the susceptibility of HIV-AIDS in Yogyakarta. The research participants were selected from three localizations in Yogyakarta namely Pasar Kembang, Bongsuwung, and Giwangan. It is revealed that the participants had a good perception on the susceptibility of AIDS infection as seen from the fact there are free avalaible condoms for them to use everytime they have a sexual intercourse with the clients. All participants were aware of their high susceptibility against the infection of STIs/HIV/AIDS and thus they want to save their skin from those diseases. Also they had a good knowledge that having an intercourse without condom may get them infected.

  14. A community empowerment approach to the HIV response among sex workers: effectiveness, challenges, and considerations for implementation and scale-up.

    Science.gov (United States)

    Kerrigan, Deanna; Kennedy, Caitlin E; Morgan-Thomas, Ruth; Reza-Paul, Sushena; Mwangi, Peninah; Win, Kay Thi; McFall, Allison; Fonner, Virginia A; Butler, Jennifer

    2015-01-10

    A community empowerment-based response to HIV is a process by which sex workers take collective ownership of programmes to achieve the most effective HIV outcomes and address social and structural barriers to their overall health and human rights. Community empowerment has increasingly gained recognition as a key approach for addressing HIV in sex workers, with its focus on addressing the broad context within which the heightened risk for infection takes places in these individuals. However, large-scale implementation of community empowerment-based approaches has been scarce. We undertook a comprehensive review of community empowerment approaches for addressing HIV in sex workers. Within this effort, we did a systematic review and meta-analysis of the effectiveness of community empowerment in sex workers in low-income and middle-income countries. We found that community empowerment-based approaches to addressing HIV among sex workers were significantly associated with reductions in HIV and other sexually transmitted infections, and with increases in consistent condom use with all clients. Despite the promise of a community-empowerment approach, we identified formidable structural barriers to implementation and scale-up at various levels. These barriers include regressive international discourses and funding constraints; national laws criminalising sex work; and intersecting social stigmas, discrimination, and violence. The evidence base for community empowerment in sex workers needs to be strengthened and diversified, including its role in aiding access to, and uptake of, combination interventions for HIV prevention. Furthermore, social and political change are needed regarding the recognition of sex work as work, both globally and locally, to encourage increased support for community empowerment responses to HIV. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Sexually transmitted diseases among female commercial sex workers in Finote Selam town, northwest Ethiopia: a community-based cross-sectional study.

    Science.gov (United States)

    Anteneh, Zelalem Alamrew; Agumas, Yirdaw Amare; Tarekegn, Molalign

    2017-01-01

    Female commercial sex workers (FCSWs) are considered a high-risk group for acquiring sexually transmitted diseases (STDs), yet the reported prevalence varies in studies around the world. The aim of this study was to determine the magnitude and associated factors of STDs among female sex workers. A community-based cross-sectional study was conducted among female sex workers in Finote Selam town. A total of 389 sex workers were studied using census method. Data were collected using an interview with structured questionnaires. The data were entered and analyzed by using SPSS version 20 software package. The findings of this study showed that the overall prevalence of STDs was 20.6%. The reported prevalence of genital discharge, ulcer, and bubo was 15.9%, 15.2%, and 11.6%, respectively. In the multivariable logistic regression analysis, respondents who did not use a condom were about four times at higher risk of STDs than those who were using a condom consistently (adjusted odds ratio [AOR] = 4.07; 95% confidence interval [CI]: 1.812, 9.139). Respondents who experienced condom breakages were more than 12 times more likely to report STDs than those who never experienced condom breakages (AOR = 12.291, 95% CI: 5.701, 26.495). The findings of this study showed that one in five commercial sex workers in Finote Selam town had STDs. Sex without a condom and condom breakage during sexual intercourse showed a significant association with STDs. Therefore, the Woreda Health Office in collaboration with nongovernmental organizations in the area should work on safe sex promotion to enhance consistent condom use and reduce condom breakage through continuous education among commercial sex workers.

  16. Sexually transmitted diseases among female commercial sex workers in Finote Selam town, northwest Ethiopia: a community-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Anteneh ZA

    2017-03-01

    Full Text Available Zelalem Alamrew Anteneh,1 Yirdaw Amare Agumas,2 Molalign Tarekegn3 1School of Public Health, Bahir Dar University, 2Networks of Charitable Societies of HIV Positive Association in Amhara Region (NAP+, 3Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia Background: Female commercial sex workers (FCSWs are considered a high-risk group for acquiring sexually transmitted diseases (STDs, yet the reported prevalence varies in studies around the world. The aim of this study was to determine the magnitude and associated factors of STDs among female sex workers. Methods: A community-based cross-sectional study was conducted among female sex workers in Finote Selam town. A total of 389 sex workers were studied using census method. Data were collected using an interview with structured questionnaires. The data were entered and analyzed by using SPSS version 20 software package.Results: The findings of this study showed that the overall prevalence of STDs was 20.6%. The reported prevalence of genital discharge, ulcer, and bubo was 15.9%, 15.2%, and 11.6%, respectively. In the multivariable logistic regression analysis, respondents who did not use a condom were about four times at higher risk of STDs than those who were using a condom consistently (adjusted odds ratio [AOR] = 4.07; 95% confidence interval [CI]: 1.812, 9.139. Respondents who experienced condom breakages were more than 12 times more likely to report STDs than those who never experienced condom breakages (AOR = 12.291, 95% CI: 5.701, 26.495. Conclusion: The findings of this study showed that one in five commercial sex workers in Finote Selam town had STDs. Sex without a condom and condom breakage during sexual intercourse showed a significant association with STDs. Therefore, the Woreda Health Office in collaboration with nongovernmental organizations in the area should work on safe sex promotion to enhance consistent condom use and reduce condom breakage through continuous education among

  17. HIV risk and preventive interventions in transgender women sex workers

    Science.gov (United States)

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  18. Characteristics of female sex workers and their HIV/AIDS/STI knowledge, attitudes and behaviour in semi-urban areas in South Africa

    Directory of Open Access Journals (Sweden)

    K. Peltzer

    2004-09-01

    Full Text Available The aim of this study was to investigate characteristics of female sex workers and their HIV/AIDS/STI knowledge, attitudes and behaviour in semi-urban areas in South Africa. The sample included 70 female sex workers from the Tzaneen and Phalaborwa area in the Limpopo Province. A modified form of snowball sampling known as “targeted” sampling was used for identifying female sex workers. Results showed an inadequate knowledge of HIV prevention methods and some incorrect beliefs about AIDS transmission. Most sex workers reported condom use with their last sex client, inconsistent condom use with paying partners, and had poor condom use with regular partners. One third were drinking alcohol daily, one quarter had had voluntary HIV tests, and three quarters had been exposed to HIV interventions. Findings are discussed and implications for HIV interventions outlined.

  19. Older Male Clients of Female Sex Workers in the United States.

    Science.gov (United States)

    Milrod, Christine; Monto, Martin

    2017-08-01

    Recent research has provided increased information about the clients of sex workers; however, little is known about the population of older male customers who contract for heterosexual services online. Clients (N = 208) between 60 and 84 years of age were obtained through sex work review sites and online discussion forums. Participants completed a 129-item questionnaire focusing on physical health, sexual and non-sexual behaviors with sex providers, and the qualities sought in the same. More than half reported having visited sex providers between 13 and 24 times or more during the past 12 months. Participants' advancing age was positively associated with frequency of paid sex. Most frequent sexual activities with providers were fellatio without a condom, followed by penile-vaginal sex with a condom. Analyses also examine the relationship between aging and buying sex. Those with higher incomes and without spouses or partners were more likely to report non-sexual activities with providers, and many participants sought a "GFE" or girlfriend experience, in which paid sexual exchanges are part of a relationship that mirrors conventional non-remunerative relationships.

  20. HIV-testing among female sex workers on the border between Brazil and French Guiana: the need for targeted interventions.

    Science.gov (United States)

    Parriault, Marie-Claire; van Melle, Astrid; Basurko, Célia; Gaubert-Marechal, Emilie; Macena, Raimunda Hermelinda Maia; Rogier, Stéphanie; Kerr, Ligia Regina Franco Sansigolo; Nacher, Mathieu

    2015-08-01

    The border between Brazil and French Guiana is a place of economic, cultural, social and sexual exchange. Female sex workers represent a high risk population for HIV in this area where sexual tourism is particularly developed. HIV testing seems to be an important element in the fight against the epidemic. Indeed, early HIV testing gives access to treatments and prevention. An HIV/AIDS knowledge, attitudes, behaviors and practices survey was conducted in 2011 among sex workers along the border between Brazil and French Guiana. A total of 213 female sex workers were interviewed. One third (31.5%) of the interviewed had never tested for HIV. Factors associated with non HIV-testing were the lack of knowledge of places where to do an HIV test, to be 30 or older, feeling at risk of HIV, not evaluating one's own risk towards HIV, and living in Oiapoque. These results clearly suggest that targeted interventions are needed to encourage and assist female sex workers to get tested regularly.

  1. Sexually transmitted infection screening uptake and knowledge of sexually transmitted infection symptoms among female sex workers participating in a community randomised trial in Peru.

    Science.gov (United States)

    Kohler, Pamela K; Campos, Pablo E; Garcia, Patricia J; Carcamo, Cesar P; Buendia, Clara; Hughes, James P; Mejia, Carolina; Garnett, Geoff P; Holmes, King K

    2016-04-01

    This study aims to evaluate condom use, sexually transmitted infection (STI) screening, and knowledge of STI symptoms among female sex workers in Peru associated with sex work venues and a community randomised trial of STI control. One component of the Peru PREVEN intervention conducted mobile-team outreach to female sex workers to reduce STIs and increase condom use and access to government clinics for STI screening and evaluation. Prevalence ratios were calculated using multivariate Poisson regression models with robust standard errors, clustering by city. As-treated analyses were conducted to assess outcomes associated with reported exposure to the intervention. Care-seeking was more frequent in intervention communities, but differences were not statistically significant. Female sex workers reporting exposure to the intervention had a significantly higher likelihood of condom use, STI screening at public health clinics, and symptom recognition compared to those not exposed. Compared with street- or bar-based female sex workers, brothel-based female sex workers reported significantly higher rates of condom use with last client, recent screening exams for STIs, and HIV testing. Brothel-based female sex workers also more often reported knowledge of STIs and recognition of STI symptoms in women and in men. Interventions to promote STI detection and prevention among female sex workers in Peru should consider structural or regulatory factors related to sex work venues. © The Author(s) 2015.

  2. Motivations for entry into sex work and HIV risk among mobile female sex workers in India.

    Science.gov (United States)

    Saggurti, Niranjan; Verma, Ravi K; Halli, Shiva S; Swain, Suvakanta N; Singh, Rajendra; Modugu, Hanimi Reddy; Ramarao, Saumya; Mahapatra, Bidhubhusan; Jain, Anrudh K

    2011-09-01

    This paper assesses the reasons for entry into sex work and its association with HIV risk behaviours among mobile female sex workers (FSWs) in India. Data were collected from a cross-sectional survey conducted in 22 districts across four high HIV prevalence states in India during 2007-2008. Analyses were limited to 5498 eligible mobile FSWs. The reasons given by FSWs for entering sex work and associations with socio-demographic characteristics were assessed. Reported reasons for entering sex work include poor or deprived economic conditions; negative social circumstances in life; own choice; force by an external person; and family tradition. The results from multivariate analyses indicate that those FSWs who entered sex work due to poor economic conditions or negative social circumstances in life or force demonstrated elevated levels of current inconsistent condom use as well as in the past in comparison with those FSWs who reported entering sex work by choice or family tradition. This finding indicates the need for a careful assessment of the pre-entry contexts among HIV prevention interventions since these factors may continue to hinder the effectiveness of efforts to reduce the spread of HIV/AIDS in India and elsewhere.

  3. Access to and utilisation of healthcare services by sex workers at ...

    African Journals Online (AJOL)

    North Star Alliance (North Star) is a public-private partnership providing a healthcare service package in roadside wellness clinics (RWCs) to at-risk populations along transport corridors in sub-Saharan Africa. Objectives. To inform future service development for sex workers and describe North Star's contribution to ...

  4. Food Insecurity Increases HIV Risk Among Young Sex Workers in Metro Vancouver, Canada.

    Science.gov (United States)

    Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; Jean, Jessica St; Goldenberg, Shira M; Duff, Putu; Deering, Kathleen N

    2017-03-01

    This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) sex workers (2010-2013). We examined the independent relationship between YSWs' food insecurity and being pressured into sex without a condom by clients ("client condom refusal"). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23-3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs' particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity.

  5. Environmental–Structural Interventions to Reduce HIV/STI Risk Among Female Sex Workers in the Dominican Republic

    Science.gov (United States)

    Kerrigan, Deanna; Moreno, Luis; Rosario, Santo; Gomez, Bayardo; Jerez, Hector; Barrington, Clare; Weiss, Ellen; Sweat, Michael

    2006-01-01

    Objectives. We assessed the effectiveness of 2 environmental–structural interventions in reducing risks of HIV and sexually transmitted infections (STIs) among female sex workers in the Dominican Republic. Methods. Two intervention models were implemented over a 1-year period: community solidarity in Santo Domingo and solidarity combined with government policy in Puerto Plata. Both were evaluated via preintervention–postintervention cross-sectional behavioral surveys, STI testing and participant observations, and serial cross-sectional STI screenings. Results. Significant increases in condom use with new clients (75.3%–93.8%; odds ratio [OR]=4.21; 95% confidence interval [CI]=1.55, 11.43) were documented in Santo Domingo. In Puerto Plata, significant increases in condom use with regular partners (13.0%–28.8%; OR=2.97; 95% CI=1.33, 6.66) and reductions in STI prevalence (28.8%–16.3%; OR = 0.50; 95% CI = 0.32, 0.78) were documented, as were significant increases in sex workers’ verbal rejections of unsafe sex (50.0%–79.4%; OR=3.86; 95% CI=1.96, 7.58) and participating sex establishments’ ability to achieve the goal of no STIs in routine monthly screenings of sex workers (OR=1.17; 95% CI=1.12, 1.22). Conclusions. Interventions that combine community solidarity and government policy show positive initial effects on HIV and STI risk reduction among female sex workers. PMID:16317215

  6. Violence, trauma and living with HIV: Longitudinal predictors of initiating crystal methamphetamine injection among sex workers.

    Science.gov (United States)

    Argento, Elena; Strathdee, Steffanie A; Goldenberg, Shira; Braschel, Melissa; Montaner, Julio; Shannon, Kate

    2017-06-01

    Despite rapid increases in crystal methamphetamine (CM) use worldwide and established gendered patterns of use, empirical research on CM injection initiation among sex workers is limited. Given the wide range of harms associated with CM, alongside stimulant effects including sexual dis-inhibition and prolonged awake-ness, this study aimed to longitudinally investigate socio-structural predictors of initiating CM injection among sex workers in Vancouver, Canada. Data (2010-2014) were drawn from a community-based cohort of women sex workers: AESHA (An Evaluation of Sex Workers Health Access). Participants completed bi-annual interviewer-administered questionnaires and HIV/STI testing. Kaplan Meier methods and Cox proportional hazards regression were used to model predictors of CM injection initiation among CM injection-naïve participants. Of 455 participants eligible at baseline, 14.3% (n=65) injected CM for the first time over follow-up, with an incidence density of 6.79 per 100 person-years (95% Confidence Interval [CI] 5.30-8.69). In multivariable analysis, injection heroin use (Adjusted Hazard Ratio [AHR] 6.11; 95%CI 3.24-11.52), having an intimate partner who injects drugs (AHR 2.93; 95%CI 1.57-5.46), workplace violence (AHR 2.85; 95%CI 1.74-4.67), HIV seropositivity (AHR 2.69; 95%CI 1.45-5.00), and childhood abuse (AHR 1.86; 95%CI 0.99-3.49) were independently associated with initiating CM injection. Findings underscore the gendered and social risk environment of CM injection initiation among sex workers. The strong influences of historical/workplace violence, coupled with heroin injection (known to be self-medicating for post-traumatic stress) as a primary risk pathway, emphasize the urgency of increasing access to integrated, trauma-informed addiction treatment and HIV care for marginalized women. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Intimate-Partner and Client-Initiated Violence among Female Street-Based Sex Workers in China: Does a Support Network Help?

    Directory of Open Access Journals (Sweden)

    Katie Hail-Jares

    Full Text Available Globally, female street-based sex workers are vulnerable to gender-based violence. Previous research has shown having a peer social network can reduce sex workers' risks of victimization. However, mechanisms of how social network impacts violence among female street-based sex workers are still far from clear.Our study was based on data abstracted from a paper-and-pencil survey administered among 218 female street-based sex workers in Shanghai, China. We focused on self-reported client-initiated violence and intimate-partner violence in emotional, physical, and sexual forms. Social networks were characterized by the size and sources of financial and psychosocial support (e.g. family, friends, and peers. Multi-variable logistic regression was used to estimate adjusted odds ratios (AOR of each type of violence exposure by social network structure after the adjustment of age, education, and years in Shanghai.The street-based female sex workers in our study were primarily rural-to-urban migrants (95.7% with an average age of 41 years old. 24.3% and 62.8% of the sex workers reported intimate-partner violence and client-initiated violence respectively. Lack of financial support, as defined by having only one individual or none in her peer support system to help financially, was significantly associated with self-reported intimate-partner violence (AOR: 2.5; 95% CI: 1.1-5.9. Respondents who reported client-initiated violence, by contrast, were more likely to report lacked psychosocial support from family (AOR: 2.2, 95% CI: 1.0-4.6 and peers (AOR: 5.1, 95% CI: 2.2-11.This study is one of the first to systematically analyze the associations between social network and gender-based violence among street-based female sex worker. We reported a high prevalence of both types of gender-based violence and their complex associations with family, friends, and peer support network. Policies with goals to reduce violence against women may apply these findings to

  8. Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico.

    Science.gov (United States)

    Goldenberg, Shira M; Engstrom, David; Rolon, Maria Luisa; Silverman, Jay G; Strathdee, Steffanie A

    2013-01-01

    Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange) contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31) in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1) reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2) mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3) provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

  9. Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs in a City of Northern India

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    Pallavi Shukla

    2015-01-01

    Full Text Available Introduction: Sexually transmitted infections (STIs and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs in Uttar Pradesh (UP and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. Materials and Methods: A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO, registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS Control Society (UPSACS of Lucknow city. Total 288 subjects were studied. Results: The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6% than home-based (29.8%. Majority (42.7% of sex workers with STI had non-regular partners only while majority (52.4% of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client′s demand for unsafe sex were found to be significant in causing STI. Conclusions: Prevalence of STI among the female sex workers as

  10. Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India.

    Science.gov (United States)

    Shukla, Pallavi; Masood, Jamal; Singh, J V; Singh, V K; Gupta, Abhishek; Krishna, Asuri

    2015-01-01

    Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia

  11. Differing HIV vulnerability among female sex workers in a high HIV burden Indian state.

    Science.gov (United States)

    Mamulwar, Megha; Godbole, Sheela; Bembalkar, Shilpa; Kamble, Pranil; Dulhani, Nisha; Yadav, Rajesh; Kadu, Chitra; Kumar, Pradeep; Lalikar, Shivraj; Acharya, Shrikala; Gangakhedkar, Raman; Risbud, Arun; Venkatesh, Srinivas

    2018-01-01

    The HIV sentinel surveillance [HSS] conducted in 2010-11 among female sex workers [FSW] in the state of Maharashtra, India provided an opportunity to assess characteristics of different types of FSWs and their HIV risk. It is important for India's National AIDS Control Program, to understand the differences in vulnerability among these FSW, in order to define more specific and effective risk reduction intervention strategies. Therefore, we analyzed data from HSS with the objective of understanding the HIV vulnerability among different types of FSW in Maharashtra. Cross sectional data collected as a part of HSS among FSWs in year 2010-11 from 21 sentinel sites in the state of Maharashtra were analyzed to understand the vulnerability and characteristics of different types of female sex workers based on their place of solicitation using multinomial logistic regression. While the HIV prevalence was 6.6% among all FSWs, it was 9.9% among brothel based [BB], 9% among street based [SB] and 3.1% and 3.7% among home based [HB], and bar based [Bar-B] sex workers respectively. SB FSWs were least likely to be located in HIV low burden districts [ANC] [ARRR: 0.61[95% CI: 0.49, 0.77

  12. Ground-breaking research into Ghanaian sex-workers suggests high awareness. Country surveys.

    Science.gov (United States)

    1996-02-01

    The first nationwide research into prostitution in Ghana has been completed by Dr. Matilida Pappoe. She has found that there has been exponential growth in prostitution over the past three years in the country. While 10 years ago, people would not openly talk about prostitution, now that people's friends are increasingly entering the trade, people freely discuss prostitution. The research indicates that this growth is linked to the negative effects of macroeconomic policies aimed at economic growth, such as structural adjustment. For example, 39 of 121 sex workers studied claimed to have begun working as a prostitute after their trading businesses collapsed. Study findings suggest a high level of AIDS awareness among Ghanaian prostitutes. Prostitutes in Ghana are considered to be either seaters or roamers. Seaters are a loosely organized group of women who tend to work from a common compound, attracting customers by sitting in the doorway of their rooms. They typically report to an older retired sex worker who settles disputes and raises credit if one of the women must pay a police fine. Seaters are largely 30-45 years old and work in industrial centers. Roamers, however, tend to be 20-30 years old, work in coastal towns, and are usually better educated. They move from place to place and are probably at lower risk of contracting HIV due to the higher rates they charge and the correspondingly lower number of clients they entertain. Roamers seem to have higher rates of condom use and clients who are aware of the dangers. Roamers, too, are not organized as a group and may even often be highly competitive. Their work in the isolation of hotels makes them particularly vulnerable. Economic necessity has therefore increasingly drawn Ghanaian women into the sex trade, while Ghanaian men who typically support two or three women in exchange for sex, but can no longer do so due to current economic conditions, turn to occasional sex with prostitutes. This paper notes that

  13. Differentiated Typology of Sex Work and Implication for HIV Prevention Programs among Female Sex Workers in Nepal.

    Science.gov (United States)

    Mishra, Shiva Raj; Neupane, Sanjeev Raj

    2015-01-01

    Sex work in exchange for kind and cash has long been practiced in Nepal. The HIV prevention program in Nepal is focused mainly on these two typologies of sex work. There might be more typologies of sex work beyond streets and establishments seeking research and programmatic attention. The objective of the study is to explore the differentiated typologies of sex work. This is a cross-sectional study conducted using a qualitative technique. Researchers carried out eight Focus Group Discussions with female sex workers (FSWs) (n = 50) in different places of Tanahu district. Data were analyzed using a deductive thematic analysis approach. We identified a more differentiated typology of sex work. Private contact-based sex work and the covert sex work on the cruising areas along the major highways were common. Sex work has become easier to operate with the advent of new technologies such as cell phone. With limited role of facilitation by brokers and pimps, now FSWs are better off and have longer duration of relationship with clients. Soft prostitution was common, as FSWs complemented their income through sex work. The conventional mode of peer and outreach educational approach needs to be further strengthened and modified according to the changing typology of sex work. HIV testing sites need to be further expanded to cruising areas along the highways.

  14. Differentiated Typology of Sex Work and Implication for HIV Prevention Programs among Female Sex Workers in Nepal

    Science.gov (United States)

    Mishra, Shiva Raj; Neupane, Sanjeev Raj

    2015-01-01

    Background: Sex work in exchange for kind and cash has long been practiced in Nepal. The HIV prevention program in Nepal is focused mainly on these two typologies of sex work. There might be more typologies of sex work beyond streets and establishments seeking research and programmatic attention. The objective of the study is to explore the differentiated typologies of sex work. Methods: This is a cross-sectional study conducted using a qualitative technique. Researchers carried out eight Focus Group Discussions with female sex workers (FSWs) (n = 50) in different places of Tanahu district. Data were analyzed using a deductive thematic analysis approach. Results: We identified a more differentiated typology of sex work. Private contact-based sex work and the covert sex work on the cruising areas along the major highways were common. Sex work has become easier to operate with the advent of new technologies such as cell phone. With limited role of facilitation by brokers and pimps, now FSWs are better off and have longer duration of relationship with clients. Soft prostitution was common, as FSWs complemented their income through sex work. Conclusion: The conventional mode of peer and outreach educational approach needs to be further strengthened and modified according to the changing typology of sex work. HIV testing sites need to be further expanded to cruising areas along the highways. PMID:25785259

  15. Differentiated typology of sex work and implication for HIV prevention programs among female sex workers in Nepal

    Directory of Open Access Journals (Sweden)

    Shiva Raj Mishra

    2015-03-01

    Full Text Available BackgroundSex work in exchange for kind and cash has long been practiced in Nepal. The HIV prevention program in Nepal is focused mainly on these two typologies of sex work. There might be more typologies of sex work beyond streets and establishments seeking research and programmatic attention. The objective of the study is to explore the differentiated typologies of sex work.MethodsThis is a cross sectional study conducted using a qualitative technique. Researchers carried out eight Focus Group Discussions with Female Sex Workers (FSWs (n=50 in different places of Tanahu district. Data was analyzed using a deductive thematic analysis approach.ResultsWe identified a more differentiated typology of sex work. Private contact-based sex work and the covert sex work on the cruising areas along the major highways were common. Sex work has become easier to operate with the advent of new technologies such as cellphone. With limited role of facilitation by brokers and pimps, now FSWs are better off and have longer duration of relationship with clients. Soft prostitution was common, as FSWs complemented their income through sex work.ConclusionsThe conventional mode of peer and outreach educational approach needs to be further strengthened and modified according to the changing typology of sex work. HIV testing sites need to be further expanded to cruising areas along the highways.

  16. HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry.

    Science.gov (United States)

    Mwanri, Lillian; Fauk, Nelsensius Klau; Kustanti, Christina Yeni; Ambarwati, Atik; Merry, Maria Silvia

    2018-02-15

    Background: The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.

  17. Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in northern Mexico.

    Science.gov (United States)

    Morris, Meghan D; Lemus, Hector; Wagner, Karla D; Martinez, Gustavo; Lozada, Remedios; Gómez, Rangel María Gudelia; Strathdee, Steffanie A

    2013-01-01

    To identify factors associated with time to initiation of (i) sex work prior to injecting drugs initiation; (ii) injection drug use prior to sex work initiation; and (iii) concurrent sex work and injection drug use (i.e. initiated at the same age) among female sex workers who currently inject drugs (FSW-IDU). Parametric survival analysis of baseline data for time to initiation event. Tijuana and Ciudad Juarez situated on the Mexico-US border. A total of 557 FSW-IDUs aged ≥18 years. Interview-administered surveys assessing context of sex work and injection drug use initiation. Nearly half (n = 258) initiated sex work prior to beginning to inject, a third (n = 163) initiated injection first and a quarter (n = 136) initiated both sex work and injection drug use concurrently. Low education and living in Ciudad Juarez accelerated time to sex work initiation. Being from a southern Mexican state and initiating drug use with inhalants delayed the time to first injection drug use. Having an intimate partner encourage entry into sex work and first injecting drugs to deal with depression accelerated time to initiating sex work and injection concurrently. Early physical abuse accelerated time to initiating sex work and injection, and substantially accelerated time to initiation of both behaviors concurrently. Among female sex workers who currently inject drugs in two Mexican-US border cities, nearly half appear to initiate sex work prior to beginning to inject, nearly one-third initiate injection drug use before beginning sex work and one-quarter initiate both behaviors concurrently. Predictors of these three trajectories differ, and this provides possible modifiable targets for prevention. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  18. Policing the epidemic: High burden of workplace violence among female sex workers in conflict-affected northern Uganda.

    Science.gov (United States)

    Muldoon, Katherine A; Akello, Monica; Muzaaya, Godfrey; Simo, Annick; Shoveller, Jean; Shannon, Kate

    2017-01-01

    Sex workers in sub-Saharan Africa experience a high burden of HIV with a paucity of data on violence and links to HIV risk among sex workers, and even less within conflict-affected environments. Data are from a cross-sectional survey of female sex workers in Gulu, northern Uganda (n = 400). Logistic regression was used to determine the specific association between policing and recent physical/sexual violence from clients. A total of 196 (49.0%) sex workers experienced physical/sexual violence by a client. From those who experienced client violence the most common forms included physical assault (58.7%), rape (38.3%), and gang rape (15.8%) Police harassment was very common, a total of 149 (37.3%) reported rushing negotiations with clients because of police presence, a practice that was significantly associated with increased odds of client violence (adjusted odds ratio: 1.61, 95% confidence intervals: 1.03-2.52). Inconsistent condom use with clients, servicing clients in a bar, and working for a manager/pimp were also independently associated with recent client violence. Structural and community-led responses, including decriminalisation, and engagement with police and policy stakeholders, remain critical to addressing violence, both a human rights and public health imperative.

  19. Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India.

    Science.gov (United States)

    Biello, Katie B; Thomas, Beena E; Johnson, Blake E; Closson, Elizabeth F; Navakodi, Pandiaraja; Dhanalakshmi, A; Menon, Sunil; Mayer, Kenneth H; Safren, Steven A; Mimiaga, Matthew J

    2017-02-01

    Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/sexually transmitted infections (STIs). Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR = 2.3-10.0), and earned 3000 (IQR = 2000-8000) Rupees (India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives.

  20. Structural determinants of inconsistent condom use with clients among migrant sex workers: findings of longitudinal research in an urban canadian setting.

    Science.gov (United States)

    Sou, Julie; Shannon, Kate; Li, Jane; Nguyen, Paul; Strathdee, Steffanie A; Shoveller, Jean; Goldenberg, Shira M

    2015-06-01

    Migrant women in sex work experience unique risks and protective factors related to their sexual health. Given the dearth of knowledge in high-income countries, we explored factors associated with inconsistent condom use by clients among migrant female sex workers over time in Vancouver, BC. Questionnaire and HIV/sexually transmitted infection testing data from a longitudinal cohort, An Evaluation of Sex Workers Health Access, were collected from 2010 to 2013. Logistic regression using generalized estimating equations was used to model correlates of inconsistent condom use by clients among international migrant sex workers over a 3-year study period. Of 685 participants, analyses were restricted to 182 (27%) international migrants who primarily originated from China. In multivariate generalized estimating equations analyses, difficulty accessing condoms (adjusted odds ratio [AOR], 3.76; 95% confidence interval [CI], 1.13-12.47) independently correlated with increased odds of inconsistent condom use by clients. Servicing clients in indoor sex work establishments (e.g., massage parlors) (AOR, 0.34; 95% CI, 0.15-0.77), and high school attainment (AOR, 0.22; 95% CI, 0.09-0.50) had independent protective effects on the odds of inconsistent condom use by clients. Findings of this longitudinal study highlight the persistent challenges faced by migrant sex workers in terms of accessing and using condoms. Migrant sex workers who experienced difficulty in accessing condoms were more than 3 times as likely to report inconsistent condom use by clients. Laws, policies, and programs promoting access to safer, decriminalized indoor work environments remain urgently needed to promote health, safety, and human rights for migrant workers in the sex industry.

  1. Sex and cultural differences in spatial performance between Japanese and North Americans.

    Science.gov (United States)

    Sakamoto, Maiko; Spiers, Mary V

    2014-04-01

    Previous studies have suggested that Asians perform better than North Americans on spatial tasks but show smaller sex differences. In this study, we evaluated the relationship between long-term experience with a pictorial written language and spatial performance. It was hypothesized that native Japanese Kanji (a complex pictorial written language) educated adults would show smaller sex differences on spatial tasks than Japanese Americans or North Americans without Kanji education. A total of 80 young healthy participants (20 native Japanese speakers, 20 Japanese Americans-non Japanese speaking, and 40 North Americans-non Japanese speaking) completed the Rey Complex Figure Test (RCFT), the Mental Rotations Test (MRT), and customized 2D and 3D spatial object location memory tests. As predicted, main effects revealed men performed better on the MRT and RCFT and women performed better on the spatial object location memory tests. Also, as predicted, native Japanese performed better on all tests than the other groups. In contrast to the other groups, native Japanese showed a decreased magnitude of sex differences on aspects of the RCFT (immediate and delayed recall) and no significant sex difference on the efficiency of the strategy used to copy and encode the RCFT figure. This study lends support to the idea that intensive experience over time with a pictorial written language (i.e., Japanese Kanji) may contribute to increased spatial performance on some spatial tasks as well as diminish sex differences in performance on tasks that most resemble Kanji.

  2. Feasible, Efficient and Necessary, without Exception - Working with Sex Workers Interrupts HIV/STI Transmission and Brings Treatment to Many in Need.

    Science.gov (United States)

    Steen, Richard; Wheeler, Tisha; Gorgens, Marelize; Mziray, Elizabeth; Dallabetta, Gina

    2015-01-01

    High rates of partner change in sex work-whether in professional, 'transactional' or other context-disproportionately drive transmission of HIV and other sexually transmitted infections. Several countries in Asia have demonstrated that reducing transmission in sex work can reverse established epidemics among sex workers, their clients and the general population. Experience and emerging research from Africa reaffirms unprotected sex work to be a key driver of sexual transmission in different contexts and regardless of stage or classification of HIV epidemic. This validation of the epidemiology behind sexual transmission carries an urgent imperative to realign prevention resources and scale up effective targeted interventions in sex work settings, and, given declining HIV resources, to do so efficiently. Eighteen articles in this issue highlight the importance and feasibility of such interventions under four themes: 1) epidemiology, data needs and modelling of sex work in generalised epidemics; 2) implementation science addressing practical aspects of intervention scale-up; 3) community mobilisation and 4) the treatment cascade for sex workers living with HIV. Decades of empirical evidence, extended by analyses in this collection, argue that protecting sex work is, without exception, feasible and necessary for controlling HIV/STI epidemics. In addition, the disproportionate burden of HIV borne by sex workers calls for facilitated access to ART, care and support. The imperative for Africa is rapid scale-up of targeted prevention and treatment, facilitated by policies and action to improve conditions where sex work takes place. The opportunity is a wealth of accumulated experience working with sex workers in diverse settings, which can be tapped to make up for lost time. Elsewhere, even in countries with strong interventions and services for sex workers, an emerging challenge is to find ways to sustain them in the face of declining global resources.

  3. Male sex workers: Are we ignoring a risk group in Mumbai, India?

    Directory of Open Access Journals (Sweden)

    Shinde Santosh

    2009-01-01

    Full Text Available Background: Male sex workers (MSWs have recently been recognized as an important risk group for sexually transmitted infections (STIs including human immunodeficiency virus (HIV infection. Although there are global studies on MSWs, few such studies describe the behavioral patterns and STIs among this population in India. Methods: MSWs were evaluated at the Humsafar trust, a community based organization situated in suburban Mumbai, India. We report on the demographics, sexual behaviors, and STIs including HIV of these sex workers. Results: Of the 75 MSWs, 24 were men and 51 were transgenders. The mean age of the group was 23.3 (+ 4.9 years. About 15% were married or lived with a permanent partner. Of these individuals, 85% reported sex work as a main source of income and 15% as an additional source. All the individuals reported anal sex (87% anal receptive sex and 13% anal insertive sex. About 13% of MSWs had never used a condom. The HIV prevalence was 33% (17% in men vs 41% in transgenders, P = 0.04. The STI prevalence was 60% (58% in men vs 61% in transgenders, P = 0.8. Syphilis was the most common STI (28% in these MSWs. HIV was associated with being a transgender (41 vs 17%, P = 0.04, age > 26 years (57 vs 28%, P = 0.04, more than one year of sex work (38 vs 8%, P = 0.05, and income < Rs. 2000 per month (62 vs 27%, P = 0.02. Conclusions: The MSWs have high-risk behaviors, low consistent condom use, and high STI/HIV infections. These groups should be the focus of intensive public health interventions aimed at reduction of risky sexual practices, and STI/HIV prevention and care.

  4. Reasons for not using condoms among female sex workers in Indonesia.

    NARCIS (Netherlands)

    Basuki, E.; Wolffers, I.; Devillé, W.; Erlaini, N.; Luhpuri, D.; Hargono, R.; Maskuri, N.; Suesen, N.; Beelen, N. van

    2002-01-01

    The aim of this study was to gather data on condom use among brothel-based female sex workers in Indonesia and to study the reasons for not using condoms in order to provide new and existing condom promotion programs with information to improve their performance. Quantitative data were gathered by

  5. HIV and AIDS risk perception among sex workers in semi-urban ...

    African Journals Online (AJOL)

    Background: Several health behaviour theories propose that risk perception affects the likelihood of behaviour intentions and practice. The perception of risk to HIV and AIDS among female sex workers in Malawi has not been well described. Yet knowledge of how this most at risk population perceives contagion could help ...

  6. Socio-economic vulnerabilities and HIV: Drivers of transactional sex among female bar workers in Yaoundé, Cameroon.

    Science.gov (United States)

    Akoku, Derick Akompab; Tihnje, Mbah Abena; Vukugah, Thomas Achombwom; Tarkang, Elvis Enowbeyang; Mbu, Robinson Enow

    2018-01-01

    The purpose of this study was to examine the relationship between socio-demographic characteristics, risky sexual behaviour, alcohol use and transactional sex among female bar workers in Yaounde, Cameroon. A cross-sectional survey was conducted among a representative sample of 410 female bar workers, recruited through a modified version of venue-based cluster sampling technique from May to June 2017. Transactional sex was defined as having received money/gifts in exchange for sex with any sexual partner in the past 12 months. Logistic regression models were performed to identify the factors associated with transactional sex. The level of statistical significance was set at panalysis showed that those who engaged in transactional sex were more likely to have had sex with a male customer in the past 6 months (aOR = 7.34; 95% CI, 3.63-16.98), had sex under the influence of alcohol in the past 6 months (aOR = 2.42; 95% CI, 1.18-4.96) and frequent alcohol consumers (aOR = 2.06; 95%CI, 1.04-4.10). Respondents who had their last sexual intercourse 4 weeks or more prior to the study (aOR = 0.26; 95% CI, 0.08-0.84) were less likely to have engaged in transactional sex. Our study concludes that female bar workers are exposed to male customers and engage in risky sexual practices including transaction sex. Most of them also consume alcohol which increases their risk of HIV and STI acquisition. They are a high-risk group that need to be targeted with HIV prevention interventions.

  7. Structural and Interpersonal Benefits and Risks of Participation in HIV Research: Perspectives of Female Sex Workers in Guatemala

    Science.gov (United States)

    Goldenberg, Shira M.; Mindt, Monica Rivera; Jimenez, Teresita Rocha; Brouwer, Kimberly C.; Miranda, Sonia Morales; Fisher., Celia B.

    2016-01-01

    This study explored perceived benefits and risks of participation in HIV research among 33 female sex workers in Tecun Uman, Guatemala. Stigma associated with sex work and HIV was a critical barrier to research participation. Key benefits of participation included access to HIV/STI prevention and testing, as well as positive and trusting relationships between sex workers and research teams. Control exerted by managers had mixed influences on perceived research risks and benefits. Results underscore the critical need for HIV investigators to develop population-tailored procedures to reduce stigma, engage managers, and reinforce trusting, reciprocal relationships between sex work communities and researchers. PMID:27840564

  8. [Characteristics of social supportive network serving the older female sex workers in Qingdao].

    Science.gov (United States)

    Xu, Y Q; Li, Y F; Jiang, Z X; Zhang, X J; Yuan, X; Zhang, N; Li, X F; Jiang, B F

    2016-02-01

    To overview the status of social support on older female sex workers (OFSWs) in Qingdao and to better understand the characteristics of this egocentric social support networks. Ucinet 6 software was used to analyze the characteristics of egocentric social networks which involving 400 OFSWs who were recruited by respondent-driven sampling (RDS) method in Qingdao during March 2014 to June. Structural equation model (SEM) was used for data analysis, fitted test and estimation. A total of 400 OFSWs of Qingdao nominated 1 617 social supportive members, and the average size of egocentric social networks of OFSWs was (4.0 ± 1.5). Among all the alter egos (social support network members of the egos), 613 were female sex workers fellows, accounted for the most important part of all the social ties (37.91%). Characteristics of small size and non-relative relationships were seen more obviously among OFSWs with non-local registration and the ratings of emotional support (4.42±2.38) was significantly lower than the tangible support (5.73 ± 1.69) (Psocial support from friends who were also female sex workers. Stronger the joint strength between egos and alters, greater the homogeneity between the two was seen. Tighter relations among the alter egos, higher degree of average social support of the egos were acquired.

  9. Sex work and its associations with alcohol and methamphetamine use among female bar and spa workers in the Philippines.

    Science.gov (United States)

    Urada, Lianne A; Strathdee, Steffanie A; Morisky, Donald E; Schilling, Robert F; Simbulan, Nymia P; Estacio, Leonardo R; Raj, Anita

    2014-03-01

    To assess the prevalence of sex work and its associations with substance use among female bar/spa workers in the Philippines (N = 498), workers from 54 bar or spa venues in Metro Manila (2009-2010) were surveyed on demographics, drug/alcohol use, abuse history, and sex work. Their median age was 23 years and 35% engaged in sex work. Sex work was independently associated with methamphetamine use (19% vs 4%; adjusted odds ratio [AOR] =2.9, 95% confidence interval [CI] = 1.3-6.2), alcohol use with patrons (49% vs. 27%; AOR = 1.9, 95% CI = 1.1-3.4), and alcohol intoxication during sex (50% vs. 24%; AOR = 2.0, 95% CI = 1.2-3.5), but inversely associated with daily alcohol use (13% vs. 16%; AOR = 0.2, 95% CI = 0.1-0.5). Additional significant covariates included sexual abuse history, younger age, and not having a higher education. Findings suggest that interventions with sex workers in bars and spas should focus on methamphetamine use, alcohol use contexts, and violence victimization, to better meet the needs of this population.

  10. Risk perception of sexually transmitted infections and HIV in Nigerian commercial sex workers living in Barcelona: a study protocol

    Science.gov (United States)

    Coma Auli, Núria; Mejía-Lancheros, Cília; Berenguera, Anna; Mayans, Martí Vall; Lasagabaster, Maider Arando; Pujol-Ribera, Enriqueta

    2013-01-01

    Introduction Sexually transmitted infections (STIs) and HIV are a serious global public health issue. These diseases are largely preventable, as they are directly and indirectly associated with potentially modifiable factors, including socioeconomic conditions. Sexual transmission is responsible for over 75% of new HIV infections worldwide. Moreover, commercial sex workers and their clients are two of the groups at the highest risk of acquiring and transmitting these infectious diseases, due to an extensive number of sexual encounters and the various factors related to commercial sex situations. This qualitative study aims to deepen the understanding of the risk perception of STIs and HIV and their associated factors in Nigerian commercial sex workers in the city of Barcelona. Methods and analysis This is a qualitative, descriptive, interpretive study based on a social constructivist and phenomenological perspective conducted on a saturated sample of Nigerian commercial sex workers in the city of Barcelona. Data will be collected through semistructured individual and triangular group interviews. Information will be examined using a sociological discourse analysis, allowing us to understand the social and individual factors related to the risk perception of STIs and HIV in commercial sex workers. Discussion Qualitative studies are an important element in identifying individual, social and contextual factors directly or indirectly related to the health/disease process. This qualitative study will provide essential knowledge to improve health promotion, prevention strategies and effective management of STIs both for commercial sex workers and their clients. Ethics This study has been approved by the clinical research ethics committee (CEIC) of IDIAP Jordi Gol in Barcelona, 2012. PMID:23901029

  11. Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico.

    Directory of Open Access Journals (Sweden)

    Shira M Goldenberg

    Full Text Available Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31 in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1 reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2 mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3 provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

  12. Individual, interpersonal, and social-structural correlates of involuntary sex exchange among female sex workers in two Mexico-U.S. border cities.

    Science.gov (United States)

    Goldenberg, Shira M; Rangel, Gudelia; Staines, Hugo; Vera, Alicia; Lozada, Remedios; Nguyen, Lucie; Silverman, Jay G; Strathdee, Steffanie A

    2013-08-15

    To investigate individual, interpersonal, and social-structural factors associated with involuntary sex exchange among female sex workers (FSWs) along the Mexico-U.S. border. In 2010 to 2011, 214 FSWs from Tijuana (n = 106) and Ciudad Juarez (n = 108) aged ≥ 18 years who reported lifetime use of heroin, cocaine, crack, or methamphetamine, having a stable partner, and having sold/traded sex in the past month completed quantitative surveys and HIV/sexually transmitted infection testing. Logistic regression was used to identify correlates of involuntary sex exchange among FSWs. Of 214 FSWs, 31 (14.5%) reported involuntary sex exchange These women were younger at sex industry entry [adjusted odds ratio (AOR): 0.84/1-year increase, 95% confidence interval (CI): 0.72 to 0.97] and were significantly more likely to service clients whom they perceived to be HIV/sexually transmitted infection-infected (AOR: 12.41, 95% CI: 3.15 to 48.91). In addition, they were more likely to have clients who used drugs (AOR: 7.88, 95% CI: 1.52 to 41.00), report poor working conditions (AOR: 3.27, 95% CI: 1.03 to 10.31), and report a history of rape (AOR: 4.46, 95% CI: 1.43 to 13.91). Involuntary sex exchange is disproportionate among FSWs who begin to exchange sex at a younger age, and these women experience elevated risk of violence and HIV/STIs related to their clients' behaviors and their working conditions. These data suggest the critical need for evidence-based approaches to preventing sexual exploitation of women and girls and to reducing harm among current sex workers. Multilevel interventions for all females who exchange sex and their clients that target interpersonal and social-structural risks (eg, measures to improve safety and reduce exploitation within the workplace) are needed.

  13. Truck drivers, middlemen and commercial sex workers: AIDS and the mediation of sex in south west Uganda.

    Science.gov (United States)

    Gysels, M; Pool, R; Bwanika, K

    2001-06-01

    Although long distance truck drivers have been implicated in the spread of HIV in Africa, there is a paucity of studies of their sexual cultures. This paper reports on a study of the sexual culture of drivers, mediators and commercial sex workers (CSWs) in a roadside truck stop on the Trans-Africa highway in south west Uganda. Sixty-nine truck drivers, six middlemen and 12 CSWs were interviewed using semi-structured questionnaires. Interviewing truck drivers also entailed participating in the town's nightlife and spending much time in the bars. Truck drivers stop briefly at the truck stop for various reasons: to eat, sleep, have sex and sell goods they are carrying. Middlemen mediate the latter two activities. Middlemen buy goods from the drivers and introduce them to 'suitable' women with whom they can have casual sex. Most drivers have sex when they spend the night at the truck stop, and most make use of the services of the middlemen. The most important reasons why drivers use middlemen are that the latter speak the local languages and, in particular, know the trustworthy and 'safe' (HIV-negative) women. The CSWs use middlemen mainly because they are a guarantee that the driver will pay and they usually ensure that drivers pay well. The mediation system is becoming increasingly professionalized. Most drivers claimed to use condoms during casual sex, and this was confirmed by the CSWs. General use of condoms is encouraging, particularly given the context of a culture generally opposed to condoms. The idea that middlemen can recognize 'safe' women is worrying. However, given their key position, middlemen could form the hub of an opinion leader type intervention focused on drivers and the professional group of sex workers described here, providing condoms, advising about the importance of condom use in all casual sexual encounters, giving information about HIV and STDs, and possibly referring drivers and women to appropriate sources of HIV counselling and testing

  14. Toward a legal framework that promotes and protects sex workers' health and human rights.

    Science.gov (United States)

    Overs, Cheryl; Loff, Bebe

    2013-06-14

    Complex combinations of law, policy, and enforcement practices determine sex workers vulnerability to HIV and rights abuses. We identify "lack of recognition as a person before the law" as an important but undocumented barrier to accessing services and conclude that multi-faceted, setting-specific reform is needed-rather than a singular focus on decriminalization-if the health and human rights of sex workers are to be realized. Copyright © 2013 Overs and Loff. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  15. Risk Factors in Host and Environment for Cervicitis Among Commercial Sex Workers

    OpenAIRE

    Saputra, Nazarwin; Widjanarko, Bagoes; Setyawan, Henry

    2016-01-01

    sexually transmitted infection (STI) remains a major health problem in some parts of the world. This study aimed to determine the host and environmental factors the effect on the incidence of cervicitis on sex workers. The study was observational case-control design with consecutive sampling technique. Risk factor for cervicitis is a history of sexually transmitted infections (p=0,0001), have couple (boy friend) different gender (p=0,014, OR=4,4; CI95%=1,3-14,3), history of oral sex/cunniling...

  16. Predictors of unprotected sex among female sex workers in Madagascar: comparing semen biomarkers and self-reported data.

    Science.gov (United States)

    Gallo, Maria F; Steiner, Markus J; Hobbs, Marcia M; Weaver, Mark A; Hoke, Theresa Hatzell; Van Damme, Kathleen; Jamieson, Denise J; Macaluso, Maurizio

    2010-12-01

    Research on the determinants of condom use and condom non-use generally has relied on self-reported data with questionable validity. We identified predictors of recent, unprotected sex among 331 female sex workers in Madagascar using two outcome measures: self-reports of unprotected sex within the past 48 h and detection of prostate-specific antigen (PSA), a biological marker of recent semen exposure. Multivariable logistic regression revealed that self-reported unprotected sex was associated with three factors: younger age, having a sipa (emotional partner) in the prior seven days, and no current use of hormonal contraception. The sole factor related to having PSA detected was prevalent chlamydial infection (adjusted odds ratio, 4.5; 95% confidence interval, 2.0-10.1). Differences in predictors identified suggest that determinants of unprotected sex, based on self-reported behaviors, might not correlate well with risk of semen exposure. Caution must be taken when interpreting self-reported sexual behavior measures or when adjusting for them in analyses evaluating interventions for the prevention of HIV/STIs.

  17. Differing HIV vulnerability among female sex workers in a high HIV burden Indian state.

    Directory of Open Access Journals (Sweden)

    Megha Mamulwar

    Full Text Available The HIV sentinel surveillance [HSS] conducted in 2010-11 among female sex workers [FSW] in the state of Maharashtra, India provided an opportunity to assess characteristics of different types of FSWs and their HIV risk. It is important for India's National AIDS Control Program, to understand the differences in vulnerability among these FSW, in order to define more specific and effective risk reduction intervention strategies. Therefore, we analyzed data from HSS with the objective of understanding the HIV vulnerability among different types of FSW in Maharashtra.Cross sectional data collected as a part of HSS among FSWs in year 2010-11 from 21 sentinel sites in the state of Maharashtra were analyzed to understand the vulnerability and characteristics of different types of female sex workers based on their place of solicitation using multinomial logistic regression.While the HIV prevalence was 6.6% among all FSWs, it was 9.9% among brothel based [BB], 9% among street based [SB] and 3.1% and 3.7% among home based [HB], and bar based [Bar-B] sex workers respectively. SB FSWs were least likely to be located in HIV low burden districts [ANC] [ARRR: 0.61[95% CI: 0.49, 0.77

  18. Differing HIV vulnerability among female sex workers in a high HIV burden Indian state

    Science.gov (United States)

    Godbole, Sheela; Bembalkar, Shilpa; Kamble, Pranil; Dulhani, Nisha; Yadav, Rajesh; Kadu, Chitra; Kumar, Pradeep; Lalikar, Shivraj; Acharya, Shrikala; Gangakhedkar, Raman; Risbud, Arun; Venkatesh, Srinivas

    2018-01-01

    Introduction The HIV sentinel surveillance [HSS] conducted in 2010–11 among female sex workers [FSW] in the state of Maharashtra, India provided an opportunity to assess characteristics of different types of FSWs and their HIV risk. It is important for India’s National AIDS Control Program, to understand the differences in vulnerability among these FSW, in order to define more specific and effective risk reduction intervention strategies. Therefore, we analyzed data from HSS with the objective of understanding the HIV vulnerability among different types of FSW in Maharashtra. Material and methods Cross sectional data collected as a part of HSS among FSWs in year 2010–11 from 21 sentinel sites in the state of Maharashtra were analyzed to understand the vulnerability and characteristics of different types of female sex workers based on their place of solicitation using multinomial logistic regression. Results While the HIV prevalence was 6.6% among all FSWs, it was 9.9% among brothel based [BB], 9% among street based [SB] and 3.1% and 3.7% among home based [HB], and bar based [Bar-B] sex workers respectively. SB FSWs were least likely to be located in HIV low burden districts [ANC] [ARRR: 0.61[95% CI: 0.49, 0.77

  19. Micro-level social and structural factors act synergistically to increase HIV risk among Nepalese female sex workers.

    Science.gov (United States)

    Deuba, Keshab; Anderson, Sarah; Ekström, Anna Mia; Pandey, Satish Raj; Shrestha, Rachana; Karki, Deepak Kumar; Marrone, Gaetano

    2016-08-01

    Sex workers face stigma, discrimination, and violence across the globe and are almost 14 times more likely to be HIV-infected than other women in low- and middle-income countries. In Asia, condom campaigns at brothels have been effective in some settings, but for preventive interventions to be sustainable, it is important to understand micro-level social and structural factors that influence sexual behaviours of sex workers. This study assessed the syndemic effects of micro-level social and structural factors of unprotected sex and the prevalence of HIV among female sex workers (FSWs) in Nepal. This quantitative study included 610 FSWs who were recruited using two-stage cluster sampling from September to November 2012 in 22 Terai Highway districts of Nepal. Rapid HIV tests and face-to-face interviews were conducted to collect biological and behavioural information. A count of physical (sexual violence and other undesirable events), social (poor social support and condom negotiation skills), and economic (unprotected sex to make more money) factors that operate at the micro-level was calculated to test the additive relationship to unprotected sex. The HIV prevalence was 1%; this is presumably representative, with a large sample of FSWs in Nepal. The prevalence of unprotected sex with clients was high (24%). For each additional adverse physical, social, and economic condition, the probability of non-use of condoms with clients increased substantially: one problem = 12% (psocial, and economic environments increased the risk of unprotected sex among Nepalese FSWs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Levels of advertised unprotected vaginal and oral sex by independent indoor female sex workers in West Yorkshire, UK.

    Science.gov (United States)

    Eccles, Claire; Clarke, Janette

    2014-02-01

    To assess the proportion of independent indoor female sex workers (FSW) in West Yorkshire, UK who advertise unprotected sex, and to investigate any association with cost, location and provision of anal sex. Data on whether independent indoor FSW (defined as those not advertising via an escort agency or through a parlour) advertised unprotected sexual services, along with demographic data, were collected from 462 advertisement profiles of FSW in West Yorkshire from the website http://www.adultwork.com. Independent t test and χ(2) statistics were used to test the association between advertised unprotected vaginal and oral sex, and FSW age, cost of services, location and whether they advertised anal sex. Unprotected vaginal sex was advertised by 8% of FSW, and unprotected oral sex by 74% of FSW. FSW advertising unprotected vaginal sex were more likely to live in Wakefield and Bradford than in Leeds, had significantly lower hourly rates, and were more likely to advertise anal sex. Advertised condom use for vaginal and oral sex by independent indoor FSW in West Yorkshire was significantly lower than reported rates of protected sex found in previous studies based in London and the south of England. The advertisement of unprotected vaginal sex is associated with factors such as lower hourly rates and the advertisement of higher risk anal sex, which may signify greater economic need. FSW offering unprotected sex therefore represent an at-risk target group for health promotion.

  1. Violence as a Barrier for HIV Prevention among Female Sex Workers in Argentina

    Science.gov (United States)

    Pando, María A.; Coloccini, Romina S.; Reynaga, Elena; Rodriguez Fermepin, Marcelo; Gallo Vaulet, Lucia; Kochel, Tadeusz J.; Montano, Silvia M.; Avila, María M.

    2013-01-01

    Background Violence against female sex workers (FSWs) has been increasingly reported as an important determinant of HIV infection risk. This study explores the frequency of different violent experiences (sexual abuse, rejection, beating and imprisonment) among FSWs in Argentina and its association with condom use and HIV and T. pallidum prevalence. Methods A convenience sample of 1255 FSWs was included in a cross-sectional study conducted between October 2006 and November 2009. Results Sexual abuse was reported by 24.1% (219/907) of women. A total of 34.7% (42/1234) reported rejection experiences, 21.9% (267/1215) reported having been beaten and 45.4% (561/1236) stated having been arrested because of their sex work activity. There was a higher frequency of inconsistent condom use with clients among FSWs who had experienced sexual abuse, rejection, and police detention. A higher frequency of HIV and T. pallidum infection was detected among FSWs who reported having been arrested by the police. Conclusion The study shows for the first time the frequency of different violent situations among FSWs in Argentina. The association between violence against sex workers, condom use and STI prevalence demonstrated here calls for measures to reduce stigma and violence against FSWs. Such violent experiences may increase vulnerability to STI through coerced unprotected sex. PMID:23342092

  2. Interpersonal and structural contexts of intimate partner violence among female sex workers in conflict-affected northern Uganda.

    Science.gov (United States)

    Erickson, Margaret; Goldenberg, Shira M; Master, Aditi; Muzaaya, Godfrey; Akello, Monica; Braschel, Melissa; Birungi, Josephine; Shannon, Kate

    2017-07-06

    Intimate partner violence (IPV) is the most prevalent form of violence against women, yet remains under-researched among sex workers in sub-Saharan Africa. We explored the interpersonal and structural determinants of recent IPV among female sex workers in northern Uganda. This analysis drew on data from a community-based cross-sectional study (conducted May 2011-January 2012), involving 379 female sex workers in Gulu, northern Uganda. Using logistic regression and multivariable modeling, we examined the correlates of recent male-perpetrated physical or sexual IPV. Of 379 women with noncommercial partners, 59 percent reported having experienced recent moderate/severe physical or sexual IPV. Reporting recent client violence (adjusted odds ratio (AOR): 3.67; 95 percent confidence interval [CI]: 2.31-5.83), doing what their partner wanted (AOR: 2.46; 95 percent CI: 1.46-4.13), and forced sexual debut (AOR: 1.92; 95 percent CI: 1.20-3.05) were independently associated with moderate/severe IPV; recent police arrest and/or incarceration were/was marginally significantly associated with IPV (AOR: 2.25; 95 percent CI: 0.86-5.88, p = 0.097). Greater odds of IPV among sex workers were associated with recent workplace violence, forced sexual debut, and gendered power dynamics favoring male partner control. Programs and policies promoting the safety and health of marginalized women and addressing gender dynamics and violence are needed.

  3. Arresting HIV: Fostering Partnerships between Sex Workers and Police to Reduce HIV Risk and Promote Professionalization within Policing Institutions: A Realist Review.

    Science.gov (United States)

    Tenni, Brigitte; Carpenter, Jenae; Thomson, Nicholas

    2015-01-01

    In many countries around the world sex work is criminalised and its regulatory control is therefore often in the hands of the police. In addition to the impact of this criminalised legal environment, much literature describes the negative impact that certain police practices can have on the ability of sex workers and the programs that work with sex workers to access essential HIV prevention, treatment, care and support services. This situation has resulted in persistent concentrated HIV epidemics among sex workers in many countries of the world. The need for multi-sector partnerships between police and HIV programs is increasingly recognised in various UN declarations and resolutions yet descriptions of the process or key ingredients required to actually establish and sustain these necessary partnerships between police and sex workers [or the programs that provide essential services to sex workers] are sparse. The paper seeks to establish key considerations and critical processes that are required to foster partnerships that if further investigated and scaled up, could result in an enhanced enabling environment for the provision of essential HIV services for sex workers around the globe. This paper is based on a realist review that investigated isolated examples of partnership formation between law enforcement and HIV programs working with sex workers. This methodology research is designed to work with complex social interventions and is based on the emerging 'realist' approach to evaluation. A realist review methodology was chosen given the paucity of relevant literature in this vein and the authors' familiarity with the grey literature and relationships with experts who work in this sphere. The review found that political and police leadership, civil society strengthening and police reform in relation to HIV, are critical factors and key ingredients in changing the enabling environment in which sex work takes place to ensure that HIV prevention, individual and

  4. Feasible, Efficient and Necessary, without Exception – Working with Sex Workers Interrupts HIV/STI Transmission and Brings Treatment to Many in Need

    Science.gov (United States)

    Steen, Richard; Wheeler, Tisha; Gorgens, Marelize; Mziray, Elizabeth; Dallabetta, Gina

    2015-01-01

    Background and Overview High rates of partner change in sex work—whether in professional, ‘transactional’ or other context—disproportionately drive transmission of HIV and other sexually transmitted infections. Several countries in Asia have demonstrated that reducing transmission in sex work can reverse established epidemics among sex workers, their clients and the general population. Experience and emerging research from Africa reaffirms unprotected sex work to be a key driver of sexual transmission in different contexts and regardless of stage or classification of HIV epidemic. This validation of the epidemiology behind sexual transmission carries an urgent imperative to realign prevention resources and scale up effective targeted interventions in sex work settings, and, given declining HIV resources, to do so efficiently. Eighteen articles in this issue highlight the importance and feasibility of such interventions under four themes: 1) epidemiology, data needs and modelling of sex work in generalised epidemics; 2) implementation science addressing practical aspects of intervention scale-up; 3) community mobilisation and 4) the treatment cascade for sex workers living with HIV. Conclusion Decades of empirical evidence, extended by analyses in this collection, argue that protecting sex work is, without exception, feasible and necessary for controlling HIV/STI epidemics. In addition, the disproportionate burden of HIV borne by sex workers calls for facilitated access to ART, care and support. The imperative for Africa is rapid scale-up of targeted prevention and treatment, facilitated by policies and action to improve conditions where sex work takes place. The opportunity is a wealth of accumulated experience working with sex workers in diverse settings, which can be tapped to make up for lost time. Elsewhere, even in countries with strong interventions and services for sex workers, an emerging challenge is to find ways to sustain them in the face of

  5. HIV Testing and Counseling Among Female Sex Workers : A Systematic Literature Review

    NARCIS (Netherlands)

    Tokar, Anna; Broerse, Jacqueline E.W.; Blanchard, James; Roura, Maria

    2018-01-01

    HIV testing uptake continues to be low among Female Sex Workers (FSWs). We synthesizes evidence on barriers and facilitators to HIV testing among FSW as well as frequencies of testing, willingness to test, and return rates to collect results. We systematically searched the MEDLINE/PubMed, EMBASE,

  6. Legalising sex workers during the 2010 FIFA Soccer World CupTM ...

    African Journals Online (AJOL)

    The eagerly anticipated 2010 FIFA Soccer World CupTM, which takes place in South Africa, brings along a variety of challenges and issues which have prompted the attention of the public as well as decision-makers. An issue that is currently being debated in many quarters is the legalisation of sex workers. It is anticipated ...

  7. HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review.

    Science.gov (United States)

    Tokar, Anna; Broerse, Jacqueline E W; Blanchard, James; Roura, Maria

    2018-02-20

    HIV testing uptake continues to be low among Female Sex Workers (FSWs). We synthesizes evidence on barriers and facilitators to HIV testing among FSW as well as frequencies of testing, willingness to test, and return rates to collect results. We systematically searched the MEDLINE/PubMed, EMBASE, SCOPUS databases for articles published in English between January 2000 and November 2017. Out of 5036 references screened, we retained 36 papers. The two barriers to HIV testing most commonly reported were financial and time costs-including low income, transportation costs, time constraints, and formal/informal payments-as well as the stigma and discrimination ascribed to HIV positive people and sex workers. Social support facilitated testing with consistently higher uptake amongst married FSWs and women who were encouraged to test by peers and managers. The consistent finding that social support facilitated HIV testing calls for its inclusion into current HIV testing strategies addressed at FSW.

  8. 'Female condoms give women greater control': a qualitative assessment of the experiences of commercial sex workers in Swaziland.

    Science.gov (United States)

    Mathenjwa, Thulile; Maharaj, Pranitha

    2012-10-01

    To explore commercial sex workers' experiences with the female condom in Swaziland. This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it. Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.

  9. Molecular status of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among transgender commercial sex workers in Surakarta, Indonesia

    Science.gov (United States)

    Prasetyo, Afiono Agung; Sari, Yulia; Dharmawan, Ruben; Marwoto

    2017-02-01

    Sexual contact and other risk behavior among transgender working as commercial sex workers are important factors for sexual and blood-borne virus (BBV) infections. However, there no data concerning the molecular status of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) circulated among transgender working as commercial sex workers. Blood samples obtained from transgender working as commercial sex workers in Surakarta were examined for HIV antibodies, HBsAg and HCV antibodies, respectively, by immunological assays. All blood samples were also subjected for viral nucleic acid extraction and molecular detection of HIV, HBV and HCV by nested RT-PCR. The PCR products were purified from agarose gels, and the nucleotide sequences were retrieved and molecular analyzed. HIV, HBV and HCV was detected in 26.9% (7/26), 19.2% (5/26) and 46.2% (12/26), respectively. HIV CRF01_AE and B were found to be circulating in the community. HBV genotype B3 predominated, followed by C1. HCV genotype 1a predominated among HCV-infected transgender working as commercial sex workers, followed by 1c, 3a, and 4a. HIV, HBV, and HCV were found circulating in the transgender working as commercial sex workers in Surakarta, Indonesia.

  10. Recruitment of Caribbean female commercial sex workers at high risk of HIV infection

    Directory of Open Access Journals (Sweden)

    Marie Marcelle Deschamps

    2013-08-01

    Full Text Available OBJECTIVE: To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. METHODS: A prospective cohort study was conducted in 2009-2012 among 799 female commercial sex workers in the Dominican Republic, Haiti, and Puerto Rico. Minimum eligibility criteria included exchange of sex for goods, services, or money in the previous 6 months and unprotected vaginal or anal sex with a man during the same period. Sites used local epidemiology to develop more stringent eligibility criteria and recruitment strategies. Participants were asked questions about HIV/AIDS and their level of concern about participating in an HIV vaccine trial. Logistic regression modeling was used to assess predictors of prevalent HIV infection and willingness to participate in a future HIV vaccine study. RESULTS: HIV prevalence at screening was 4.6%. Crack cocaine use [odds ratio (OR = 4.2, 95% confidence interval (CI (1.8-9.0] was associated with and having sex with clients in a hotel or motel [OR = 0.5, CI (0.3-1.0] was inversely associated with HIV infection. A total of 88.9% of enrolled women were definitely or probably willing to participate in a future HIV vaccine trial. CONCLUSIONS: This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial.

  11. Immigrant health workers in Chile: is there a Latin American "brain drain"?

    Directory of Open Access Journals (Sweden)

    Baltica Cabieses

    2012-08-01

    Full Text Available Most research on the phenomenon of "brain drain" (one-way flow of highly skilled/educated individuals has focused on movement between the least developed and most highly developed countries. Therefore, the significance of patterns of migration to middle-income countries such as those in Latin America is less clear. The aim of this study was to outline key features of international health worker "brain drain" to Chile to promote discussion and further research on this phenomenon as it pertains to the Latin American region. The study compared immigrant health workers living in Chile to both Chilean-born health workers and other immigrants living in Chile using a qualitative nationwide dataset (the results of Chile's 2009 National Socioeconomic Characterization Survey. Demographic, socioeconomic, and health-related variables were included in the analyses, which were weighted by population to obtain nationally representative estimates. In 2009, immigrant health workers represented 2.2% of all health personnel and 2.6% of all resident immigrants in the country. While most immigrant health workers had a universitylevel education, about 25% had only a high school-level education or less. There was no statistically significant difference between the distribution of immigrant health workers' household income and that of Chilean-born health workers. A significantly higher proportion of the immigrant group reported no entitlement to health care provision. While the results of this study do not indicate a significant international health worker "brain drain" to Chile, they do suggest distinctive patterns of migration within the Latin American region. Future studies in Chile could confirm the validity of these results, using a larger sample of immigrant health workers.

  12. Immigrant health workers in Chile: is there a Latin American "brain drain"?

    Science.gov (United States)

    Cabieses, Baltica; Tunstall, Helena

    2012-08-01

    Most research on the phenomenon of "brain drain" (one-way flow of highly skilled/educated individuals) has focused on movement between the least developed and most highly developed countries. Therefore, the significance of patterns of migration to middle-income countries such as those in Latin America is less clear. The aim of this study was to outline key features of international health worker "brain drain" to Chile to promote discussion and further research on this phenomenon as it pertains to the Latin American region. The study compared immigrant health workers living in Chile to both Chilean-born health workers and other immigrants living in Chile using a qualitative nationwide dataset (the results of Chile's 2009 National Socioeconomic Characterization Survey). Demographic, socioeconomic, and health-related variables were included in the analyses, which were weighted by population to obtain nationally representative estimates. In 2009, immigrant health workers represented 2.2% of all health personnel and 2.6% of all resident immigrants in the country. While most immigrant health workers had a universitylevel education, about 25% had only a high school-level education or less. There was no statistically significant difference between the distribution of immigrant health workers' household income and that of Chilean-born health workers. A significantly higher proportion of the immigrant group reported no entitlement to health care provision. While the results of this study do not indicate a significant international health worker "brain drain" to Chile, they do suggest distinctive patterns of migration within the Latin American region. Future studies in Chile could confirm the validity of these results, using a larger sample of immigrant health workers.

  13. A Sex Work Research Symposium: Examining Positionality in Documenting Sex Work and Sex Workers’ Rights

    OpenAIRE

    Megan Lowthers; Magdalena Sabat; Elya M. Durisin; Kamala Kempadoo

    2017-01-01

    Historically, academic literature on sex work has documented the changing debates, policies, and cultural discourse surrounding the sex industry, and their impact on the rights of sex workers worldwide. As sex work scholars look to the future of sex workers’ rights, however, we are also in a critical moment of self-reflection on how sex work scholarship engages with sex worker communities, produces knowledge surrounding sex work, and represents the lived experiences of sex workers’ rights, or...

  14. Influence of peer support on HIV/STI prevention and safety amongst international migrant sex workers: A qualitative study at the Mexico-Guatemala border.

    Science.gov (United States)

    Febres-Cordero, Belen; Brouwer, Kimberly C; Rocha-Jimenez, Teresita; Fernandez-Casanueva, Carmen; Morales-Miranda, Sonia; Goldenberg, Shira M

    2018-01-01

    Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border. This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecún Umán and Quetzaltenango, Guatemala. Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified. Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex

  15. Using the Venom of a Snake for an Antidote: exploring strategies and services for sex workers in preparation for the World Cup 2014.

    Science.gov (United States)

    Ewen, Janine Elizabeth

    2015-07-01

    This article considers the public health implications that were predicted by sex workers a year prior to the FIFA World Cup 2014, with considerations towards the Olympic Games in 2016. Primary research conducted in 2013 in Brazil's second largest city, Rio de Janeiro, gave sex workers and civil society organizations the opportunity to voice concerns of the everyday disadvantages faced by those involved in the sex industry, with emphasis on what could cause further detriments from acting as a double draw international sporting host. This research largely took place through invitation at the 2013 Rio State Conference on HIV/AIDS, Equality and Human Rights. Mixed methods research - pre-arrival questionnaires and interviews led by a semi-structured interview guide - was deemed suitable for the primary research collection. The use of the research software NVivo allowed data to be categorised into key themes to form the basis of this research article. Working with a Portuguese translator, case studies of transsexual sex workers and civil society organizations were developed. Police violence was the main re-occurring theme expressed as a continued fear, alongside the added increase of security measures that the games would bring, to reduce organized crime, and through the Pacification programme. The majority of sex workers and organizations believed that there was no support from the Brazilian government to continue to provide services of high demand, including social care and legal assistance. Sex workers also felt prejudice in receiving HIV/AIDS treatment from government-led health services. A desirable outcome for the sex worker community would be for the government to consider the following: recommendations devised for further health and well being support; an act or law of non-violence against them; and recommendations to decimalize the sex industry. The Brazilian government has received global recognition for its response to the HIV/AIDS epidemic, however the

  16. Behaviour change and associated factors among female sex workers in Kenya.

    Science.gov (United States)

    Nyagero, Josephat; Wangila, Samuel; Kutai, Vincent; Olango, Susan

    2012-01-01

    Initiatives aimed at behaviour change of key populations such as the female sex workers (FSWs) are pivotal in reducing the transmission of HIV. An 8-year implementation research to establish the predictor factors of behaviour change among FSWs in Kenya was initiated by the African Medical Research Foundation (AMREF) with Sida and DfID support. This cross-sectional survey interviewed 159 female sex workers (FSWs) identified through snowball procedure. The measurement of behaviour change was based on: the consistent use of condoms with both regular and non regular clients, reduced number of clients, routine checks for STIs, and involvement in alternative income generating activities. The adjusted odds ratios at 95% confidence interval computed during binary logistic regression analysis were used to determine the behaviour change predictor factors. Most FSWs (84%) had participated in AMREF's integrated intervention programme for at least one year and 59.1% had gone through behaviour change. The adjusted odds ratio showed that the FSWs with secondary education were 2.23 times likely to change behaviour, protestants were 4.61 times, those in sex work for >4 years were 2.36 times, FSWs with good HIV prevention knowledge were 4.37 times, and those engaged in alternative income generating activities were 2.30 times more likely to change their behaviour compared to respective counterparts. Behaviour change among FSWs was possible and is associated with the level of education, religious affiliation, number of years in sex work and one's level of HIV prevention knowledge. A re-orientation on the peer education programme to focus on HIV preventive measures beyond use of condoms is emphasized.

  17. Psychological fears among low-paid female sex workers in southwest China and their implications for HIV prevention.

    Science.gov (United States)

    Qiao, Shan; Li, Xiaoming; Zhang, Chen; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu; Stanton, Bonita

    2014-01-01

    Commercial sex plays a critical role in rapidly increasing heterosexual transmission of HIV in China. Low-paid female sex workers (FSWs) are especially vulnerable to HIV/AIDS. Because of the illegality and stigma associated with sex work, FSWs may constantly live with fears in their daily life. Based on cross-sectional study of 794 low-paid FSWs in China we described their psychological fears related to commercial sex and examined the associations between fears and HIV-related behaviors. Fear of HIV infection was significantly associated with consistent use of condoms with clients. However, fear of breaching sex worker identity significantly prevented the FSWs from consistently using condoms with clients and taking HIV tests. Fear of being arrested by the police was positively associated with consistent use of condoms but negatively associated with accessing HIV prevention services. Our findings underlined the importance of examining the triadic interaction of behavioral, psychological and environmental factors in HIV prevention interventions among low-paid FSWs.

  18. Sex, drugs, and HIV: rapid assessment of HIV risk behaviors among street-based drug using sex workers in Durban, South Africa.

    Science.gov (United States)

    Needle, Richard; Kroeger, Karen; Belani, Hrishikesh; Achrekar, Angeli; Parry, Charles D; Dewing, Sarah

    2008-11-01

    South Africa is experiencing significant changes in patterns of illicit drug use, including increasing injection and non-injection drug use, and the use of drugs by persons engaged in sex work, both of which could further expand the HIV/AIDS epidemic. In 2005, a rapid ethnographic assessment was conducted in Durban, South Africa, to learn more about patterns of drug use and HIV risk behaviors among drug-using, street-based sex workers. Field teams recruited 52 current injection and non-injection drug users for key informant interviews and focus groups, and they conducted mapping and observation in identified high-risk neighborhoods. Key informants were offered free, voluntary counseling and HIV rapid testing. The results of the assessment indicate that in this population, drugs play an organizing role in patterns of daily activities, with sex work closely linked to the buying, selling, and using of drugs. Participants reported using multiple drugs including crack cocaine, heroin, Ecstasy and Mandrax, and their choices were based on their expectations about the functional role and behavioral and pharmacological properties of the drugs. The organization of sex work and patterns of drug use differ by gender, with males exercising more control over daily routines and drug and sexual transactions than females. Activities of female sex workers are subject to considerable control by individual pimps, many of whom also function as landlords and drug dealers. A strong hold over the overlapping economies of drugs and sex work by a few individuals extends to control of the physical and social settings in which sex is exchanged and drugs are sold and used as well as the terms under which sex work is carried out. The potential for accelerated HIV spread is considerable given the evidence of overlapping drug-using and sexual risk behaviors and the mixing patterns across drug and sexual risk networks.

  19. 77 FR 59986 - Johnson Controls Including Workers Whose Wages Were Reported Under IMECO LLC; North American...

    Science.gov (United States)

    2012-10-01

    ... applicable to workers and former workers of Johnson Controls, North American Refrigeration, Dixon, Illinois... to TA-W-71,663 is hereby issued as follows: All workers of Johnson Controls, including workers whose... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,663] Johnson Controls...

  20. The syndemic condition of psychosocial problems and HIV risk among male sex workers in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Biello, Katie B; Colby, Donn; Closson, Elizabeth; Mimiaga, Matthew J

    2014-07-01

    In Vietnam, the co-occurrence (i.e., "syndemic") of psychosocial factors (e.g., depression and substance use) may disproportionately burden male sex workers and increase their HIV risk. A comprehensive survey was conducted among 300 male sex workers in Ho Chi Minh City, Vietnam in 2010. We performed logistic regression to examine the association between the syndemic variable-a count score of the number of five psychosocial conditions endorsed-and unprotected anal sex (UAS) in the past. One-third of participants reported any UAS, and 42 % reported ≥2 psychosocial health problems. In multivariable models, experiencing ≥4 psychosocial health problems was significantly associated with UAS. Every unit increase in number of psychosocial health problems was associated with a 25-30 % increase in odds of UAS. Understanding the syndemic condition and its association with HIV risk among male sex workers in Vietnam may lead to the development of more effective, comprehensive interventions.

  1. Breaking the ice! Predictors about communication between nonresident African American fathers and sons about sex.

    Science.gov (United States)

    Burns, Jade C; Caldwell, Cleopatra H

    2016-02-01

    Research on communication between resident and nonresident African American fathers and their sons about sex has been understudied. The purpose of this study is to determine the influence of parenting variables, specifically, racial socialization and father involvement on nonresident African American father-son communication about sex. Data for this study are from the Fathers and Sons Project. This intervention study is designed to enhance relationships between nonresident African American fathers and their 8-12 year old sons and to prevent risky health behaviors among sons. The present study is based on 345 African American boys who completed baseline face-to-face interviews. The average age of the sons was 10.2 years old (SD = 1.4), with an average of two siblings (SD = 1.53). Age and sons' perceptions of more parental monitoring by their fathers were predictive of increased communication about sex. Racial socialization messages explained additional variance in communication about sex above other parenting variables and controls. Findings suggest when working with African American families, providers who counsel parents, and in particular provide outreach to fathers regarding communication about sex, are in a unique position to enhance parenting communication skills about sexuality. ©2015 American Association of Nurse Practitioners.

  2. Condoms and sexual health education as evidence: impact of criminalization of in-call venues and managers on migrant sex workers access to HIV/STI prevention in a Canadian setting

    OpenAIRE

    Anderson, S.; Shannon, K.; Li, J.; Lee, Y.; Chettiar, J.; Goldenberg, S.; Kr?si, A.

    2016-01-01

    Background Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers. Methods Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business owners of in-call sex work venues in Metro Vanco...

  3. Profile of female sex workers in a Chinese county: does it differ by where they came from and where they work?

    Science.gov (United States)

    Fang, Xiaoyi; Li, Xiaoming; Yang, Hongmei; Hong, Yan; Zhao, Ran; Dong, Baiqing; Liu, Wei; Zhou, Yuejiao; Liang, Shaoling; Stanton, Bonita

    2007-01-01

    Since the 1980s, informal or clandestine sex work in the service or entertainment industry has spread from municipalities to small towns in most areas of China. Despite recognition of the important role of female sex workers in HIV and STD epidemics in China, limited data are available regarding their individual characteristics and the social and environmental context of their work. Furthermore, most existing studies on commercial sex in China have been conducted in large cities or tourist attractions. Using data from 454 female sex workers in a rural Chinese county, the current study was designed to explore the individual profiles of commercial sex workers and to examine whether the profile and sexual risk behaviour differ by where the female sex workers came from and where they work. The sample in the current study was different from previous studies in a number of key individual characteristics. However, similarly to previous studies, the subjects in the current study were driven into commercial sex by poverty or limited employment opportunities, lived a stressful life, were subject to sexual harassment and related violence, and engaged in a number of health-compromising behaviours including behaviours that put them at risk of HIV/STD infection and depression. The findings of the current study underscore the urgent need for effective HIV/STD prevention, intervention and mental health promotion programs among female sex workers in China. The data in the current study suggest a strong association of individual profile with the economic conditions of work sites and residence status (in-province residency vs. out-of-province residency), which suggests that such efforts must take the social and cultural contextual factors of working environment (and sexual risks) into consideration.

  4. Condoms and sexual health education as evidence: impact of criminalization of in-call venues and managers on migrant sex workers access to HIV/STI prevention in a Canadian setting.

    Science.gov (United States)

    Anderson, S; Shannon, K; Li, J; Lee, Y; Chettiar, J; Goldenberg, S; Krüsi, A

    2016-11-17

    Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers. Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business owners of in-call sex work venues in Metro Vancouver, Canada. The criminalization of in-call venues and third parties explicitly limits sex workers' access to HIV/STI prevention, including manager restrictions on condoms and limited onsite access to sexual health information and HIV/STI testing. With limited labour protections and socio-cultural barriers, criminalization and policing undermine the health and human rights of migrant sex workers working in -call venues. This research supports growing evidence-based calls for decriminalization of sex work, including the removal of criminal sanctions targeting third parties and in-call venues, alongside programs and policies that better protect the working conditions of migrant sex workers as critical to HIV/STI prevention and human rights.

  5. A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention.

    Science.gov (United States)

    Underhill, Kristen; Morrow, Kathleen M; Colleran, Christopher; Holcomb, Richard; Calabrese, Sarah K; Operario, Don; Galárraga, Omar; Mayer, Kenneth H

    2015-08-01

    Access to biomedical HIV prevention technologies such as pre-exposure prophylaxis (PrEP) requires individuals to disclose risk behavior to clinicians, but experiences of discrimination and medical mistrust may limit disclosure among male sex workers and other MSM. We explored experiences of perceived discrimination, medical mistrust, and behavior disclosure among male sex workers compared to other men who have sex with men (MSM). We conducted 56 interviews with MSM and compared findings about medical mistrust, discrimination, and disclosure for 31 men who engaged in sex work vs. 25 men who did not. MSM who engaged in sex work reported more medical mistrust and healthcare discrimination due to issues beyond MSM behavior/identity (e.g., homelessness, substance use, poverty). MSM who did not report sex work described disclosing sex with men to clinicians more often. Both subgroups reported low PrEP awareness, but willingness to disclose behavior to obtain PrEP. Medical mistrust and perceived discrimination create barriers for sexual behavior disclosure to clinicians, potentially impeding access to PrEP and other forms of biomedical HIV prevention. These barriers may be higher among male sex workers compared to other MSM, given overlapping stigmas including sex work, substance use, homelessness, and poverty. An intersectionality framework for understanding multiple stigmas can help to identify how these dynamics may limit access to biomedical HIV prevention among male sex workers, as well as suggesting strategies for addressing stigmas to improve the delivery of PrEP and other HIV prevention approaches in this population.

  6. Accountancy, teaching methods, sex, and American College Test scores.

    Science.gov (United States)

    Heritage, J; Harper, B S; Harper, J P

    1990-10-01

    This study examines the significance of sex, methodology, academic preparation, and age as related to development of judgmental and problem-solving skills. Sex, American College Test (ACT) Mathematics scores, Composite ACT scores, grades in course work, grade point average (GPA), and age were used in studying the effects of teaching method on 96 students' ability to analyze data in financial statements. Results reflect positively on accounting students compared to the general college population and the women students in particular.

  7. Barriers to free antiretroviral treatment access for female sex workers in Chennai, India.

    Science.gov (United States)

    Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Kurian, Abraham K; Dubrow, Robert

    2009-11-01

    India's National AIDS Control Organization (NACO) provides free first-line antiretroviral treatment (ART) at government centers for people living with HIV. To assist in developing policies and programs to ensure equity in ART access, we explored barriers to ART access among female sex workers (FSWs) living with HIV in Chennai. Between August and November 2007, we conducted three focus group discussions and two key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family/social, health care system/programmatic, and individual levels. Major barriers included fear of adverse consequences of disclosure of HIV status due to stigma and discrimination associated with HIV and sex work, lack of family support, negative experiences with health care providers, lack of adequate counseling services at government centers and by outreach workers employed by nongovernmental organizations (NGOs), perceived biased treatment of FSWs who are not referred by NGOs, lack of adequate knowledge about ART, and fatalism. Barriers can be addressed by: creating effective measures to reduce stigma associated with HIV/AIDS and sex work at the familial, societal, and health care system levels; incorporating information about ART into targeted interventions among FSWs; training counselors at government hospitals and NGO outreach workers on treatment issues; improving infrastructure and staffing levels at government centers to allow adequate time and privacy for counseling; and implementing government mass media campaigns on ART availability. Finally, it is crucial that NACO begin monitoring ART coverage of FSWs and other marginalized populations to ensure equitable ART access.

  8. Prevalence and associated factors of condomless receptive anal intercourse with male clients among transgender women sex workers in Shenyang, China

    Science.gov (United States)

    Cai, Yong; Wang, Zixin; Lau, Joseph TF; Li, Jinghua; Ma, Tiecheng; Liu, Yan

    2016-01-01

    Introduction Globally, transgender women sex workers have a high prevalence of HIV and condomless receptive anal intercourse with male clients (CRAIMC). We investigated the prevalence of CRAIMC and factors associated with CRAIMC among transgender women sex workers in China. Methods In 2014, we anonymously interviewed 220 transgender women sex workers face to face in Shenyang, China. Those who self-reported as HIV negative or as having unknown HIV serostatus were invited to take up free, anonymous HIV rapid testing (n=183); 90 did so. Using CRAIMC in the last month as the dependent variable, three types of associated factors were investigated, in addition to background factors: feminizing medical interventions, sex work and perceptions related to condom use. Univariate and multiple logistic regression models were fitted. Results Of the participants, 16.8% self-reported as HIV positive and 9.1% were detected to be HIV positive through free HIV testing; 26.8% had had CRAIMC in the last month, 45.5% had performed sex work in other Chinese cities (last year), and 23.2% had had condomless anal intercourse with men who were non-clients. In the adjusted analysis, significant factors associated with CRAIMC (last month) included the following: 1) any feminizing medical intervention performed (adjusted odds ratio, AOR: 2.22); 2) sex-work-related factors, including recruitment of male clients most often at hotels (AOR: 5.02) and charge per episode of transactional sex (201 to 400 RMB, AOR: 0.27; reference group: ≤100 RMB); and 3) perceptions related to condom use, including perceived transgender identity's impact on condomless sex such as wearing feminine attire, concern about exposing their status as a transgender woman to male clients (AOR: 1.20) and perceived self-efficacy of consistent condom use with male clients (AOR: 0.56). Perceived self-efficacy of consistent condom use with male clients fully mediated the association between perceived transgender identity's impact

  9. Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Semple, Shirley J; Strathdee, Steffanie A; Pitpitan, Eileen V; Chavarin, Claudia; Patterson, Thomas L

    2015-05-01

    Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members.

  10. Circadian variation of melatonin, light exposure, and diurnal preference in day and night shift workers of both sexes.

    Science.gov (United States)

    Papantoniou, Kyriaki; Pozo, Oscar J; Espinosa, Ana; Marcos, Josep; Castaño-Vinyals, Gemma; Basagaña, Xavier; Ribas, Ferran Calduch; Mirabent, Joan; Martín, Jordi; Carenys, Gemma; Martín, Celia Reyes; Middleton, Benita; Skene, Debra J; Kogevinas, Manolis

    2014-07-01

    Light-at-night has been shown in experimental studies to disrupt melatonin production but this has only partly been confirmed in studies of night shift workers. In this cross-sectional study, we examined the circadian variation of melatonin in relation to shift status, individual levels of light-at-night exposure, and diurnal preference, an attribute reflecting personal preference for activity in the morning or evening. One hundred and seventeen workers (75 night and 42 day) of both sexes, ages 22 to 64 years, were recruited from four companies. Participants collected urine samples from all voids over 24 hours and wore a data logger continuously recording their light exposure. Sociodemographic, occupational, lifestyle, and diurnal preference information were collected by interview. Concentrations of urinary 6-sulfatoxymelatonin (aMT6s), the main melatonin metabolite, were measured. Mean aMT6s levels were lower in night [10.9 ng/mg creatinine/hour; 95% confidence interval (CI), 9.5-12.6] compared with day workers (15.4; 95% CI, 12.3-19.3). The lowest aMT6s levels were observed in night workers with morning preference (6.4; 95% CI, 3.0-13.6). Peak time of aMT6s production occurred 3 hours later in night (08:42 hour, 95% CI, 07:48-09:42) compared with day workers (05:36 hour, 95% CI, 05:06-06:12). Phase delay was stronger among subjects with higher light-at-night exposure and number of nights worked. Night shift workers had lower levels and a delay in peak time of aMT6s production over a 24-hour period. Differences were modified by diurnal preference and intensity of light-at-night exposure. Night shift work affects levels and timing of melatonin production and both parameters may relate to future cancer risk. ©2014 American Association for Cancer Research.

  11. Sexual behaviours of clients of sex workers reported within phone calls at HIV/AIDS/STIs Italian Helpline

    Directory of Open Access Journals (Sweden)

    Ilaria Mulieri

    2013-06-01

    Full Text Available BACKGROUND: Clients of sex workers represent a relevant target for interventions aimed at the prevention of HIV and sexually transmitted infections (STIs. Within prevention strategies, the AIDS and sexually transmitted infections helpline (Telefono Verde AIDS/ IST, TVA-IST of National Institute of Health in Italy has provided, since 1987, specific information and counselling interventions. AIM: The present study reports data on anagraphical characteristics and behaviours of clients of sex workers, anonymously reported at TVA-IST in the period 1987-2010. DISCUSSION: Among 95 149 phone calls (14% of the total considered 99.5% came from males, over 80% aged under 37 years and prevalently from Northern Italy. Among sexual behaviours, unprotected sexual intercourses were reported in the 26% of the calls. Subjects under 27 years reported a higher frequency of unprotected anal intercourse, while they used protection with oral and vaginal intercourses in a greater extent than older ones. Due to differential behaviours within clients of sex workers, specific informative strategies for this targeted population should adequately consider age-related differences.

  12. High risk of HIV in non-brothel based female sex workers in India

    Directory of Open Access Journals (Sweden)

    McPherson Sam

    2005-08-01

    Full Text Available Abstract Background Heterosexual contact is the most common mode of HIV transmission in India that is largely linked to sex work. We assessed the non-use of condoms in sex work and with regular sex partners by female sex workers (FSWs, and identified its associations that could assist in planning HIV prevention programmes. Methods Detailed documentation of various aspects of sex work, and sexual behaviour with regular sex partners, was done through confidential interviews for 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. Multivariate analysis was done to understand condom non-use with clients. Results 5010 (75.4%, 1499 (22.5%, and 139 (2.1% FSWs were street-, home-, and brothel-based, respectively. Of the total 6648 FSWs, 6165 (92.7% had penetrative vaginal/anal sex with at least one client in the last 15 days, and of these 2907 (47.2%; 95% CI 41.2–53.2% reported non-use of condom with at least one of her last three clients. Lack of knowledge that HIV could be prevented (odds ratio 5.01; 95% CI 4.38–5.73, no access to free condoms (odds ratio 3.45; 95% CI 2.99–3.98, being street-based as compared with brothel-based (odds ratio 3.36; 95% CI 1.87–6.04, and no participation in FSW support groups (odds ratio 2.02; 95% CI 1.50–2.70 were the most significant predictors of condom non-use with clients. Other associations included lower social support, lower income, age >24 years, illiteracy, and living in medium-size urban or rural areas. Of the 2582 who had penetrative sex with regular sex partner within the last 7 days, 2428 (94%; 95% CI 92.1–95.9% had not used condom at last sex, and 1032 (41.8% had neither used condom consistently with clients nor with regular sex partner. Conclusion About half the FSWs do not use condom consistently with their clients in this Indian state putting them at high risk of HIV infection. Non-brothel-based FSWs, who form the majority of sex workers in India, were at a significantly higher

  13. Social Workers' Role in the Disproportionality of African American Students in Special Education

    Directory of Open Access Journals (Sweden)

    Kristen Faye Bean

    2011-11-01

    Full Text Available There is an overrepresentation of African American students in special education. Research on this phenomenon has primarily focused on educators within schools. School social workers are in unique positions to impact the disproportionality. Patricia Collins’ Domains-of-Power Framework is used to demonstrate how school social workers can practice transformational resistance to eliminate the overrepresentation of African American students in special education. School social workers should: 1 attend IEP meetings and conduct home visits and biopsychosocial evaluations with students who are being assessed for special education services, 2 offer to evaluate and conduct home visits with students whom teachers deem to be “at-risk” to prevent inappropriate assessments for special education, 3 create a school culture of acceptance of difference, and 4 ask themselves how they individually foster racial domination or emancipation in their daily actions.

  14. Negotiating Ability of Using Condom to Prevent Sexually Transmitted Disease and HIV/AIDS of Commercial Sex Worker Woman in Region Surakarta

    Directory of Open Access Journals (Sweden)

    Arif Widodo

    2016-12-01

    Full Text Available The data from Board of Health in Surakarta City, on 8 September 2005, from 155 commercial sex worker woman had blood examined, there were 7 persons positive in HIV. One of factor affecting the high infection HIV/AIDS in women commercial sex worker was low use of condom. Aims of this research was to know factor-factor associated with didn’t use of condom and social aspect negotiations about using condom (education, economics status, working experience, devilling place, occupation, ethnic, religious, and income. This research is qualitative research using guided group discussion technique, in-depth interview, and participatory observation. Subject for this research were 30 persons, consist of 25 commercial sex worker, 3 guest, 1 room owner, and 1 parent. Independent variables in this research are social economics characteristic, demography and community characteristics. Dependent variables as PPSK capability in condom using negotiating to prevent sexually transmitted disease and HIV/AIDS. Commonly, despite knowing that everyone, including themselves, is vulnerable to AIDS infection, the respondents ignore asking the guest/partners for condom use. Most of them don’t ask for condom use due to their fear of either being the target of the guest anger and bad words, or losing money from them. Women commercial sex worker Silir in using condom and prevent sexual transmitted disease had free education from Board of Health in Surakarta City. In the street prostitutes are low support from peer, room owner, hotel owner, or guest about using condom for women commercial sex worker in illegal place, caused women commercial sex worker in the street more potential and high risk to spread sexual transmitted diseases than they were operated in Silir. The low capability of the street prostitutes for negotiating condom use with the guest customers results from: misperception on "safe-sex" behavior for seeking "help", economic and psychology pressure, free and

  15. Young Sex-Workers in Ho Chi Minh City Telling Their Life Stories

    Science.gov (United States)

    Rubenson, Birgitta; Hanh, Le Thi; Hojer, Bengt; Johansson, Eva

    2005-01-01

    In this study the life stories of 22 sex-workers (age 15-18 years) in Vietnam are organized into three thematic narratives depicting how the girls presented their lives. Poverty, lack of job alternatives and the responsibility to share in the support of their families led the girls into prostitution. Strong family ties gave many girls…

  16. HIV prevalence and characteristics of sex work among female sex workers in Hargeisa, Somaliland, Somalia.

    Science.gov (United States)

    Kriitmaa, Kelsi; Testa, Adrienne; Osman, Mohamed; Bozicevic, Ivana; Riedner, Gabriele; Malungu, Jacqueline; Irving, Greg; Abdalla, Ismail

    2010-07-01

    To measure prevalence of HIV and syphilis and describe characteristics of sex work among female sex workers (FSWs) in Hargeisa, Somaliland, Somalia. A cross-sectional survey recruited 237 FSWs using respondent-driven sampling (RDS). A face-to-face, structured interview using handheld-assisted personal interviewing (HAPI) on personal digital assistants (PDAs) was completed and blood collected for serological testing. FSWs 15-19 years old accounted for 6.9% of the population; 20-24 year-old constituted an additional 18.0%. The majority (86.6%) never attended school. International (59.0%) and interzonal (10.7%) migration was common. Most (95.7%) reported no other source of income; 13.8% had five or more clients in the last 7 days. A minority (38.4%) had heard of STIs, even fewer (6.9%) held no misconceptions about HIV. Only 24% of FSW reported using a condom at last transactional sex, and 4% reported ever been tested for HIV. HIV prevalence was 5.2% and syphilis prevalence was 3.1%. Sex work in Hargeisa, Somaliland, Somalia, is characterized by high numbers of sexual acts and extremely low knowledge of HIV. This study illustrates the need for targeted HIV prevention interventions focusing on HIV testing, risk-reduction awareness raising, and review of condom availability and distribution mechanisms among FSWs and males engaging with FSWs.

  17. HIV Stigma Mediates the Association Between Social Cohesion and Consistent Condom Use Among Female Sex Workers Living with HIV in the Dominican Republic.

    Science.gov (United States)

    Carrasco, Maria Augusta; Nguyen, Trang Q; Barrington, Clare; Perez, Martha; Donastorg, Yeycy; Kerrigan, Deanna

    2018-07-01

    Evidence indicates that social cohesion is a successful strategy to improve consistent condom use (CCU) among female sex workers. However, the individual and layered or combined effect that various types of overlapping stigmas may have on CCU between female sex workers living with HIV and their clients and steady partners has not been analyzed. Drawing on the Abriendo Puertas cohort of female sex workers living with HIV in the Dominican Republic, we used structural equation modeling to test the hypothesis that both HIV stigma and sex work stigma mediate the association between social cohesion and CCU and that they have a layered effect. The results indicated that HIV stigma mediated the association between social cohesion and CCU with clients and partners, while sex work-related stigma did not. There was no evidence of a layered HIV stigma and sex work stigma effect, which may be due to methodological limitations to handle highly correlated latent variables. Findings highlight the need to address internalized HIV stigma within the context of community-based approaches to enhance their HIV prevention impact. This will help to reduce the risk of HIV re-infection with a new distinct HIV viral strain, STI infection, and onward HIV transmission among female sex workers living with HIV.

  18. Uptake of a women-only, sex-work-specific drop-in center and links with sexual and reproductive health care for sex workers.

    Science.gov (United States)

    Kim, Soyoun Rachel; Goldenberg, Shira M; Duff, Putu; Nguyen, Paul; Gibson, Kate; Shannon, Kate

    2015-03-01

    To longitudinally examine female sex workers' (FSWs') uptake of a women-only, sex-work-specific drop-in service and its impact on their access to sexual and reproductive health (SRH) services. For the present longitudinal analysis, data were drawn from the AESHA (An Evaluation of Sex Workers' Health Access) study, a community-based, open, prospective cohort of FSWs from Vancouver, BC, Canada. Data obtained between January 2010 and February 2013 were analyzed. Participants are followed up on a semi-annual basis. Multivariable logistic regression using generalized estimating equations was used to identify correlates of service uptake. Of 547 FSWs included in the present analysis, 330 (60.3%) utilized the services during the 3-year study period. Service use was independently associated with age (adjusted odds ratio [AOR] 1.04; 95% confidence interval [CI] 1.03-1.06), Aboriginal ancestry (AOR 2.18; 95% CI 1.61-2.95), injection drug use (AOR 1.67; 95% CI 1.29-2.17), exchange of sex for drugs (AOR 1.40; 95%CI 1.15-1.71), and accessing SRH services (AOR 1.65; 95% CI 1.35-2.02). A sex-work-specific drop-in space for marginalized FSWs had high uptake. Women-centered and low-threshold drop-in services can effectively link marginalized women with SRH services. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Earnshaw, Valerie A; Patterson, Thomas L

    2015-02-01

    HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino versus non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed.

  20. Effectiveness of Culturally Appropriate Initiative on Drug-Related Harm Reduction for Sex Workers on the Thai/Malaysian Border.

    Science.gov (United States)

    Nunun, Worapol; Kanato, Manop

    2015-07-01

    Drug use can harm to sex workers. Abstinence intervention, however, may not be appropriate since drug use fosters their career performance. The objective was to develop the culturally appropriate model for sex workers participation on drug demand reduction at the Thailand/Malaysian border This study was a pre-post quasi-experimental design. Tripartite participation was used to develop the model aiming to reduce harm regarding drug use. The study carried out during June 2010-May 2011. Data were collected from 150 key informant interviews, 56 focus group discussions, 22 participant observations in various situations, and numerous related materials. Descriptive statistics, survival analysis and 95% confidence interval were utilizedfor quantitative data. Qualitative data were analyzed by content analysis. Drug related harm reduction was evaluated at two-week time along implementation period of 12 months. 89.5% of all sessions introduced could decrease drug related harm. Of all sex workers participated in the study, intended to treat analysis showed 86.9% success rate (95% CI; 77.1, 96.7). Of these, 32.6% became abstinence, 39.1% reduced most of drug related harm. 13.0% reduced partial drug related harm either lessfrequency, less quantity, less concentration, decrease types of drugs/switch to safe drugs or safer method of administration. 2.2% was infancy stage, which needed further support. Key success ofthe model was tripartite participation. With active leaders and strong support, sex workers were continually motivated to reduce harm regarding drug use.

  1. Sexually transmitted infections: prevalence, knowledge and treatment practices among female sex workers in a cosmopolitan city in Nigeria.

    Science.gov (United States)

    Sekoni, Adekemi O; Odukoya, Oluwakemi O; Onajole, Adebayo T; Odeyemi, Kofoworola A

    2013-03-01

    Sexually transmitted infections constitute economic burden for developing countries, exposure to causative agents is an occupational hazard for female sex workers. Targeted interventions for this population can reduce the incidence and prevalence of sexually transmitted infections including human immunodeficiency virus, but barriers exists which can hinder effective implementation of such programs. This descriptive cross sectional study sought to assess the prevalence, knowledge and treatment practices of sexually transmitted infections among brothel based female sex workers. Three hundred and twenty three consenting female sex workers were surveyed using pre tested, interviewer administered questionnaires. More than half of the respondents (54.2%) had poor knowledge of symptoms of sexually transmitted infections. Only 13.9% were aware that sexually transmitted infections could be asymptomatic. The self reported prevalence of symptomatic sexually transmitted infections was 36.5%. About half of those with sexually transmitted infectionss sought treatment in a hospital or health centre while 32.5% from a patent medicine vendor. Most respondents (53.8%) mentioned the perceived quality of care as the main reason for seeking treatment in their chosen place. More of the respondents with good knowledge of sexually transmitted infections reported symptoms compared to those with fair and poor knowledge. The knowledge of sexually transmitted infections among these female sex workers is poor and the prevalence is relatively high. Efforts to improve knowledge promote and encourage preventive as well as effective treatment practices must be made for this population.

  2. Foreign Workers, Foreign Multinationals, and Wages after Controlling for Occupation and Sex in Malaysia’s Manufacturing Plants during the mid-1990s

    OpenAIRE

    Eric D., Ramstetter

    2017-01-01

    This paper investigates the effects of foreign worker shares and MNE ownership on wages after controlling for worker sex and occupation in Malaysian manufacturing plants during 1994-1996, an important period during which use of foreign workers began to increase substantially. In a previous paper, I estimated similar wage equations separately for five occupation groups of both sexes in large heterogeneous samples of plants in many industries and more homogeneous samples of plants in seven indu...

  3. Addressing Poverty, Unemployment and Gender Inequality in Southern Africa: An Alternative Strategy for HIV/AIDS Prevention with Sex Workers in Botswana

    Science.gov (United States)

    Ntseane, Peggy Gabo

    2004-01-01

    This article presents the results of a study that was conducted as an effort to identify the needs of sex workers as potential beneficiaries of future HIV prevention and empowerment activities. The purpose of this study was to assess the situation and needs of sex workers in the context of HIV/AIDS. Data were collected from one of the small…

  4. Sex-work harm reduction.

    Science.gov (United States)

    Rekart, Michael L

    2005-12-17

    Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.

  5. [Accepted Manuscript] Overlapping HIV and sex-work stigma among female sex workers recruited to 14 respondent-driven sampling surveys across Zimbabwe, 2013.

    OpenAIRE

    Hargreaves, J.R.; Busza, J.; Mushati, P.; Fearon, E.; Cowan, F.M.

    2016-01-01

    : HIV stigma can inhibit uptake of HIV testing and antiretroviral therapy as well as negatively affect mental health. Efforts to reduce discrimination against people living with HIV (LWH) have contributed to greater acceptance of the infection. Female sex workers (FSW) LWH may experience overlapping stigma due to both their work and HIV status, although this is poorly understood. We examined HIV and sex-work stigma experienced by FSW LWH in Zimbabwe. Using the SAPPH-IRe cluster-randomised tri...

  6. Region of birth, sex, and agricultural work of immigrant Latino farm workers: the MICASA study.

    Science.gov (United States)

    McCurdy, S A; Stoecklin-Marois, M T; Tancredi, D J; Bennett, D H; Schenker, M B

    2014-04-01

    Agricultural work is hazardous, and immigrant workers perform the majority of production tasks, yet there are few data describing agricultural work and use of protective measures by demographic characteristics. We examined cross-sectionally the influence of region of birth (Mexico vs. Central America) and sex on agricultural work and use of protective measures in the MICASA cohort of immigrant Latino farm workers in Mendota, California. Of 445 participants, 293 (65.8%) were born in Mexico (163 men, 130 women) and 152 (34.2%) were born in Central America (80 men, 72 women). Men worked on average 74.4 more days than women (95% CI 62.0, 86.9) and were more likely to perform tasks requiring high levels of training or strength, such as machine operation, pruning, picking, planting, and irrigation; more likely to work in dusty conditions; and more likely to work directly with pesticides. Women predominated in packing. Respondents from Mexico were more likely to work with tomatoes and less likely to work with melon and lettuce. Central America-born respondents were less likely to engage in planting, irrigation, and pesticide use. Use of task-appropriate personal protective measures on at least a half-time basis was rare, with the exception of persons working with pesticides (a group limited to men) and for facial scarves among Central American women. Further work should focus on identifying barriers to use of preventive measures and programs to further their use. Educational models accounting for cultural factors and driving social norm change, employer engagement, and use of community health workers (promotores) may be helpful in promoting use of preventive measures.

  7. Client demands for unsafe sex: the socioeconomic risk environment for HIV among street and off-street sex workers.

    Science.gov (United States)

    Deering, Kathleen N; Lyons, Tara; Feng, Cindy X; Nosyk, Bohdan; Strathdee, Steffanie A; Montaner, Julio S G; Shannon, Kate

    2013-08-01

    Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural, and client-related factors associated with being offered and accepting more money after clients' demand for sex without a condom. Cross-sectional study using baseline (February 2010 to October 2011) data from a longitudinal cohort of 510 SWs. A 2-part multivariable regression model was used to identify factors associated with 2 separate outcomes: (1) being offered more money for sex without a condom in the last 6 months; and (2) accepting more money, among those who had been offered more money. The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms, and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine less than daily (versus none) and less likely for SWs who solicited mainly indoors for clients (versus outdoor/public places). These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor workspaces are urgently required.

  8. Multiple Identity Considerations among African American Christian Men Experiencing Same-Sex Attraction

    Science.gov (United States)

    Yarhouse, Mark A.; Nowacki-Butzen, Stephanie; Brooks, D. Fredrica

    2009-01-01

    The authors explored the experiences of African American men who identified as Christian and experienced same-sex attraction. Participants completed an online questionnaire addressing experiences of same-sex attraction; meaning attributed to their attractions; the sharing of their experiences with others; and perceptions regarding the intersection…

  9. Threats during sex work and association with mental health among young female sex workers in Hong Kong.

    Science.gov (United States)

    Mo, Phoenix K H; Mak, Winnie W S; Kwok, Yvonne T Y; Xin, Meiqi; Chan, Charlie W L; Yip, Louise W M

    2018-08-01

    Young female sex workers (YFSWs) are confronted with significant threats during sex work. The present cross-sectional study examined different levels of threats (i.e., threats to life and health, threats to humanity, threats to control of work and financial security, and the threats to future) experienced by 87 YFSWs (age 16-25) in Hong Kong, and identified their association with mental health (i.e., psychological well-being) together with other factors, including childhood trauma, self-efficacy, hope, and social support. Results showed that the participants encountered a significant number of threats. More than half reported that they had a condom removed by clients during sex (51.7%); or have been humililated by clients (51.7%). Because of sex work, about a quarter (25.3%) have had sexually transmitted disease, and respectively 10.3% and 12.6% have had abortion and unplanned pregnancy. The majority have had friends found out that they engaged in sex work (72.4%). They also showed a high level of worry about the various threats. Multiple linear regression analysis showed that childhood trauma (β = -.26) and worry about threats during sex work (β = -.22) were significantly negative predictors, while self-efficacy (β = .20) and hope (β = .27) were significantly positive predictors of mental health. Future services should improve YFSWs' skills to minimize potential threats during female sex work, address the structural correlates and relieve their worries, and empower them with more hope and self-efficacy in choosing clients.

  10. An HIV-Prevention Intervention for Sex Workers in Tijuana, Mexico: A Pilot Study

    Science.gov (United States)

    Patterson, Thomas L.; Semple, Shirley J.; Fraga, Miguel; Bucardo, Jesus; Davila-Fraga, Wendy; Strathdee, Steffanie A.

    2005-01-01

    Female sex workers (FSW) are at high risk of acquiring sexually transmitted infections (STIs), including HIV, and putting their clients and other partners at risk for infection. There is considerable evidence that Social Cognitive Theory (SCT)?based interventions are effective in reducing high-risk sexual behavior among at-risk populations in the…

  11. Risk of sexual, physical and verbal assaults on men who have sex with men and female sex workers in coastal Kenya

    NARCIS (Netherlands)

    Micheni, Murugi; Rogers, Sam; Wahome, Elizabeth; Darwinkel, Marianne; van der Elst, Elise; Gichuru, Evans; Graham, Susan M.; Sanders, Eduard J.; Smith, Adrian D.

    2015-01-01

    Violence toward MSM and female sex workers (FSW) is associated with HIV risk, and its prevention is prioritized in international HIV/AIDS policy. Sociodemographic and behavioural data derived from HIV risk and follow-up cohorts including MSM and FSW in coastal Kenya between 2005 and 2014 was used to

  12. Determinants of Human Papillomavirus Vaccination Intention Among Female Sex Workers in Amsterdam, the Netherlands

    NARCIS (Netherlands)

    Marra, E.; Dam, L. van; Kroone, N.; Alberts, C.J.; Craanen, M.; Zimet, G.D.; Heijmam, T.; Hogewoning, A.A.; Sonder, G.J.B.; Vries, H.J.C. de; Alberts, C.J.; Paulussen, T.G.W.M.; Schim van der Loeff, M.F.

    2017-01-01

    Introduction: Female sex workers (FSWs) are at risk for human papillomavirus (HPV)-induced diseases but are currently not targeted by the HPV vaccination program in the Netherlands. We explored determinants of their intention to get vaccinated against HPV in case vaccination would be offered to

  13. Risks, benefits and survival strategies-views from female sex workers in Savannakhet, Laos

    Directory of Open Access Journals (Sweden)

    Phrasisombath Ketkesone

    2012-11-01

    Full Text Available Abstract Background Female sex workers (FSWs are vulnerable to sexually transmitted infections (STIs and encounter socio-economic and health problems, including STIs/HIV, unintended pregnancy and complications from unsafe abortion, stigma, violence, and drug addiction. Reducing risks associated with sex work requires an understanding of the social and cultural context in which sex workers live and work. This study aimed to explore the working environment and perceived risks among FSWs in Savannakhet province in Laos. Methods Five focus group discussions (FGDs and seven interviews were conducted with FSWs in Kaysone Phomvihan district in Laos. Latent content analysis was used to analyze the transcribed text. Results The results revealed that the FSWs were aware of risks but they also talked about benefits related to their work. The risks were grouped into six categories: STIs/HIV, unintended pregnancy, stigma, violence, being cheated, and social and economic insecurity. The reported benefits were financial security, fulfilling social obligations, and sexual pleasure. The FSWs reported using a number of strategies to reduce risks and increase benefits. Conclusions The desire to be self-sufficient and earn as much money as possible put the FSWs in disadvantaged and vulnerable situations. Fear of financial insecurity, obligations to support one’s family and the need to secure the future influenced FSWs’ decisions to have safe or unsafe sex. The FSWs were, however, not only victims. They also had some control over their lives and working environment, with most viewing their work as an easy and good way of earning money.

  14. The occupational health status of African-American women health care workers.

    Science.gov (United States)

    Arnold, C W

    1996-01-01

    Race, ethnicity, and gender are significant indicators of occupational status, general health status, and thus, occupational health status. Although African-American women constitute only 6.8% of the total U.S. labor force, they hold 20% of the jobs in the health care industry and are disproportionately represented in those jobs that have the highest levels of workplace exposure to hazards. As a result, they are therefore more likely to be at greater exposure and risk to the spectrum of occupational health problems. In order to gain insight into the effects of race and gender on the occupational health status of African-American women health care workers, this article uses three data sources that provide different but complementary sources of information on the demographic characteristics of workers, location of categories of occupations, working conditions of jobs, and other job and worker characteristics. Given the concentration of African-American women in health care positions where there exists a greater likelihood of being exposed to occupational hazards, it is therefore both logical and appropriate for primary care physicians, especially those engaged in office-based practices, to identify this target population for special services and to be more aware of the type of health issues with which these patients are more likely to present and to experience during their working lives. Health care providers have a responsibility to assess occupational factors related to a patient's health problems and to incorporate this information into their treatment protocols and into the design and explanation of each patient's care plan.

  15. AIDS prevention in the sex industry.

    Science.gov (United States)

    Morgan-thomas, R; Overs, C

    1992-01-01

    Most sex work research examines the impact of HIV on prostitutes and on society and involves testing prostitutes for HIV antibodies, but it does not examine the role of others in the sex industry. Sex industry workers include female prostitutes, transvestites, transsexuals, and male prostitutes, bar and brothel owners, taxi drivers, sex workers' partners, and sex business managers. Since sex workers provide sexual services to clients, they are in a perfect position to teach them about sexual health. Society must recognize that we cannot wish the sex industry away and that we need an effective health promotion strategy now. Some successful relevant AIDS education campaigns provide us some guidelines on how to develop campaigns. Any campaign targeting the sex industry should also target the public. Sex workers should participate in developing health messages and educational activities. They should also participate in the project. Any campaign must deal with major obstacles to safer sexual practices of which sex workers are aware and be consulted. Common obstacles are client demand for unprotected sex and irregular and inadequate supply of inexpensive condoms. A health promotion strategy cannot be effective, however, if sex workers do not have access to social support and health care services. Health promotion workers should also encourage local authorities to end discrimination of sex workers so they can freely obtain needed services. In some countries, sex workers operate fantasy workshops providing peers with ideas to sell sex services which reduce the risk of HIV transmission. Other campaigns distribute safer sex messages on small cards, cigarette lighters, key rings, condom packages, and T shirts. Training of sex workers other than prostitutes to reinforce safer sex messages to clients is also effective, e.g., taxi drivers can say they will take a client to a woman who uses condoms rather than to a clean girl. Street theater and puppets have also successfully

  16. [Importance of studying the balance of vaginal content (BAVACO) in the preventive control of sex workers].

    Science.gov (United States)

    Bologno, Romina; Díaz, Yanina M; Giraudo, María C; Fernández, Rosa; Menéndez, Viviana; Brizuela, Juan C; Gallardo, Adriana A; Alvarez, Laura A; Estevao Belchior, Silvia G

    2011-01-01

    The aim of this work was to study the vaginal microenvironment in sex workers from Comodoro Rivadavia, Chubut. For that purpose, BAVACO procedures were applied. A total of 229 female sex workers attended public health centers. Vaginal secretions were analyzed by Gram and Giemsa stains. The following results were obtained: normal microbiota 35.37 %, intermediate microbiota 15.72 %, bacterial vaginosis 23.14 %, microbial non-specific vaginitis, Donders'"aerobic vaginitis" 10.48 %, yeast vulvovaginitis 8.30 %, and trichomoniasis 6.99 %. The intermediate microbiota was characterized by a decrease in the number of lactobacilli and the presence of diphtheroid bacilli cell types. The population studied shared increased values of vaginal dysfunctions. These results are considered risk factors for obstetric and gynecologic diseases.

  17. Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners.

    Science.gov (United States)

    Syvertsen, Jennifer L; Bazzi, Angela Robertson; Martinez, Gustavo; Rangel, M Gudelia; Ulibarri, Monica D; Fergus, Kirkpatrick B; Amaro, Hortensia; Strathdee, Steffanie A

    2015-08-01

    We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico-US border. From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners' HIV risk. HIV interventions should consider the emotional quality of sex workers' intimate relationships.

  18. Peer outreach work as economic activity: implications for HIV prevention interventions among female sex workers.

    Directory of Open Access Journals (Sweden)

    Annie George

    Full Text Available Female sex workers (FSWs who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers' economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers' relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers.

  19. Science Majors and Degrees among Asian-American Students: Influences of Race and Sex in "model Minority" Experiences

    Science.gov (United States)

    Meng, Yu; Hanson, Sandra L.

    Both race and sex continue to be factors that stratify entry into science education and occupations in the United States. Asian-Americans (men and women) have experienced considerable success in the sciences and have earned the label of "model minority." The complexities and patterns involved in this success remain elusive. We use several concepts coming out of the status attainment framework and a multicultural gender perspective to explore the way in which race and sex come together to influence choices of science major and degree. Our sample consists of Asian-American and white students in the National Educational Longitudinal Study. Findings suggest that being male and being Asian-American are both associated with higher chances of pursuing majors and degrees in science. The male advantage is greater than the Asian-American advantage. Findings also suggest that race and sex interact in the science decision. For example, race differences (with an Asian-American advantage) in choice of science major are significant for women but not men. Sex differences (with a male advantage) in choice of science major are significant in the white, but not the Asian-American sample. A different set of race and sex patterns is revealed in the science degree models. Processes associated with family socioeconomic status and student characteristics help to explain race and sex patterns. Findings suggest that when Asian-American youths have closer ties to the Asian culture, they are more likely to choose science majors and degrees. Implications for policy, practice, and research in science education are discussed.

  20. When Sex Work Becomes Your Everything: The Complex Linkages Between Economy and Affection Among Male Sex Workers in Peru.

    Science.gov (United States)

    Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J

    2014-09-01

    In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs' perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs' perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. © The Author(s) 2013.

  1. Sex-selective abortion in Nepal: a qualitative study of health workers' perspectives.

    Science.gov (United States)

    Lamichhane, Prabhat; Harken, Tabetha; Puri, Mahesh; Darney, Philip D; Blum, Maya; Harper, Cynthia C; Henderson, Jillian T

    2011-01-01

    Sex-selective abortion is expressly prohibited in Nepal, but limited evidence suggests that it occurs nevertheless. Providers' perspectives on sex-selective abortion were examined as part of a larger study on legal abortion in the public sector in Nepal. In-depth interviews were conducted with health care providers and administrators providing abortion services at four major hospitals (n = 35), two in the Kathmandu Valley and two in outlying rural areas. A grounded theory approach was used to code interview transcripts and to identify themes in the data. Most providers were aware of the ban on sex-selective abortion and, despite overall positive views of abortion legalization, saw sex selection as an increasing problem. Greater availability of abortion and ultrasonography, along with the high value placed on sons, were seen as contributing factors. Providers wanted to perform abortions for legal indications, but described challenges identifying sex-selection cases. Providers also believed that illegal sex-selective procedures contribute to serious abortion complications. Sex-selective abortion complicates the provision of legal abortion services. In addition to the difficulty of determining which patients are seeking abortion for sex selection, health workers are aware of the pressures women face to bear sons and know they may seek unsafe services elsewhere when unable to obtain abortions in public hospitals. Legislative, advocacy, and social efforts aimed at promoting gender equality and women's human rights are needed to reduce the cultural and economic pressures for sex-selective abortion, because providers alone cannot prevent the practice. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  2. 'You already drank my beer, I can decide anything': using structuration theory to explore the dynamics of alcohol use, gender-based violence and HIV risk among female sex workers in Tanzania.

    Science.gov (United States)

    Leddy, Anna M; Kerrigan, Deanna; Kennedy, Caitlin E; Mbwambo, Jessie; Likindikoki, Samuel; Underwood, Carol R

    2018-03-16

    Female sex workers experience high rates of gender-based violence and HIV. Alcohol has been shown to facilitate women's risk of both gender-based violence and HIV; however, little research has explored how aspects of the sex work environment shape this risk. Drawing on structuration theory, this study explored how social conduct is patterned across time and space within the sex work environment to influence alcohol consumption, gender-based violence and HIV risk among female sex workers. Qualitative in-depth interviews were conducted with 24 female sex workers enrolled in an ongoing community randomised controlled trial of a combination HIV prevention intervention in Iringa, Tanzania. Data were analysed using both inductive and deductive approaches. Findings reveal how routine interactions between female sex workers and their clients occur at three moments of time and space during the sex exchange process to facilitate alcohol consumption and increase women's risk of gender-based violence and HIV. Findings also highlight how sex workers utilise collective agency to address aspects of the sex work environment that place them at risk of alcohol abuse, gender-based violence and HIV. Implications for future interventions to prevent gender-based violence and HIV among female sex workers in Tanzania and similar contexts are discussed.

  3. Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study.

    Science.gov (United States)

    Liu, Hongjie; Dumenci, Levent; Morisky, Donald E; Xu, Yongfang; Li, Xiaojing; Jiang, Baofa

    2016-05-10

    This study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China. A cross-sectional study with respondent-driven sampling (RDS). A multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014. 1245 middle-aged female sex workers who were over 35 years old (about 400 per study site). Unprotected commercial sex, and syphilis and HIV infection were biologically tested and measured. The RDS-adjusted prevalence of active syphilis was 17.3% in Hefei, 9.9% in Qingdao, and 5.4% in Nanning. The RDS-adjusted prevalence of prevalent syphilis was between 6.8% and 33.6% in the three cities. The proportion of unprotected sex in the past 48 h verified by the prostate-specific antigen test (PSA) was between 27.8% and 42.4%. Multiple log-binomial regression analyses indicate that middle-aged FSWs who had 5 or more clients in the past week prior to interviews and engaged in unprotected sex were more likely to be active syphilitic cases. Middle-aged FSWs who had rural residency were less likely to be active syphilitic cases. In contrast with previous studies that reported low prevalence of syphilis and high prevalence of protected sex among FSWs in China, both the prevalence of syphilis and unprotected sex were high among middle-aged FSWs. Evidence-based intervention programmes should be developed and evaluated among this vulnerable population in China and other countries with similar settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study

    Science.gov (United States)

    Huq, Nafisa Lira; Chowdhury, Mahbub Elahi

    2012-01-01

    In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and…

  5. Use of spermicide and impact of prophylactic condom use among sex workers in Santa Fe de Bogota, Colombia.

    Science.gov (United States)

    Farr, G; Acosta Castro, L A; DiSantostefano, R; Claassen, E; Olguin, F

    1996-01-01

    Condom use is one of the most important preventive measures sex workers can take to reduce the risk of becoming infected with a sexually transmitted disease. However, a client may refuse to use a condom when requested. Some sexually transmitted disease prevention programs are recommending that sex workers use spermicide as an alternative prophylaxis when a condom is refused, yet little is known about the effect of this recommendation on prophylactic condom use. To determine if using spermicide, either in conjunction with condoms or as a backup, influenced overall condom use among a group of sex workers at high risk of sexually transmitted diseases in Santa Fe de Bogota, Colombia. Participants were assigned randomly to one of three condom use groups: use of condoms only (Condoms Only), use of condoms and spermicides concurrently (Condom and Spermicide), or use of spermicide when condoms were refused (Spermicide as a Backup). A total of 199 sex workers entered the study and were asked to return for follow-up every 2 weeks for a period of 12 weeks. Women assigned to the Spermicide as a Backup group used a condom for an average of 78.1% of their reported acts of intercourse, compared with an average of 94.5% in the Condom Only and 92.3% in the Condom and Spermicide groups. However, women in the Spermicide as a Backup group used a condom or spermicide for an average of 96.9% of their acts of intercourse. Condoms were used for every intercourse act by less than 5% of the women in the Spermicide as a Backup groups, compared with 50.7% in the Condom Only group and 41.2% in the Condom and Spermicide group (P 0.001). When condoms were not used, client refusal was the primary reason reported. The incidence of sexually transmitted diseases and other urogenital inflammations in all groups was lower than expected. Among Colombian sex workers, condom use declined substantially when women were instructed to use spermicides if they were unable to persuade their partner to use a

  6. Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases.

    Science.gov (United States)

    Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

    2009-10-01

    The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women's empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n=110) compared to a control community (n=106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention's impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000-2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study

  7. Is scale-up of community mobilisation among sex workers really possible in complex urban environments? The case of Mumbai, India.

    Science.gov (United States)

    Kongelf, Anine; Bandewar, Sunita V S; Bharat, Shalini; Collumbien, Martine

    2015-01-01

    In the last decade, community mobilisation (CM) interventions targeting female sex workers (FSWs) have been scaled-up in India's national response to the HIV epidemic. This included the Bill and Melinda Gates Foundation's Avahan programme which adopted a business approach to plan and manage implementation at scale. With the focus of evaluation efforts on measuring effectiveness and health impacts there has been little analysis thus far of the interaction of the CM interventions with the sex work industry in complex urban environments. Between March and July 2012 semi-structured, in-depth interviews and focus group discussions were conducted with 63 HIV intervention implementers, to explore challenges of HIV prevention among FSWs in Mumbai. A thematic analysis identified contextual factors that impact CM implementation. Large-scale interventions are not only impacted by, but were shown to shape the dynamic social context. Registration practices and programme monitoring were experienced as stigmatising, reflected in shifting client preferences towards women not disclosing as 'sex workers'. This combined with urban redevelopment and gentrification of traditional red light areas, forcing dispersal and more 'hidden' ways of solicitation, further challenging outreach and collectivisation. Participants reported that brothel owners and 'pimps' continued to restrict access to sex workers and the heterogeneous 'community' of FSWs remains fragmented with high levels of mobility. Stakeholder engagement was poor and mobilising around HIV prevention not compelling. Interventions largely failed to respond to community needs as strong target-orientation skewed activities towards those most easily measured and reported. Large-scale interventions have been impacted by and contributed to an increasingly complex sex work environment in Mumbai, challenging outreach and mobilisation efforts. Sex workers remain a vulnerable and disempowered group needing continued support and more

  8. Is scale-up of community mobilisation among sex workers really possible in complex urban environments? The case of Mumbai, India.

    Directory of Open Access Journals (Sweden)

    Anine Kongelf

    Full Text Available In the last decade, community mobilisation (CM interventions targeting female sex workers (FSWs have been scaled-up in India's national response to the HIV epidemic. This included the Bill and Melinda Gates Foundation's Avahan programme which adopted a business approach to plan and manage implementation at scale. With the focus of evaluation efforts on measuring effectiveness and health impacts there has been little analysis thus far of the interaction of the CM interventions with the sex work industry in complex urban environments.Between March and July 2012 semi-structured, in-depth interviews and focus group discussions were conducted with 63 HIV intervention implementers, to explore challenges of HIV prevention among FSWs in Mumbai. A thematic analysis identified contextual factors that impact CM implementation. Large-scale interventions are not only impacted by, but were shown to shape the dynamic social context. Registration practices and programme monitoring were experienced as stigmatising, reflected in shifting client preferences towards women not disclosing as 'sex workers'. This combined with urban redevelopment and gentrification of traditional red light areas, forcing dispersal and more 'hidden' ways of solicitation, further challenging outreach and collectivisation. Participants reported that brothel owners and 'pimps' continued to restrict access to sex workers and the heterogeneous 'community' of FSWs remains fragmented with high levels of mobility. Stakeholder engagement was poor and mobilising around HIV prevention not compelling. Interventions largely failed to respond to community needs as strong target-orientation skewed activities towards those most easily measured and reported.Large-scale interventions have been impacted by and contributed to an increasingly complex sex work environment in Mumbai, challenging outreach and mobilisation efforts. Sex workers remain a vulnerable and disempowered group needing continued support

  9. Early sex work initiation and condom use among alcohol-using female sex workers in Mombasa, Kenya: a cross-sectional analysis.

    Science.gov (United States)

    Parcesepe, Angela M; L'Engle, Kelly L; Martin, Sandra L; Green, Sherri; Suchindran, Chirayath; Mwarogo, Peter

    2016-12-01

    Early initiation of sex work is prevalent among female sex workers (FSWs) worldwide. The objectives of this study were to investigate if early initiation of sex work was associated with: (1) consistent condom use, (2) condom negotiation self-efficacy or (3) condom use norms among alcohol-using FSWs in Mombasa, Kenya. In-person interviews were conducted with 816 FSWs in Mombasa, Kenya. Sample participants were: recruited from HIV prevention drop-in centres, 18 years or older and moderate risk drinkers. Early initiation was defined as first engaging in sex work at 17 years or younger. Logistic regression modelled outcomes as a function of early initiation, adjusting for drop-in centre, years in sex work, supporting others and HIV status. FSWs who initiated sex work early were significantly less likely to report consistent condom use with paying sex partners compared with those who initiated sex work in adulthood. There was no significant difference between groups in consistent condom use with non-paying sex partners. FSWs who initiated sex work early endorsed less condom negotiation self-efficacy with paying sex partners compared with FSWs who did not initiate sex work early. Findings highlight a need for early intervention for at-risk youth and adolescent FSWs, particularly in relation to HIV sexual risk behaviours. Evidence-based interventions for adolescent FSWs or adult FSWs who began sex work in adolescence should be developed, implemented and evaluated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. HIV testing behaviors among female sex workers in Southwest China.

    Science.gov (United States)

    Hong, Yan; Zhang, Chen; Li, Xiaoming; Fang, Xiaoyi; Lin, Xiuyun; Zhou, Yuejiao; Liu, Wei

    2012-01-01

    Despite the recognized importance of HIV testing in prevention, care and treatment, HIV testing remains low in China. Millions of female sex workers (FSW) play a critical role in China's escalating HIV epidemic. Limited data are available regarding HIV testing behavior among this at-risk population. This study, based on a cross-sectional survey of 1,022 FSW recruited from communities in Southwest China, attempted to address the literature gap. Our data revealed that 48% of FSW ever took HIV testing; older age, less education, working in higher-income commercial sex venues and better HIV knowledge were associated with HIV testing. Those who never took HIV testing were more likely to engage in high-risk behaviors including inconsistent condom use with clients and stable partners. A number of psychological and structural barriers to testing were also reported. We call for culturally appropriate interventions to reduce HIV risks and promote HIV testing for vulnerable FSW in China.

  11. HIV-Related Risk Behaviors among Kathoey (Male-to-Female Transgender) Sex Workers in Bangkok, Thailand

    OpenAIRE

    Nemoto, Tooru; Iwamoto, Mariko; Perngparn, Usaneya; Areesantichai, Chitlada; Kamitani, Emiko; Sakata, Maria

    2011-01-01

    Based on combined methods, this study investigated substance use and HIV risk behaviors among kathoey sex workers (KSWs) in Bangkok, Thailand. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months. About one third of the participants reported having engaged in unprotected anal sex with customers in the past 6 months. Almost all participants reported al...

  12. A gap in science's and the media images of people who use drugs and sex workers: research on organizations of the oppressed.

    Science.gov (United States)

    Dziuban, Agata; Friedman, Samuel R

    2015-03-01

    This paper discusses organizations of the oppressed, such as drug user and sex worker groups, and the images of themselves that they construct. We suggest that analysis of these organizationally-produced collective self-images -frequently overlooked in scholarly research -is crucial to understanding the complex internal dynamics of users' and sex workers' organizations and struggles they engage in when defining their collective (organizational) identities and course of action.

  13. HIV prevention among male clients of female sex workers in Kaolack, Senegal: results of a peer education program.

    Science.gov (United States)

    Leonard, L; Ndiaye, I; Kapadia, A; Eisen, G; Diop, O; Mboup, S; Kanki, P

    2000-02-01

    This article reports the results of a peer-led HIV prevention education and condom promotion program among transport workers in Kaolack, Senegal. As part of a 2-year longitudinal follow-up study, changes in men's AIDS-related knowledge, sexual behavior, condom use, and perceived barriers to condom use were evaluated by self-reports obtained from a systematic sample of transport workers interviewed before and after intervention. In addition to men's self-reports, preintervention and postintervention data on men's sexual and condom use behavior were gathered from a sample of licensed, commercial sex workers, who cited transport workers as their primary source of clients. Significant increases in men's HIV-related knowledge, previous use of condoms (from 30.4% to 53.5%), and consistent condom use with regular sex partners were documented over the study period, as were significant declines in perceived barriers to condom use. Though men reported significantly fewer sexual encounters with casual and commercial partners at follow-up compared to baseline, these data were unreliable. Women's postintervention reports indicate that a greater proportion of clients (including, but not limited to transport workers) "always" agree to use condoms (p money for unprotected sex (p taking greater initiative in the mechanics of condom use (supplying the condom, putting it on, and taking it off) than they did prior to the intervention, and significantly (p < .05) fewer women think that most of their clients know how to use a condom. The findings indicate that the peer-mediated intervention had a positive impact on several important outcomes measured and suggest that HIV prevention efforts need to focus on male client groups despite the logistical and methodological challenges.

  14. Mobile phones and sex work in South India: the emerging role of mobile phones in condom use by female sex workers in two Indian states.

    Science.gov (United States)

    Navani-Vazirani, Sonia; Solomon, Davidson; Gopalakrishnan; Heylen, Elsa; Srikrishnan, Aylur Kailasom; Vasudevan, Canjeevaram K; Ekstrand, Maria L

    2015-01-01

    The aim of this study was to examine female sex workers' solicitation of clients using mobile phones and the association between this and condom use with clients. Cross-sectional data were utilised to address the study's aim, drawing on data collected from female sex workers in Calicut, Kerala, and Chirala, Andhra Pradesh. Use of mobile phone solicitation was reported by 46.3% (n = 255) of Kerala participants and 78.7% (n = 464) of those in Andhra Pradesh. Kerala participants reporting exclusive solicitation using mobile phones demonstrated 1.67 times higher odds (95% CI: 1.01-2.79) of inconsistent condom use than those reporting non-use of mobile phones for solicitation. However, those reporting exclusive solicitation through mobile phones in Andhra Pradesh reported lower odds of inconsistent condom use (OR: 0.03; 95% CI: 0.01-0.26) than those not using mobile phones for solicitation. Findings indicate that solicitation of clients using mobile phones facilitates or hampers consistency in condom use with clients depending on the context, and how mobile phones are incorporated into solicitation practices. Variations in sex work environments, including economic dependence on sex work or lack thereof may partially account for the different effects found.

  15. HIV, Sex Work, and Law Enforcement in China.

    Science.gov (United States)

    Shen, Tingting; Csete, Joanne

    2017-12-01

    HIV prevalence in China is low in the general population but higher among certain key affected populations, including sex workers. Providing and purchasing sexual services are administrative offenses. Police engage in humiliating and repressive practices against sex workers. A study reported here based on the experience of over 500 sex workers highlights that the human rights abuses that sex workers face at the hands of the police directly undermine the country's HIV response toward sex workers. An important element of this phenomenon is the police's use of condoms as evidence of sex work, which impedes sex workers' possession and use of condoms. Whereas in some countries, sex worker collectives have helped empower sex workers to stand up to the police and safeguard their use of condoms, restrictions on civil society in China make such a strategy impossible. Removing sex work and related activities as offenses under the law in China, however politically difficult it might be, would ease this situation. Short of that, improving the coordination among and strategic harmony of public health and police roles and authorities would be useful.

  16. Molecular status of Human Immunodeficiency Virus, Hepatitis B virus, and Hepatitis C virus among injecting drug male commercial sex workers in Surakarta, Indonesia

    Science.gov (United States)

    Agung Prasetyo, Afiono; Marwoto; Arifin Adnan, Zainal; Hartono

    2018-05-01

    Male commercial sex workers are one of the high-risk community for blood-borne viruses. However, there are no data concerning the molecular status of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) circulated among male commercial sex workers with injecting drug habits in Surakarta, Indonesia. Blood samples obtained from injecting drug male commercial sex workers in Surakarta were examined for HIV antibodies, HBsAg, and HCV antibodies, respectively, by immunological assays. Blood samples were also subjected to viral nucleic acid extraction and molecular detection of HIV, HBV, and HCV by nested (RT) PCRs. The PCR products were purified from agarose gels, and the nucleotide sequences were retrieved and molecular analyzed. HIV, HBV, and HCV were detected in 29.4% (10/34), 17.6% (6/34), and 52.9% (18/34), respectively. HIV CRF01_AE and B were found to be circulating in the community. HBV genotype B3 was predominated, followed by C1. HCV genotype 1a was predominated, followed by 1c, 3a, 1b, and 4a. HIV, HBV, and HCV were found circulating in the male commercial sex workers with injecting drug habits in Surakarta, Indonesia.

  17. Hazardous drinking and HIV-risk-related behavior among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Goodman-Meza, David; Pitpitan, Eileen V; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Strathdee, Steffanie A; Patterson, Thomas L

    2014-01-01

    Male clients of female sex workers (FSWs) are at high risk for HIV. Whereas the HIV risks of alcohol use are well understood, less is known about hazardous alcohol use among male clients of FSWs, particularly in Mexico. We sought to identify risk factors for hazardous alcohol use and test associations between hazardous alcohol use and HIV risk behavior among male clients in Tijuana. Male clients of FSWs in Tijuana (n = 400) completed a quantitative interview in 2008. The AUDIT was used to characterize hazardous alcohol use. Multivariate logistic regression was used to determine independent associations of demographic and HIV risk variables with hazardous alcohol use (vs. non-hazardous). Forty percent of our sample met criteria for hazardous alcohol use. Variables independently associated with hazardous drinking were reporting any sexually transmitted infection (STI), having sex with a FSW while under the influence of alcohol, being younger than 36 years of age, living in Tijuana, and ever having been jailed. Hazardous drinkers were less likely ever to have been deported or to have shared injection drugs. Hazardous alcohol use is associated with HIV risk, including engaging in sex with FSWs while intoxicated and having an STI among male clients of FSWs in Tijuana. We systematically described patterns and correlates of hazardous alcohol use among male clients of FSWs in Tijuana, Mexico. The results suggest that HIV/STI risk reduction interventions must target hazardous alcohol users, and be tailored to address alcohol use. © American Academy of Addiction Psychiatry.

  18. Juggling work and elder caregiving: work-life balance for aging American workers.

    Science.gov (United States)

    Pitsenberger, D Jeanne

    2006-04-01

    As the American work force ages, the demands of caring for aging relatives increase. Family caregiving often interferes with workplace responsibilities, creating physical, emotional, and financial stress for caregivers. Employers must address the productivity losses created by absenteeism of workers who struggle with work-life issues created by caregiving roles. Occupational health nurses must understand the factors that affect workers in their caregiving roles and make appropriate nursing interventions. They are in key positions to help aging employees and their employers face the increased demands on work-life balance created by elder caregiving.

  19. Culturally Informed Social Work Practice with American Indian Clients: Guidelines for Non-Indian Social Workers.

    Science.gov (United States)

    Williams, Edith Ellison; Ellison, Florence

    1996-01-01

    Culturally informed social work health and mental health interventions directed toward American Indian clients must be harmonious with their environment and acculturation. Discusses American Indian beliefs about health and illness and degrees of acculturation. Guidelines are offered to help non-Indian social workers design culturally appropriate…

  20. Acculturation and parent-adolescent communication about sex in Filipino-American families: a community-based participatory research study.

    Science.gov (United States)

    Chung, Paul J; Travis, Raphael; Kilpatrick, Shelley D; Elliott, Marc N; Lui, Camillia; Khandwala, Shefali B; Dancel, Theresa M; Vollandt, Lori; Schuster, Mark A

    2007-06-01

    To examine whether acculturation is associated with parent-adolescent communication about sex in Filipino-American families. Filipino-Americans, the United States' second-largest Asian and Pacific Islander (API) group, have more adolescent pregnancy and HIV infection than other APIs. High-quality parent-adolescent communication about sex has been associated with healthy sexual development, and acculturation has been associated with various increased health risks. Whether acculturation affects parent-adolescent communication is unknown. We surveyed 120 pairs of Filipino-American parents and adolescents at a single large high school. We asked adolescents about their frequency of parent-adolescent communication about sex and measured adolescent acculturation in two ways: disagreement with traditional Asian values and preferential use of English. In bivariate and multivariate regressions, we examined whether adolescent acculturation was associated with adolescent reports of parent-adolescent communication. Few adolescents (22%) reported regularly discussing sex with parents. Although most adolescents (72%) agreed with traditional Asian values, most (63%) preferred using English. In bivariate regressions, less parent-adolescent communication about sex was associated with less adolescent agreement with traditional Asian values (p = .002) and more adolescent English use (p = .009). In multivariate regressions, these associations were largely explained by adolescent perceptions of parent knowledge about their whereabouts and activities. Acculturation may influence Filipino-American parent-adolescent communication about sex and, consequently, Filipino-American adolescent sexual health. Health care and public health providers may need to tailor adolescent sexual health programs based on acculturation or other immigration-related factors.

  1. [Survey adaptation for bio-behavioural surveillance of HIV in Chilean female sex workers].

    Science.gov (United States)

    Carvajal, Bielka; Stuardo, Valeria; Manríquez, José Manuel; Belmar, Julieta; Folch, Cinta

    To adapt a behavioural questionnaire for second-generation HIV/AIDS surveillance in female sex workers (FSWs) in the Metropolitan Region, Chile. Qualitative study of instruments validation. A Spanish instrument adapted in Catalonia was validated through a translation and back-translation of the original version. The content validity was determined through a modified Delphi method, via FSW and HIV experts representing community, political and institutional levels. Applicability aspects were determined by the application of the questionnaire to FSW in the Metropolitan Region. The questionnaire, drafted in Spain, was successfully adapted to Chilean Spanish. The content validity process enabled sections to be created that address HIV in FSWs. The adapted questionnaire takes less than 15minutes to complete, which makes it usable in fieldwork. The 61 women surveyed came from different countries (all were Latin Americans) and had different educational levels; all this enabled potential applicability problems to be detected. The adapted questionnaire for Chile contains all the UNAIDS indicators for FSWs, as well as the recommended indicators of Family Health International for bio-behavioural surveillance. Said questionnaire serves as a tool for second-generation HIV/other STD surveillance and further contributes to preventive policies in Chilean FSWs. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. The embodiment of tourism among bisexually-behaving Dominican male sex workers.

    Science.gov (United States)

    Padilla, Mark B

    2008-10-01

    While theories of "structure" and social inequality have increasingly informed global health efforts for HIV prevention--with growing recognition of the linkages between large-scale political and economic factors in the distribution and impact of the HIV/AIDS epidemic--there is still little theorization of precisely how structural factors shape the very bodies and sexualities of specific populations and groups. In order to extend the theoretical understanding of these macro-micro linkages, this article examines how the growth of the tourism industry in the Dominican Republic has produced sexual practices and identities that reflect both the influence of large-scale structural processes and the resistant responses of local individuals. Drawing on social science theories of political economy, embodiment, and authenticity, I argue that an understanding of patterns of sexuality and HIV risk in the region requires analysis of how political-economic transformations related to tourism intersect with the individual experiences and practices of sexuality on the ground. The analysis draws on long-term ethnographic research with bisexually behaving male sex workers in two cities in the Dominican Republic, including participant observation, in-depth interviews, focus groups, and surveys. By examining the global and local values placed on these men's bodies and the ways sex workers use their bodies to broker tourists' pleasure, we may better understand how the large-scale structures of the tourism industry are linked to the specific meanings and practices of sexuality.

  3. Short Report: HIV Infection among Commercial Sex Workers and Injecting Drug Users in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Brůčková, M.; Bautista, C.T.; Graham, R.R.; Malý, Marek; Vandasová, J.; Presl, J.; Sumegh, L.; Chapman, G.D.; Carr, J.K.; Sanchez, J.L.; Earhart, K.C.

    2006-01-01

    Roč. 75, č. 5 (2006), s. 1017-1020 ISSN 0002-9637 Source of funding: V - iné verejné zdroje Keywords : HIV infection * commercial sex workers Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.546, year: 2006

  4. 'Health is wealth and wealth is health'--perceptions of health and ill-health among female sex workers in Savannakhet, Laos.

    Science.gov (United States)

    Phrasisombath, Ketkesone; Thomsen, Sarah; Sychareun, Vanphanom; Faxelid, Elisabeth

    2013-01-02

    Female sex workers (FSWs) are vulnerable to sexually transmitted infections (STIs) and other types of health problems and they also encounter socio-economic difficulties. Efforts to develop effective health intervention programs for FSWs have been hampered by a lack of information on why FSWs do not seek or delay seeking treatment for STIs. To further understand their reasons, our study applied a qualitative approach to explore perceptions of health and ill-health among FSWs in Savannakhet province in Laos. Fifteen in-depth interviews were conducted with FSWs in Savannakhet province. Latent content analysis was used for analysis. Sex workers' definitions of health and wealth are intertwined. Thus, good health was described as strongly related to wealth, and wealth was needed in order to be healthy. This is explained in two sub-themes: health is necessary for work and income and ill-health creates social and economic vulnerability. Female sex workers' beliefs and perceptions about health and ill-health were dominated by their economic need, which in turn was influenced by expectations and demands from their families.

  5. Compensated for Life: Sex Work and Disease Risk

    Science.gov (United States)

    Arunachalam, Raj; Shah, Manisha

    2013-01-01

    Sex workers draw a premium for engaging in unprotected sex. We theoretically motivate a test of whether this premium represents a compensating differential for disease, thereby mitigating sex workers' propensity to use condoms. Using transaction-level data and biological STI markers from sex workers in Ecuador, we exploit within-worker variation…

  6. Exploring causes and consequences of sex workers' psychological health: Implications for health care policy. A study conducted in Spain.

    Science.gov (United States)

    Picos, Andrés Palacios; González, Ruth Pinedo; de la Iglesia Gutiérrez, Myriam

    2018-03-22

    The aim of the researchers is to explore the causes and consequences of the psychological health of sex workers as well as provide an intervention model for the prevention of mental disorders in accordance with World Health Organization (WHO) levels. The study sample consisted of 146 sex workers from Spain. Loneliness and maltreatment have a negative influence on psychological health, while self-esteem has a protector role over psychological health. Psychological health has a positive impact on perceived quality of life and other health domains. On the contrary, psychological health has a negative impact on drug use and symptoms of anxiety. Data are discussed.

  7. Perspectives on HIV Pre- and Post-Exposure Prophylaxes (PrEP and PEP) Among Female and Male Sex Workers in Mombasa, Kenya: Implications for Integrating Biomedical Prevention into Sexual Health Services.

    Science.gov (United States)

    Restar, Arjee J; Tocco, Jack Ume; Mantell, Joanne E; Lafort, Yves; Gichangi, Peter; Masvawure, Tsitsi B; Chabeda, Sophie Vusha; Sandfort, Theo G M

    2017-04-01

    Pre- and post-exposure prophylaxes (PrEP and PEP) can reduce the risk of HIV acquisition, yet often are inaccessible to and underutilized by most-vulnerable populations, including sex workers in sub-Saharan Africa. Based on in-depth interviews with 21 female and 23 male HIV-negative sex workers in Mombasa, Kenya, we found that awareness and knowledge of PrEP and PEP were low, although willingness to use both was high. Participants felt PrEP would be empowering and give added protection against infection, although some expressed concerns about side effects. Despite PEP's availability, few knew about it and even fewer had used it, but most who had would use it again. Sex workers valued confidentiality, privacy, trustworthiness, and convenient location in health services and wanted thorough HIV/STI assessments. These findings suggest the importance of situating PrEP and PEP within sex worker-friendly health services and conducting outreach to promote these biomedical prevention methods for Kenyan sex workers.

  8. Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe

    Science.gov (United States)

    Otobo, Eloghene; Nhongo, Kundai; Takaruza, Albert; White, Peter J; Nyamukapa, Constance Anesu; Gregson, Simon

    2018-01-01

    Objective Globally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake. Methods Data from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression. Results HIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy. Conclusion FSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake. PMID:29490957

  9. Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe.

    Science.gov (United States)

    Rhead, Rebecca; Elmes, Jocelyn; Otobo, Eloghene; Nhongo, Kundai; Takaruza, Albert; White, Peter J; Nyamukapa, Constance Anesu; Gregson, Simon

    2018-02-28

    Globally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake. Data from a household survey conducted in 2009-2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression. HIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02-2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03-5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs' greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy. FSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs' need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

  10. Quality assurance and quality improvement using supportive supervision in a large-scale STI intervention with sex workers, men who have sex with men/transgenders and injecting-drug users in India

    NARCIS (Netherlands)

    Mogasale, V.; Wi, T.C.; Das, A.; Kane, S.; Singh, A.K.; George, B.; Steen, R.

    2010-01-01

    Background Documentation of the long-term impact of supportive supervision using a monitoring tool in STI intervention with sex workers, men who have sex with men and injection-drug users is limited. The authors report methods and results of continued quality monitoring in a large-scale STI services

  11. Clients of sex workers in Switzerland: it makes sense to counsel and propose rapid test for HIV on the street, a preliminary report.

    Science.gov (United States)

    Diserens, Esther-Amélie; Bodenmann, Patrick; N'Garambe, Chantal; Ansermet-Pagot, Anne; Vannotti, Marco; Masserey, Eric; Cavassini, Matthias

    2010-03-19

    Clients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. For 5 evenings, clients in cars were stopped by trained field staff for face-to-face interviews focusing on sex-related HIV risk behaviors and HIV testing history. The clients were then offered a free anonymous rapid HIV test in a bus parked nearby. Rapid HIV testing and counselling were performed by experienced nurse practitioners. Clients with reactive tests were offered confirmatory testing, medical evaluation, and care in our HIV clinic. We intercepted 144 men, 112 (77.8%) agreed to be interviewed. Among them, 50 (46.6%) had never been tested for HIV. A total of 31 (27.7%) rapid HIV tests were performed, 16 (51.6%) in clients who had not previously been tested. None were reactive. Initially, 19 (16.9%) additional clients agreed to HIV testing but later declined due to the 40-minute queue for testing. This pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate. This setting seems particularly appropriate for targeted HIV screening, since more than 40% of the clients had not previously been tested for HIV even though they engaged in sex-related HIV risk behaviour.

  12. Benefits and constraints of intimate partnerships for HIV positive sex workers in Kibera, Kenya.

    Science.gov (United States)

    Benoit, Cecilia; Roth, Eric; Hallgrimsdottir, Helga; Jansson, Mikael; Ngugi, Elizabeth; Sharpe, Kimberly

    2013-09-03

    Research on the intimate partnerships of female sex workers (FSWs) tends to focus on the risks associated with these relationships. This paper takes as its starting point that the situation of FSWs is better understood by including knowledge of the benefits of their intimate partnerships. Specifically, we employ the conceptual framework provided by emergent research examining intimacy as a complex fusion of affective and instrumental dimensions among sex workers. This perspective allows us to frame information about FSWs' intimate partnerships within a behaviour-structural approach that is helpful for identifying how intimate partnerships can be a source of both benefit as well as increased risk to FSWs. Our results are based on a mixed-methods study carried out in the summer of 2011 in Kibera, Kenya. We conducted face-to-face interviews (n=30) with a non-probability sample of FSWs stratified by age who self-identified as Human Immune Virus positive (HIV+). We asked about participants' involvement in current and past intimate partnerships, and whether these relationships had a positive or negative impact on their health and well‒being. Participants currently in intimate partnerships had fewer clients and thus lower incomes than those without intimate partnerships. Participants presently with partners were also more likely to receive some financial support from partners, to report lower intimate partner violence, and to narrate higher partner emotional support and greater assistance with medications. These participants were also more likely to have disclosed their sex work and HIV+ statuses to their partners. Intimate partnerships, on the other hand, showed increased risk of economic vulnerability and emotional dependence for FSWs. This became especially problematic for those participants in fragile relationships. Despite these variations, none of the differences between the two groups were statistically significant. Intimacy and transactional relations are bound

  13. Conflicting Rights: How the Prohibition of Human Trafficking and Sexual Exploitation Infringes the Right to Health of Female Sex Workers in Phnom Penh, Cambodia.

    Science.gov (United States)

    Maher, Lisa; Dixon, Thomas; Phlong, Pisith; Mooney-Somers, Julie; Stein, Ellen; Page, Kimberly

    2015-06-11

    While repressive laws and policies in relation to sex work have the potential to undermine HIV prevention efforts, empirical research on their interface has been lacking. In 2008, Cambodia introduced antitrafficking legislation ostensibly designed to suppress human trafficking and sexual exploitation. Based on empirical research with female sex workers, this article examines the impact of the new law on vulnerability to HIV and other adverse health outcomes. Following the introduction of the law, sex workers reported being displaced to streets and guesthouses, impacting their ability to negotiate safe sex and increasing exposure to violence. Disruption of peer networks and associated mobility also reduced access to outreach, condoms, and health care. Our results are consistent with a growing body of research which associates the violation of sex workers' human rights with adverse public health outcomes. Despite the successes of the last decade, Cambodia's AIDS epidemic remains volatile and the current legal environment has the potential to undermine prevention efforts by promoting stigma and discrimination, impeding prevention uptake and coverage, and increasing infections. Legal and policy responses which seek to protect the rights of the sexually exploited should not infringe the right to health of sex workers. Copyright 2015 Maher et al. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  14. "Who Is Helsinki" Sex Workers Advise Improving Communication for Good Participatory Practice in Clinical Trials

    Science.gov (United States)

    Ditmore, Melissa Hope; Allman, Dan

    2011-01-01

    After premature closures in 2004 of biomedical human immunodeficiency virus (HIV) prevention trials involving sex workers in Africa and Asia, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Global Advocacy for HIV Prevention (AVAC) undertook consultations to establish better participatory guidelines for such trials in order to address…

  15. HIV, sex work, and civil society in China.

    Science.gov (United States)

    Kaufman, Joan

    2011-12-01

    Harm reduction programs for sex workers have been hampered by the prioritization of law enforcement over AIDS prevention. For example, the April 2010 "strike-hard" campaign against prostitution in Beijing, during which bars, nightclubs, saunas, and karaoke bars were raided, created an atmosphere that critically impeded human immunodeficiency virus (HIV) outreach activities for sex workers. In China, criminalization has limited the growth of a coherent and cohesive set of nongovernmental organization (NGO) actors working with sex workers to prevent HIV infection. Compared with other risk groups for HIV sexual transmission, such as men who have sex with men, the NGO community for sex workers is fragmented and poorly coordinated with government efforts, and basic rights for sex workers are often violated. This article examines civil society groups working on AIDS prevention and care for female sex workers in China and reviews constraints to their operations. China's HIV prevention programs for sex workers are compared with sex worker HIV prevention in other Asian states where more well-developed NGOs exist and criminalization has been better balanced with harm reduction approaches, and recommendations are offered on improving China's policies and programs.

  16. Lethal infection thresholds of Paenibacillus larvae for honeybee drone and worker larvae (Apis mellifera).

    Science.gov (United States)

    Behrens, Dieter; Forsgren, Eva; Fries, Ingemar; Moritz, Robin F A

    2010-10-01

    We compared the mortality of honeybee (Apis mellifera) drone and worker larvae from a single queen under controlled in vitro conditions following infection with Paenibacillus larvae, a bacterium causing the brood disease American Foulbrood (AFB). We also determined absolute P. larvae cell numbers and lethal titres in deceased individuals of both sexes up to 8 days post infection using quantitative real-time PCR (qPCR). Our results show that in drones the onset of infection induced mortality is delayed by 1 day, the cumulative mortality is reduced by 10% and P. larvae cell numbers are higher than in worker larvae. Since differences in bacterial cell titres between sexes can be explained by differences in body size, larval size appears to be a key parameter for a lethal threshold in AFB tolerance. Both means and variances for lethal thresholds are similar for drone and worker larvae suggesting that drone resistance phenotypes resemble those of related workers. © 2010 Society for Applied Microbiology and Blackwell Publishing Ltd.

  17. Influence of indoor work environments on health, safety, and human rights among migrant sex workers at the Guatemala-Mexico Border: a call for occupational health and safety interventions.

    Science.gov (United States)

    Goldenberg, Shira M; Rocha Jiménez, Teresita; Brouwer, Kimberly C; Morales Miranda, Sonia; Silverman, Jay G

    2018-02-02

    Migrant women are over-represented in the sex industry, and migrant sex workers experience disproportionate health inequities, including those related to health access, HIV and sexually transmitted infections (STIs), and violence. Despite calls for occupational sex work interventions situated in labour rights frameworks, there remains a paucity of evidence pertaining to migrant sex workers' needs and realities, particularly within Mexico and Central America. This study investigated migrant sex workers' narratives regarding the ways in which structural features of work environments shape vulnerability and agency related to HIV/STI prevention and violence at the Guatemala-Mexico border. Drawing on theoretical perspectives on risk environments and structural determinants of HIV in sex work, we analyzed in-depth interviews, focus groups, and ethnographic fieldwork conducted with 39 migrant sex workers in indoor work environments between 2012 and 2015 in Tecún Umán, Guatemala. Participant narratives revealed the following intersecting themes to be most closely linked to safety and agency to engage in HIV/STI prevention: physical features of indoor work environments (e.g., physical layout of venue, proximity to peers and third parties); social norms and practices for alcohol use within the workplace; the existence and nature of management practices and policies on health and safety practices; and economic influences relating to control over earnings and clients. Across work environments, health and safety were greatly shaped by human rights concerns stemming from workplace interactions with police, immigration authorities, and health authorities. Physical isolation, establishment norms promoting alcohol use, restricted economic agency, and human rights violations related to sex work policies and immigration enforcement were found to exacerbate risks. However, some establishment policies and practices promoted 'enabling environments' for health and safety, supporting

  18. Correlates of Mental Depression Among Female Sex Workers in Southern India.

    Science.gov (United States)

    Patel, Sangram Kishor; Saggurti, Niranjan; Pachauri, Saroj; Prabhakar, Parimi

    2015-11-01

    Mental health is an integral part of overall health status but has been a largely neglected issue in the developing world especially among female sex workers (FSWs). This study examines the prevalence and correlates of major depression among FSWs in southern India. Major depression was assessed using Patient Health Questionnaire-2 depression scale data from a cross-sectional Behavioral Tracking Survey, 2010-2011 conducted among FSWs (n = 1986) in Andhra Pradesh, a state in southern India. Almost two-fifths of FSWs (39%) reported major depression. Multivariate logistic regression analysis shows a significant association between major depression and the following characteristics for FSWs: low autonomy, alcohol use, experience of violence, police arrest, inconsistent condom use with clients, mobility for sex work, and being HIV positive or not wanting to disclose HIV status. Research and advocacy efforts are needed to ensure that the mental health issues of marginalized groups are appropriately addressed in HIV prevention programs. © 2015 APJPH.

  19. Social support and amphetamine-type stimulant use among female sex workers in China.

    Science.gov (United States)

    Zhao, Qun; Mao, Yuchen; Li, Xiaoming; Zhou, Yuejiao; Shen, Zhiyong

    2017-10-01

    Existing research has suggested a positive role of social support in reducing drug use among female sex workers (FSWs). However, there is limited research on the role of social support in amphetamine-type stimulant (ATS) use among FSWs in China. This study explored the present situation of ATS use among FSWs in Guangxi, China and examined the associations of different types of social support from different sources with ATS use. A sample of 1022 FSWs was recruited from 56 commercial sex venues in Guangxi Autonomous Region in China. Bivariate comparison was used to compare demographic characteristics and source of emotional or tangible social support across frequency of ATS use among FSWs. The relationship between social support and ATS use was examined using multiple ordinal logistic regression models controlling for the potential confounding effects of demographic variables. The multiple ordinal logistic regression indicated that FSWs who were from younger age groups (aOR = 10.88 for age group workers for tangible support (aOR = 1.17). Different types of social support from different sources can be either positively or negatively associated with ATS use among FSWs, therefore, the future intervention efforts should differentiate and target different types and different sources of social support in response to the living and work conditions of FSWs.

  20. Sex ratio of offspring and occupational exposure to fly ash : a historical cohort study of municipal solid waste incinerator workers in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Mori, I.; Ogawa, Y. [National Inst. of Industrial Health, Tokyo (Japan); Kumagai, S. [Osaka Prefectural Inst. of Public Health, Osaka (Japan); Koda, S. [Kochi Medical School, Nangoku (Japan); Ueno, M. [All-Japan Prefectural and Municipal Workers Union, Tokyo (Japan)

    2005-07-01

    This paper described a cohort study which focused on risk assessment for cancer mortality and changes in the sex ratio of offspring among municipal solid waste incinerator (MSWI) workers in Japan. A baseline survey was conducted by survey with both MSWI workers as well as a reference population of waste collection workers. Questions were related to offspring, job history, and frequency of exposure to fly ash during incinerator work. A total of 5211 records were then analyzed as well as 10,571 children. Duration of exposure to fly ash was used as a surrogate exposure index. Results showed that longer exposure to fly ash influenced the sex ratio. Results of a multivariate analysis conducted to compute the odds ratio of female birth by different exposure indices were similar to results obtained in a univariate analysis. It was concluded that an association between duration of exposure to fly ash and changes in sex ratio was determined. 5 refs., 3 tabs.

  1. Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal

    Directory of Open Access Journals (Sweden)

    Dahal Rashmi

    2011-09-01

    Full Text Available Abstract Background Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs including Human Immunodeficiency Virus (HIV in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. Methods This paper is based on a qualitative study of Female Sex Workers (FSWs in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. Results The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients' resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. Conclusion This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work.

  2. A human rights-focused HIV intervention for sex workers in Metro Manila, Philippines: evaluation of effects in a quantitative pilot study.

    Science.gov (United States)

    Urada, Lianne A; Simmons, Janie; Wong, Betty; Tsuyuki, Kiyomi; Condino-Enrera, Gerlita; Hernandez, Laufred I; Simbulan, Nymia Pimentel; Raj, Anita

    2016-11-01

    This study evaluated a brief human rights-focused HIV community mobilization intervention for sex workers in the Philippines, a country with one of the fastest rising number of HIV cases worldwide. Five single-session group interventions to reduce sexual risk and increase HIV testing among 86 sex workers in Manila were evaluated with pre-post-test data via Wilcoxon's signed-ranks and Mann-Whitney tests. The 4-h intervention, Kapihan (August-November, 2013), integrated human rights with HIV skill-building. Demographic data, violence/trafficking victimization, human rights knowledge, and intentions to HIV test and treat were collected. Participants were median aged 23; female (69 %); had children (55; 22 % had 3+ children); used drugs (past 3 months: 16 %); sexually/physically abused by clients (66 %); 20 % street sex workers ever took an HIV test. Pre-post-test scores significantly improved in knowledge of HIV (z = -8.895, p research participants (z = -5.081, p test (z = -4.868, p test for HIV.

  3. Sexual behavior of female sex workers and access to condoms in Kenya and Uganda on the Trans-Africa highway.

    Science.gov (United States)

    Morris, Chester N; Morris, Sheldon R; Ferguson, Alan G

    2009-10-01

    Female sex workers and their clients remain a high risk core group for HIV in Africa. We measured sexual behavior of a snowball sample of female sex workers (FSW) along the Trans Africa highway from Mombasa, Kenya to Kampala, Uganda and surveyed the availability of male condoms at 1,007 bars and lodgings in Kenya along the highway trucking stops where transactional sex occurs. There were 578 FSW one month sex diaries analyzed, 403 from Kenya and 175 from Uganda. Kenyan FSW had a median of 45 sexual acts per 28 days compared to 39 sex acts per 28 days by Ugandan FSW (P lodges in Kenya compared to Uganda were more likely to: have condom dispensers, 25% versus 1%, respectively (P < 0.01); distribute or sell condoms, 73.9% versus 47.6% (P < 0.01); and have more weekly condom distribution, 4.92 versus 1.27 condoms per seating capacity (P < 0.01). Our data indicate that in both countries condom use for FSW is suboptimal, particularly with regular partners, and greater condom use by Trans African highway FSW in Kenya compared to Uganda may be related to availability. Targeted interventions are warranted for FSW and truck drivers to prevent transmission in this important core group.

  4. High rates of Unintended Pregnancies among Young Women Sex Workers in Conflict-affected Northern Uganda: The Social Contexts of Brothels/Lodges and Substance Use.

    Science.gov (United States)

    Duff, Putu; Muzaaya, Godfrey; Muldoon, Katherine; Dobrer, Sabina; Akello, Monika; Birungi, Josephine; Shannon, Kate

    2017-06-01

    This study aimed to examine the correlates of unintended pregnancies among young women sex workers in conflict-affected northern Uganda. Data were drawn from the Gulu Sexual Health Study, a cross-sectional study of young women engaged in sex work. Bivariable and multivariable logistic regression was used to examine the correlates of ever having an unintended pregnancy. Among 400 sex workers (median age=20 years; IQR 19-25), 175 (43.8%) reported at least one unintended pregnancy. In multivariable analysis, primarily servicing clients in lodges/brothels [Adjusted Odds Ratio (AOR= 2.24; 95% Confidence Interval: 1.03-4.84)], hormonal contraceptive usage [AOR=1.68; 95%CI 1.11-2.59] and drug/alcohol use while working [AOR= 1.64; 95%CI 1.04-2.60] were positively correlated with previous unintended pregnancy. Given that unintended pregnancy is an indicator of unmet reproductive health need, these findings highlight a need for improved access to integrated reproductive health and HIV services, catered to sex workers' needs. Sex work-led strategies (e.g., peer outreach) should be considered, alongside structural strategies and education targeting brothel/lodge owners and managers.

  5. Correlates of unprotected sex with male clients among female sex workers in 13 Mexican cities.

    Science.gov (United States)

    Semple, Shirley J; Pitpitan, Eileen V; Chavarin, Claudia V; Strathdee, Steffanie A; Mendoza, Doroteo V; Aarons, Gregory A; Patterson, Thomas L

    2017-12-01

    This study examined correlates of unprotected vaginal and anal sex (UVA) with male clients among female sex workers (FSWs). Baseline data were gathered from 1089 FSWs recruited from 13 cities across Mexico enrolled in an evidence-based sexual risk reduction intervention. We used generalised estimating equations (GEE) to predict total UVA while controlling for the nested structure of the data. Total UVA with clients in the past month was examined in relation to selected sociodemographic, substance-use, and micro- and macro-environmental factors. A greater number of UVA acts was associated with three micro-level environmental factors (i.e. never getting condoms for free, unaffordability of condoms, greater number of clients per month), and three macro-level environmental factors (i.e. lower health and higher education indices, greater population size of city). These findings suggest the development of social and structural approaches to HIV prevention for FSWs in Mexico, including modification of venue-based policies that pressure FSWs to maximise client volume, changes to the work environment that promote availability and affordability of condoms, and improved population health. Moreover, our findings call for the development of context-specific HIV interventions that take into account variations in the sexual risk behaviours and HIV risk environments of FSWs throughout Mexico.

  6. Occupational and demographic factors associated with drug use among female sex workers at the China-Myanmar border.

    Science.gov (United States)

    Hail-Jares, Katie; Choi, Sugy; Duo, Lin; Luo, Zhi; Huang, Z Jennifer

    2016-04-01

    Within the last decade, the use of amphetamine type stimulants (ATS) has swelled in Myanmar. Regionally, female sex workers have reported turning to ATS for occupational reasons. In doing so, drug-using female sex workers (FSW) face compounded risks for HIV and other sexually transmitted infections (STI). Here, we examine the factors that impact FSW drug use in Muse, a town along the China-Myanmar border. In 2012, 101 FSW were recruited from entertainment venues and brothels along the Myanmar-Chinese border. Participants participated in a self-administered behavioral survey covering demographics, drug use, sex work, and risk behaviors. Bivariate and regression analyses were conducted in SPSS. Thirty four percent of respondents indicated current drug use. ATS derivatives were the most commonly used drugs (87.5%) with injection drug use being nearly non-existent in the sample. Drug using FSWs were older, had engaged in sex work longer, had more Chinese clients, and were more likely to have a previous boyfriend who had used drugs. They were also 3.5 times more likely to report a STI. Client condom use, HIV testing rates, and familiarity with public health resources did not statistically differ by drug use status. More research is needed to examine how romantic and professional sexual relationships push-and-pull FSW into using drugs. Our results suggest that diverse safer sex strategies, beyond client condom use, should be promoted with drug using FSWs, including strategies that acknowledge the impact of ATS use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study

    OpenAIRE

    Shaw Souradet Y; Deering Kathleen N; Reza-Paul Sushena; Isac Shajy; Ramesh Banadakoppa M; Washington Reynold; Moses Stephen; Blanchard James F

    2011-01-01

    Abstract Background Studies have demonstrated the significance of commercial sex work in the ongoing transmission of HIV and other sexually transmitted infections (STIs) in India. Clients of female sex workers (FSWs) are thought to be an important bridging population for HIV/STIs. However, there is a lack of information on basic characteristics of sex work clients. This study sought to describe the prevalence of HIV and other STIs, as well as examine the determinants of these pathogens among ...

  8. Beliefs about appropriate pain behavior: cross-cultural and sex differences between Japanese and Euro-Americans.

    Science.gov (United States)

    Hobara, Mieko

    2005-08-01

    The Appropriate Pain Behavior Questionnaire (APBQ) was employed to examine the effects of the participants' sex and culture on their beliefs regarding gender-appropriate pain behavior. The APBQ examines beliefs about the social acceptability to male and female participants of the behavioral and verbal expressions of pain by men and women (referents) in the presence of others [Nayak, S., 2000. Cross Cult Research 34, 135-151]. The participants were 18 male and 14 female Japanese, and 11 male and 21 female Euro-Americans. There was a significant effect of sex: female participants considered pain behaviors more acceptable than male participants. There was a significant effect of culture: compared to both male and female Japanese, Euro-American participants rated pain behaviors in both sexes to be more acceptable. There was also a significant effect of referent gender: for both sexes in both cultures, pain behaviors in women were rated as more acceptable than in men. Furthermore, a significant interaction was found between referent gender and sex of the participant: Male and female participants of both cultures were equally accepting of pain behaviors in women, but male participants were less accepting of pain behaviors in men than in women. There also was a significant interaction between referent gender and culture of the participant: Japanese participants considered pain behavior in both genders to be less acceptable than did Americans. The results are explained in terms of cultural traditions and social roles, and have clear implications for clinical treatment and diagnosis.

  9. Sex Estimation From Modern American Humeri and Femora, Accounting for Sample Variance Structure

    DEFF Research Database (Denmark)

    Boldsen, J. L.; Milner, G. R.; Boldsen, S. K.

    2015-01-01

    several decades. Results: For measurements individually and collectively, the probabilities of being one sex or the other were generated for samples with an equal distribution of males and females, taking into account the variance structure of the original measurements. The combination providing the best......Objectives: A new procedure for skeletal sex estimation based on humeral and femoral dimensions is presented, based on skeletons from the United States. The approach specifically addresses the problem that arises from a lack of variance homogeneity between the sexes, taking into account prior...... information about the sample's sex ratio, if known. Material and methods: Three measurements useful for estimating the sex of adult skeletons, the humeral and femoral head diameters and the humeral epicondylar breadth, were collected from 258 Americans born between 1893 and 1980 who died within the past...

  10. Parent-adolescent communication about sex in Filipino American families: a demonstration of community-based participatory research.

    Science.gov (United States)

    Chung, Paul J; Borneo, Hena; Kilpatrick, Shelley D; Lopez, Donna M; Travis, Raphael; Lui, Camillia; Khandwala, Shefali; Schuster, Mark A

    2005-01-01

    Pregnancy rates among Filipino American adolescents exceed those of other Asian and Pacific Islander adolescents. Strong parent-adolescent communication may promote healthy sexual development and protect against adolescent sexual risk behaviors. We explored communication barriers between Filipino American parents and adolescents. Using community-based participatory research (CBPR), we collaborated with Filipino American community leaders, parents, and adolescents to design a focus-group study. Trained bilingual moderators conducted focus groups with 85 Filipino Americans (41 parents and grandparents and 44 adolescents aged 14-18 years) from various neighborhoods in Los Angeles. Sessions were recorded, transcribed, coded, and analyzed for themes. Focus-group participants appeared to divide sex information into 3 categories, which we termed facts, feelings, and values. Adolescents emphasized facts and feelings. Parents and grandparents emphasized facts and values. In general, facts were obtained through school, feelings through friends, and values through parents. The focus groups identified large barriers to value transmission, stemming from adolescent acculturation to the United States. Parents and grandparents felt that values were transmitted best through traditional Filipino respect for parents who often eschewed open discussion. Adolescents believed that open discussion was necessary for value transmission to occur. The result was bilateral withdrawal from family communication about sex. Our focus groups found that parent-child communication about sex, especially regarding values, was limited. Potential causes included conflicts between Filipino and US beliefs regarding respect for parents and open discussion. Our results raise important questions about the effect of acculturation on sex education for Filipino American adolescents and demonstrate potential advantages of CBPR.

  11. Sex, Obesity, and Blood Pressure Among African American Adolescents: The Jackson Heart KIDS Pilot Study.

    Science.gov (United States)

    Bruce, Marino A; Beech, Bettina M; Norris, Keith C; Griffith, Derek M; Sims, Mario; Thorpe, Roland J

    2017-09-01

    This study examined the degree to which sex, weight status, and the presence of hypertension and obesity in parents/grandparents were associated with systolic (SBP) and diastolic (DBP) blood pressure (BP) among African American youth in a pilot offspring study examining obesity-related cardiovascular disease (CVD) risks among adolescents. Fully adjusted linear regression models of the total sample produced results indicating that obesity was associated with BP (SBP: β = 7.08, P obesity were associated with SBP (overweight: β = 6.77, P obese: β = 11.65, P obesity was correlated with DBP (β = 9.86, P obesity was associated with DBP (β = 6.98, P obesity was significantly associated with SBP among adolescent females but not males. The relationship between weight status, familial hypertension and obesity status, and BP among adolescents vary by sex. This study underscores the need for additional research investigating the relationship between individual sex, weight status, BP and familial BP, and obesity status on risk among African American adolescents. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Burden and characteristics of HIV infection among female sex workers in Kampala, Uganda - a respondent-driven sampling survey.

    Science.gov (United States)

    Hladik, Wolfgang; Baughman, Andrew L; Serwadda, David; Tappero, Jordan W; Kwezi, Rachel; Nakato, Namakula D; Barker, Joseph

    2017-06-10

    Sex workers in Uganda are at significant risk for HIV infection. We characterized the HIV epidemic among Kampala female sex workers (FSW). We used respondent-driven sampling to sample FSW aged 15+ years who reported having sold sex to men in the preceding 30 days; collected data through audio-computer assisted self-interviews, and tested blood, vaginal and rectal swabs for HIV, syphilis, neisseria gonorrhea, chlamydia trachomatis, and trichomonas vaginalis. A total of 942 FSW were enrolled from June 2008 through April 2009. The overall estimated HIV prevalence was 33% (95% confidence intervals [CI] 30%-37%) and among FSW 25 years or older was 44%. HIV infection is associated with low levels of schooling, having no other work, never having tested for HIV, self-reported genital ulcers or sores, and testing positive for neisseria gonorrhea or any sexually transmitted infections (STI). Two thirds (65%) of commercial sex acts reportedly were protected by condoms; one in five (19%) FSW reported having had anal sex. Gender-based violence was frequent; 34% reported having been raped and 24% reported having been beaten by clients in the preceding 30 days. One in three FSW in Kampala is HIV-infected, suggesting a severe HIV epidemic in this population. Intensified interventions are warranted to increase condom use, HIV testing, STI screening, as well as antiretroviral treatment and pre-exposure prophylaxis along with measures to overcome gender-based violence.

  13. Determinants of consistent condom use among female sex workers in Savannakhet, Lao PDR

    OpenAIRE

    Andrews, Carin Hillerdal; Faxelid, Elisabeth; Sychaerun, Vanphanom; Phrasisombath, Ketkesone

    2015-01-01

    Background Female sex workers (FSWs) are a high-risk population for HIV. Correct and consistent use of condoms is the most effective measure for reducing transmission of HIV. Lao PDR is a low HIV-prevalence country, but FSWs have a relatively high HIV prevalence. To be able to make recommendations for condom promotion interventions in Lao PDR it is important to know more about the context specific situation. This study looked at reasons for and associated factors of consistent condom use amon...

  14. Process assessment of a peer education programme for HIV prevention among sex workers in Dhaka, Bangladesh : a social support framework.

    Science.gov (United States)

    Sarafian, Isabelle

    2012-08-01

    This study evaluated the process of a peer education program for hotel-based sex workers in Dhaka, Bangladesh, with social support proposed as an organizing framework. Programme outcomes were examined through baseline and follow-up assessments. Sex workers naïve to peer education were assessed on socio-cognitive and behavioural variables; a subsample was reassessed at follow-up 23 weeks later on average. Process was assessed in terms of the content of peer education sessions. These sessions were recorded and coded into percentages of social support types provided by the peer educator to her audience: informational, instrumental, appraisal, emotional, companionship, non-support. Peer educators were classified into three "social support profiles" based on average proportions of emotional and informational support they provided. Seeing more peer educators with a high informational support profile was related to higher sex worker self-efficacy, self-reported STI symptoms, and self-reported condom use at follow-up; the same was true for the high emotional support profile and treatment seeking. Social support constituted a useful framework, but needs further exploration. This study provided a direct, in-depth examination of the process of peer education based on a comprehensive theoretical framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers

    Science.gov (United States)

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-01-01

    Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%). Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission

  16. Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women.

    Science.gov (United States)

    Hahm, Hyeouk Chris; Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A

    2012-01-01

    We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

  17. Sex work among men who have sex with men and transgender women in Bogotá.

    Science.gov (United States)

    Bianchi, Fernanda T; Reisen, Carol A; Zea, Maria Cecilia; Vidal-Ortiz, Salvador; Gonzales, Felisa A; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J

    2014-11-01

    This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with 26 displaced individuals who had done sex work: 14 were men who have sex with men and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed.

  18. HIV prevalence among the female sex workers in major cities in Myanmar and the risk behaviors associated with it

    Directory of Open Access Journals (Sweden)

    Swe LA

    2013-08-01

    Full Text Available Lin Aung Swe,1 Abdul Rashid2 1Beneficial Partner Group, Bahan Township, Myanmar; 2Department of Public Health Medicine, Penang Medical College, Georgetown, Malaysia Background: Myanmar is one of the countries hardest hit by the human immunodeficiency virus (HIV epidemic in Asia. Aim: The objective of the study was to determine HIV prevalence among the female sex workers in major cities in Myanmar and the risk behaviors associated with it. Methods: This cross-sectional study was conducted among female sex workers in major cities in Myanmar. Interviews were conducted by trained research assistants, in private, using a questionnaire. The HIV status of the respondents was asked and confirmed by the blood test reports from the laboratories of the Myanmar National AIDS Programme sexually transmitted infections (STI/acquired immunodeficiency syndrome (AIDS Teams and nongovernmental organizations (NGOs. Results: There were 200 respondents in this study. Out of the 136 participants who were tested for HIV, 25 (18.4% were HIV-positive. Respondents of other ethnic groups than Myanmars and other religions than Buddhist were about six times (odds ratio [OR] 5.9 and five times (OR 4.6, respectively, at higher odds of being HIV-positive. Those who were earning an income of less than 200,000 kyats were almost three times (OR 2.9 at higher odds of being HIV-positive. The difference in the age group was found to be statistically significant (P = 0.001. Respondents who did not have HIV counseling (OR 7.3, who did not use condoms (OR 1.3, and with regular partners who refused the use of condoms (OR 6.0 were at higher odds of being HIV-positive. Conclusion: HIV prevention services should include socioeconomic support programs, and the clients and regular partners of sex workers should also be targeted for behavior-change messages, to reduce condom resistance. Keywords: HIV prevalence, risk factors, Myanmar, sex workers, condom

  19. Barriers and Facilitators to HIV Testing Among Zambian Female Sex Workers in Three Transit Hubs.

    Science.gov (United States)

    Chanda, Michael M; Perez-Brumer, Amaya G; Ortblad, Katrina F; Mwale, Magdalene; Chongo, Steven; Kamungoma, Nyambe; Kanchele, Catherine; Fullem, Andrew; Barresi, Leah; Bärnighausen, Till; Oldenburg, Catherine E

    2017-07-01

    Zambia has a generalized HIV epidemic, and HIV is concentrated along transit routes. Female sex workers (FSWs) are disproportionately affected by the epidemic. HIV testing is the crucial first step for engagement in HIV care and HIV prevention activities. However, to date little work has been done with FSWs in Zambia, and little is known about barriers and facilitators to HIV testing in this population. FSW peer educators were recruited through existing sex worker organizations for participation in a trial related to HIV testing among FSWs. We conducted five focus groups with FSW peer educators (N = 40) in three transit towns in Zambia (Livingstone, Chirundu, and Kapiri Mposhi) to elicit community norms related to HIV testing. Emerging themes demonstrated barriers and facilitators to HIV testing occurring at multiple levels, including individual, social network, and structural. Stigma and discrimination, including healthcare provider stigma, were a particularly salient barrier. Improving knowledge, social support, and acknowledgment of FSWs and women's role in society emerged as facilitators to testing. Interventions to improve HIV testing among FSWs in Zambia will need to address barriers and facilitators at multiple levels to be maximally effective.

  20. GLOBAL EPIDEMIOLOGY OF HIV AMONG FEMALE SEX WORKERS: INFLUENCE OF STRUCTURAL DETERMINANTS

    Science.gov (United States)

    Shannon, K; Strathdee, SA; Goldenberg, SM; Duff, P; Mwangi, P; Rusakova, M; Reza-Paul, S; Lau, J; Deering, K; Pickles, M; Boily, M-C

    2014-01-01

    SUMMARY Female sex workers (FSWs) bear a disproportionately large burden of HIV infection worldwide. Despite decades of research and programme activity, the epidemiology of HIV and the role that structural determinants have in mitigating or potentiating HIV epidemics and access to care for FSWs is poorly understood. We reviewed available published data for HIV prevalence and incidence, condom use, and structural determinants among this group. Only 87 (43%) of 204 unique studies reviewed explicitly examined structural determinants of HIV. Most studies were from Asia, with few from areas with a heavy burden of HIV such as sub-Saharan Africa, Russia, and eastern Europe. To further explore the potential effect of structural determinants on the course of epidemics, we used a deterministic transmission model to simulate potential HIV infections averted through structural changes in regions with concentrated and generalised epidemics, and high HIV prevalence among FSWs. This modelling suggested that elimination of sexual violence alone could avert 17% of HIV infections in Kenya (95% uncertainty interval [UI] 1–31) and 20% in Canada (95% UI 3–39) through its immediate and sustained effect on non-condom use) among FSWs and their clients in the next decade. In Kenya, scaling up of access to antiretroviral therapy among FSWs and their clients to meet WHO eligibility of a CD4 cell count of less than 500 cells per μL could avert 34% (95% UI 25–42) of infections and even modest coverage of sex worker-led outreach could avert 20% (95% UI 8–36) of infections in the next decade. Decriminalisation of sex work would have the greatest effect on the course of HIV epidemics across all settings, averting 33–46% of HIV infections in the next decade. Multipronged structural and community-led interventions are crucial to increase access to prevention and treatment and to promote human rights for FSWs worldwide. PMID:25059947

  1. Pragati§: an empowerment programme for female sex workers in Bangalore, India

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    Sjoerd M. Euser

    2012-11-01

    Full Text Available Objectives: To describe the effects of a broad empowerment programme among female sex workers (FSWs in Bangalore, India, which seeks to develop the capacities of these women to address the issues that threaten their lives and livelihoods. Design: This study is based on a comprehensive, on-going HIV-prevention and empowering programme, known as Pragati, which reaches out to approximately 10,000–12,000 FSWs in Bangalore each year. The programme has been designed in collaboration with the sex worker community and provides a personalised set of services, which include STI prevention and treatment services, crisis-response facilities, de-addiction services, and microfinance support all of which have been tailored to adequately fulfil each woman's needs. During the period examined by this study, the programme reached out to 20,330 individual FSWs [median (IQR age 28 (24–35 years]. The programme's personal records of the participating FSWs were used for this descriptive study. Results: Between 2005 and 2010, the number of participating FSWs increased from 2,307 to 13,392. These women intensified their contact with the programme over time: the number of programme contacts increased from 10,351 in 2005 to 167,709 in 2010. Furthermore, data on the effects of crisis-response facilities, de-addiction and microfinance services, condom distribution schemes, and STI diagnosis and treatment showed an accumulating involvement of the participating FSWs in these programme services. Conclusion: This programme, which focuses on social and economic empowerment among FSWs, is successful in reaching and involving the target population.

  2. Working, sex partner age differences, and sexual behavior among African American youth.

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    Bauermeister, José A; Zimmerman, Marc; Xue, Yange; Gee, Gilbert C; Caldwell, Cleopatra H

    2009-10-01

    Participation in the workplace has been proposed as a potential structural-level HIV/STI prevention strategy for youth. Only a few cross-sectional studies have explored the effect of work during adolescence and young adulthood on sexual behavior and their results have been mixed. This study builds on this literature by exploring whether work influences youths' sexual behavior in a cohort of African American youth (N = 562; 45% males; M = 14.5 years, SD = 0.6) followed from adolescence to young adulthood (ages 13-25 years). Using growth curve modeling, we tested whether working was associated with older sex partners. Then, we explored the association between sex partner age differences and sexual behaviors (i.e., number of sex partners, condom use, and frequency of sexual intercourse). Finally, we tested whether the relationship between sex partner age differences and sexual behaviors was confounded by working. Working greater number of hours was not significantly associated with having older sex partners. Sex partner age differences was associated with number of partners, condom use, and higher sex frequency. These associations were larger for females. Working was associated with higher sex frequency, after accounting for age differences. We discuss the implications of these findings for future research and program planning, particularly in the context of youth development programs.

  3. Gender Power Control, Sexual Experiences, Safer Sex Practices, and Potential HIV Risk Behaviors Among Young Asian-American Women

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    Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A.

    2012-01-01

    We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women’s perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women’s intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population. PMID:21259042

  4. Work environments and HIV prevention: a qualitative review and meta-synthesis of sex worker narratives.

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    Goldenberg, Shira M; Duff, Putu; Krusi, Andrea

    2015-12-16

    Sex workers (SWs) experience a disproportionately high burden of HIV, with evidence indicating that complex and dynamic factors within work environments play a critical role in mitigating or producing HIV risks in sex work. In light of sweeping policy efforts to further criminalize sex work globally, coupled with emerging calls for structural responses situated in labour and human-rights frameworks, this meta-synthesis of the qualitative and ethnographic literature sought to examine SWs' narratives to elucidate the ways in which physical, social and policy features of diverse work environments influence SWs' agency to engage in HIV prevention. We conducted a meta-synthesis of qualitative and ethnographic studies published from 2008 to 2014 to elucidate SWs' narratives and lived experiences of the complex and nuanced ways in which physical, social, and policy features of indoor and outdoor work environments shape HIV prevention in the sex industry. Twenty-four qualitative and/or ethnographic studies were included in this meta-synthesis. SWs' narratives revealed the nuanced ways that physical, social, and policy features of work environments shaped HIV risk and interacted with macrostructural constraints (e.g., criminalization, stigma) and community determinants (e.g., sex worker empowerment initiatives) to shape SWs' agency in negotiating condom use. SWs' narratives revealed the ways in which the existence of occupational health and safety standards in indoor establishments, as well as protective practices of third parties (e.g., condom promotion) and other SWs/peers were critical ways of enhancing safety and sexual risk negotiation within indoor work environments. Additionally, working in settings where negative interactions with law enforcement were minimized (e.g., working in decriminalized contexts or environments in which peers/managers successfully deterred unjust policing practices) was critical for supporting SWs' agency to negotiate HIV prevention. Policy

  5. A reconfiguration of the sex trade: How social and structural changes in eastern Zimbabwe left women involved in sex work and transactional sex more vulnerable.

    Science.gov (United States)

    Elmes, Jocelyn; Skovdal, Morten; Nhongo, Kundai; Ward, Helen; Campbell, Catherine; Hallett, Timothy B; Nyamukapa, Constance; White, Peter J; Gregson, Simon

    2017-01-01

    Understanding the dynamic nature of sex work is important for explaining the course of HIV epidemics. While health and development interventions targeting sex workers may alter the dynamics of the sex trade in particular localities, little has been done to explore how large-scale social and structural changes, such as economic recessions-outside of the bounds of organizational intervention-may reconfigure social norms and attitudes with regards to sex work. Zimbabwe's economic collapse in 2009, following a period (2000-2009) of economic decline, within a declining HIV epidemic, provides a unique opportunity to study community perceptions of the impact of socio-economic upheaval on the sex trade. We conducted focus group discussions with 122 community members in rural eastern Zimbabwe in January-February 2009. Groups were homogeneous by gender and occupation and included female sex workers, married women, and men who frequented bars. The focus groups elicited discussion around changes (comparing contemporaneous circumstances in 2009 to their memories of circumstances in 2000) in the demand for, and supply of, paid sex, and how sex workers and clients adapted to these changes, and with what implications for their health and well-being. Transcripts were thematically analyzed. The analysis revealed how changing economic conditions, combined with an increased awareness and fear of HIV-changing norms and local attitudes toward sex work-had altered the demand for commercial sex. In response, sex work dispersed from the bars into the wider community, requiring female sex workers to employ different tactics to attract clients. Hyperinflation meant that sex workers had to accept new forms of payment, including sex-on-credit and commodities. Further impacting the demand for commercial sex work was a poverty-driven increase in transactional sex. The economic upheaval in Zimbabwe effectively reorganized the market for sex by reducing previously dominant forms of commercial sex

  6. A reconfiguration of the sex trade: How social and structural changes in eastern Zimbabwe left women involved in sex work and transactional sex more vulnerable.

    Directory of Open Access Journals (Sweden)

    Jocelyn Elmes

    Full Text Available Understanding the dynamic nature of sex work is important for explaining the course of HIV epidemics. While health and development interventions targeting sex workers may alter the dynamics of the sex trade in particular localities, little has been done to explore how large-scale social and structural changes, such as economic recessions-outside of the bounds of organizational intervention-may reconfigure social norms and attitudes with regards to sex work. Zimbabwe's economic collapse in 2009, following a period (2000-2009 of economic decline, within a declining HIV epidemic, provides a unique opportunity to study community perceptions of the impact of socio-economic upheaval on the sex trade. We conducted focus group discussions with 122 community members in rural eastern Zimbabwe in January-February 2009. Groups were homogeneous by gender and occupation and included female sex workers, married women, and men who frequented bars. The focus groups elicited discussion around changes (comparing contemporaneous circumstances in 2009 to their memories of circumstances in 2000 in the demand for, and supply of, paid sex, and how sex workers and clients adapted to these changes, and with what implications for their health and well-being. Transcripts were thematically analyzed. The analysis revealed how changing economic conditions, combined with an increased awareness and fear of HIV-changing norms and local attitudes toward sex work-had altered the demand for commercial sex. In response, sex work dispersed from the bars into the wider community, requiring female sex workers to employ different tactics to attract clients. Hyperinflation meant that sex workers had to accept new forms of payment, including sex-on-credit and commodities. Further impacting the demand for commercial sex work was a poverty-driven increase in transactional sex. The economic upheaval in Zimbabwe effectively reorganized the market for sex by reducing previously dominant forms

  7. Drinking reasons and alcohol problems by work venue among female sex workers in Guangxi, China.

    Science.gov (United States)

    Chen, Yiyun; Li, Xiaoming; Shen, Zhiyong; Zhou, Yuejiao; Tang, Zhenzhu

    2015-04-01

    Alcohol use is a key determinant of sexual risk behaviors, but pathways to alcohol use in the context of commercial sex still remain unclear. The present study explores reasons for drinking and their roles on alcohol use problems among female sex workers (FSWs) in different types of commercial sex venues. In 2009, a sample of 1,022 FSWs from Guangxi, China completed a survey containing a 10-item Alcohol Use Disorders Identification Test (AUDIT) and a 28-item measure of reasons for drinking. Factor analysis revealed five reasons for drinking: suppression, disinhibition, work requirement, sexual enhancement, and confidence booster. All identified reasons except confidence booster appeared to be related to a higher tendency of developing alcohol use problems among FSWs. Types of commercial sex venues moderated the relationship between work requirement and alcohol use problems. Alcohol-risk reduction interventions among this population need to provide them with alternative approaches to regulate emotions and modify their misconceptions about alcohol's sexual enhancing function. More attention is needed to FSWs' vulnerability to the negative influence of occupational drinking.

  8. HIV infection among foreign transsexual sex workers in Rome: prevalence, behavior patterns, and seroconversion rates.

    Science.gov (United States)

    Spizzichino, L; Zaccarelli, M; Rezza, G; Ippolito, G; Antinori, A; Gattari, P

    2001-07-01

    The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people. To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center. A cross-sectional, follow-up study was conducted. Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion. The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.

  9. Homosexuality, Religion, and the Family: The Effects of Religion on Americans' Appraisals of the Parenting Abilities of Same-Sex Couples.

    Science.gov (United States)

    Whitehead, Andrew L

    2018-01-01

    Although a growing body of research focuses on Americans' attitudes toward same-sex couples as parents, very few include measures of religion, and those that do fail to capture its multidimensional nature. Furthermore, many past studies relied on convenience samples of college students, or samples gathered outside the United States. Multivariate analyses of the 2012 General Social Survey-a nationally representative sample of adults in the United States-reveal that a slim majority of Americans still do not believe same-sex couples can parent as well as male-female couples, and the religious beliefs, behaviors, and affiliations of Americans are significantly and at times differentially associated with appraisals of same-sex couples' parenting abilities. It appears that although religion is generally associated with more negative appraisals of the parenting abilities of same-sex couples, it is not uniformly so. Americans' immediate religious and cultural context can shape their appraisals of homosexuality in diverse ways.

  10. The Effectiveness of the Harm Reduction Group Therapy Based on Bandura's Self-Efficacy Theory on Risky Behaviors of Drug-Dependent Sex Worker Women.

    Science.gov (United States)

    Rabani-Bavojdan, Marjan; Rabani-Bavojdan, Mozhgan; Rajabizadeh, Ghodratollah; Kaviani, Nahid; Bahramnejad, Ali; Ghaffari, Zohreh; Shafiei-Bafti, Mehdi

    2017-07-01

    The aim of this study was to investigate the effectiveness of the harm reduction group therapy based on Bandura's self-efficacy theory on risky behaviors of sex workers in Kerman, Iran. A quasi-experimental two-group design (a random selection with pre-test and post-test) was used. A risky behaviors questionnaire was used to collect. The sample was selected among sex workers referring to drop-in centers in Kerman. Subjects were allocated to two groups and were randomly classified into two experimental and control groups. The sample group consisted of 56 subjects. The experimental design was carried out during 12 sessions, and the post-test was performed one month and two weeks after the completion of the sessions. The results were analyzed statistically. By reducing harm based on Bandura's self-efficacy theory, the risky behaviors of the experimental group, including injection behavior, sexual behavior, violence, and damage to the skin, were significantly reduced in the pre-test compared to the post-test (P group therapy based on Bandura's self-efficacy theory can reduce the risky behaviors of sex workers.

  11. Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting.

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    Goldenberg, Shira M; Chettiar, Jill; Simo, Annick; Silverman, Jay G; Strathdee, Steffanie A; Montaner, Julio S G; Shannon, Kate

    2014-01-01

    To explore factors associated with early sex work initiation and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Baseline data (2010-2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. SWs completed a questionnaire and HIV/sexually transmitted infection testing. Using multivariate logistic regression, we identified associations with early sex work initiation (prostitution arrests among adult SWs. Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian born [adjusted odds ratio (AOR): 6.8, 95% confidence interval (CI): 2.42 to 19.02], inject drugs (AOR: 1.6, 95% CI: 1.0 to 2.5), and to have worked for a manager (AOR: 2.22, 95% CI: 1.3 to 3.6) or been coerced into sex work (AOR: 2.3, 95% CI: 1.14 to 4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3 to 3.2) and prostitution arrests (AOR: 2.0, 95% CI: 1.3 to 3.2). Adolescent sex work initiation is concentrated among marginalized, drug, and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs.

  12. Prevalence and characteristics of abuse experiences and depression symptoms among injection drug-using female sex workers in Mexico.

    Science.gov (United States)

    Ulibarri, Monica D; Hiller, Sarah P; Lozada, Remedios; Rangel, M Gudelia; Stockman, Jamila K; Silverman, Jay G; Ojeda, Victoria D

    2013-01-01

    This mixed methods study examined the prevalence and characteristics of physical and sexual abuse and depression symptoms among 624 injection drug-using female sex workers (FSW-IDUs) in Tijuana and Ciudad Juarez, Mexico; a subset of 47 from Tijuana also underwent qualitative interviews. Linear regressions identified correlates of current depression symptoms. In the interviews, FSW-IDUs identified drug use as a method of coping with the trauma they experienced from abuse that occurred before and after age 18 and during the course of sex work. In a multivariate linear regression model, two factors-ever experiencing forced sex and forced sex in the context of sex work-were significantly associated with higher levels of depression symptoms. Our findings suggest the need for integrated mental health and drug abuse services for FSW-IDUs addressing history of trauma as well as for further research on violence revictimization in the context of sex work in Mexico.

  13. Prevalence and Characteristics of Abuse Experiences and Depression Symptoms among Injection Drug-Using Female Sex Workers in Mexico

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    Monica D. Ulibarri

    2013-01-01

    Full Text Available This mixed methods study examined the prevalence and characteristics of physical and sexual abuse and depression symptoms among 624 injection drug-using female sex workers (FSW-IDUs in Tijuana and Ciudad Juarez, Mexico; a subset of 47 from Tijuana also underwent qualitative interviews. Linear regressions identified correlates of current depression symptoms. In the interviews, FSW-IDUs identified drug use as a method of coping with the trauma they experienced from abuse that occurred before and after age 18 and during the course of sex work. In a multivariate linear regression model, two factors—ever experiencing forced sex and forced sex in the context of sex work—were significantly associated with higher levels of depression symptoms. Our findings suggest the need for integrated mental health and drug abuse services for FSW-IDUs addressing history of trauma as well as for further research on violence revictimization in the context of sex work in Mexico.

  14. An analysis of the implementation of PEPFAR's anti-prostitution pledge and its implications for successful HIV prevention among organizations working with sex workers

    Science.gov (United States)

    Ditmore, Melissa Hope; Allman, Dan

    2013-01-01

    Introduction Since 2003, US government funding to address the HIV and AIDS pandemic has been subject to an anti-prostitution clause. Simultaneously, the efficacy of some HIV prevention efforts for sex work in areas receiving US government funding has diminished. This article seeks to explain why. Methods This analysis utilizes a case story approach to build a narrative of defining features of organizations in receipt of funding from the President's Emergency Plan for AIDS Relief (PEPFAR) and other US funding sources. For this analysis, multiple cases were compiled within a single narrative. This helps show restrictions imposed by the anti-prostitution clause, any lack of clarity of guidelines for implementation and ways some agencies, decision-making personnel, and staff on the ground contend with these restrictions. Results Responses to PEPFAR's anti-prostitution clause vary widely and have varied over time. Organizational responses have included ending services for sex workers, gradual phase-out of services, cessation of seeking US government HIV funds and increasing isolation of sex workers. Guidance issued in 2010 did not clarify what was permitted. Implementation and enforcement has been dependent in part on the interpretations of this policy by individuals, including US government representatives and organizational staff. Conclusions Different interpretations of the anti-prostitution clause have led to variations in programming, affecting the effectiveness of work with sex workers. The case story approach proved ideal for working with information like this that is highly sensitive and vulnerable to breach of anonymity because the method limits the potential to betray confidences and sources, and limits the potential to jeopardize funding and thereby jeopardize programming. This method enabled us to use specific examples without jeopardizing the organizations and individuals involved while demonstrating unintended consequences of PEPFAR's anti

  15. The Relationship between Pain, Disability, and Sex in African Americans.

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    Walker, Janiece L; Thorpe, Roland J; Harrison, Tracie C; Baker, Tamara A; Cary, Michael; Szanton, Sarah L; Allaire, Jason C; Whitfield, Keith E

    2016-10-01

    Older African Americans consistently report diminished capacities to perform activities of daily living (ADL) compared with other racial groups. The extent to which bodily pain is related to declining abilities to perform ADL/ADL disability in African Americans remains unclear, as does whether this relationship exists to the same degree in African American men and women. For nurses to provide optimal care for older African Americans, a better understanding of the relationship between bodily pain and ADL disability and how it may differ by sex is needed. The aim of this study was to examine whether pain, age, education, income, marital status and/or comorbid conditions were associated with ADL disabilities in older African American women and men. This was a cross-sectional descriptive study. The sample included 598 participants (446 women, 152 men) from the first wave of the Baltimore Study on Black Aging. African American women (odds ratio [OR] = 4.06; 95% confidence interval [CI] 2.63-6.26) and African American men (OR = 6.44; 95% CI = 2.84-14.57) who reported bodily pain had greater ADL disability than those who did not report bodily pain. Having two or more comorbid conditions also was significantly associated with ADL disability in African American women (OR = 3.95; 95% CI: 2.09-7.47). Further work is needed to understand pain differences between older African American women and men to develop interventions that can be tailored to meet the individual pain needs of both groups. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  16. Burden and characteristics of HIV infection among female sex workers in Kampala, Uganda – a respondent-driven sampling survey

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    Wolfgang Hladik

    2017-06-01

    Full Text Available Abstract Background Sex workers in Uganda are at significant risk for HIV infection. We characterized the HIV epidemic among Kampala female sex workers (FSW. Methods We used respondent-driven sampling to sample FSW aged 15+ years who reported having sold sex to men in the preceding 30 days; collected data through audio-computer assisted self-interviews, and tested blood, vaginal and rectal swabs for HIV, syphilis, neisseria gonorrhea, chlamydia trachomatis, and trichomonas vaginalis. Results A total of 942 FSW were enrolled from June 2008 through April 2009. The overall estimated HIV prevalence was 33% (95% confidence intervals [CI] 30%-37% and among FSW 25 years or older was 44%. HIV infection is associated with low levels of schooling, having no other work, never having tested for HIV, self-reported genital ulcers or sores, and testing positive for neisseria gonorrhea or any sexually transmitted infections (STI. Two thirds (65% of commercial sex acts reportedly were protected by condoms; one in five (19% FSW reported having had anal sex. Gender-based violence was frequent; 34% reported having been raped and 24% reported having been beaten by clients in the preceding 30 days. Conclusions One in three FSW in Kampala is HIV-infected, suggesting a severe HIV epidemic in this population. Intensified interventions are warranted to increase condom use, HIV testing, STI screening, as well as antiretroviral treatment and pre-exposure prophylaxis along with measures to overcome gender-based violence.

  17. HIV prevention and care-seeking behaviour among female sex workers in four cities in India, Kenya, Mozambique and South Africa.

    Science.gov (United States)

    Lafort, Yves; Greener, Ross; Roy, Anuradha; Greener, Letitia; Ombidi, Wilkister; Lessitala, Faustino; Haghparast-Bidgoli, Hassan; Beksinska, Mags; Gichangi, Peter; Reza-Paul, Sushena; Smit, Jenni A; Chersich, Matthew; Delva, Wim

    2016-10-01

    To identify gaps in the use of HIV prevention and care services and commodities for female sex workers, we conducted a baseline cross-sectional survey in four cities, in the context of an implementation research project aiming to improve use of sexual and reproductive health services. Using respondent-driven sampling, 400 sex workers were recruited in Durban, 308 in Tete, 400 in Mombasa and 458 in Mysore and interviewed face-to-face. RDS-adjusted proportions were estimated by nonparametric bootstrapping and compared across cities using post hoc pairwise comparison. Condom use with last client ranged from 88.3% to 96.8%, ever female condom use from 1.6% to 37.9%, HIV testing within the past 6 months from 40.5% to 70.9%, receiving HIV treatment and care from 35.5% to 92.7%, care seeking for last STI from 74.4% to 87.6% and having had at least 10 contacts with a peer educator in the past year from 5.7% to 98.1%. Many of the differences between cities remained statistically significant (P sex worker characteristics. Models to improve use of condoms and HIV prevention and care services should be tailored to the specific context of each site. Programmes at each site must focus on improving availability and uptake of those services that are currently least used. © 2016 John Wiley & Sons Ltd.

  18. "What makes you think you have special privileges because you are a police officer?" A qualitative exploration of police's role in the risk environment of female sex workers.

    Science.gov (United States)

    Sherman, Susan G; Footer, Katherine; Illangasekare, Samantha; Clark, Erin; Pearson, Erin; Decker, Michele R

    2015-01-01

    Worldwide, female sex workers (FSWs) have high rates of HIV. Many factors that escalate their risk lay outside of their control, primarily in the environments in which they practice sex. An understudied yet powerful risk environment is that of police. We qualitatively explored sex workers' interactions with police in their personal and professional lives. Thirty-five FSWs were purposively sampled in Baltimore, MD, in 2012. Women discussed experiences of police verbal harassment, sexual exploitation, extortion, and a lack of police responsiveness to 911 calls in emergencies, largely partner violence. Women's mistrust of police was often developed at an early age and further reinforced by interactions in their personal and professional lives. The study underscores the need for targeting police in reducing sex workers' HIV and other risks. The case for police's role in generating risk is evident, which could be addressed through structural interventions targeting both police practices and policies.

  19. Sex tourism in Thailand.

    Science.gov (United States)

    Van Kerkwijk, C

    1992-01-01

    Many foreigners visit Thailand in search of sex. While long-distance tourism was long enjoyed by members of more privileged social classes, even the lower economical classes of Japan, Malaysia, Europe, America, and Australia can now afford to travel over long distances. This relatively new breed of tourist is more likely to be of lower socioeconomic and educational status and less likely to use condoms when having sex. An estimated 30,000 sex workers are active in Bangkok, of whom 7000/10,000 are females who work specifically in the tourism sector. 1/2-1/3 of the 600 commercial sex establishments in the city are visited by foreigners. Phuket, Pattaya, Koh Samui, and Chiangmai are also well-frequented by sex tourists. Overall, a large, diverse, inexpensive, and accessible commercial sex market exists in Thailand. One may meet sex workers quasi-ubiquitously and be assured to find someone capable of meeting one's sexual needs. With these attributes, Thailand strongly attracts tourists in search of sex. A certain degree of recklessness also prevails among those on vacation. Away from the peers and social mores of their native lands, tourists may engage in sexually activities without criticism. Likewise, Thai sex workers who cater to foreigners, especially females, enjoy more freedom and control in sexual relations than their peers who work among nationals. Neither single nor married women in Thailand are allowed much sexual freedom and are traditionally expected to be obliging docile, and submissive. The greater than normal personal latitude enjoyed by both sex worker and foreigner lead to more negotiation on condom use and overall lower use. As such, Thailand's commercial sex market with foreigners' involvement therein threatens to spread HIV to many other countries throughout the world.

  20. Indigenous HIV Prevention Beliefs and Practices Among Low-Earning Chinese Sex Workers as Context for Introducing Female Condoms and Other Novel Prevention Options.

    Science.gov (United States)

    Dunn, Jennifer; Zhang, Qingning; Weeks, Margaret R; Li, Jianghong; Liao, Susu; Li, Fei

    2017-07-01

    New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women's existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women's HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available.

  1. Prevalence of HIV Infection and Risk Factors Among Female Sex Workers in a Southeast Province of Vietnam.

    Science.gov (United States)

    Nguyen, Tri; Stewart, Donald Edwin; Lee, Chiao Tzu Patricia; Dang, Thi Nhu Hang

    2017-08-01

    Female sex workers (FSWs) are at heightened risk of HIV infection. This research aims to determine the prevalence of HIV and relevant risk factors and related behavior among FSWs in Ba Ria - Vung Tau, a southeast province of Vietnam. 420 FSWs were interviewed using a structured questionnaire and biological samples tested for HIV. 2.6 % were found to be HIV positive. HIV infection was significantly higher in FSWs who had low income (≤AUD 200 per month), have had anal sex, have had sex with injecting drug users, and had a low level of HIV/AIDS-related knowledge. Improved employment opportunities and income are important to reduce the pressure for young women to engage in sex work for income purposes, but in public health terms, existing HIV treatment, prevention and intervention programs needs better targeting and improvements to reduce the risk of HIV infection.

  2. Condom use among female sex workers in China: role of gatekeepers.

    Science.gov (United States)

    Yang, Hongmei; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Zhao, Ran; Dong, Baiqing; Liu, Wei; Liang, Shaoling; Zhou, Yuejiao; Hong, Yan

    2005-09-01

    The objective of this study was to assess the potential role of gatekeepers of establishments in promoting condom use among female sex workers (FSWs) in China. The goals of this study were to explore FSWs' perceptions of gatekeeper attitudes and support for condom use, and to assess their association with FSWs' practice, communication, intention, proper use, knowledge of correct use, and perceptions related to condom use. The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Perceived gatekeeper support for condom use was low among FSWs. Perceived support was positively associated with condom use communication with sexual partners, condom use frequency and intention, but not associated with proper condom use among FSWs. Perceived support was significantly associated with most condom use-related perceptions (e.g., self-efficacy of condom use, barriers to condom use, and perceived peer condom use) among FSWs. Healthcare professionals should work with gatekeepers to create a supportive local environment for condom use in sex work establishments. Gatekeepers need to clearly articulate their support for condom use to the FSWs. Training and skill acquisition regarding correct use of condoms among FSWs will be necessary.

  3. The balancing act: exploring stigma, economic need and disclosure among male sex workers in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Closson, Elizabeth F; Colby, Donn J; Nguyen, Thi; Cohen, Samuel S; Biello, Katie; Mimiaga, Matthew J

    2015-01-01

    In Vietnam, there is an emerging HIV epidemic among men who have sex with men (MSM). Male sex workers engage in high-risk sexual behaviours that make them particularly vulnerable to HIV infection. In 2010, 23 MSM in Ho Chi Minh City (HCMC) who recently received payment for sex with another man completed in-depth qualitative interviews exploring motivations for sex work, patterns of sex work disclosure and experiences of social stigma. Interviews were recorded, transcribed and translated into English and analysed using a qualitative descriptive approach. Low wages, unstable employment and family remittances were motivating factors for MSM in HCMC to sell sex. Participants described experiences of enacted and felt social stigma related to their involvement in sex work. In response, they utilised stigma management techniques aimed at concealment of involvement in sex work. Such strategies restricted sexual communication with non-paying sex partners and potentially limited their ability to seek social support from family and friends. Departing from decontextualized depictions of sex work disclosure, our findings describe how decisions to reveal involvement in sex work are shaped by social and structural factors such as social stigma, techniques to minimise exposure to stigma, economic imperatives and familial responsibilities.

  4. Silent killers of the night: an exploration of psychological health and suicidality among female street sex workers.

    Science.gov (United States)

    Ling, Davina C; Wong, William C W; Holroyd, Eleanor A; Gray, Sister Ann

    2007-01-01

    This article examines factors that relate to psychological health (as measured by the World Health Organization Quality of Life Instrument) as well as suicide attempts among female street sex workers (FSSWs) in Hong Kong. On average, our sampled FSSWs scored significantly lower on the psychological health domain in comparison to the general Hong Kong female population. Factors associated with the working environment in the sex industry were significantly associated with poor psychological health and suicidality. Greater attention is needed to examine the physical and emotional harm intrinsic to certain occupations and the role of financial needs in the experience of psychological stress.

  5. Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting

    Science.gov (United States)

    GOLDENBERG, Shira M.; CHETTIAR, Jill; SIMO, Annick; SILVERMAN, Jay G.; STRATHDEE, Steffanie A.; MONTANER, Julio; SHANNON, Kate

    2014-01-01

    Objectives To explore factors associated with early sex work initiation, and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Design Baseline data (2010–2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time-location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. Methods SWs completed a questionnaire and HIV/STI testing. Using multivariate logistic regression, we identified associations with early sex work initiation (prostitution arrests among adult SWs. Results Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian-born (Adjusted Odds Ratio (AOR): 6.8, 95% Confidence Interval (CI): 2.42–19.02), inject drugs (AOR: 1.6, 95%CI: 1.0–2.5), and to have worked for a manager (AOR: 2.22, 95%CI: 1.3–3.6) or been coerced into sex work (AOR: 2.3, 95%CI: 1.14–4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3–3.2) and prostitution arrests (AOR: 2.0, 95%CI: 1.3–3.2). Conclusions Adolescent sex work initiation is concentrated among marginalized, drug and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs. PMID:23982660

  6. Exploring the Relationship between Workaholism Facets and Personality Traits: A Replication in American Workers

    Science.gov (United States)

    Aziz, Shahnaz; Tronzo, Casie L.

    2011-01-01

    In this study, we further explored whether any of the dimensions in the five-factor model of personality (i.e., openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) were related to facets of workaholism (i.e., work involvement, work drive, and work enjoyment) in a sample of American workers in various…

  7. Estimating the number of female sex workers in Côte d'Ivoire: results and lessons learned.

    Science.gov (United States)

    Vuylsteke, Bea; Sika, Lazare; Semdé, Gisèle; Anoma, Camille; Kacou, Elise; Laga, Marie

    2017-09-01

    To report on the results of three size estimations of the populations of female sex workers (FSW) in five cities in Côte d'Ivoire and on operational lessons learned, which may be relevant for key population programmes in other parts of the world. We applied three methods: mapping and census, capture-recapture and service multiplier. All were applied between 2008 and 2009 in Abidjan, San Pedro, Bouaké, Yamoussoukro and Abengourou. Abidjan was the city with the highest number of FSW by far, with estimations between 7880 (census) and 13 714 (service multiplier). The estimations in San Pedro, Bouaké and Yamoussoukro were very similar, with figures ranging from 1160 (Yamoussoukro, census) to 1916 (San Pedro, capture-recapture). Important operational lessons were learned, including strategies for mapping, the importance of involving peer sex workers for implementing the capture-recapture and the identification of the right question for the multiplier method. Successful application of three methods to estimate the population size of FSW in five cities in Côte d'Ivoire enabled us to make recommendations for size estimations of key population in low-income countries. © 2017 John Wiley & Sons Ltd.

  8. Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study

    OpenAIRE

    Liu, Hongjie; Dumenci, Levent; Morisky, Donald E; Xu, Yongfang; Li, Xiaojing; Jiang, Baofa

    2016-01-01

    Objectives This study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China. Design A cross-sectional study with respondent-driven sampling (RDS). Setting A multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014....

  9. HIV/AIDS risk factors and economic empowerment needs of female sex workers in Enugu Urban, Nigeria.

    Science.gov (United States)

    Onyeneho, N G

    2009-07-01

    While successes are recorded in the developed world with respect to control of HIV/AIDS, the dream of halting and reversing its spread seems to be a mirage in most parts of the developing world. The forces that drive the transmission of HIV/AIDS in Nigeria, as in many other resource poor societies include the activities of high-risk groups. Commercial sex workers remain a major source of HIV/AIDS transmission in Nigeria. The knowledge, attitude and practice (KAP) of HIV/AIDS among female sex workers (FSWs) faced with the threat of contracting HIV/AIDS were assessed. A total of 135 FSWs from four most popular brothels in Enugu were interviewed with a structured interview schedule. Six focus group discussion (FGD) sessions were held with FSWs from neighbouring communities. FSWs in Enugu were of diverse socioeconomic backgrounds. They were however mostly in their productive ages of 16-47, with a mean age of 26.9 years. Poverty was the common reason for sex work. Some engaged in sex work to provide their school needs and those of other dependants. The respondents were aware of HIV/AIDS and dread being infected by it because of the stigma and absence of cure. Three percent do not use condom at all. Others use unorthodox methods (e.g. douching with salt solution immediately after sex), if a client refuses to use condom. Condom use depended on the client's choice. Misconceptions exist among the respondents on mode of transmission. Perceptual factors, more than demographic differences played great role in the attitude of the FSWs towards HIV/AIDS. Steps need to be taken to improve on the level of knowledge of HIV/AIDS among the respondents. This should cut across socio-demographic lines and should target the perceptual factors, which tended to provide adequate explanation for the attitude of the respondents to HIV/AIDS. The FSWs should be provided with income earning skills to improve their income earner ability and make them self-reliant.

  10. Female Sex Workers in the City of Bogotá: From Stigma to Empowerment

    Directory of Open Access Journals (Sweden)

    Maria Adelaida Martinez

    2014-12-01

    Full Text Available Female sex workers (FSWs in Bogotá, Colombia experience stigmatization due to their work, which results in a violation of basic human rights. The article describes the social challenges and violations faced by this group due to different types of stigma present in Colombian society and discusses current political debates around the legality of sex work. It proposes that through empowering these women using a participatory approach and giving them access to technology such as photography and video, empathy can be mobilized and can reduce the barriers that FSWs and their children are facing. By raising awareness of the problem of stigmatization, it becomes possible to effect change on a political level through critical social inclusion praxis. The article begins by analyzing different stigmas that exist in Colombian society and the problems that result from such stigmas, before offering a review of social initiatives and proposing a project outline and policy options using participatory methods.

  11. The Expression of Depressive Symptomatology in Korean American Undergraduates: Sex and Generational Differences

    Science.gov (United States)

    Castellanos, Jeanett; Gloria, Alberta M.; Kim, Sara Cho; Park, Yong S.

    2014-01-01

    This study examined the influence of acculturation and perception of the university environment on the depressive symptomatology of 228 Korean American undergraduates, with a focus on sex and generational differences. Perceptions of the university environment and perceived barriers were positive predictors of depressive symptomatology in…

  12. Using brothel leadership to promote condom use among brothel-based female sex workers in Abuja, Nigeria : study protocol for a cluster randomized pilot trial

    NARCIS (Netherlands)

    Okafor, Uchenna; Crutzen, Rik; Okekearu, Ifeanyi; Adebajo, Sylvia; Uzoh, Adaora; Awo, Egbe Aneotah; Chima, Chukwuemeka; Agwagwa, Ogechukwu; Van Den Borne, Bart

    2017-01-01

    Background The HIV prevalence among female populations involved in sex work in Nigeria has heightened interest in HIV prevention programming for this sub-population with brothel-based female sex workers (BB FSWs) having a prevalence of 27.4%, six times higher than the prevalence in the general

  13. Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: A systematic review

    NARCIS (Netherlands)

    L. Moore (Laurence); M. Chersich (Matthew); R. Steen (Richard); S. Reza-Paul (Sushena); A. Dhana (Ashar); B. Vuylsteke (Bea); Y. Lafort (Yves); F. Scorgie (Fiona)

    2014-01-01

    textabstractBackground: Female sex workers (FSWs) experience high levels of sexual and reproductive health (SRH) morbidity, violence and discrimination. Successful SRH interventions for FSWs in India and elsewhere have long prioritised community mobilisation and structural interventions, yet little

  14. A comprehensive review of HIV/STI prevention and sexual and reproductive health services among sex Workers in Conflict-Affected Settings: call for an evidence- and rights-based approach in the humanitarian response.

    Science.gov (United States)

    Ferguson, Alyssa; Shannon, Kate; Butler, Jennifer; Goldenberg, Shira M

    2017-01-01

    While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. This review identified significant gaps in HIV/STI and SRH research, policy

  15. Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities.

    Directory of Open Access Journals (Sweden)

    Shirley J Semple

    Full Text Available Globally, client-perpetrated violence against female sex workers (FSWs has been associated with multiple health-related harms, including high-risk sexual behavior and increased exposure to HIV/STIs. This study examined correlates of client-perpetrated sexual, physical, and economic violence (e.g., robbery against FSWs in 13 cities throughout Mexico.FSWs (N = 1,089 who were enrolled in a brief, evidence-based, sexual risk reduction intervention for FSWs (Mujer Segura were interviewed about their work context, including experiences of violence perpetrated by clients, sexual risk and substance use practices, financial need, and social supports. Three broad categories of factors (sociodemographic, work context, behavioral and social characteristics of FSWs were examined as correlates of sexual, physical, and economic violence.The prevalence of different types of client-perpetrated violence against FSWs in the past 6 months was: sexual (11.7%, physical (11.8%, economic (16.9%, and any violence (22.6%. Greater financial need, self-identification as a street worker, and lower perceived emotional support were independently associated with all three types of violence. Alcohol use before or during sex with clients in the past month was associated with physical and sexual violence. Using drugs before or during sex with clients, injection drug use in the past month, and population size of city were associated with sexual violence only, and FSWs' alcohol use score (AUDIT-C was associated with economic violence only.Correlates of client-perpetrated violence encompassed sociodemographic, work context, and behavioral and social factors, suggesting that approaches to violence prevention for FSWs must be multi-dimensional. Prevention could involve teaching FSWs strategies for risk avoidance in the workplace (e.g., avoiding use of alcohol with clients, enhancement of FSWs' community-based supports, development of interventions that deliver an anti

  16. Consistent Condom Use by Female Sex Workers in Kolkata, India: Testing Theories of Economic Insecurity, Behavior Change, Life Course Vulnerability and Empowerment.

    Science.gov (United States)

    Fehrenbacher, Anne E; Chowdhury, Debasish; Ghose, Toorjo; Swendeman, Dallas

    2016-10-01

    Consistent condom use (CCU) is the primary HIV/STI prevention option available to sex workers globally but may be undermined by economic insecurity, life-course vulnerabilities, behavioral factors, disempowerment, or lack of effective interventions. This study examines predictors of CCU in a random household survey of brothel-based female sex workers (n = 200) in two neighborhoods served by Durbar (the Sonagachi Project) in Kolkata, India. Multivariate logistic regression analyses indicated that CCU was significantly associated with perceived HIV risk, community mobilization participation, working more days in sex work, and higher proportion of occasional clients to regular clients. Exploratory analyses stratifying by economic insecurity indicators (i.e., debt, savings, income, housing security) indicate that perceived HIV risk and community mobilization were only associated with CCU for economically secure FSW. Interventions with FSW must prioritize economic security and access to social protections as economic insecurity may undermine the efficacy of more direct condom use intervention strategies.

  17. Vulnerabilities faced by the children of sex workers in two Mexico-US border cities: a retrospective study on sexual violence, substance use and HIV risk.

    Science.gov (United States)

    Servin, Argentina E; Strathdee, Steffanie; Muñoz, Fatima A; Vera, Alicia; Rangel, Gudelia; Silverman, Jay G

    2015-01-01

    Most studies of female sex workers (FSWs) conducted in the Mexico-US border region have focused on individual HIV risk, centered on sexual behaviors and substance abuse patterns. Little attention has been drawn to the reality that sex workers are often parents whose children potentially face vulnerabilities unique to their family situation. The objective of the present study was to identify the vulnerabilities faced by the children of FSWs in two Mexican-US border cities. From 2008 to 2010, 628 FSW-injection drug users underwent interviewer-administered surveys and HIV/STI testing. Approximately one in five participants (20%) reported having a parent involved in sex work and majority referred it was their mother (88%). Close to one-third of participants (31%) reported first injecting drugs prostitute <18 years of age. First drinking alcohol <18 years old (AOR = 1.87, 95%CI: 1.13-3.08), lifetime cocaine use (AOR = 1.76, 95%CI: 1.09-2.84), ever being forced or coerced into non-consensual sex as a minor (<18 years of age; AOR = 1.54, 95%CI: 1.01-2.35), and injecting drugs with used syringes in the prior month (AOR = 1.63, 95%CI: 1.07-2.49) were the factors associated with having had a parent involved in sex work. These findings begin to lay the groundwork for understanding the potential vulnerabilities faced by the children of sex workers. Understanding these potential needs is necessary for creating relevant, evidence-based interventions focused on supporting these women.

  18. Trends in risk behaviors among female sex workers in south India: priorities for sustaining the reversal of HIV epidemic.

    Science.gov (United States)

    Charles, Bimal; Jeyaseelan, Lakshmanan; Edwin Sam, Asirvatham; Kumar Pandian, Arvind; Thenmozhi, Mani; Jeyaseelan, Visalakshi

    2013-01-01

    HIV epidemic in India is predominantly concentrated in subgroups of population, such as female sex workers (FSWs) and their clients, whose behavior exposes them to a higher risk of acquiring HIV infection. This paper aims to present the changing patterns of socio-demographic characteristics, behaviors, reported sexually transmitted infections (STIs), and associated factors among FSWs over 11 years. Multistage cluster sampling with probability-proportional-to-size (PPS) method was used in the surveys. A sample of 400 FSWs was studied every year. The mean age and literacy at the baseline level increased significantly over the years. House-based sex increased by 40% from 43.3% in 1997 to 83% in 2008 (p<0.001). Condom use at last sex with one-time clients; consistent condom use (CCU) with one-time and regular clients indicated increasing trends. FSWs reported low levels of condom use at last sex (14.5% in 1997 to 5% in 2008; p<0.001) and CCU (12.6% in 2004 to 3.6% in 2008; p<0.01) with regular partners. FSWs who used condom with one-time clients at last sex reported significantly less STI symptoms. A two-third reduction in genital ulcers was found from 13.1% in 1997 to 4.5% in 2008 (p<0.001). Nonliterate and hotel-based sex workers were 1.6 (1.0-2.5; 95% CI) and 2.2(1.3-3.7; 95% CI) times more likely to have reported STI symptoms. The percentage of FSWs who underwent HIV testing increased (p<0.001); similarly, a 20% increase was found in FSWs who availed counseling services from 65.2% in 1997 to 85.4% in 2008 (p<0.001). Poor, illiterate, and marginalized were more likely to get involved in risky behaviors which suggest the need for structural interventions as part of HIV prevention strategy.

  19. Low completion rate of hepatitis B vaccination in female sex workers.

    Science.gov (United States)

    Magalhães, Rosilane de Lima Brito; Teles, Sheila Araújo; Reis, Renata Karina; Galvão, Marli Teresinha Gimeniz; Gir, Elucir

    2017-01-01

    to assess predictive factors for noncompletion of the hepatitis B vaccination schedule in female sex workers in the city of Teresina, Northeastern Brazil. 402 women were interviewed and, for those who did not wish to visit specialized sites, or did not know their hepatitis B vaccination status, the vaccine was offered at their workplaces. Bi- and multivariate analyses were performed to identify potential predictors for noncompletion of the vaccination schedule. of the 284 women eligible for vaccination, 258 (90.8%) received the second dose, 157/258 (60.8%) and 68/258 (26.3%) received the second and third doses, respectively. Working at clubs and consuming illicit drugs were predictors for noncompletion of the vaccination schedule. the high acceptability of the vaccine's first dose, associated with low completion rates of the vaccination schedule in sex workers, shows the need for more persuasive strategies that go beyond offering the vaccine at their workplaces. avaliar fatores preditores de não completude do esquema vacinal contra hepatite B em mulheres que se prostituem em Teresina, Nordeste do Brasil. Um total de 402 mulheres foi entrevistado e, para as que se negaram a irem a lugares especializados, ou desconheciam sua situação vacinal contra hepatite B, a vacina foi oferecida no local do trabalho. Análises bi e multivariadas foram realizadas para identificar potenciais preditores de não completude do esquema vacinal. Das 284 mulheres elegíveis para vacinação, 258 (90,8%) receberam a primeira dose, 157/258 (60,8%) e 68/258 (26,3%) receberam a segunda e terceira doses. Trabalhar em boates e consumir drogas ilícitas foram preditores de não completude do esquema vacinal (p<0,05). A elevada aceitabilidade da primeira dose da vacina, associada à baixa completude do esquema vacinal em profissionais do sexo, evidencia a necessidade de estratégia mais persuasiva que vá além da oferta da vacina no local de trabalho.

  20. Mothers’ Parenting and Child Sex Differences in Behavior Problems among African American Preschoolers

    Science.gov (United States)

    Barnett, Melissa A.; Scaramella, Laura V.

    2014-01-01

    Sex differences in rates of behavior problems, including internalizing and externalizing problems, begin to emerge during early childhood. These sex differences may occur because mothers parent their sons and daughters differently, or because the impact of parenting on behavior problems is different for boys and girls. This study examines whether associations between observations of mothers’ positive and negative parenting and children’s externalizing and internalizing behaviors vary as a function of child sex. The sample consists of 137 African American, low-income families with one sibling approximately two-years-old and the closest aged older sibling who is approximately four-years-old. Results from fixed-effects within-family models indicate clear sex differences regardless of child age. Mothers were observed to use less positive parenting with sons than with daughters. Higher levels of observed negative parenting were linked to more externalizing behaviors for boys, while lower levels of positive parenting were linked to more externalizing behaviors for girls. No child sex differences emerged regarding associations between observed positive and negative parenting and internalizing behaviors. PMID:23937420

  1. Partner violence and psychosocial distress among female sex workers in China.

    Directory of Open Access Journals (Sweden)

    Yan Hong

    Full Text Available Despite recognized vulnerability of female sex workers (FSW, most data on this population are focused on their HIV and STI prevalence; studies on their experience of partner violence and psychosocial distress are limited, especially FSW in China.A cross-sectional survey was administered among 1,022 FSW recruited from 9 different types of commercial sex venues in Southwest China. Partner violence scales were adapted from WHO's Women's Health and Domestic Violence scale and psychosocial distress was measured by five indicators, including alcohol intoxication, drug use, suicidal behavior, depression, and loneliness. Random effects modeling was used to control for cluster effects.About 58% of FSW ever experienced violence from their stable partners, and 45% suffered it from their clients. Partner violence was strongly associated with each of the five measures of psychosocial distress, even after controlling for potential confounders.This study is one of the first to examine the association between partner violence and psychosocial distress among FSW in China. The high prevalence of violence experience and distress in this population suggests urgency for intervention. The public health programs targeting FSW should go beyond the focus on HIV/STI prevention and care for the fundamental health and human rights of millions of FSW in China.

  2. HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers.

    Science.gov (United States)

    Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin

    2016-11-01

    Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs

  3. Context matters: the moderating role of bar context in the association between substance use during sex and condom use among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Pitpitan, Eileen V; Wagner, Karla D; Goodman-Meza, David; Semple, Shirley J; Chavarin, Claudia; Strathdee, Steffanie A; Patterson, Thomas L

    2013-10-01

    Tijuana is situated on Mexico's northern border with the U.S., where sex work is quasi-legal. Whereas previous work has focused on the risk behaviors of female sex workers (FSWs), less is known about the risk behaviors of their male clients. Further, research has not examined structural factors as moderators of the association between substance use and condom use, including the contexts in which sex takes place. The purpose of the current study is to examine whether having sex with FSWs in a bar moderates the link between alcohol intoxication during sex and condom use. We recruited 375 male clients of FSWs in Tijuana, Mexico from San Diego, California and Tijuana. Using computer assisted interviewing, we surveyed participants on their alcohol use, condom use, and physical contexts of sex with FSWs in the past 4 months. Results showed that more frequent intoxication during sex with FSWs is associated with more unprotected sex, but only among clients having sex with FSWs in a bar context. Results point to potential reasons for inconsistent condom use with FSWs in this context, including lower risk perceptions of sex with FSWs in bars. Future research should examine structural factors that underlie clients' risk behavior in bars in order to inform structural-level HIV prevention interventions.

  4. The Female Sex Work Industry in a District of India in the Context of HIV Prevention.

    Science.gov (United States)

    Buzdugan, Raluca; Halli, Shiva S; Hiremath, Jyoti M; Jayanna, Krishnamurthy; Raghavendra, T; Moses, Stephen; Blanchard, James; Scambler, Graham; Cowan, Frances

    2012-01-01

    HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified. In addition to previously documented brothel, lodge, street, dhaba (highway restaurant), and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges, dhabas, and on highways describe factors that put them at high HIV risk. Of these, dhaba and highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme.

  5. The Female Sex Work Industry in a District of India in the Context of HIV Prevention

    Directory of Open Access Journals (Sweden)

    Raluca Buzdugan

    2012-01-01

    Full Text Available HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex are identified. In addition to previously documented brothel, lodge, street, dhaba (highway restaurant, and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges, dhabas, and on highways describe factors that put them at high HIV risk. Of these, dhaba and highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme.

  6. HIV risks and HIV prevention among female sex workers in two largest urban settings in Croatia, 2008-2014.

    Science.gov (United States)

    Štulhofer, Aleksandar; Landripet, Ivan; Božić, Jasmina; Božičević, Ivana

    2015-01-01

    Harm reduction-based HIV prevention has been in place among female sex workers (FSWs) in Croatia for more than a decade. However, little is known about how well the existing programs meet the needs of FSWs in an environment where sex work remains criminalized and highly stigmatized. This study aims to assess changes in FSWs' vulnerability to HIV infection in the 2008-2014 period. Using convenience samples of FSWs in Croatia's two largest urban settings, behavioral data were collected in 2007-2008 and 2014. Outreach workers interviewed 154 FSWs in the first wave of the survey and 158 in the second. The period under observation was characterized by a stable prevalence of most HIV-relevant risk behaviors and experiences. Significant changes in client-based victimization and HIV knowledge were observed only among FSWs in the capital city. Substantial and mostly sustained levels of sexual and nonsexual victimization call for more research into the limits of the current behavior-based harm reduction approach to HIV prevention in the country.

  7. Access to and utilisation of healthcare services by sex workers at truck-stop clinics in South Africa: A case study

    NARCIS (Netherlands)

    Fobosi, S. C.; Lalla-Edward, S. T.; Ncube, S.; Buthelezi, F.; Matthew, P.; Kadyakapita, A.; Slabbert, M.; Hankins, C. A.; Venter, W. D. F.; Gomez, G. B.

    2017-01-01

    Background. Sex worker-specific health services aim to respond to the challenges that this key population faces in accessing healthcare. These services aim to integrate primary healthcare (PHC) interventions, yet most services tend to focus on prevention of HIV and sexually transmitted infections

  8. A comparison of registered and unregistered female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Sirotin, Nicole; Strathdee, Steffanie A; Lozada, Remedios; Nguyen, Lucie; Gallardo, Manuel; Vera, Alicia; Patterson, Thomas L

    2010-01-01

    Sex work is regulated in Tijuana, Mexico, but only half of the city's female sex workers (FSWs) are registered with the municipal health department, which requires regular screening for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). We examined correlates of registration to determine if it confers measurable health benefits. From 2004 to 2006, we interviewed FSWs in Tijuana > or = 18 years of age who reported recent unprotected sex with at least one client and were not knowingly HIV-positive, and tested them for HIV, syphilis, gonorrhea, and chlamydia. Logistic regression identified factors associated with registration. Of 410 FSWs, 44% were registered, 69% had been tested for HIV, 6% were HIV-positive, and 44% tested positive for any STI. Compared with unregistered FSWs, registered FSWs were more likely to have had HIV testing (86% vs. 56%, p $30 per transaction without a condom (AOR = 2.41), whereas working on the street (AOR = 0.34), injecting cocaine (AOR = 0.06), snorting or smoking methamphetamine (AOR = 0.27), and being born in the Mexican state of Baja California (AOR = 0.35) were inversely associated with registration. Registered FSWs were more likely than unregistered FSWs to have had HIV testing and to engage in less drug use, but did not have significantly lower HIV or STI prevalence after adjusting for confounders. Current regulation of FSWs in Tijuana should be further examined to enhance the potential public health benefits of registration.

  9. Sex-Role Egalitarian Attitudes and Gender Role Socialization Experiences of African American Men and Women: A Mixed Methods Paradigm

    Science.gov (United States)

    Heard, Courtney Christian Charisse

    2013-01-01

    The purpose of this study was to assess the sex-role egalitarian attitudes and gender role socialization experiences of African American men and women. A sequential mixed-methods design was employed to research this phenomenon. The Sex-Role Egalitarianism Scale-Short Form BB (SRES-BB) was utilized to assess sex-role egalitarian attitudes (King…

  10. Associations between social support and condom use among commercial sex workers in China: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Ren Chen

    Full Text Available OBJECTIVE: The aim of this study was to investigate the association between social support and AIDS high-risk behaviors in commercial sex workers (CSWs in China. METHODS: A cross-sectional study was performed based on a convenience sample. Data were collected through questionnaire interviews including information about social demographic characteristics, the Social Support Rating Scale (SSRS and AIDS knowledge. Multiple logistic regression was performed to evaluate the association between social support and AIDS high-risk behaviors, specifically condom use during commercial sex. RESULTS: A total of 581 commercial sex workers from 4 counties in East China participated in the study. The majority of the participants were 15 to 30 years old (79.7%. Sources of individual and family support were mainly provided by their parents (50.3%, relatives and friends (46.3%, spouses (18.4%, respectively. Univariate analysis revealed that marital status, hobbies, smoking habit, individual monthly income and family monthly income were all significantly correlated with current levels of social support being received (P = 0.04, P = 0.00, P = 0.01, P = 0.01, P = 0.01, respectively. Furthermore, Multiple logistic regression analysis indicated that after adjusting for confounding factors, high levels of social support were significantly correlated with increased condom use at the last sexual encounter (P = 0.02, OR = 1.86, 95%CI: 1.10-3.16; and consistently in the past month with clients (P = 0.03, OR = 2.10, 95%CI: 1.09-4.04. CONCLUSION: CSWs with high levels of social support are more likely to use condoms during commercial sex. This suggests that increasing social support can potentially reduce AIDS-related high-risk behaviors and accordingly play an important role in AIDS prevention.

  11. Predictors of unprotected sex among young sexually active African American, Hispanic, and White MSM: the importance of ethnicity and culture.

    Science.gov (United States)

    Warren, Jacob C; Fernández, M Isabel; Harper, Gary W; Hidalgo, Marco A; Jamil, Omar B; Torres, Rodrigo Sebastián

    2008-05-01

    Despite the recognized need for culturally tailored HIV prevention interventions for gay, bisexual, and questioning youth, few studies have examined if predictors of unprotected sex vary for youth from different ethnic groups. This study reports on a sample of 189 gay, bisexual, and questioning youth (age 15-22) from three racial/ethnic backgrounds (African American, Hispanic, and White) recruited in Chicago, IL and Miami-Dade and Broward Counties, Florida. For African American youth, being in a long-term relationship, having been kicked out of the home for having sex with men, and younger age at initiation of sexual behavior were associated with unprotected sex. For Hispanic youth, higher ethnic identification and older age at initiation of sexual behavior were associated with unprotected sex. For White youth, no predictors were associated with unprotected sex. Our findings point to the importance of understanding the varying predictors of unprotected sex and integrating them into tailored prevention interventions.

  12. Commercial sex work or ukuphanda? Sex-for-money exchange in Soweto and Hammanskraal area, South Africa.

    Science.gov (United States)

    Wojcicki, Janet Maia

    2002-09-01

    This article introduces the concept of ukuphanda, a Zulu verb that is used to describe the sex-for-money exchanges that take place outside of commercial sex work in Soweto and Hammanskraal area, South Africa. In line with the ethnographic literature from others areas of sub-Saharan Africa, it is argued that women who exchange sex for money in taverns do not self-identify as commercial sex workers and experience less stigma from the community. Unlike commercial sex work (as characterized by the commercial sex work in Hillbrow, Johannesburg), which is understood to be associated with short skirts and other revealing attire, sex-for-money exchange in the taverns is viewed as more private, ambiguous and informal. Women who work as informal sex workers, or "-phandela imali" ('try to get money'), are understood to be using sex-for-money exchange to survive financially.

  13. Technology, normalisation and male sex work.

    Science.gov (United States)

    MacPhail, Catherine; Scott, John; Minichiello, Victor

    2015-01-01

    Technological change, particularly the growth of the Internet and smart phones, has increased the visibility of male escorts, expanded their client base and diversified the range of venues in which male sex work can take place. Specifically, the Internet has relocated some forms of male sex work away from the street and thereby increased market reach, visibility and access and the scope of sex work advertising. Using the online profiles of 257 male sex workers drawn from six of the largest websites advertising male sexual services in Australia, the role of the Internet in facilitating the normalisation of male sex work is discussed. Specifically we examine how engagement with the sex industry has been reconstituted in term of better informed consumer-seller decisions for both clients and sex workers. Rather than being seen as a 'deviant' activity, understood in terms of pathology or criminal activity, male sex work is increasingly presented as an everyday commodity in the market place. In this context, the management of risks associated with sex work has shifted from formalised social control to more informal practices conducted among online communities of clients and sex workers. We discuss the implications for health, legal and welfare responses within an empowerment paradigm.

  14. Utilisation of sexual health services by female sex workers in Nepal

    Directory of Open Access Journals (Sweden)

    van Teijlingen Edwin R

    2011-04-01

    Full Text Available Abstract Background The Nepal Demographic Health Survey (NDHS in 2006 showed that more than half (56% of the women with sexually transmitted infections (STIs, including HIV, in Nepal sought sexual health services. There is no such data for female sex workers (FSWs and the limited studies on this group suggest they do not even use routine health services. This study explores FSWs use of sexual health services and the factors associated with their use and non-use of services. Methods This study aimed to explore the factors associated with utilisation of sexual health services by FSWs in the Kathmandu Valley of Nepal, and it used a mixed-method approach consisting of an interviewer administered questionnaire-based survey and in-depth interviews. Results The questionnaire survey, completed with 425 FSWs, showed that 90% FSWs self-reported sickness, and (30.8% reported symptoms of STIs. A quarter (25% of those reporting STIs had never visited any health facilities especially for sexual health services preferring to use non-governmental clinics (72%, private clinics (50%, hospital (27% and health centres (13%. Multiple regression analysis showed that separated, married and street- based FSWs were more likely to seek health services from the clinics or hospitals. In- depth interviews with 15 FSWs revealed that FSWs perceived that personal, structural and socio-cultural barriers, such as inappropriate clinic opening hours, discrimination, the judgemental attitude of the service providers, lack of confidentiality, fear of public exposure, and higher fees for the services as barriers to their access and utilisation of sexual health services. Conclusion FSWs have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints. The 'education' to change individual behaviour, health worker and community perceptions, as well as the training of the health workers, is necessary.

  15. Sex work, reform initiatives and HIV/AIDS in inner-city Johannesburg.

    Science.gov (United States)

    Richter, Marlise

    2008-11-01

    The on-going criminalisation of sex work in South Africa, concurrent sexual partnerships, socio-economic vulnerability, migrant status and gender-based violence intensify sex workers' risk of contracting HIV. These factors combine to restrict the skills, ability and resources of sex workers to negotiate safer sex and to access HIV prevention, treatment and healthcare services. The paper situates the living and working conditions of sex workers in Hillbrow, an inner-city area of Johannesburg, within the South African legal context, especially in regard to current law reform initiatives regarding sex work, as well as the increasing anxiety about the influx of (sex) tourists during the 2010 FIFA World Cup. In addition, the paper describes an intervention by the Reproductive Health & HIV Research Unit at the University of the Witwatersrand, Johannesburg, an innovator in providing mobile healthcare services and education to hotel-based sex workers in Hillbrow. The paper contends that a legal-rights-approach to HIV risk and vulnerability, together with powerful public health considerations, render decriminalisation an imperative response to sex workers' material conditions.

  16. Depression, anxiety symptoms and substance use amongst sex ...

    African Journals Online (AJOL)

    Background: Sex work is a high-risk occupation for mental health problems as sex workers are vulnerable to high rates of violence, sexual coercion, stigma and HIV. Aim: To determine the prevalence of depressive and anxiety symptoms and substance use in sex workers.Method: A crosssectional questionnaire survey of all ...

  17. Anxiety Symptoms in African American Youth: The Role of Puberty and Biological Sex

    Science.gov (United Stat