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1

HIV risk and preventive interventions in transgender women sex workers.  

PubMed

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

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

2014-07-21

2

Living the reality of forced sex work: perspectives from young migrant women sex workers in northern Vietnam.  

PubMed

Young women are often lured or forced into selling sex as a result of migrating from rural to urban areas to find work. In this setting, they are exposed to high-risk situations, which may leave them vulnerable to exploitation. Using interviews with young migrant women currently working as sex workers in northern Vietnam, we recorded the perspectives of their initiation into sex work and life as a sex worker. The study found that high levels of forced sex and sexual exploitation were experienced by the majority of the young women interviewed. The young women describe their entry into sex work, first sexual experience (intercourse), violence, and condom negotiation and use. Although access to health care was available, the young women perceived the stigma attached to sex work as a barrier to receiving health care, and thus, preferred health education and care from peers. Health education programs focusing on peer education and support are essential for protecting and empowering these young women. In addition, policies and programs must work toward effective strategies to protect young migrant women. PMID:15973256

Rushing, Rosanne; Watts, Charlotte; Rushing, Sharon

2005-01-01

3

When Street Sex Workers Are Mothers  

Microsoft Academic Search

Many women who engage in street sex work experience pregnancies and become mothers. Unfortunately, little research has examined how their pregnancies and parenting impact themselves as street sex workers and their street sex work. In this qualitative research study, 16 mothers who were currently involved in street sex work in a Midwestern city of the United States participated in semistructured

Christine M. Sloss; Gary W. Harper

2004-01-01

4

“… But Then He Became My Sipa”: The Implications of Relationship Fluidity for Condom Use Among Women Sex Workers in Antananarivo, Madagascar  

PubMed Central

Increasing evidence indicates that sex workers use condoms less consistently with regular (i.e., nonpaying) partners than with clients. Few studies have examined the extent to which these 2 categories are mutually exclusive. In an ethnographic study of women's sex work in Antananarivo, Madagascar, we examined how the meaning of women sex workers’ sexual relationships could shift among 3 different forms of sex work. Condom use was less likely in forms in which the distinction between client and lover (sipa in Malagasy) was fluid. For many sex workers, therefore, relationships they understood to be intimate imparted the greatest health vulnerability. It is important to examine the influence of the meaning of sexual relationships on condom use for HIV prevention. Policy implications for HIV prevention work with sex workers are considered. PMID:19299685

Hindin, Michelle J.; Nathanson, Constance A.; Rakotoarison, Paul Ghislain; Razafintsalama, Violette

2009-01-01

5

Perceived discrimination and smoking among rural-to-urban migrant women working as restaurant/hotel workers and sex workers in China  

PubMed Central

Background Smoking may be a coping mechanism for psychosocial stress caused by discrimination. Methods We conducted a cross-sectional survey of rural-to-urban migrant women working as restaurant/hotel workers (RHWs) and those working as sex workers (FSWs) in 10 Chinese cities to investigate whether perceived discrimination is associated with smoking. We interviewed RHWs at medical examination clinics and FSWs at entertainment venues. Modified Poisson regression was used to estimate prevalence ratios. Results Of the 1696 RHWs and 532 FSWs enrolled, 155 (9.1%) and 63 (11.8%) reported perceived discrimination, respectively. Perceived discrimination was independently associated with ever tried smoking (prevalence ratio [PR], 1.71; 95% confidence interval [CI], 1.31–2.23) and current smoking (PR, 2.52; 95% CI, 1.32–4.79) among RHWs and ever tried smoking (PR, 1.36; 95% CI, 1.16–1.61) and current smoking (PR, 1.63; 95% CI, 1.28–2.06) among FSWs. Discussion Perceived discrimination is associated with higher prevalence of smoking among rural-to-urban migrant women in China. PMID:22389186

Shin, Sanghyuk S.; Wan, Xia; Wang, Qian; Raymond, H. Fisher; Liu, Huilin; Ding, Ding; Yang, Gonghuan; Novotny, Thomas E.

2013-01-01

6

RISKY HEALTH ENVIRONMENTS:WOMEN SEX WORKERS’ STRUGGLES TO FIND SAFE, SECURE AND NON-EXPLOITATIVE HOUSING IN CANADA’S POOREST POSTAL CODE  

PubMed Central

This study explored low-income and transitional housing environments of women sex workers and their role in shaping agency and power in negotiating safety and sexual risk reduction in Vancouver, Canada. A series of 12 focus group discussions were conducted with 73 women currently involved in street-based sex work. These women were purposively sampled for a range of experiences living in low-income housing environments, including homeless shelters, transitional housing, and co-ed and women-only single room occupancy (SRO) hotels. Drawing on the risk environment framework and theoretical constructs of gender, agency and power, analyses demonstrate that women continue to be vulnerable to violence and sexual and economic exploitation and have reduced ability to negotiate risk reduction resulting from the physical, structural and social environments of current dominant male-centred housing models. Within the physical environment, women described inhabitable housing conditions in SROs with infestations of bedbugs and rats, leading women to even more transitional housing options such as shelters and couch-surfing. In many cases, this resulted in their economic exploitation and increased sexual risk. Within the structural environment, enforcement of curfews and guest policies forced women to accept risky clients to meet curfew, or work outdoors where their ability to negotiate safety and condom use were limited. Certain policies promoted women’s agency and mitigated their ability to reduce risks when selling sex. These included flexible curfews and being able to bring clients home. The social environments of co-ed single-room occupancy hotels resulted in repeated violence by male residents and discrimination by male building staff. Women-only shelters and SROs facilitated ‘enabling environments’ where women developed support systems with other working women that resulted in safer work practices. The narratives expressed in this study reveal the critical need for public health interventions and safer supportive housing to account for the daily lived experiences of women sex workers. PMID:22018526

Lazarus, L; Chettiar, J; Deering, K; Nabess, R; Shannon, K

2011-01-01

7

Risky health environments: women sex workers' struggles to find safe, secure and non-exploitative housing in Canada's poorest postal code.  

PubMed

This study explored low-income and transitional housing environments of women sex workers and their role in shaping agency and power in negotiating safety and sexual risk reduction in Vancouver, Canada. A series of 12 focus group discussions were conducted with 73 women currently involved in street-based sex work. These women were purposively sampled for a range of experiences living in low-income housing environments, including homeless shelters, transitional housing, and co-ed and women-only single-room occupancy (SRO) hotels. Drawing on the risk environment framework and theoretical constructs of gender, agency and power, analyses demonstrate that women continue to be vulnerable to violence and sexual and economic exploitation and have reduced ability to negotiate risk reduction resulting from the physical, structural and social environments of current dominant male-centred housing models. Within the physical environment, women described inhabitable housing conditions in SROs with infestations of bedbugs and rats, leading women to even more transitional housing options such as shelters and couch-surfing. In many cases, this resulted in their economic exploitation and increased sexual risk. Within the structural environment, enforcement of curfews and guest policies forced women to accept risky clients to meet curfew, or work outdoors where their ability to negotiate safety and condom use were limited. Certain policies promoted women's agency and mitigated their ability to reduce risks when selling sex. These included flexible curfews and being able to bring clients home. The social environments of co-ed single-room occupancy hotels resulted in repeated violence by male residents and discrimination by male building staff. Women-only shelters and SROs facilitated 'enabling environments' where women developed support systems with other working women that resulted in safer work practices. The narratives expressed in this study reveal the critical need for public health interventions and safer supportive housing to account for the daily lived experiences of women sex workers. PMID:22018526

Lazarus, L; Chettiar, J; Deering, K; Nabess, R; Shannon, K

2011-12-01

8

Protecting the rights of sex workers: the Indian experience.  

PubMed

Although India is a signatory to numerous international agreements on the rights of women and has a constitution that prohibits discrimination and exploitation by gender, as well as a plethora of related legislation, it has failed to satisfactorily protect the human rights of women, particularly those of sex workers. This is manifested in high levels of violence in the sex industry, child sex workers, lack of access to health care, and high levels of HIV infection. Policies that revolve around rescue and rehabilitation, or are based on the premise that sex work is immoral, are unlikely to effectively promote the well-being of sex workers. An alternative paradigm, which revolves around an explicit recognition of the human rights of sex workers together with an activist approach to achieve them, involving a collaboration between NGOs and collectives of sex workers, has worked well to protect the human rights and health of sex workers in India. PMID:11154525

Misra, G; Mahal, A; Shah, R

2000-01-01

9

Enhancing benefits or increasing harms: community responses for HIV among men who have sex with men, transgender women, female sex workers, and people who inject drugs.  

PubMed

Studies completed over the past 15 years have consistently demonstrated the importance of community-level determinants in potentiating or mitigating risks for the acquisition and transmission of HIV. Structural determinants are especially important in mediating HIV risk among key populations, including men who have sex with men, people who inject drugs, sex workers of all genders, and transgender women. The objective of this systematic review was to synthesize the evidence characterizing the community-level determinants that potentiate or mitigate HIV-related outcomes for key populations. The results of the review suggest that although health communication programs represent community-level strategies that have demonstrated the effectiveness in increasing the uptake of HIV testing and decreasing the experienced stigma among people living with HIV, there are limited studies focused on key populations in low- and middle-income settings. Moreover, interpretation from the 22 studies that met inclusion and exclusion criteria reinforce the importance of the continued measurement of community-level determinants of HIV risks and of the innovation in tools to effectively address these risks as components of the next generation of the HIV response. Consequently, the next generation of effective HIV prevention science research must improve our understanding of the multiple levels of HIV risk factors, while programming for key populations must address each of these risk levels. Failure to do so will cost lives, harm communities, and undermine the gains of the HIV response. PMID:25007203

Baral, Stefan; Holland, Claire E; Shannon, Kate; Logie, Carmen; Semugoma, Paul; Sithole, Bhekie; Papworth, Erin; Drame, Fatou; Beyrer, Chris

2014-08-15

10

HIV and female sex workers.  

PubMed Central

In this review of published findings on human immunodeficiency virus (HIV) infection and risk factors among female sex workers, we summarize the results of seroprevalence studies in different countries and discuss the different patterns of transmission among such workers in various geographical regions. The highest rates of HIV infection occur in sub-Saharan Africa, where the widespread existence of sexually transmitted diseases may play an important role in sustaining transmission. In Europe and North America injecting drug use continues to be the major factor associated with HIV infection among female sex workers, while in Latin America and parts of Asia there is a more mixed pattern of heterosexual and parenteral transmission from injecting drug use. Reviewed also are studies of the risk factors associated with HIV infection among female sex workers, such as drug use, sexual behaviour, the presence of sexually transmitted diseases, and condom use; in addition, we comment on some studies of the clients of sex workers. Finally, we propose directions that future research in this area might take and discuss various interventions that need to be undertaken to reduce HIV transmission among female sex workers. PMID:8324860

Estébanez, P.; Fitch, K.; Nájera, R.

1993-01-01

11

Women Workers' History.  

ERIC Educational Resources Information Center

This document consists of one page chapters each documenting women's roles in changing the conditions for U.S. workers during and after the industrial revolution. Each chapter is a series of period style drawings with captions detailing the story of that particular incident and cartoon balloons offering humorous comments from the participants. The…

Huck, Gary; Gilmore, Peter

12

Women Youth Workers and Outdoor Education.  

ERIC Educational Resources Information Center

A study examined personal and professional development experienced by women youth workers participating in five 5-day, residential, single-sex, outdoor education courses in England. Analysis of diaries and poetry at the end of the courses and questionnaires completed 1 year later by participants and their managers yielded findings in the areas of…

Collins, Di

13

Mujer Mas Segura (Safer Women): a combination prevention intervention to reduce sexual and injection risks among female sex workers who inject drugs  

PubMed Central

Background Female sex workers who inject drugs (FSW-IDUs) are at risk of acquiring HIV, sexually transmitted infections (STI) and blood-borne infections through unprotected sex and sharing injection equipment. We conducted a 2×2 factorial randomized controlled trial to evaluate combination interventions to simultaneously reduce sexual and injection risks among FSW-IDUs in Tijuana and Ciudad Juarez, Mexico. Methods/design FSW-IDUs ?18 years reporting sharing injection equipment and unprotected sex with clients within the last month were randomized to one of four conditions based on an a priori randomization schedule, blinding interviewer/counselors to assignment. Due to the extreme vulnerability of this population, we did not include a control group that would deny some women access to preventive information. All women received similar information regardless of group allocation; the difference was in the way the information was delivered and the extent to which women had an interactive role. Each condition was a single 60-minute session, including either an interactive or didactic version of an injection risk intervention and sexual risk intervention. Women underwent interviewer-administered surveys and testing for HIV, syphilis, gonorrhea, Chlamydia, and Trichomonas at baseline and quarterly for 12 months. Combined HIV/STI incidence will be the primary outcome. Secondary outcomes are proportionate reductions in sharing of injection equipment and unprotected sex with clients. Discussion Of 1,132 women, 548 (48.4%) were excluded (88.9% were ineligible; 11.1% refused to participate or did not return); 584 eligible women enrolled (284 in Tijuana; 300 in Ciudad Juarez). All 584 participants completed the baseline interview, provided biological samples and were randomized to one of the four groups. During follow-up, 17 participants (2.9%) were lost to follow-up, of whom 10 (58.8%) had died, leaving 567 participants for analysis. This study appears to be the first intervention to attempt to simultaneously reduce injection and sexual risk behaviors among FSW-IDUs. The factorial design will permit analysis to determine whether the combination of the two interactive interventions and/or its respective components are effective in reducing injection and/or sexual risks, which will have direct, tangible policy implications for Mexico and potentially other resource-poor countries. Trial registration NCT00840658 PMID:22891807

2012-01-01

14

Sex worker incarceration in the People's Republic of China.  

PubMed

Tens of thousands of commercial sex workers in China are administratively detained each year in female re-education through labor (RTL) centres for moral education and vocational training. Recent increases in syphilis and heterosexual HIV make tailored HIV prevention efforts for sex workers increasingly important in many regions of China. However, RTL centres focused on detaining commercial sex workers have not traditionally been linked to sexually transmitted infections (STI)/HIV programmes. The stigma of being incarcerated and selling sex complicates STI/HIV prevention for these women. Incarcerated sex workers represent a particularly marginalized HIV risk group that has been excluded from domestic and international HIV programmes to date. Although several laws and administrative decrees provide a legal mandate for sex worker STI/HIV testing, treatment and rights, there is still substantial variation in how laws are implemented. Creating devoted medical services and legal aid for incarcerated sex workers is important in curbing the spread of heterosexual HIV and other STIs in China. Recent legal and social developments suggest that China's RTL system will be transformed in the near future, gaining momentum for reform that could improve the sexual and human rights of incarcerated sex workers. PMID:18212187

Tucker, J D; Ren, X

2008-02-01

15

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

PubMed

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. PMID:23173716

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

2013-01-01

16

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

PubMed

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. PMID:19962636

Lutnick, Alexandra; Cohan, Deborah

2009-11-01

17

An action agenda for HIV and sex workers.  

PubMed

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. PMID:25059950

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

2014-07-21

18

Women as Workers.  

ERIC Educational Resources Information Center

As increasing numbers of women make the transition from the household sector into the labor market, dramatic changes in household composition have occurred that have thrust many women into the role of provider. This new role for women has led to dramatic and rapid changes in attitudes, as well as in the institutions and laws relating to women's…

Barrett, Nancy S.

19

Asian women workers in Kuwait.  

PubMed

The author examines trends in the roles of immigrant Asian women workers in Kuwait, using data from published censuses and reports and from three national-level surveys conducted in 1977-1979, 1983, and 1986-1987. "The study deals separately with the two major types of migrants: the domestic servants and the clerical and professional (or semiprofessional) workers.... The policies of sending countries and of Kuwait are discussed to reach some conclusions about the likely future patterns of migration of Asian women workers to Kuwait." PMID:12284362

Shah, N M; Al-qudsi, S S; Shah, M A

1991-01-01

20

Sex Work Venue and Condom Use among Female Sex Workers in Senggigi, Indonesia  

PubMed Central

This paper examines the structural influence of sex work venues on condom use among female sex workers in the Senggigi area of Lombok, Indonesia. A cross-sectional design employing ethnographic observation, structured interviews and hierarchical linear modeling was used to examine condom use among female sex workers who solicited clients at three types of sex work venues: freelance, brothels, and entertainment places (karaoke bars and massage parlours). The sample consisted of 115 women “nested” within 16 sex work venues drawn from the three venue types. Rate (39%) of condom use varied across sex work venues. Perceived management style, HIV/AIDS-related policies, and risk-reduction services differed by venue, but this variation did not explain differences in condom use. At the individual level, higher condom use was associated with female sex workers having ever been married. At the client level, condoms were more likely to be used with foreign rather than domestic/local Indonesian clients. Low rates of condom use among Indonesian female sex workers during commercial sex suggests the need for increased HIV prevention efforts that acknowledge sex worker characteristics and relationships with clients that place them at risk. Future research into the effects of social context on HIV risk should also be considered. PMID:23472595

Safika, Iko; Levy, Judith A.; Johnson, Timothy P.

2013-01-01

21

Alcoholic Women Workers.  

ERIC Educational Resources Information Center

The National Institute on Alcohol Abuse and Alcoholism awarded contracts to assemble information about practices which identify, refer, and treat employed women alcoholics. In Phase I data were collected on the frequency of use of employee assistance programs by women alcoholics. Findings indicated no great differences between men and women.…

Blai, Boris, Jr.

22

Kaposi`s sarcoma associated herpesvirus infection among female sex workers and general population women in Shanghai, China: a cross-sectional study  

PubMed Central

Background Limited information on epidemiologic patterns of KSHV, with none focusing on heterosexual transmission, is available in mainland China. To clarify this, a cross-sectional study was conducted among a group of female sex workers (FSW) and general population women (GW) in Shanghai, China. Methods An anonymous questionnaire interview was administrated among 600 FSW and 600 GW. Blood samples were collected and tested for antibodies to KSHV, HSV-2, HIV, syphilis and HBsAg. Correlates of KSHV and HSV-2 were examined using multiple logistic regression analysis. Results None of the study participants were tested positive for HIV. The seroprevalence of KSHV, HSV-2 , HBV and syphilis was 10.0%, 52.2%, 12.3% and 10.5%, respectively for FSW, and was 11.0%, 15.3%, 9.8% and 2.8%, respectively for GW. KSHV seropositivity was not associated with syphilis and HSV-2 infection as well as sexual practices among either FSW or GW. Nevertheless, HSV-2 infection among FSW was independently associated with being ever married (OR?=?1.59; 95%CI: 1.04-2.45), >5 years of prostitution (OR?=?2.06; 95%CI: 1.16-3.68) and being syphilis positive (OR?=?2.65; 95%CI: 1.43-4.93). HSV-2 infection among GW was independently associated with an age of >35 years (OR?=?2.29; 95%CI: 1.07-4.93), having had more than 2 sex partners in the prior 12 months (OR?=?6.44; 95%CI: 1.67-24.93) and being syphilis positive (OR?=?3.94; 95%CI: 1.38-11.23). A gradual increase of prevalence with the prostitution time group was also detected for HSV-2 and syphilis, but not for KSHV. Conclusions KSHV is moderately and equivalently prevalent among FSW and GW. Heterosexual contact is not a predominant route for KSHV transmission among Chinese women. PMID:24498947

2014-01-01

23

Adolescent female sex workers: invisibility, violence and HIV.  

PubMed

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. PMID:21357241

Silverman, Jay G

2011-05-01

24

Preparing for Civil Disobedience: Indian Sex Workers and the Law  

Microsoft Academic Search

This article deals with the reform of prostitution laws in India. It begins with an outline of the current legislative framework available in this regard and then critically evaluates the various alternatives to the framework that have been proposed through the 1990s by the Indian government, universities and research institutions, the Indian women's movement and sex-worker organizations. After undertaking an

Prabha Kotiswaran

2001-01-01

25

[Sex workers: limited access to healthcare].  

PubMed

Sex workers constitute a heterogeneous group possessing a combination of vulnerability factors such as geographical instability, forced migration, substance addiction and lack of legal residence permit. Access to healthcare for sex workers depends on the laws governing the sex market and on migration policies in force in the host country. In this article, we review different European health strategies established for sex workers, and present preliminary results of a pilot study conducted among 50 sex workers working on the streets in Lausanne. The results are worrying: 56% have no health insurance, 96% are migrants and 66% hold no legal residence permit. These data should motivate public health departments towards improving access to healthcare for this vulnerable population. PMID:21815501

Gloor, E; Meystre-Agustoni, G; Ansermet-Pagot, A; Vaucher, P; Durieux-Paillard, S; Bodenmann, P; Cavassini, M

2011-06-29

26

Sex Work among Men Who Have Sex with Men and Transgender Women in Bogotá  

PubMed Central

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 a 26 displaced individuals who had done sex work: 14 were men who have sex with men (MSM) 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. PMID:24464550

Bianchi, Fernanda T.; Reisen, Carol A.; Zea, Maria Cecilia; Vidal-Ortiz, Salvador; Gonzales, Felisa A.; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J.

2014-01-01

27

Sex work among men who have sex with men and transgender women in Bogotá.  

PubMed

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. PMID:24464550

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

28

Sexual safety practices of massage parlor-based sex workers and their clients.  

PubMed

The Outreach and Research in Community Health Initiatives and Development (ORCHID) project examines social and structural factors that contribute to HIV/AIDS risk among women working in Vancouver's indoor sex industry and their clients. From 2006 to 2009, two mixed method studies were undertaken in ORCHID: one exploring experiences of women working in the indoor sex industry, mainly in massage parlors, and the other exploring experiences of men as sex "buyers." Both studies emphasize sexual health and safety, risk and protective behaviors, and related contextual factors. No analyses examining the sexual health and safety practices of massage parlor-based sex workers and clients exist in the Canadian context. To address this gap, we analyze two survey datasets - with 118 sex workers and 116 clients. Upon comparing demographics of sex workers and clients, we discuss their condom use and sexually transmitted infections (STI) and HIV testing practices. Sex workers and clients reported high rates of condom use for vaginal/anal intercourse. While both groups reported lower rates of condom use for oral sex during sex transactions, clients did so to a greater extent (p < 0.001). Condom use with noncommercial sex partners was reported to be less consistent by both groups. STI testing was higher among sex workers than clients (p < 0.001). Initiatives targeting clients of massage parlor-based sex workers for STI education and testing are needed. Future research should investigate how different types of relationships between sex workers and clients impact their sexual safety practices. PMID:24617632

Kolar, Kat; Atchison, Chris; Bungay, Vicky

2014-01-01

29

Drug use among sex workers in Hungary.  

PubMed

Drug use and sex work are both controversial issues with multiple interesting connections. This article presents findings from the first-ever survey on drug use and sex work in Hungary. The study aimed to chart the prevalence, function, and problems of drug use among various groups of sex workers. Survey forms were collected from 510 participants (average age 29.5 years, 91% female) in and near Budapest over a period of six months. The results show that sex workers have manifold higher lifetime prevalence, 84.3%, of illicit drug use compared with the prevalence of the Hungarian general young adult population, 20.9%. In our sample, it was very rare to perform sex work for alcohol or drugs (5%) or for money to purchase alcohol or drugs (20%). Findings also indicate notable relationships between location-based sex work types and the drugs used. One-third of the street sex workers reported regular amphetamine use, but none reported regular cocaine use. On the contrary, no escorts reported regular amphetamine use, but 38% admitted to regular cocaine use. The location of sex work may pose an additional occupational health risk factor for substance use. Regular use of alcohol was twice as typical (64%) for sex workers who were employed in bars, in salons/parlors, or alone in rented apartments than it was for those working in other indoor locations (33-34%). Furthermore, 74% of street sex workers smoked tobacco compared with 17% of escorts. Problem drug use was roughly estimated by asking the participants about the main problem domains (medical, legal, social, etc.) from the Addiction Severity Index instrument. The most problematic drug was amphetamine, and the most frequent problem was prolonged or excessive drug use. These main findings may contribute to more focused planning of health intervention services, harm reduction measures, outreach programs, and specific treatments. PMID:23906122

Móró, Levente; Simon, Katalin; Sárosi, Péter

2013-09-01

30

Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand  

Microsoft Academic Search

BackgroundThe trafficking of women and girls for sexual exploitation is an internationally recognised form of gender-based violence, and is thought to confer unique sexual and reproductive health vulnerabilities. To date, little research has compared sexual risk or health outcomes among female sex workers (FSWs) on the basis of experiences of sex trafficking.AimTo compare experiences of sexual risk and sexual and

Michele R Decker; Heather L McCauley; Dusita Phuengsamran; Surang Janyam; Jay G Silverman

2010-01-01

31

Intimate partner violence against female sex workers in Mombasa, Kenya.  

PubMed

Female sex workers are known to be at risk of intimate partner violence (IPV) from numerous sources including clients, pimps, boyfriends and husbands. Better understanding the factors associated with IPV in this population will enhance prevention efforts. This work examines baseline survey data collected as part of a randomised controlled trial for an alcohol-harm reduction intervention. The study sample included 619 sex workers. IPV was common in this sample, with 78.7% of women reporting any IPV in the last 30 days. Multivariate logistic regression results indicated that supporting one to two other people, experiencing child abuse, witnessing mother abuse, and greater alcohol consumption were risk factors for IPV in our sample. Women who frequented Population, Health and Integrated Assistance (APHIA) II drop-in centres located along transport corridors were also at greater risk of recent IPV, as compared with those who frequented other drop-in centres. Only one protective effect was identified in this study: condom use at last sex with a non-paying partner was associated with less recent IPV. Health programmes for women sex workers in Mombasa and elsewhere need to expand beyond HIV prevention - they need to incorporate information on violence prevention and treatment referrals, as well as information on alcohol harm reduction. PMID:24329103

Pack, Allison P; L'engle, Kelly; Mwarogo, Peter; Kingola, Nzioki

2013-12-11

32

Trafficked female sex workers awaiting deportation: comparison with brothel workers  

Microsoft Academic Search

Summary In 2002, we researched the psychosocial characteristics of 55 women working in the commercial brothel-based sex industry in three Israeli cities. This previous social epidemiological study focused exclusively on women working in brothels and the brothel owners consented to their interviews, suggesting that this might be a sample of the most organized brothels with the best social conditions. We

J. Cwikel; B. Chudakov; M. Paikin; K. Agmon; R. H. Belmaker

2004-01-01

33

Incarcerated sex workers and HIV prevention in China: social suffering and social justice countermeasures.  

PubMed

Sex workers in China are routinely coercively detained through administrative mechanisms outside of legal procedures, but very little is known about the anthropologic and public health context of these policies. This biosocial analysis of female Chinese sex worker detention uses ethnographic, legal, and public health data to describe social suffering and countervailing social justice responses among incarcerated sex workers (ISW) in China. Compared to sex workers not detained in China, ISW face substantive inequalities inscribed in physical and psychological suffering. Chinese sex worker detention camp practices may not only systematically increase HIV/syphilis risk among ISW, but also work to narrow women's social spheres of influence, a particularly cruel tragedy in a Chinese social system that highly values social and personal connections. A limited empiric analysis of Guangxi Province STI clinic data shows that cities detaining sex workers have higher mean HIV prevalence compared to cities that do not detain sex workers. While incipient medical and legal movements in China have generated momentum for expanding ISW services and resources, there is still substantial variation in the implementation of laws that ensure basic life-saving medical treatments. Post-incarceration social justice programs for sex workers linking women to essential STI/HIV resources, reconnecting broken social lives, and helping restore interpersonal relationships are urgently needed. PMID:19880233

Tucker, Joseph; Ren, Xin; Sapio, Flora

2010-01-01

34

A Descriptive Profile of Abused Female Sex Workers in India  

PubMed Central

This descriptive study presents the profiles of abused female sex workers (FSWs) in Chennai, India. Of 100 abused FSWs surveyed using a structured questionnaire, severe forms of violence by intimate partners were reported by most (98%) respondents. Of the total sample, 76% experienced violence by clients. Sexual coercion experiences of the FSWs included verbal threats (77%) and physical force (87%) by intimate partners and forced unwanted sexual acts (73%) by clients. While 39% of the women consumed alcohol before meeting a client, 26% reported that their drunkenness was a trigger for violence by clients. The findings suggest that there is an urgent need to integrate services, along with public-health interventions among FSWs to protect them from violence. Recognition of multiple identities of women in the contexts of intimate relationships versus sex work is vital in helping women to stay safe from adverse effects on health. PMID:20635631

Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Zelaya, Carla; Solomon, Suniti; Go, Vivian F.; Celentano, David

2010-01-01

35

The health of female sex workers from three industry sectors in Queensland, Australia.  

PubMed

Previous studies have reported poor mental health amongst sex workers without distinguishing the context in which commercial sex is provided. This study describes the self-reported mental and physical health of female sex workers in three industry sectors in Queensland, Australia. In 2003, cross-sectional convenience sampling was used to collect data from 247 female sex workers working in licensed brothels (n=102), as private sole operators (n=103) and illegally (n=42). The average age was 32 years (range 18-57), with most participants being born either in Australia or New Zealand. Overall, there were few differences in the physical health of women from different industry sectors. Illegal (and predominantly street-based) sex workers were four times more likely to report poor mental health with some of this difference attributable to the particular social background of this group. Much of the increased levels of poor mental health among illegal sex workers were associated with more negative experiences before, and subsequent to entering the sex industry. These patterns were not seen among women from the legal industry sectors. This research suggests that illegal, street-based sex workers, from whom many previous results have been derived, may show patterns of disadvantage, and health outcomes not seen in sex workers from other industry sectors. PMID:19026478

Seib, Charrlotte; Fischer, Jane; Najman, Jackob M

2009-02-01

36

Women Workers as Users of Computer Technology.  

ERIC Educational Resources Information Center

Discussion of expectations, trends, and implications of growth of computer technology and its effect on women workers argues that the experience of women is different from that of men in the nature of jobs in which women are found, their training and education, home-family conflict, and discrimination. The impact on women of increasing…

Larwood, Laurie

1992-01-01

37

Reframing the Interpretation of Sex Worker Health: A Behavioral–Structural Approach  

PubMed Central

Expanding sexually transmitted infection (STI) epidemics in many parts of Asia increase the importance of effective human immunodeficiency virus (HIV)/STI prevention programs for female sex workers. Designing sex worker health research and programs demands a well-stated conceptual approach, especially when one is interpreting the relationship between local policy environments and sex worker health. However, the core principles of the 2 most common conceptual approaches used in sex worker health programs—abolitionism and empowerment—have frequently divergent assumptions and implications. The abolitionist approach sees major aspects of the sex industry as fundamentally coercive and exploitative of women and supports dismantling all or parts of the sex sector. The empowerment approach strengthens sex workers’ agency and rights in order to build collective self-efficacy and have women invested in implementing their own HIV/STI prevention programs. This review compares these approaches using implication analysis and empirical cases from Asia. The misperception of an unresolvable gap between the 2 approaches ignores common ground that forms the basis of a new behavioral–structural conceptual framework. Explicitly accounting for the interaction between female sex worker behaviors and larger structures and policies, a behavioral–structural approach may provide a solid foundation for sex work research and programs. PMID:22043033

Tuminez, Astrid S.

2011-01-01

38

Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection  

Microsoft Academic Search

Sex workers have long been considered a high-risk group for HIV infection, but to date little quantitative research has explored the association between HIV risk and exchange of sex for material gain by women in the general population. The objective of this study was to estimate the prevalence of such transactional sex among women attending antenatal clinics in Soweto, South

Kristin L. Dunkle; Rachel K. Jewkes; Heather C. Brown; Glenda E. Gray; James A. McIntryre

2004-01-01

39

HIV risk practices by female sex workers according to workplace  

PubMed Central

OBJECTIVE To investigate differences in HIV infection- related risk practices by Female Sex Workers according to workplace and the effects of homophily on estimating HIV prevalence. METHODS Data from 2,523 women, recruited using Respondent-Driven Sampling, were used for the study carried out in 10 Brazilian cities in 2008-2009. The study included female sex workers aged 18 and over. The questionnaire was completed by the subjects and included questions on characteristics of professional activity, sexual practices, use of drugs, HIV testing, and access to health services. HIV quick tests were conducted. The participants were classified in two groups according to place of work: on the street or indoor venues, like nightclubs and saunas. To compare variable distributions by place of work, we used Chi-square homogeneity tests, taking into consideration unequal selection probabilities as well as the structure of dependence between observations. We tested the effect of homophily by workplace on estimated HIV prevalence. RESULTS The highest HIV risk practices were associated with: working on the streets, lower socioeconomic status, low regular smear test coverage, higher levels of crack use and higher levels of syphilis serological scars as well as higher prevalence of HIV infection. The effect of homophily was higher among sex workers in indoor venues. However, it did not affect the estimated prevalence of HIV, even after using a post-stratification by workplace procedure. CONCLUSIONS The findings suggest that strategies should focus on extending access to, and utilization of, health services. Prevention policies should be specifically aimed at street workers. Regarding the application of Respondent-Driven Sampling, the sample should be sufficient to estimate transition probabilities, as the network develops more quickly among sex workers in indoor venues. PMID:25119937

Damacena, Giseli Nogueira; Szwarcwald, Célia Landmann; de Souza, Paulo Roberto Borges

2014-01-01

40

History of sex trafficking, recent experiences of violence, and HIV vulnerability among female sex workers in coastal Andhra Pradesh, India  

PubMed Central

Synopsis Findings from female sex workers in southern India indicate that women who enter sex work via trafficking are exposed to unique HIV vulnerabilities. Objectives To estimate the prevalence of sex trafficking as a mode of entry into sex work, and to examine associations between sex trafficking and recent violence experiences and HIV vulnerability among female sex workers (FSWs). Methods In a cross-sectional study in 2006 in coastal Andhra Pradesh, India, 812 FSWs were recruited via respondent-driven sampling to take part in an oral survey of their experiences in sex work. Results One in 5 (19.3%) FSWs met the UN definition of sex trafficking. Women trafficked into sex work were more likely than other FSWs to report recent violence experiences (adjusted odds ratio [AOR], 1.93; 95% confidence interval [CI], 1.32–2.81), more clients per week (AOR, 1.63; 95% CI, 1.11–2.41), and more days of sex work per week (AOR, 1.76; 95% CI, 1.18–2.63), and were less likely to report use of FSW-focused services (AOR, 0.60; 95% CI, 0.42–0.86). No significant differences emerged regarding HIV knowledge or consistent condom use. Conclusion There was a high prevalence of sex trafficking. A history of sex trafficking was associated with a greater vulnerability to recent violence and HIV risk behaviors, underscoring the need for increased attention to the public health needs of trafficked populations. PMID:21620402

Gupta, Jhumka; Reed, Elizabeth; Kershaw, Trace; Blankenship, Kim M.

2011-01-01

41

Barriers to Health and Social Services for Street-Based Sex Workers  

Microsoft Academic Search

Homelessness, poverty, drug abuse and violent victimization faced by street-based women sex workers create needs for a variety of health and social services, yet simultaneously serve as barriers to accessing these very services. The present study utilized interview (n = 586) and focus group (n = 25) data to examine the service needs and associated barriers to access among women

Steven P. Kurtz; Hilary L. Surratt; Marion C. Kiley; James A. Inciardi

2005-01-01

42

Prevalence and determinants of hepatitis C virus infection among female drug injecting sex workers in Glasgow  

Microsoft Academic Search

BACKGROUND: Few studies of the prevalence of hepatitis C virus (HCV) infection have focussed on women who work as street sex workers to finance their drug use. METHODS: The investigators report the survey findings of such a population in Glasgow. All women attending the health and social care drop-in centre, situated in Glasgow's \\

Avril Taylor; Sharon J Hutchinson; Gail Gilchrist; Sheila Cameron; Susan Carr; David J Goldberg

2008-01-01

43

From Client to Pimp: Male Violence against Female Sex Workers  

ERIC Educational Resources Information Center

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…

Karandikar, Sharvari; Prospero, Moises

2010-01-01

44

“Over here, it’s just drugs, women and all the madness”: The HIV risk environment of clients of female sex workers in Tijuana, Mexico  

PubMed Central

HIV vulnerability depends upon social context. Based in broader debates in social epidemiology, political economy, and sociology of health, Rhodes’ (2002) “risk environment” framework provides one heuristic for understanding how contextual features influence HIV risk, through different types of environmental factors (social, economic, policy, and physical) which interact at different levels of influence (micro, macro). Few data are available on the “risk environment” of male clients of female sex workers (FSWs); such men represent a potential “bridge” for transmission of HIV and other sexually transmitted infections from high- to low-prevalence populations. Using in-depth interviews (n=30), we describe the HIV risk environment of male clients in Tijuana, Mexico, where disproportionately high HIV prevalence has been reported among FSWs and their clients. A number of environmental themes influence risky sex with FSWs and the interplay between individual agency and structural forces: social isolation and the search for intimacy; meanings and identities ascribed to Tijuana’s Zona Roja (red light district) as a risky place; social relationships in the Zona Roja; and economic roles. Our findings suggest that clients’ behaviors are deeply embedded in the local context. Using the HIV “risk environment” as our analytic lens, we illustrate how clients’ HIV risks are shaped by physical, social, economic, and political factors. The linkages between these and the interplay between structural- and individual-level experiences support theories that view structure as both enabling as well as constraining. We discuss how the “embeddedness” of clients’ experiences warrants the use of environmental interventions that address the circumstances contributing to HIV risk at multiple levels. PMID:21414702

Goldenberg, Shira; Strathdee, Steffanie A.; Gallardo, Manuel; Rhodes, Tim; Wagner, Karla D.; Patterson, Thomas L.

2011-01-01

45

Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work  

Microsoft Academic Search

High rates of violence among street-level sex workers have been described across the globe, while in cities across Canada the disappearance and victimization of drug-using women in survival sex work is ongoing. Given the pervasive levels of violence faced by sex workers over the last decades, and extensive harm reduction and HIV prevention efforts operating in Vancouver, Canada, this research

Kate Shannon; Thomas Kerr; Shari Allinott; Jill Chettiar; Jean Shoveller; Mark W. Tyndall

2008-01-01

46

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

ERIC Educational Resources Information Center

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…

Sircar, Oishik; Dutta, Debolina

2011-01-01

47

Condom use, power and HIV\\/AIDS risk: sex-workers bargain for survival in Hillbrow\\/Joubert Park\\/Berea, Johannesburg  

Microsoft Academic Search

Through interviews with 50 female sex-workers in the Hillbrow\\/Berea\\/Joubert Park area of Johannesburg, this paper explores sexual negotiations between men and women in the sex industry. This paper focuses on factors that affect sexual decision-making including safer sex practices. In moving beyond approaches that emphasize women's ‘powerlessness’ in sexual negotiation, this article focuses on ways in which sex-workers capitalize on

Janet Maia Wojcicki; Josephine Malala

2001-01-01

48

The sexual health of female sex workers compared with other women in England: analysis of cross-sectional data from genitourinary medicine clinics  

PubMed Central

Background While female sex workers (FSWs) are assumed to be at increased risk of sexually transmitted infections (STIs), there are limited comparative data with other population groups available. Using routine STI surveillance data, we investigated differences in sexual health between FSWs and other female attendees at genitourinary medicine (GUM) clinics in England. Methods Demographic characteristics, STI prevalence and service usage among FSWs and other attendees in 2011 were compared using logistic regression. Results In 2011, 2704 FSWs made 8411 recorded visits to 131/208 GUM clinics, (primarily large, FSW-specialist centres in London). FSWs used a variety of services, however, 10% did not have an STI/HIV test at presentation. By comparison with other female attendees, FSWs travelled further for their care and had increased risk of certain STIs (eg, gonorrhoea ORadj: 2.76, 95% CI 2.16 to 3.54, p<0.001). Migrant FSWs had better sexual health outcomes than UK-born FSWs (eg, period prevalence of chlamydia among those tested: 8.5% vs 13.5%, p<0.001) but were more likely to experience non-STI outcomes (eg, pelvic inflammatory disease ORadj: 2.92, 95% CI 1.57 to 5.41, p<0.001). Conclusions FSWs in England have access to high-quality care through the GUM clinic network, but there is evidence of geographical inequality in access to these services. A minority do not appear to access STI/HIV testing through clinics, and some STIs are more prevalent among FSWs than other female attendees. Targeted interventions aimed at improving uptake of testing in FSWs should be developed, and need to be culturally sensitive to the needs of this predominantly migrant population. PMID:24493858

Mc Grath-Lone, Louise; Marsh, Kimberly; Hughes, Gwenda; Ward, Helen

2014-01-01

49

Cervical HPV Infection in Female Sex Workers: A Global Perspective  

PubMed Central

Introduction: Approximately 291 million women worldwide are HPV DNA carriers. Studies have indicated that having multiple sexual partners may lead to higher HPV transmission. Thus female sex workers (FSWs) may be at greater risk of infection compared to the general population. Herein we review publications with data on FSW cervical HPV test results. We also examine variations of HPV prevalence and risk behaviors by region. Knowledge of prevalent HPV types in FSWs may lead to improved prevention measures and assist in understanding vaccination in high-risk groups. Methods: We conducted a review of the literature by searching PUBMED using the terms “prostitution” or “female sex workers”, “human papillomavirus” or “HPV”, and “prevalence” or “PCR” to find articles. We excluded studies without HPV testing or HPV type specific results, or unconventional HPV testing. Results: A total of 35 peer-reviewed publications were included in our review. High risk HPV types 16 and 18 ranged from 1.1-38.9‰ in prevalence. In addition to high-risk HPV types, newer studies reported non-carcinogenic HPV types also of high prevalence. The most prevalent HPV types reported among FSWs included HPV 6 (11.5%), 16 (38.9%), 18 (23.1%), 31 (28.4%), 52 (32.7%), and 58 (26.0%). Conclusions: Female sex workers have an overall high prevalence of HPV infection of high-risk types as evident through various testing methods. FSWs are thought to be at increased risk of cervical cancer because of high HPV exposure. This highlights the need for HPV and cervical prevention campaigns tailored to FSWs. PMID:24511334

Soohoo, Melissa; Blas, Magaly; Byraiah, Gita; Carcamo, Cesar; Brown, Brandon

2013-01-01

50

Lived experiences of street-based female sex workers in Kathmandu: implications for health intervention strategies.  

PubMed

The lived experiences of women sex workers illustrate that sex work is frequently a manifestation of limited access to education, resources and jobs due to violence, oppression and patriarchy. However, some Nepalese sex workers reconstitute sex work as a viable form of work that provides food and shelter for their families and allows fulfillment of their duties as mothers. Through a culture-centred approach to research, which emphasis the voices of the marginalised and their own articulations of how marginalised spaces are negotiated, this paper offers an entry point to locating sex workers as active participants in their day-to-day lives. Thirty-five in-depth, semi-structured interviews were conducted with street-based female sex workers. Thematic analysis revealed the following three themes: (1) surviving through sex work, (2) financial security in sex work and (3) surviving sex work stigma. These findings have implications for health promotion involving members of this population. Lived experiences illustrate the need to move away from traditional, top-down, linear behaviour-change health campaigns to reconstitute health interventions within a participatory bottom-up approach that includes the voices of participants and is situated within their own context and needs. PMID:24938825

Basnyat, Iccha

2014-01-01

51

Sex Roles and Fertility in College Women.  

ERIC Educational Resources Information Center

The relationship of sex role acceptance to actual and desired fertility was assessed in a sample of female college students and women's organization members. Multiple regression analysis indicated that behavioral measures of sex role acceptance accounted for more variance in predicting desired fertility than did the Bem Sex Role Inventory.…

Falbo, Toni; And Others

1978-01-01

52

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

PubMed Central

Objective To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution. Design Prospective observational study. Setting Vancouver, Canada during 2006-8. Participants 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. Main outcome measure Self reported gender based violence. Results 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 (aORphysicalviolence) 2.14, 95% confidence interval 1.34 to 3.43; adjusted odds ratio for rape (aORrape) 1.73, 1.09 to 3.12); inability to access drug treatment (adjusted odds ratio for client violence (aORclientviolence) 2.13, 1.26 to 3.62; aORphysicalviolence 1.96, 1.03 to 3.43); servicing clients in cars or public spaces (aORclientviolence 1.50, 1.08 to 2.57); prior assault by police (aORclientviolence 3.45, 1.98 to 6.02; aORrape 2.61, 1.32 to 5.16); confiscation of drug use paraphernalia by police without arrest (aORphysicalviolence 1.50, 1.02 to 2.41); and moving working areas away from main streets owing to policing (aORclientviolence 2.13, 1.26 to 3.62). Conclusions 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-legal policy reforms, improved access to housing and drug treatment, and scale up of violence prevention efforts, including police-sex worker partnerships, will be crucial to stemming violence against female sex workers. PMID:19671935

2009-01-01

53

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

PubMed

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. PMID:23421339

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

2013-01-01

54

Ant workers selfishly bias sex ratios by manipulating female development.  

PubMed

Kin selection theory predicts that social insects should perform selfish manipulations as a function of colony genetic structure. We describe a novel mechanism by which this occurs. First, we use microsatellite analyses to show that, in a population of the ant Leptothorax acervorum, workers' relatedness asymmetry (ratio of relatedness to females and relatedness to males) is significantly higher in monogynous (single-queen) colonies than in polygynous (multiple-queen) colonies. Workers rear mainly queens in monogynous colonies and males in polygynous colonies. Therefore, split sex ratios in this population are correlated with workers' relatedness asymmetry. Together with significant female bias in the population numerical and investment sex ratios, this finding strongly supports kin-selection theory. Second, by determining the primary sex ratio using microsatellite markers to sex eggs, we show that the ratio of male to female eggs is the same in both monogynous and polygynous colonies and equals the overall ratio of haploids (males) to diploids (queens and workers) among adults. In contrast to workers of species with selective destruction of male brood, L. acervorum workers therefore rear eggs randomly with respect to sex and must achieve their favoured sex ratios by selectively biasing the final caste (queen or worker) of developing females. PMID:11798433

Hammond, R L; Bruford, M W; Bourke, A F G

2002-01-22

55

Sex and Women with Cancer -- Overview  

MedlinePLUS

... Topic How a woman’s body works Sex and Women With Cancer: Overview This is a shorter, easier- ... Voices Blog Programs & Services Breast Cancer Support TLC Hair Loss & Mastectomy Products Hope Lodge® Lodging Rides To Treatment ...

56

Dyspareunia: Painful Sex for Women  

MedlinePLUS

... part of the genitals can cause pain during sex. Some conditions affect the skin around the vagina. ... types of birth control) does not fit correctly, sex may also be painful. Vaginismus (say: "vag-in- ...

57

Foster Care History and HIV Infection among Drug-Using African American Female Sex Workers  

PubMed Central

Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research. PMID:21818654

Surratt, Hilary L.; Kurtz, Steven P.

2011-01-01

58

Occupational health and safety among commercial sex workers.  

PubMed

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. PMID:21808944

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

2012-03-01

59

Barriers to health and social services for street-based sex workers.  

PubMed

Homelessness, poverty, drug abuse and violent victimization faced by street-based women sex workers create needs for a variety of health and social services, yet simultaneously serve as barriers to accessing these very services. The present study utilized interview (n = 586) and focus group (n = 25) data to examine the service needs and associated barriers to access among women sex workers in Miami, Florida. Women most often reported acute service needs for shelter, fresh water, transportation, crisis intervention, and drug detoxification, as well as long-term needs for mental and physical health care, drug treatment, and legal and employment services. Barriers included both structural (e.g., program target population, travel costs, office hours, and social stigma) and individual (e.g., drug use, mental stability, and fear) factors. Bridging these gaps is tremendously important from a public health perspective given the disease burden among this population. Recommendations include service staff training, outreach, and promising research directions. PMID:15937397

Kurtz, Steven P; Surratt, Hilary L; Kiley, Marion C; Inciardi, James A

2005-05-01

60

Queens versus workers: sex-ratio conflict in eusocial Hymenoptera  

Microsoft Academic Search

Studies of sex-ratio conflict in the eusocial Hymenoptera (ants, bees and wasps) have provided the most rigorous tests of kin selection theory. The hymenopteran haplodiploid system of sex determination generally renders workers more closely related to their sisters than to their brothers, whereas queens are equally related to their sons and daughters. Kin selection theory therefore predicts that resource allocation

Natasha J. Mehdiabadi; Hudson Kern Reeve; Ulrich G. Mueller

2003-01-01

61

Promoting sexual health in women who have sex with women.  

PubMed

This article aims to illustrate how women who have sex with women are at risk of sexually transmitted infections (STIs), despite perceptions that this group is at low risk. Data on the prevalence of STIs among these women are lacking and they may not be aware of the risk of contracting STIs. The article outlines the types of sexual practice that may put women who have sex with women at risk and describes methods to reduce the spread of STIs. Greater provision of safer sex information is advocated. Suggestions to improve practice are recommended, including ways to encourage uptake of sexual health services and the need to take a thorough sexual history. PMID:21922742

Ripley, Victoria

62

Bangkok 2004. Sex workers and law reform in South Africa.  

PubMed

The Sisonke movement in South Africa aims to galvanize sex workers to fight for equal rights and for improvements in their living and working conditions. This article, based on Jayne Arnott's presentation to a plenary session at the XV International AIDS Conference in Bangkok on 14 July 2004, outlines the legislation that governs the sex trade in South Africa; reviews related legal and policy developments since the end of apartheid in 1994; describes the present environment; and outlines the contribution that sex workers themselves are making to the fight for reform. PMID:15812926

Arnott, Jayne

2004-12-01

63

Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers  

Microsoft Academic Search

Previous studies have described links between violence, decreased condom use and drug sharing among intimate partners, though limited information exists about the predictors of drug sharing among female sex workers and their clients. The following analysis explored the association between sharing illicit drugs with clients and sexual and drug-related harms among survival sex workers. A total of 198 women participated

K. Shannon; T. Kerr; V. Bright; K. Gibson; M. W. Tyndall

2008-01-01

64

Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women.  

PubMed

Dental dams are distributed and promoted in some safer sex campaigns for use in oral sex. However, whether and how often dams are used for sex between Australian women remains unknown. We investigated the use of dental dams for sex by lesbians and other women who have sex with women, and the relationship between dam use and sexual risk for this group. In 2004, a self-completion questionnaire was distributed to women attending the Sydney Gay and Lesbian Mardi Gras Fair Day and lesbian community venues and health services in Sydney (n = 543). Among the 330 women who had had oral sex with a woman in the previous 6 months, 9.7% had used a dental dam and 2.1% had used one 'often'. There was little evidence of dam use for prevention of sexually transmissible infections. Although women who practised rimming (oral-anal contact) or had fetish sex involving blood were more likely to have used a dam, dam use was not significantly more common among women who had more partners, or had casual or group sex. Some women avoided oral sex during menstruation or had oral sex with a tampon in place. Latex gloves and condoms were used by more women and more often than dams. PMID:20465981

Richters, Juliet; Prestage, Garrett; Schneider, Karen; Clayton, Stevie

2010-06-01

65

Interviews with senegalese commercial sex trade workers and implications for social programming.  

PubMed

The purpose of the study was to assess the efficacy of the Senegalese pubic policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviews at the Institute d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for successful strategies in the fight against the global spread of HIV/AIDS. PMID:15804912

Homaifar, Nazaneen; Wasik, Suzan Zuljani

2005-02-01

66

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

PubMed

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. PMID:25402720

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

2015-04-01

67

Sex workers and the control of sexually transmitted disease.  

PubMed Central

OBJECTIVES: To describe and assess measures to control sexually transmitted diseases (STDs) among sex workers and their partners. METHODS: A review of medical, historical and social literature, focusing on selected cases. RESULTS: Measures to control disease in sex workers today are often prompted by concerns about HIV transmission. However, the literature shows that prostitution varies from one place and time to another, together with the risk of sexually transmitted disease. A broad social definition of prostitution rather than a narrow reference to levels of sexual activity is important for effective disease control, as an understanding of the relation between social disadvantage and sexual activity enables the provision of occupational services that sex workers actually want and use. Social prejudice and legal sanctions cause some sex workers and their partners to avoid even the most appropriate and accessible specialist services. Therefore targeted programmes can only complement, and not replace, general measures to control STDs, which are developed for other social groups or the local population as a whole. CONCLUSIONS: Sex workers and sex work differ from one place to another and so a single model for STD control is inappropriate. None the less, occupational health risks suggest a general need for specialist services. Where these do not compound the disadvantages that sex workers already suffer, medical services are likely to offer significant benefits in prevention, early diagnosis, and treatment of STDs. As the stigma of prostitution leads many people to remain invisible to services, a general health infrastructure and anti-discriminatory measures will be equally important to effective disease control. PMID:9306894

Day, S; Ward, H

1997-01-01

68

Sex trafficking of women and girls.  

PubMed

Sex trafficking involves some form of forced or coerced sexual exploitation that is not limited to prostitution, and has become a significant and growing problem in both the United States and the larger global community. The costs to society include the degradation of human and women's rights, poor public health, disrupted communities, and diminished social development. Victims of sex trafficking acquire adverse physical and psychological health conditions and social disadvantages. Thus, sex trafficking is a critical health issue with broader social implications that requires both medical and legal attention. Healthcare professionals can work to improve the screening, identification, and assistance of victims of sex trafficking in a clinical setting and help these women and girls access legal and social services. PMID:23687554

Deshpande, Neha A; Nour, Nawal M

2013-01-01

69

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

PubMed Central

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 particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally. PMID:24889853

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

2014-01-01

70

Exploring the impact of underage sex work among female sex workers in two Mexico-U.S. border cities  

PubMed Central

Although sex work and younger age increase HIV vulnerability, empirical data regarding the impacts of underage sex work are lacking. We explored associations between features of the risk environment, sex work and drug use history, and underage sex work entry among 624 female sex workers(FSWs) in Tijuana and Ciudad Juarez, Mexico. Forty-one percent (n=253) of women began sex work as minors, among whom HIV and any STI/HIV prevalence were 5.2% and 60.7%. Factors independently associated with increased odds of underage sex work were inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe-sharing. Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry. These results underscore the importance of efforts to prevent underage sex work and the wider factors contributing to HIV risk among vulnerable youth and underage FSWs. PMID:22012147

Goldenberg, Shira M; Rangel, Gudelia; Vera, Alicia; Patterson, Thomas L; Abramovitz, Daniela; Silverman, Jay G; Raj, Anita; Strathdee, Steffanie A

2011-01-01

71

Cervical smears and human papillomavirus typing in sex workers  

PubMed Central

Methods: In an outreach programme for sex workers results of 653 smears sampled between 1992 and 2001 were analysed, and compared to a control group matched for age from the general population in 2001. Separately, 99 consecutive samples were typed for HPV and compared to an equal control group, matched for age. Smears and typing were performed according to current techniques. Results: In the sex worker group 2.6% were diagnosed with atypical glandular cells of undetermined significance (AGUS)/atypical squamous cells of undetermined significance (ASCUS), 15.6% with low grade squamous intraepithelial lesion (LSIL), and 2.9% with high grade squamous intraepithelial lesion (HSIL), and in the control group results were 1.4%, 2.9% (p<0.001) and 0.6% (p<0.001) respectively. When considering only those under 25 years, 24.4% should have further follow up. Of the sex workers, 77.4% were positive for one or more types of HPV (55.9% for high risk HPV), in comparison with 27.6% of the control group (14.3% for high risk HPV) (p<0.001). In high risk HPV samples more LSIL and HSIL were found. Conclusion: Abnormal smears and high risk HPV were significantly more prevalent in sex workers than in controls. Current screening policy would miss many sex workers with an abnormal smear who should be referred for further follow up. It is proposed to screen sex workers when they enter prostitution regardless of their age. PMID:15054172

Mak, R; Van Renterghem, L; Cuvelier, C

2004-01-01

72

Stigma to Sage: Learning and Teaching Safer Sex Practices Among Canadian Sex Trade Workers. NALL Working Paper.  

ERIC Educational Resources Information Center

A study interviewed 37 Canadian sex workers in 4 cities to determine how they acquire a working knowledge of safer sex practices and what that knowledge constituted. Findings indicated the vast majority exhibited high levels of knowledge and efficacy regarding safer sex practices; sex workers took the initiative to obtain information and engage in…

Meaghan, Diane

73

Human papillomavirus infection in female sex workers in Lima, Peru  

Microsoft Academic Search

ObjectivesTo determine the prevalence and risk factors for human papillomavirus (HPV) infection in female sex workers (FSW) in Lima, Peru.MethodsCross-sectional study of 87 FSW. Information regarding demographics, sex work practices, and genital and blood specimens was collected.ResultsForty-four (50.6%) of 87 FSW had HPV detected in cervical swabs. The prevalence of coinfection by two or more HPV types was 39.1%. Thirty-one

Silvia M Montano; Evelyn J Hsieh; Martha Calderón; Thanh G N Ton; Eberth Quijano; Vicky Solari; Joseph R Zunt

2010-01-01

74

British Columbia: sex workers granted standing to challenge Criminal Code.  

PubMed

On 12 October 2010, a majority of the Court of Appeal of British Columbia allowed the appeal of Shari Kiselbach and the Downtown Eastside Sex Workers United against Violence Society (SWUAV) regarding their standing to challenge provisions of the Criminal Code concerning prostitution. PMID:21688706

Chu, Sandra Ka Hon

2011-04-01

75

Sex trade workers’ narratives of sexual violence: A field investigation  

Microsoft Academic Search

A total of 119 sex trade workers were interviewed about sexually violent experiences. Up to three narratives were elicited: a remarkable, positive (control) event (POS), a well-remembered sexual assault (WELL), and a poorly recalled sexual assault (POOR). The results demonstrated that WELL narratives contained more details than POS narratives despite the fact that the respective experiences were older. WELL narratives

Dorothee Griesel; John C. Yuille

2012-01-01

76

Sex trade workers' narratives of sexual violence: A field investigation  

Microsoft Academic Search

A total of 119 sex trade workers were interviewed about sexually violent experiences. Up to three narratives were elicited: a remarkable, positive (control) event (POS), a well-remembered sexual assault (WELL), and a poorly recalled sexual assault (POOR). The results demonstrated that WELL narratives contained more details than POS narratives despite the fact that the respective experiences were older. WELL narratives

Dorothee Griesel; John C. Yuille

2012-01-01

77

Khat in East Africa: taking women into or out of sex work?  

PubMed

Women's drug use is often associated with sex work as a means of raising money for consumption. Similarly, in Kenya and Uganda, journalists, the general public and aid agencies associate female consumption of the stimulant drug, khat (Catha edulis), as pulling women into prostitution. In contrast to Yemen and Ethiopia, these views are expressed by people living in areas where there are no rituals or traditions of female khat consumption. This paper presents data from a study carried out in Kenya and Uganda in 2004 and 2005 that documents that the majority of women engaging in khat chewing are not sex workers. Frequently, however, women who retail khat are often assumed by men to be sexually immoral. The role of women in the retail and wholesale khat trade is examined. The stigma attached to selling khat is linked to the overall situation of independent women in East Africa and the place of commercial sex in urban life. PMID:18649237

Beckerleg, Susan

2008-07-01

78

[Harm reduction program with sex workers].  

PubMed

In Nantes, the Médecins du Monde bus goes out three nights a week to meet women working as prostitutes. The objective is to create a connection, to inform and to prevent the risks inherent to their activity. In this article a nurse shares with us the experience of her round. PMID:24881240

Henriquet, Maïwenn

2014-04-01

79

“You are wasting our drugs”: health service barriers to HIV treatment for sex workers in Zimbabwe  

PubMed Central

Background Although disproportionately affected by HIV, sex workers (SWs) remain neglected by efforts to expand access to antiretroviral treatment (ART). In Zimbabwe, despite the existence of well-attended services targeted to female SWs, fewer than half of women diagnosed with HIV took up referrals for assessment and ART initiation; just 14% attended more than one appointment. We conducted a qualitative study to explore the reasons for non-attendance and the high rate of attrition. Methods Three focus group discussions (FGD) were conducted in Harare with HIV-positive SWs referred from the ‘Sisters with a Voice’ programme to a public HIV clinic for ART eligibility screening and enrolment. Focus groups explored SWs’ experiences and perceptions of seeking care, with a focus on how managing HIV interacted with challenges specific to being a sex worker. FGD transcripts were analyzed by identifying emerging and recurring themes that were specifically related to interactions with health services and how these affected decision-making around HIV treatment uptake and retention in care. Results SWs emphasised supply-side barriers, such as being demeaned and humiliated by health workers, reflecting broader social stigma surrounding their work. Sex workers were particularly sensitive to being identified and belittled within the health care environment. Demand-side barriers also featured, including competing time commitments and costs of transport and some treatment, reflecting SWs’ marginalised socio-economic position. Conclusion Improving treatment access for SWs is critical for their own health, programme equity, and public health benefit. Programmes working to reduce SW attrition from HIV care need to proactively address the quality and environment of public services. Sensitising health workers through specialised training, refining referral systems from sex-worker friendly clinics into the national system, and providing opportunities for SW to collectively organise for improved treatment and rights might help alleviate the barriers to treatment initiation and attention currently faced by SW. PMID:23898942

2013-01-01

80

Individual, Interpersonal, and Social-Structural Correlates of Involuntary Sex Exchange Among Female Sex Workers in Two Mexico–U.S. Border Cities  

PubMed Central

Objective To investigate individual, interpersonal, and social-structural factors associated with involuntary sex exchange among female sex workers (FSWs) along the Mexico–U.S. border. Methods In 2010–2011, 214 FSWs from Tijuana (n=106) and Ciudad Juarez (n=108) aged ?18 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/STI testing. Logistic regression was used to identify correlates of involuntary sex exchange among FSWs. Results Of 214 FSWs, 31 (14.5%) reported involuntary sex exchange. These women were younger at sex work entry (Adjusted odds ratio [AOR]: 0.84/1 year increase, 95% CI: 0.72–0.97) and were significantly more likely to service clients whom they perceived to be HIV/STI-infected (AOR: 12.41, 95% CI: 3.15–48.91). Additionally, they were more likely to have clients who used drugs (AOR: 7.88, 95% CI: 1.52–41.00), report poor working conditions (AOR: 3.27, 95% CI: 1.03–10.31), and report a history of rape (AOR: 4.46, 1.43–13.91).] Conclusions 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. Multi-level interventions for sex workers and their clients that target interpersonal and social-structural risks (e.g., measures to improve safety and reduce exploitation within the workplace) are needed. PMID:23614997

Goldenberg, S.M.; Rangel, G.; Staines, H.; Vera, A.; Lozada, R.; Nguyen, L.; Silverman, J.G.; Strathdee, S.A.

2013-01-01

81

Sexual practices, identities and health among women who have sex with women in Lesotho - a mixed-methods study.  

PubMed

Despite the high prevalence of HIV and STIs among women in Africa and the growing literature on HIV and STIs among women who have sex with women, research on the sexual health of women who have sex with women in Africa is scant. This study used mixed methods to describe sexual identity, practices and health among women who have sex with women in Lesotho. Most respondents (48%) described themselves as lesbian, 29% as bisexual and 23% as heterosexual. Almost half (45%) had disclosed their same-sex attraction to family, but only 25% had done so with healthcare workers. A total of 8% reported having HIV. Self-reported HIV was associated with having three or more male partners, having male and female partners at the same time and having a history of STIs. Gender norms, the criminalisation of homosexuality, varied knowledge of, and access to, safer-sex strategies, and mixed experiences of HIV/STI testing and sexual healthcare provided social and structural contexts for HIV- and STI-related vulnerability. PMID:24237008

Poteat, Tonia; Logie, Carmen; Adams, Darrin; Lebona, Judith; Letsie, Puleng; Beyrer, Chris; Baral, Stefan

2014-01-01

82

Sex role identification and young women's irrational beliefs  

Microsoft Academic Search

The present study was designed to examine the relationship between young women's beliefs about approval, frustration, and dependency and their sex-role identification. Sixty-six college women responded to a questionnaire which contained the Irrational Beliefs Test (Jones, 1969) and the Multidimensional Sex Role Inventory (MSRI; Bernard, 1981). As predicted, women who score high in irrational beliefs concerning approval, frustration, and dependency

Tracy L. Vining; William P. Gaeddert; Naomi B. McCormick

1990-01-01

83

Sexual and Drug Risk Behaviors Among Women Who Have Sex With Women  

Microsoft Academic Search

Objectives. We examined risk behaviors of female drug users, comparing those who reported recently having had sex with women (recent WSW), those who re- ported previously having had sex with women (former WSW), and those who reported never having had sex with women (never WSW). Methods. We used data from the Risk Evaluation and Assessment of Commu- nity Health III

Ann V. Bell; Danielle Ompad; Susan G. Sherman

84

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

PubMed

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. PMID:24023661

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

2013-01-01

85

Sex Workers Perspectives on Strategies to Reduce Sexual Exploitation and HIV Risk: A Qualitative Study in Tijuana, Mexico  

PubMed Central

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. PMID:24023661

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

2013-01-01

86

Sexual health and use of condoms among local and international sex workers in Sydney.  

PubMed Central

OBJECTIVES: To compare indicators of sexual health and predictors of condom use for commercial sex among local and international female sex workers first attending an STD clinic. SETTING: A public STD clinic in Sydney, Australia. SUBJECTS: All sex workers first attending between June 1991 and May 1993. METHODS: Cross-sectional analysis of demographic, behavioural and morbidity data from proforma medical records. RESULTS: 91 local sex workers and 123 international sex workers (predominantly from Thailand, Malaysia and China) first presented during the study period. There were significantly higher prevalences of chlamydia (0 v. 15%, p = 0.0002), gonorrhoea (0 v. 14%, p = 0.0006), syphilis (0 v. 10%, p = 0.006) and clinical genital herpes (0 v. 5%, p = 0.04) among international sex workers. The only case of HIV infection was in an international sex worker. Inconsistent condom use for commercial sex was significantly more common among international sex workers (RR = 4.5; 95% CI 3.1-6.5). On multivariate analysis, inconsistent condom use in international sex workers was associated with a recent history of prostitution outside Australia (p = 0.04), while inconsistent condom usage among local sex workers was associated with increasing age (p = 0.003). CONCLUSIONS: These data illustrate the efficacy of condoms and the success of targeted education programmes in local sex workers in Sydney. By contrast, international sex workers continued to be at high risk of STDs. The international sex industry in Sydney requires enhanced culture-specific interventions. Immigration laws as they affect sex workers should also be reviewed. PMID:8655167

O'Connor, C C; Berry, G; Rohrsheim, R; Donovan, B

1996-01-01

87

Oral and cervical human papillomavirus infection among female sex workers in Japan.  

PubMed

It has been reported recently that oral human papillomavirus (HPV) infection is associated with oropharyngeal squamous cell carcinomas. The aim of this study was to determine the prevalence of HPV infection and HPV types in the oral cavity and cervix of female sex workers in Japan. Oral and cervical swabs were taken from 196 female sex workers who visited a clinic for regular medical checkups in 2007, and genomic DNA was extracted from those specimens. The HPV L1 gene was amplified by polymerase chain reaction (PCR) using original and modified GP5(+)/6(+) primers, and genotyping was performed using the Kurabo GeneSquare Microarray or by sequencing cloned PCR products. HPV DNA was detected in the oral cavity of 12 (6.1%) women, with HPV-56 being the most common type (7/12). Likewise, HPV DNA was detected in the cervix of 103 (52.6%) women, with HPV-52 (30/103, 29.1%), followed by HPV-16 (24.3%) and HPV-56 (18.4%), being the most common. Of the 12 women with oral HPV infection, only two were infected with the concordant HPV genotype in the cervix. These findings suggest that oral HPV infection occurs independently of cervical HPV infection in this population, and that oral HPV infection may play a role in HPV transmission in Japan. PMID:21266753

Matsushita, Kaori; Sasagawa, Toshiyuki; Miyashita, Michiko; Ishizaki, Azumi; Morishita, Atsushi; Hosaka, Norimitsu; Saikawa, Kunikazu; Hoshina, Shinji; Bi, Xiuqiong; Ichimura, Hiroshi

2011-01-01

88

"This area has been declared a prostitution free zone": discursive formations of space, the state, and trans "sex worker" bodies.  

PubMed

The mayorally instituted and police-enforced Prostitution Free Zones in Washington, DC, serve as a tool of nation-state disciplinarity, wherein many transgender women of color, viewed as ideologically suspect, are profiled as "sex workers," facing police harassment and arrest. This article explores here how this process is not merely about sex work but rather about discourses that are evoked in the displacement of the always-already displaced-racial, sexed, and gendered "others" through interviews with activists and trans community members, as well as District of Columbia government publications. PMID:21740214

Edelman, Elijah Adiv

2011-01-01

89

The government's new prostitution strategy: A cheap fix for drug-using sex workers?  

Microsoft Academic Search

This article considers the recommendations to the government's public consultation exercise for drug-using sex workers (Home Office, 2004). It argues that the ‘problem’ of drug use by sex workers cannot be separated from wider social problems experienced by this group, especially the problem of poverty. It suggests that the new prostitution strategy conflates drug use and sex work, reducing involvement

Margaret Melrose

2007-01-01

90

[Prevalence of the HIV infection and five other sexually-transmitted infections among sex workers in Niamey, Niger].  

PubMed

We performed a systematic screening of HIV infection and five other sexually transmitted infections on a consecutive sample of 529 female sex workers from Niamey. HIV seroprevalence rate was 30.1%, with HIV-1 profile in 93.1% of the cases. For curable STI, 4.7% of women had treponematosis, 7% gonorrhoea, 16.8% Gardnerella vaginalis, 36.9% Mycoplasma hominis and 68.2% Chlamydia trachomatis infection. The percentage of women with at least one STI was significantly higher in HIV positive's: 95.6% against 87.9%. Only 7.9% of women were free of any infection. PMID:16568677

Mamadou, S; Laouel Kader, A; Rabiou, S; Aboubacar, A; Soumana, O; Garba, A; Delaporte, E; Mboup, S

2006-03-01

91

Dance Ponnaya, Dance! Police Abuses Against Transgender Sex Workers in Sri Lanka  

Microsoft Academic Search

Feminist theory and research are limited in their focus on intersections of gender and sexual orientation in the victimization of sex workers. Through inductive analysis of 24 in-depth interviews and 3 focus groups with male-to-female transgender sex workers in Sri Lanka, police mistreatment was examined to show how the abuses sex workers experience reflect the intersectional nature of gendered victimization.

Andrea Nichols

2010-01-01

92

Sexually transmitted infections and vaginal douching in a population of female sex workers in Nairobi, Kenya  

PubMed Central

Objective: To assess the association between vaginal douching and sexually transmitted infections (STI) among a group of female sex workers (FSWs) in Nairobi, Kenya. Methods: This study was part of a randomised, placebo controlled trial of monthly prophylaxis with 1 g of azithromycin to prevent STIs and HIV infection in a cohort of Nairobi FSWs. Consenting women were administered a questionnaire and screened for STIs. Results: The seroprevalence of HIV-1 among 543 FSWs screened was 30%. HIV infection was significantly associated with bacterial vaginosis (BV), trichomoniasis, gonorrhoea, and the presence of a genital ulcer. Regular douching was reported by 72% of the women, of whom the majority inserted fluids in the vagina, generally after each sexual intercourse. Water with soap was the fluid most often used (81%), followed by salty water (18%), water alone (9%), and a commercial antiseptic (5%). Douching in general and douching with soap and water were significantly associated with bacterial vaginosis (p = 0.05 and p = 0.04 respectively). There was a significant trend for increased frequency of douching and higher prevalence of BV. There was no direct relation observed between douching and risk for HIV infection or other STIs. Conclusion: The widespread habit of douching among African female sex workers was confirmed. The association between vaginal douching and BV is of concern, given the increased risk of HIV infection with BV, which has now been shown in several studies. It is unclear why we could not demonstrate a direct association between douching and HIV infection. Further research is required to better understand the complex relation between douching, risk for bacterial vaginosis, and risk for HIV and other STIs. Key Words: vaginal douching; sexually transmitted infections; female sex workers PMID:11463927

Fonck, K; Kaul, R; Keli, F; Bwayo, J; Ngugi, E; Moses, S; Temmerman, M

2001-01-01

93

HIV-related risk perception among female sex workers in Nigeria  

PubMed Central

Background Over one-third of sex workers in Nigeria are infected with human immunodeficiency virus (HIV), yet there is a lack of understanding of sex workers’ own perception of sexual risk-taking. Applying the theory of cognitive dissonance, this paper examined the personal HIV risk perception of brothel-based sex workers. Methods The study is based on 24 focus group discussions held among brothel-based sex workers in four geographically and culturally dispersed cities in Nigeria. Results It was found that sex workers underestimated their risk of infection and rationalized, defended, or justified their behaviors, a typical psychological response to worry, threat, and anxiety arising from the apparent discrepancies between beliefs and behaviors. To reduce dissonance, many sex workers had a strong belief in fatalism, predestination, and faith-based invulnerability to HIV infection. Many believed that one will not die of acquired immune deficiency syndrome if it is not ordained by God. The sex workers also had a high level of HIV-related stigma. Conclusion From these findings, most sex workers considered risk reduction and in particular condom use as far beyond their control or even unnecessary, as a result of their strong beliefs in fatalism and predestination. Therefore, one critical area of intervention is the need to assist sex workers to develop accurate means of assessing their personal vulnerability and self-appraisal of HIV-related risk. PMID:22096411

Ankomah, Augustine; Omoregie, Godpower; Akinyemi, Zacch; Anyanti, Jennifer; Ladipo, Olaronke; Adebayo, Samson

2011-01-01

94

"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.  

PubMed

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. PMID:25360822

Sherman, Susan G; Footer, Katherine; Illangasekare, Samantha; Clark, Erin; Pearson, Erin; Decker, Michele R

2015-04-01

95

HIV vulnerability and condom use among migrant women factory workers in Puebla, Mexico.  

PubMed

International migration is associated with increased HIV vulnerability, but little is known about the vulnerability of internal migrants. This qualitative study explored perceptions of HIV and condom use among Mexican migrant female factory workers. Migration and male sexual infidelity contributed to increased HIV vulnerability and unprotected sex was ubiquitous. The dominant cultural discourse that dichotomizes "good" (monogamous) and "bad" (sexually stigmatized) women, and male partner's resistance, were barriers to condom use. Women's positive attitudes toward the dual protection (pregnancy and sexually transmitted infections) offered by condoms and sexual agency expressed by refusing unwanted sexual contact are resources for HIV prevention. PMID:20461602

Kendall, Tamil; Pelcastre, Blanca Estela

2010-06-01

96

Sex Role Attributions of American-Indian Women.  

ERIC Educational Resources Information Center

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…

Portman, Tarrell Awe Agahe

2001-01-01

97

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

PubMed

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. PMID:24897916

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

2014-04-01

98

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

PubMed

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. PMID:21409304

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

2010-10-01

99

University Student Beliefs about Sex: Men vs. Women  

ERIC Educational Resources Information Center

Analysis of survey data from 326 undergraduates at a large southeastern university revealed significant differences between men and women in their sexual beliefs. Specifically, men were more likely to think that oral sex is not sex; that cybersex is not cheating, that men can't tell if a woman is faking orgasm and that sex frequency drops in…

Knox, David; Zusman, Marty; McNeely, Andrea

2008-01-01

100

The use of the Internet by gay and bisexual male escorts: sex workers as sex educators.  

PubMed

While prior studies have targeted street-based male sex workers as potential vectors of disease transmission, the number of men who work independently through Internet chat-rooms and other online endeavors has steadily increased. It is likely that these men differ substantially from their street-based counterparts in terms of sexual risk behaviors with their clients. The purpose of this study was to explore the ways in which the Internet has impacted the work of male escorts and their sexual practices with clients. Semi-structured qualitative interviews and quantitative surveys were administered to 46 such men. Less than half the men reported unprotected anal sex with clients. The qualitative data lend support to this finding, in that the majority talked about refusing any unsafe sex with clients, and many reported taking the extra step of educating their clients about the dangers of risky sex. Some of the escorts described the methods used to incorporate safer sex practices into sessions with their clients. Internet-based male escorts can play an important role as potential sex educators on the front lines of the fight against HIV and other sexually transmitted infections. PMID:15511734

Parsons, J T; Koken, J A; Bimbi, D S

2004-11-01

101

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

PubMed

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. PMID:23970599

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

2013-10-01

102

A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use and STD history  

Microsoft Academic Search

The present study aims to investigate the perspective relations between HIV\\/AIDS and condom-related knowledge, condom use, history of sexually transmitted diseases (STDs) and predictive factors of condom use by female sex workers (FSW) who were sent to the Women Re-education Center (WRC) in Shenzhen, People's Republic of China. Seven hundred and one FSW were interviewed. Whereas respondents had attained certain

J. T. F. Lau; H. Y. Tsui; P. C. Siah; K. L. Zhang

2002-01-01

103

Puerto Rican Women as Workers and Writers.  

ERIC Educational Resources Information Center

This theme issue of the "Centro Bulletin" highlights recent studies by and about employed Puerto Rican and Latina women. "La mujer en el Puerto Rico del siglo XIX" (O. Jimenez de Wagenheim), in Spanish, reviews the contributions of women to Puerto Rican economic, political, and social life during the nineteenth century. "Notas sobre el desarrollo…

Vazquez, Blanca, Ed.

1989-01-01

104

Social-Environmental Factors and Protective Sexual Behavior Among Sex Workers: The Encontros Intervention in Brazil  

PubMed Central

Objectives. We sought to determine the association of social–environmental factors with condom use and sexually transmitted infections (STIs) among 420 sex workers participating in an STI/HIV prevention study in Corumbá, Brazil, to inform future intervention efforts. Methods. Participants provided urine samples for polymerase chain reaction testing of chlamydia and gonorrhea and responded to multi-item scales addressing perceived social cohesion, participation in networks, and access to and management of resources. We conducted multivariate log-linear and negative binomial regression analyses of these data. Results. Increased social cohesion was inversely associated with number of unprotected sex acts in the preceding week among women (adjusted incidence rate ratio [IRR] = 0.80; P < .01), and there was a marginal association among men (adjusted IRR = 0.41; P = .08). Women's increased participation in social networks was associated with a decrease in frequency of unprotected sex acts (adjusted IRR = 0.83; P = .04), as was men's access to and management of social and material resources (IRR = 0.15; P = .01). Social–environmental factors were not associated with STIs. Conclusions. The social context within which populations negotiate sexual behaviors is associated with condom use. Future efforts to prevent STI/HIV should incorporate strategies to modify the social environment. PMID:19762673

Donini, Angela; Díaz, Juan; Chinaglia, Magda; Reingold, Arthur; Kerrigan, Deanna

2010-01-01

105

Social and behavioral determinants of consistent condom use among female commercial sex workers (FCSWs) in Ghana  

Microsoft Academic Search

This study aims at investigating the social and behavioral predictors of consistent condom use among female commercial sex workers (FCSWs) in Ghana. Street commercial sex workers were interviewed in Accra, Kumasi and Techiman. Whereas respondents had attained certain accurate knowledge about HIV transmission routes, misconceptions were still commonly reported. The level of condom education was very low (14%), however consistent

Ahmed Adu-Oppong

2005-01-01

106

Characteristics associated with prevalent HIV infection among a cohort of sex workers in Cameroon  

Microsoft Academic Search

OBJECTIVE: To determine prevalence of HIV infection in a cohort of female sex workers in Cameroon, and to describe characteristics associated with HIV infection in this population. METHODS: In a cross sectional study, 2260 female sex workers in Cameroon were interviewed and screened for HIV serostatus. A standardised questionnaire was used to collect information on sociodemographic characteristics and sexual and

K. A. Ryan; R. E. Roddy; L. Zekeng; S. S. Weir; U. Tamoufe

1998-01-01

107

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

PubMed Central

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. PMID:25349727

Markosyan, Karine; Lang, Delia L.; DiClemente, Ralph J.

2014-01-01

108

Freire's Lessons for Liberating Women Workers.  

ERIC Educational Resources Information Center

Women working in export processing zones in the Dominican Republic organized a union using a gendered approach and undertook organizational literacy strategies based on Freire's ideas. They developed community support services to combat oppression. (SK)

Dunn, Leith L.

1998-01-01

109

Sex trade workers' narratives of sexual violence: a field investigation.  

PubMed

A total of 119 sex trade workers were interviewed about sexually violent experiences. Up to three narratives were elicited: a remarkable, positive (control) event (POS), a well-remembered sexual assault (WELL), and a poorly recalled sexual assault (POOR). The results demonstrated that WELL narratives contained more details than POS narratives despite the fact that the respective experiences were older. WELL narratives were also associated with higher intoxication and more rehearsal than POS narratives. POOR narratives were as detailed as POS narratives. WELL narratives were associated with more PTSD symptoms than POOR narratives. No weapon focus effect and no differences in peritraumatic dissociation were observed to explain this difference. This study was the first to demonstrate great within-participants variability of narrative details in accounts of sexual violence. The findings challenge common opinions in the eyewitness literature. Implications for expert testimony and credibility assessment are discussed. PMID:22356561

Griesel, Dorothee; Yuille, John C

2012-01-01

110

Prevalence of sexually transmitted infections in female sex workers in Athens, Greece - 2005.  

PubMed

There is little data on the prevalence of STIs in female sex workers, Greek and immigrants, working in Athens, Greece, since most of them work without any form of official license. Our aim was to establish the prevalence of STIs in asymptomatic legal Greek and immigrant female sex workers in Athens, Greece. The study involved an evaluation of gonococcal and chlamydial infection, early infectious syphilis, HIV infection, HSV-2 infection, Hepatitis B and C in 299 female sex workers who applied for an official work permit between May 2005 and October 2005. HSV-2 infection was more common in the Greek sex workers. No difference was found for the other STIs. Prevalence was related to age. A significant association was found between HSV-2 and syphilis. No HIV infection was detected. We concluded that asymptomatic sex workers can be a source of STIs which points out the need for a better health system control in Greece. PMID:17229607

Papadogeorgaki, H; Caroni, C; Frangouli, E; Flemetakis, A; Katsambas, A; Hadjivassiliou, M

2006-01-01

111

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

PubMed

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. PMID:23558710

Dasgupta, Satarupa

2013-06-01

112

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

PubMed

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. PMID:20967651

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

2011-01-01

113

Seeking Authenticity: Women and Learning in the Catholic Worker Movement  

ERIC Educational Resources Information Center

Oral history interviews form the basis of an investigation into both the context and the everyday actions that contributed to the learning environment for women within the Catholic Worker Movement during the 1930s and 1940s. Findings reveal that narrators (a) were grounded in a variety of learning environments including family, Catholic Church,…

Parrish, Marilyn McKinley; Taylor, Edward W.

2007-01-01

114

Seeking Authenticity: Women and Learning in the Catholic Worker Movement  

Microsoft Academic Search

Oral history interviews form the basis of an investigation into both the context and the everyday actions that contributed to the learning environment for women within the Catholic Worker Movement during the 1930s and 1940s. Findings reveal that narrators (a) were grounded in a variety of learning environments including family, Catholic Church, and school contexts; (b) sought adventure and authenticity

Marilyn McKinley Parrish; Edward W. Taylor

2007-01-01

115

Relationships Between Teenage Smoking and Attitudes Toward Women's Rights, Sex Roles, Marriage, Sex and Family  

Microsoft Academic Search

This study analyzes the relationships of cigarette smoking to attitudes toward equal opportunities for women, attitudes toward appropriate roles for women and men, and attitudes toward marriage, sex and family. Our analyses utilize data for white high school seniors from the 1985 Monitoring the Future national survey. Smoking was not related to attitudes toward equal opportunities for women, attitudes toward

Ingrid Waldron; Diane Lye

1990-01-01

116

Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work.  

PubMed

High rates of violence among street-level sex workers have been described across the globe, while in cities across Canada the disappearance and victimization of drug-using women in survival sex work is ongoing. Given the pervasive levels of violence faced by sex workers over the last decades, and extensive harm reduction and HIV prevention efforts operating in Vancouver, Canada, this research aimed to explore the role of social and structural violence and power relations in shaping the HIV risk environment and prevention practices of women in survival sex work. Through a participatory-action research project, a series of focus group discussions were conceptualized and co-facilitated by sex workers, community and research partners with a total of 46 women in early 2006. Based on thematic, content and theoretical analysis, the following key factors were seen to both directly and indirectly mediate women's agency and access to resources, and ability to practice HIV prevention and harm reduction: at the micro-level, boyfriends as pimps and the 'everyday violence' of bad dates; at the meso-level, a lack of safe places to take dates, and adverse impacts of local policing; and at the macro-level, dopesickness and the need to sell sex for drugs. Analysis of the narratives and daily lived experiences of women sex workers highlight the urgent need for a renewed HIV prevention strategy that moves beyond a solely individual-level focus to structural and environmental interventions, including legal reforms, that facilitate 'enabling environments' for HIV prevention. PMID:18155336

Shannon, Kate; Kerr, Thomas; Allinott, Shari; Chettiar, Jill; Shoveller, Jean; Tyndall, Mark W

2008-02-01

117

Sex workers and their clients among Australian gay and bisexual men.  

PubMed

The prevalence and factors associated with being paid and paying for sex were explored in an online sample of Australian gay men. Sexual risk behavior among male sex workers and their clients was mainly related to being more sexually adventurous in general rather than male-to-male sex work specifically. PMID:24659361

Prestage, Garrett; Jin, Fengyi; Bavinton, Benjamin; Hurley, Michael

2014-07-01

118

The Use of Female Commercial Sex Workers' Services by Latino Day Laborers  

ERIC Educational Resources Information Center

This article reports the characteristics of Latino day laborers who have sex with female commercial sex workers (CSWs). A sample of 450 day laborers in Los Angeles was used. Multivariate logistic regression was used to determine the association of independent variables with the likelihood of having sex with a CSW. Overall, 26% of the 450 day…

Galvan, Frank H.; Ortiz, Daniel J.; Martinez, Victor; Bing, Eric G.

2009-01-01

119

Amphetamine-type stimulant use and HIV/STI risk behaviour among young female sex workers in Phnom Penh, Cambodia  

PubMed Central

Background Use of amphetamine-type substances (ATS) has been linked to increased risk of HIV and other sexually transmitted infections (STI) worldwide. In Cambodia, recent ATS use is independently associated with incident STI infection among young female sex workers (FSW). Methods We conducted 33 in-depth interviews with women (15–29 years old) engaged in sex work to explore ATS use and vulnerability to HIV/STI. Results Participants reported that ATS, primarily methamphetamine in pill and crystalline forms (yama), were cheap, widely available and commonly used. Yama was described as a “power drug” (thnam kamlang) which enabled women to work long hours and serve more customers. Use of ATS by clients was also common, with some providing drugs for women and/or encouraging their use, often resulting in prolonged sexual activity. Requests for unprotected sex were also more common among intoxicated clients and strategies typically employed to negotiate condom use were less effective. Conclusion ATS use was highly functional for young women engaged in sex work, facilitating a sense of power and agency and highlighting the occupational significance and normalization of ATS in this setting. This highly gendered dynamic supports the limited but emerging literature on women’s use of ATS, which to date has been heavily focused on men. Results indicate an urgent need to increase awareness of the risks associated with ATS use, to provide women with alternative and sustainable options for income generation, to better regulate the conditions of sex work, and to work with FSWs and their clients to develop and promote culturally appropriate harm reduction interventions. PMID:21316935

Maher, L; Phlong, P; Mooney-Somers, J; Keo, S; Stein, E; Page, K

2011-01-01

120

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

PubMed Central

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

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

2014-01-01

121

Moving beyond safe sex to women-controlled safe sex: A concept analysis  

PubMed Central

Aim This paper is a report of a conceptual analysis of women-controlled safe sex. Background Women bear disproportionate burdens from sexually-related health compromising outcomes. Imbalanced societal gender and power positions contribute to high morbidities. The expression, women-controlled safe sex, aims to empower women to gain control of their sexual lives. Few researchers focus on contextualized socio-cultural definitions of sexual safety among women. Data Sources The sample included scientific literature from Scopus, CINAHL, PubMed, PsychINFO, and Sociological Abstracts. Papers were published 2000–2010. Review Methods Critical analyses of literature about women-controlled safe sex were performed using Rodgers’ evolutionary concept analysis methods. The search focused on social and cultural influences on sexual practices aimed at increasing women’s control over their sexual safety. Results The analysis uncovered five attributes of women-controlled safe sex: technology; access to choices; women at-risk; “condom migration” panic; and communication. Three antecedents included: male partner influence; body awareness; and self-efficacy. Consequences were categorized as positive or negative. Nine surrogate terms included: empowerment; gender power; female-controlled sexual barrier method; microbicides; diaphragm; sexual negotiation and communication; female condom; women-initiated disease transmission prevention; and spermicides. Finally, a consensus definition was identified: a socio- culturally influenced multilevel process for initiating sexual safety by women deemed at-risk for sexually-related dangers, usually sexually transmitted infections and/or HIV/AIDS. Conclusion This concept analysis described current significance, uses, and applications of women-controlled safe sex in the scientific literature. The authors clarified its limited nature and conclude that additional conceptual refinement in nursing is necessary to influence women’s health. PMID:22111843

Alexander, Kamila A.; Coleman, Christopher L.; Deatrick, Janet A.; Jemott, Loretta S.

2011-01-01

122

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

PubMed Central

Background 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. Methods 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. Results 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. Conclusions 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 developed at sufficient scale and intensity, sex work organisations could play a critical role in reducing the present harms caused by criminalisation and stigma. PMID:23889941

2013-01-01

123

Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study  

PubMed Central

Objective To explore female and transvestite sex workers’ perceptions of risk in the sex work environment in Serbia. Design Qualitative interview study. Setting Street based locations for sex work in Belgrade and Pancevo, Serbia. Participants 31 female and transvestite sex workers. Results Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma. Conclusion Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work. PMID:18667468

2008-01-01

124

Sex guilt and sexual control in women alcoholics in early sobriety  

Microsoft Academic Search

This study was designed to determine the degree to which alcoholic women in early sobriety report sex guilt and sexual control in comparison to a matched sample of non-alcoholic women. It was hypothesized that alcoholic women would report more sex guilt and less control over their sex lives than non-alcoholic women. Sex guilt and lack of sexual control add another

Valerie Pinhas

1980-01-01

125

HIV vulnerabilities of sex-trafficked Indian women and girls  

PubMed Central

Objective To qualitatively explore potential mechanisms that may confer heightened risk for HIV infection among survivors of sex trafficking in India. Methods Case narratives of 61 repatriated women and girls who reported being trafficked into sex work and were receiving services at an NGO in Mysore, India, were reviewed. Narratives were analyzed to examine potential sources of HIV risk related to sex trafficking. Results Participants were aged 14–30 years. Among the 48 women and girls tested for HIV, 45.8% were HIV positive. Narratives described very low levels of autonomy, with control exacted by brothel managers and traffickers. Lack of control appeared to heighten trafficked women and girls’ vulnerability to HIV infection in the following ways: use of violent rape as a means of coercing initiation into sex work, inability to refuse sex, inability to use condoms or negotiate use, substance use as a coping strategy, and inadequate access to health care. Conclusion Sex trafficked women and girls lack autonomy and are rendered vulnerable to HIV infection through several means. Development of HIV prevention strategies specifically designed to deal with lack of autonomy and reach sex-trafficked women and girls is imperative. PMID:19625022

Gupta, Jhumka; Raj, Anita; Decker, Michele R.; Reed, Elizabeth; Silverman, Jay G.

2009-01-01

126

Examining predictors of sex guilt in multiethnic samples of women  

Microsoft Academic Search

Previous research has shown that attitudes, including sex guilt, may influence the nature and type of sexual practices in which a person engages. This study examined the relationship of socioeconomic status (SES), ethnicity, and religiosity to sex guilt and aspects of sexual permissiveness that relate to sexual attitudes. Subjects were random samples of 126 African American women and 122 white

Gail E. Wyatt; Kristi M. Dunn

1991-01-01

127

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

PubMed

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. PMID:25059942

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

2015-01-01

128

TOO MANY MEN? SEX RATIOS AND WOMEN’S PARTNERING BEHAVIOR IN CHINA  

PubMed Central

The relative numbers of women and men are changing dramatically in China, but the consequences of these imbalanced sex ratios have received little attention. We merge data from the Chinese Health and Family Life Survey with community-level data from Chinese censuses to examine the relationship between cohort- and community-specific sex ratios and women’s partnering behavior. Consistent with demographic-opportunity theory and sociocultural theory, we find that high sex ratios (indicating more men relative to women) are associated with an increased likelihood that women marry before age 25. However, high sex ratios are also associated with an increased likelihood that women engage in premarital and extramarital sexual relationships and have had more than one sexual partner, findings consistent with demographic-opportunity theory but inconsistent with sociocultural theory. PMID:22199403

Trent, Katherine; South, Scott J.

2011-01-01

129

The epidemiology of serum sex hormones in postmenopausal women  

SciTech Connect

Serum sex hormones may be related to the risk of several diseases including osteoporosis, heart disease, and breast and endometrial cancer in postmenopausal women. In the current report, the authors examined the epidemiology of serum sex hormones in 176 healthy, white postmenopausal women (mean age 58 years) recruited from the metropolitan Pittsburgh, Pennsylvania, area. The data were collected during 1982-1983; none of the women were on estrogen replacement therapy. Serum concentrations of estrone, estradiol, testosterone, and androstenedione were measured by a combination of extraction, column chromatography, and radioimmunoassay. Neither age nor time since menopause was a significant predictor of sex hormones. The degree of obesity was a major determinant of estrone and estradiol. The estrone levels of obese women were about 40% higher than the levels of nonobese women. There was a weak relation between obesity and the androgens. Cigarette smokers had significantly higher levels of androstenedione than nonsmokers, with little difference in serum estrogens between smokers and nonsmokers. Both estrone and estradiol levels tended to decline with increasing alcohol consumption. Physical activity was an independent predictor of serum estrone. More active women had lower levels of estrone. There was a positive relation of muscle strength with estrogen levels. The data suggest interesting relations between environmental and lifestyle factors and serum sex hormones. These environmental and lifestyle factors are potentially modifiable and, hence, if associations between sex hormones and disease exist, modification of these factors could affect disease risks.

Cauley, J.A.; Kuller, L.H.; LeDonne, D. (Univ. of Pittsburgh, PA (USA)); Gutai, J.P. (Wayne State Univ., Detroit, MI (USA)); Powell, J.G. (East Carolina School of Medicine, Greenville, NC (USA))

1989-06-01

130

Relationship of Sex Guilt and Moral Reasoning to Premarital Sex in College Women and in Couples  

ERIC Educational Resources Information Center

Experiment I assessed 119 unmarried college women with regard to sex behavior, sex guilt, and moral reasoning. Experiment II assessed 76 unmarried college couples on the same variables. The pattern of results suggests that the male partner is more influential than the female in setting standards for the couple. (Author)

D'Augelli, Judith Frankel; Cross, Herbert J.

1975-01-01

131

Acculturation and the Hispanic Woman: Attitudes Toward Women, Sex-Role Attribution, Sex-Role Behavior, and Demographics  

Microsoft Academic Search

The present study investigated the relationship of acculturation to the variables of attitudes toward women, sex-role attribution, sex-role behaviors, and demographics in Hispanic women. First, Mexican American women, and other Hispanic women, were investigated to determine if they could be placed on a continuum of acculturation. Second, the relationship between different levels of acculturation and the above variables was investigated.

Edgar J. Kranau; Vicki Green; Gloria Valencia-Weber

1982-01-01

132

Estimates of the number of female sex workers in different regions of the world  

PubMed Central

Objectives To collect estimated numbers of female sex workers (FSW) and present proportions of FSW in the female population (FSW prevalence) in different regions of the world. Methods Subnational and national estimated numbers of FSW reported in published and unpublished literature, as well as from field investigators involved in research or interventions targeted at FSW, were collected. The proportion of FSW in the adult female population was calculated. Subnational estimates were extrapolated to national estimates if appropriate. Population surveys were scanned for proportions of adult women having sex in exchange for money or goods. Results In sub?Saharan Africa, the FSW prevalence in the capitals ranged between 0.7% and 4.3% and in other urban areas between 0.4% and 4.3%. Population surveys from this same region yielded even higher proportions of women involved in transactional sex. The national FSW prevalence in Asia ranged between 0.2% and 2.6%; in the ex?Russian Federation between 0.1% and 1.5%; in East Europe between 0.4% and 1.4%; in West Europe between 0.1% and 1.4%; and in Latin America between 0.2% and 7.4%. Estimates from rural areas were only available from one country. Conclusions Although it is well known and accepted that FSW are a highly vulnerable group in the scope of the HIV epidemic, most countries in the world do not know the size of this population group. The estimates of the prevalence of FSW presented in this paper show how important this hard?to?reach population group is in all parts of the world. PMID:16735288

Vandepitte, J; Lyerla, R; Dallabetta, G; Crabbé, F; Alary, M; Buvé, A

2006-01-01

133

Peer education reaches young women factory workers in Thailand.  

PubMed

In Thailand, the International Center for Research on Women conducted a study comparing the effect of various HIV/AIDS prevention activities on never-married women 14-24 years old who migrated to Chiang Mai to work in the export garment industry. These young women are very vulnerable to HIV/AIDS because they are freed from traditional norms and exposed to urban peer pressure. However, focus groups revealed that the women did not consider themselves at risk and feared negative reactions if they tried to discuss condoms with their boyfriends (who would equate knowledge with prior sexual experience). Among the interventions were a comic book which couched condom negotiation information in humorous terms and a romantic novel about a factory worker diagnosed with HIV. For 3 months trained peer leaders and health promoters led weekly educational sessions that included role-play. All participants were given a certificate noting that they had completed an AIDS education course. This certificate enabled the young women to broach the subject of AIDS with their boyfriends, their families, and their friends. The project improved their communication skills, their self-confidence, and their perceptions of risk. The most significant improvements were found among the women enrolled in the groups facilitated by peer leaders. Even though the peer leaders were not as knowledgeable as the health promoters, the peer leaders were more sensitive to the needs of the women and more capable of leading group discussions and participatory learning activities. PMID:12288826

Cash, K

1993-12-01

134

sex and the global fund: how sex workers, lesbians, gays, bisexuals, transgender people, and men who have sex with men are benefiting from the global fund, or not  

Microsoft Academic Search

The Global Fund to Fight AIDS, Tuberculosis and Malaria has allowed countries to bring their response to HIV\\/AIDS to an unprecedented scale, resulting in inno- vative projects that reach otherwise underserved communities with HIV prevention, treatment, and care. But in regions and countries where sex workers, men who have sex with men, or lesbian, gay, bisexual, and transgender persons are

Susana T. Fried; Shannon Kowalski-Morton

135

Protection and participation: an interactive programme introducing the female condom to migrant sex workers in Cambodia.  

PubMed

The female condom has received much attention for its potential to empower users in negotiating safer sex. Studies demonstrate that the process used to introduce the method can influence subsequent use rates, resulting in calls for comprehensive documentation of introduction activities. This paper details an intervention study introducing the female condom to Vietnamese sex workers in Cambodia. Part of a wider community mobilization approach to reducing HIV/AIDS transmission, the intervention emphasized informed debate, group skills building and collective support. Research methods included both quantitative and qualitative data collection to evaluate the introduction's effect on sex workers' negotiation skills and social support networks. The findings show that approximately 16% of sex workers tried the female condom. Ever-use was significantly associated with participation in intervention workshops, and with indicators of both individual and community empowerment. Sex workers who incorporated the female condom into their work were also more likely to feel a sense of community identity. Introduced through an appropriate process, the female condom can serve as an 'entry point' to building community capacity. It can support sex workers in achieving protected sex and developing cooperative relationships, even in severely restrictive settings. PMID:15203418

Busza, J; Baker, S

2004-05-01

136

Health outcomes among women trafficked for sex in the United States: a closer look.  

PubMed

Human trafficking is recognized as a major public health problem and a tragic transnational crime. Little is known about the health outcomes of victims of human trafficking. This study identifies the relationship of risk factors to physical, sexual, and mental health outcomes in three groups of women (N = 38) exploited for sex in the United States: international trafficking victims, domestic trafficking victims, and nontrafficked sex workers. To date this is the first study to examine the impact of risk factors on health outcomes using a sample of women trafficked for sex in the United States that includes both domestic and international victims. Overall, findings suggest that the experiences in sex work of domestic trafficking victims were dissimilar to those of international trafficking victims. Moreover, domestic trafficking victims displayed poorer health outcomes compared to international trafficking victims. In terms of risk factors, a higher percentage of women involved in street prostitution reported sexual health problems, co-occurring health issues, and addiction. Childhood physical/sexual victimization was related to poor physical health. PMID:23295378

Muftic, Lisa R; Finn, Mary A

2013-06-01

137

Medical, demographical and social aspects of syphilis: the case of infected sex workers in Greece during Interwar.  

PubMed

The aim of this research is to present syphilis among women described as "indecent" according to the records of the Venereal Diseases Hospital "Andreas Syggros", which is located in Athens, during the period 1931-1935. In impoverished Greece of the Interwar period, factors such as criminal ignorance, or lack of information on sexually transmitted diseases (STDs) along with inadequate health controls of sex workers, resulted in a dramatic spread of syphilis, whereas "Andreas Syggros" hospital accommodated thousands of patients. The inflow of 1.300.000 Greek refugees from Asia Minor, after the Greek defeat by the Turkish army in the war of 1922, resulted in a notable change in the demographics of the country, while the combination of miserable living conditions, unemployment, economic crisis of the Interwar period, political instability and dysfunction of the State led to an increased number of illegal sex workers and syphilis outbreaks. Despite the introduction of an ad hoc Act to control STDs since 1923, the State was unable to limit the transmissibility of syphilis and to control prostitution. Unfortunately, the value of this historical paradigm is borne out by a contemporary example, i.e. the scandal of HIV seropositive sex workers in -beset by economic crisis- Greece in May 2012. It turns out that ignorance, failure to comply with the law, change in the mentality of the citizens in an economically ruined society, and most notably dysfunction of public services during periods of crisis, are all risk factors for the spread of serious infectious diseases. PMID:25068236

Pagratis, N; Tsiamis, C; Mandyla, M; Bampounis, C; Anoyatis-Pele, D

2014-08-01

138

Partner Violence and Psychosocial Distress among Female Sex Workers in China  

PubMed Central

Background 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. Methods and Findings 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. Findings: 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. Conclusion 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. PMID:23626798

Hong, Yan; Zhang, Chen; Li, Xiaoming; Liu, Wei; Zhou, Yuejiao

2013-01-01

139

'We are despised in the hospitals': sex workers' experiences of accessing health care in four African countries.  

PubMed

Sex workers in east and southern Africa are exposed to multiple occupational health and safety risks. Detailed understanding of barriers to accessing care would optimise design of improved services for this population. In this study, trained sex workers conducted 55 in-depth interviews and 12 focus group discussions with 106 female, 26 male and 4 transgender sex workers across 6 urban sites in Kenya, Zimbabwe, Uganda and South Africa. Data were analysed thematically, following an interpretive framework. Participants cited numerous unmet health needs, including diagnosis and treatment for sexually transmitted infections and insufficient access to condoms and lubricant. Denial of treatment for injuries following physical assault or rape and general hostility from public-sector providers was common. Resources permitting, many sex workers attended private services, citing higher quality and respect for dignity and confidentiality. Sex workers in southern Africa accessed specialised sex worker clinics, reporting mostly positive experiences. Across sites, participants called for additional targeted services, but also sensitisation and training of public-sector providers. Criminalisation of sex workers and associated stigmatisation, particularly of transgender and male sex workers, hinder HIV-prevention efforts and render access to mainstream healthcare precarious. Alongside law reform, sex worker-led peer outreach work should be strengthened and calls by sex workers for additional targeted services heeded. PMID:23414116

Scorgie, Fiona; Nakato, Daisy; Harper, Eric; Richter, Marlise; Maseko, Sian; Nare, Prince; Smit, Jenni; Chersich, Matthew

2013-01-01

140

Characterizing sexual histories of women before formal sex-work in south India from a cross-sectional survey: implications for HIV/STI prevention  

PubMed Central

Background Interventions designed to prevent HIV and STIs in female sex-workers (FSWs) reach women after they formally enter the sex-trade. We aimed to characterize the pattern of sexual behaviour among FSWs from first-sex to when they identify as sex-workers (transition period) in a region with traditional (historically characterized by dedication into sex-work at first-sex) and non-traditional forms of sex-work. Methods We conducted a cross-sectional survey of 246 traditional and 765 non-traditional FSWs across three districts in Karnataka, India. We performed univariate and multivariate logistic regression to profile FSWs most likely to engage in a commercial first-sex before identifying as a sex-worker. Sexual life-course patterns were distinguished using univariate and multivariate linear regression based on key events associated with length of transition period. Results Overall, 266 FSWs experienced a commercial first-sex, of whom 45.9% (95% CI: 38.2,53.7) continued a long-term relationship with the first partner. In adjusted analysis, traditional FSWs were more likely to experience a commercial first-sex (AOR 52.5, 95% CI: 27.4,100.7). The average transition time was 8.8 years (SD 3.9), but there was considerable variability between respondents. Among women who experienced a commercial first-sex, a slower transition was independently associated with non-traditional sex-work, the presence of long-term partnerships during the transition period, and ongoing partnerships at time of entry into sex-work. In the absence of a commercial first-sex, a faster transition was associated with traditional sex-work and the dissolution of long-term partnerships, while a slower transition was associated with the presence of long-term partnerships and widowhood. Only 18.5% (95% CI: 12.7,26.2) and 47.3% (95% CI: 32.7,62.3) of women reported ‘always’ condom use with their long-term and occasional partners during the transition period, respectively. Conclusions FSWs identify as sex-workers several years after becoming sexually active, even when the first-sex is commercial in nature. Long-term partnerships are common after a commercial first-sex, and are associated with a delay in formally entering the sex-trade. The findings call for a better understanding of HIV/STI risk before FSWs identify as sex-workers, and an adaptive programme to reach this period of vulnerability. PMID:23020789

2012-01-01

141

Evaluation of a targeted HIV prevention programme among female commercial sex workers in the south of Thailand  

PubMed Central

OBJECTIVE: To evaluate a targeted HIV prevention programme among female commercial sex workers (CSWs) in the south of Thailand. SUBJECTS AND METHODS: A pretest-post-test comparison group study was carried out in Sungai Kolok and Betong between June and December 1994. In June 408 CSWs were entered in Sungai Kolok (the intervention area) and 343 CSWs were enrolled in Betong (the comparison area). In December 1994, 416 women were enrolled in Sungai Kolok and 342 in Betong. Of these women 37% (n = 283) also participated in the June survey. All women completed an oral interview and blood samples were collected for HIV serology. The intervention programme consisted of an informational and educational campaign and peer educator training. RESULTS: Increase in knowledge and perceived vulnerability was more pronounced in the intervention area but did not translate into a greater increase in condom use. Refusal of customers unwilling to use a condom and manager support in doing so were the only factors independently related to positive changes in condom use. HIV prevalence (approximately 20%) and incidence (approximately 4.2 per 100 women years) were the same in both study locations. Women in the intervention area reported significantly fewer customers and income from sex work, possibly as a result of a coincidental police campaign to suppress (child) prostitution. CONCLUSIONS: HIV incidence among CSWs in the south of Thailand is still high. Prevention programmes should focus on improvement of negotiation and refusal skills and manager support in using condoms. ??? PMID:9634305

van Griensven, G. J.; Limanonda, B.; Ngaokeow, S.; Ayuthaya, S. I.; Poshyachinda, V.

1998-01-01

142

Prevalence and Levels of Severity of Childhood Trauma among Mexican Female Sex Workers: A Comparison of Two Mexico Border Cities  

Microsoft Academic Search

The purpose of this study is to examine the prevalence of childhood trauma in a sample of female sex workers in Mexico. One hundred and nine female sex workers were recruited from Nuevo Laredo and Ciudad Juarez and administered the Childhood Trauma Questionnaire. Findings reveal a high prevalence rate of childhood trauma among the total sample (94%). Nuevo Laredo sex

Alice Cepeda

2011-01-01

143

Reconceptualizing the HIV Epidemiology and Prevention Needs of Female Sex Workers (FSW) in Swaziland  

PubMed Central

Background HIV is hyperendemic in Swaziland with a prevalence of over 25% among those between the ages of 15 and 49 years old. The HIV response in Swaziland has traditionally focused on decreasing HIV acquisition and transmission risks in the general population through interventions such as male circumcision, increasing treatment uptake and adherence, and risk-reduction counseling. There is emerging data from Southern Africa that key populations such as female sex workers (FSW) carry a disproportionate burden of HIV even in generalized epidemics such as Swaziland. The burden of HIV and prevention needs among FSW remains unstudied in Swaziland. Methods A respondent-driven-sampling survey was completed between August-October, 2011 of 328 FSW in Swaziland. Each participant completed a structured survey instrument and biological HIV and syphilis testing according to Swazi Guidelines. Results Unadjusted HIV prevalence was 70.3% (n?=?223/317) among a sample of women predominantly from Swaziland (95.2%, n?=?300/316) with a mean age of 21(median 25) which was significantly higher than the general population of women. Approximately one-half of the FSW(53.4%, n?=?167/313) had received HIV prevention information related to sex work in the previous year, and about one-in-ten had been part of a previous research project(n?=?38/313). Rape was common with nearly 40% (n?=?123/314) reporting at least one rape; 17.4% (n?=?23/314)reported being raped 6 or more times. Reporting blackmail (34.8%, n?=?113/314) and torture(53.2%, n?=?173/314) was prevalent. Conclusions While Swaziland has a highly generalized HIV epidemic, reconceptualizing the needs of key populations such as FSW suggests that these women represent a distinct population with specific vulnerabilities and a high burden of HIV compared to other women. These women are understudied and underserved resulting in a limited characterization of their HIV prevention, treatment, and care needs and only sparse specific and competent programming. FSW are an important population for further investigation and rapid scale-up of combination HIV prevention including biomedical, behavioral, and structural interventions. PMID:25531771

Baral, Stefan; Ketende, Sosthenes; Green, Jessie L.; Chen, Ping-An; Grosso, Ashley; Sithole, Bhekie; Ntshangase, Cebisile; Yam, Eileen; Kerrigan, Deanna; Kennedy, Caitlin E.; Adams, Darrin

2014-01-01

144

Risk Behaviors for Reproductive Tract Infection in Women Who Have Sex with Women in Beijing, China  

PubMed Central

Objectives To assess risk behaviors for reproductive tract infections (RTI) including sexually transmitted infections (STI) among women who have sex with women (WSW) in Beijing, China. Methods A cross-sectional study of women recruited from venues and internet outreach analyzed using interviews. Results We recruited 224 WSW, among whom were 37 couples. The average age of participants was 25.6 years. Sex with men in the past year was reported by 10.7% of participants. During the past year, 34.3% (77/224) had had >1 sexual partner and 72.4% (162/224) had ever had >1 sexual partner. Condom use in the last sex with a man was reported by 54.2% (13/24) of women; 12.5% (3/24) reported never having used a condom with a man in the past year. In the past year, 13.4% (30/224) reported using sex toys with their female partners; of these, 43.3% (13/30) reported consistent condom use with the sex toys and 36.7% (11/30) had shared sex toys. Among participants 65.2% (120/184) reported that their “G-spot” had been stimulated during sex, 49.2% (59/120) of whom reported bleeding during or after sex. Only 12.5% (8/64) of those never reporting “G spot” stimulation reported bleeding during or after sex (P<0.001). Conclusions WSW in Beijing engaged in high-risk sexual behaviors that may carry a substantial risk of being infected with STI/RTI. To implement STI/RTI prevention and intervention among women, women-women sexual behavior should be considered when doing research and intervention programs. PMID:22768334

Wang, Xiaofang; Norris, Jessie L.; Liu, Yingjie; Vermund, Sten H.; Qian, Han-Zhu; Han, Ling; Wang, Ning

2012-01-01

145

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

PubMed

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. PMID:22165257

Galldin, Karin; Robertson, Leslie; Wiseman, Charlene

2011-10-01

146

Cervical human papillomavirus infection among female sex workers in southern Vietnam  

PubMed Central

Background Cervical cancer is the most frequently diagnosed malignancy among women in southern Vietnam where its incidence is one of the highest observed worldwide. Results Cervical HPV DNA infection was measured in a cross-sectional sample of 282 female sex workers (FSW) in Soc Trang province in southern Vietnam. HPV DNA was detected in 85% of FSW and prevalence did not vary by age. Thirty-five HPV genotypes were detected; HPV 52 was the most common type. Half of HPV-positive women were infected with oncogenic types and 37% were infected with multiple genotypes. The prevalence of oncogenic HPV infection was lower among FSW with more formal education (adj. prevalence ratio = 0.63, 95% CI 0.42–0.93), those servicing 25 or more clients per month (adj. PR = 0.66 95% CI 0.48–0.92), and those engaging in withdrawal prior to ejaculation (adj. PR = 0.68, 95% CI 0.53–0.87). Oncogenic HPV prevalence was higher among FSW with regular male partners who had other female partners (adj. PR = 1.75, 95% CI 1.34–2.28) and FSW who were HIV+ (adj. PR = 1.42, 95% CI 1.08–1.88). Conclusion Our results demonstrate that although cervical HPV infection is extremely common among FSW in southern Vietnam, prevalence varies by education level, sexual activity, habits of regular partners, and HIV status. PMID:18433504

Hernandez, Brenda Y; Vu Nguyen, Thuong

2008-01-01

147

Utilisation of sexual health services by female sex workers in Nepal  

PubMed Central

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. PMID:21501473

2011-01-01

148

Sexual and reproductive health needs of sex workers: two feminist projects in Brazil.  

PubMed

The sexual and reproductive health needs of sex workers have been neglected both in research and public health interventions, which have almost exclusively focused on STI/HIV prevention. Among the reasons for this are the condemnation, stigma and ambiguous legal status of sex work. This paper describes work carried out by two feminist NGOs in Brazil, Mulher e Saúde (MUSA) in Belo Horizonte and Coletivo Feminista Sexualidade e Saúde in São Paulo, to promote sexual and reproductive health for sex workers. MUSA's project "In the Battle for Health", was begun in 1992; sex workers were trained as peer educators and workshops were offered on self-care for sex workers and their clients. In São Paulo, the Coletivo project "Get Friendly with Her", begun in 2002, offers clinic consultations and self-care workshops on sexuality, contraception, STI/HIV prevention and self-examination. Health care needs during menstruation and unhealthy vaginal practices led to promotion of the diaphragm as a contraceptive, for prevention of reproductive tract infection and to catch menstrual blood. Meeting the sexual and reproductive health needs of sex workers depends on the promotion of their human rights, access to health care without discrimination, and attention to psychosocial health issues, alcohol and drug abuse, and violence from clients, partners, pimps and police. PMID:17512382

Chacham, Alessandra S; Diniz, Simone G; Maia, Mônica B; Galati, Ana F; Mirim, Liz A

2007-05-01

149

Mental Health and Sexual Identity in a Sample of Male Sex Workers in the Czech Republic  

PubMed Central

Background Previous qualitative research has examined male sex workers in the Czech Republic, but this mapping study is the first to investigate male sex work in a quantitative research design and focus on the mental health of these sex workers. This study also examines male sex workers’ mental health problems in relation to their sexual identity or orientation. Material/Methods A sample of Czech male sex workers (N=40) were examined on a range of sexual and psychological variables using a quantitative survey administered face-to-face. The study employed locally validated versions of Beck’s Depression Inventory and Zung’s Self-Report Anxiety Scale. Results The results indicate that for homosexuals, working as a male sex worker is not related to any serious mental health problems. However, those identifying as heterosexual and bisexual more frequently reported symptoms of depression and bisexuals showed significantly more anxiety. Conclusions These findings suggest sexual identity is an important issue to consider when addressing the mental health needs of this population. PMID:25239091

Bar-Johnson, Michael; Weiss, Petr

2014-01-01

150

Violence against substance-abusing South African sex workers: intersection with culture and HIV risk  

Microsoft Academic Search

The Republic of South Africa has become an epicentre of heterosexual HIV transmission among Black women, and the interface between violence against women, substance abuse, and HIV risk is becoming evident. This paper describes the characteristics of Black South African women who engage in sex work in Pretoria and examines their intersecting experiences of high-risk sexual behaviour, substance abuse, and

W. M. Wechsberg; W. K. Luseno; W. K. Lam

2005-01-01

151

Sexual and physical violence against female sex workers in Kenya: a qualitative enquiry.  

PubMed

Few studies in Africa provide detailed descriptions of the vulnerabilities of female sex workers (FSW) to sexual and physical violence, and how this impacts on their HIV risk. This qualitative study documents FSW's experiences of violence in Mombasa and Naivasha, Kenya. Eighty-one FSW who obtained clients from the streets, transportation depots, taverns, discos and residential areas were recruited through local sex workers trained as peer counsellors to participate in eight focus-group discussions. Analysis showed the pervasiveness of sexual and physical violence among FSW, commonly triggered by negotiation around condoms and payment. Pressing financial needs of FSW, gender-power differentials, illegality of trading in sex and cultural subscriptions to men's entitlement for sex sans money underscore much of this violence. Sex workers with more experience had developed skills to avoid threats of violence by identifying potentially violent clients, finding safer working areas and minimising conflict with the police. Addressing violence and concomitant HIV risks and vulnerabilities faced by FSW should be included in Kenya's national HIV/AIDS strategic plan. This study indicates the need for multilevel interventions, including legal reforms so that laws governing sex work promote the health and human rights of sex workers in Kenya. PMID:21390890

Okal, Jerry; Chersich, Matthew F; Tsui, Sharon; Sutherland, Elizabeth; Temmerman, Marleen; Luchters, Stanley

2011-05-01

152

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

PubMed

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. PMID:22304493

Katsulis, Yasmina; Durfee, Alesha

2012-01-01

153

Indian men's use of commercial sex workers: prevalence, condom use, and related gender attitudes  

PubMed Central

Background/Objectives Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past-year CSW contact, condom non-use therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. Methods The nationally representative Indian National Family Health Survey-3 (NFHS-3) was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past-year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past-year CSW contact and inconsistent condom use. Results Approximately 1 in 100 ( 0.9%) Indian men reported past-year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never-married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (AOR=1.64; 95% CI 1.24, 2.17) and justification of violence against wives (AOR=1.41; 95% CI 1.03, 1.93). Conclusions Men's past-year CSW contact was concentrated among young and unmarried Indian men; condom non-use with CSWs was common. Traditional gender ideologies appeared to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk sub-populations and indicating that gender ideologies should be addressed. PMID:19904213

Decker, Michele R.; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G.

2013-01-01

154

Sex hormones in women on hemodialysis.  

PubMed

The pituitary-ovarian axis was studied in 12 women with a creatinine clearance of less than 5 ml/min per 17 m2, established on regular hemodialysis for at least 12 months. Follicle stimulating hormone (FSH) serum levels were found to be slightly lower than normal, luteinizing hormone (LH) plasma concentration generally elevated, while progesterone and estradiol values were extremely low. The major reproductive consequence of chronic renal failure in women on hemodialysis is a severe impairment in ovulatory function. PMID:6151921

Mantouvalos, H; Metallinos, C; Makrygiannakis, A; Gouskos, A

1984-10-01

155

Testosterone Plays Minor Role in Older Women's Sex Lives, Study Finds  

MedlinePLUS

... JavaScript. Testosterone Plays Minor Role in Older Women's Sex Lives, Study Finds Quality of relationships may have ... reproductive hormones have some effect on menopausal women's sex lives, their emotional health and quality of their ...

156

Sex hormones, appetite and eating behaviour in women.  

PubMed

Sex hormones play essential roles in the regulation of appetite, eating behaviour and energy metabolism and have been implicated in several major clinical disorders in women. Estrogen inhibits food intake, whereas progesterone and testosterone may stimulate appetite. This review describes recent findings concerning interactions between sex hormones and neuroendocrinological mechanisms in the control of appetite and eating in women. Furthermore, we are gaining insights into the roles played by sex hormones in the development of eating disorders and obesity. For instance, androgens may promote bulimia by stimulating appetite and reducing impulse control, a proposal supported by the observation that antiandrogenic treatment attenuates bulimic behaviour. Androgens are also involved in the pathophysiology of abdominal obesity in women. On the other hand, hormone replacement therapy with estrogen counteracts the weight gain and accumulation of abdominal fat associated with the menopausal transition. In conclusion, sex hormones and/or agents that exhibit similar activities may provide novel strategies for the treatment of eating disorders and android obesity, two of the most serious health problems for women today. PMID:22281161

Hirschberg, Angelica Lindén

2012-03-01

157

The Use of Female Commercial Sex Workers’ Services by Latino Day Laborers  

PubMed Central

This article reports the characteristics of Latino day laborers who have sex with female commercial sex workers (CSWs). A sample of 450 day laborers in Los Angeles was utilized. Multivariate logistic regression was used to determine the association of independent variables with the likelihood of having sex with a CSW. Overall, 26% of the 450 day laborers reported having had sex with a CSW in the previous 12 months. A lower likelihood of having sex with a CSW was found for those with more than six years of education and for those who were married and living with their spouses. A higher likelihood of having sex with a CSW was found for those who met the criteria for harmful drinking or drug dependence. Commercial sex work has been associated with sexually transmitted infections and other problems among clients of CSWs and warrants further attention by providers working with day laborers. PMID:20354572

Galván, Frank H.; Ortiz, Daniel J.; Martinez, Victor; Bing, Eric G.

2010-01-01

158

Reducing Sexual HIV/STI Risk and Harmful Alcohol Use Among Female Sex Workers in Mongolia: A Randomized Clinical Trial  

PubMed Central

This study examined the efficacy of an enhanced intervention to reduce sexual risk of HIV/STI and harmful alcohol use among female sex workers in Mongolia. Women (n = 166) were recruited and randomized to either (1) a relationship-based HIV sexual risk reduction intervention; (2) the same sexual risk reduction intervention plus motivational interviewing; or (3) a control condition focused on wellness promotion. At three and six month follow-up, both treatment interventions and the wellness promotion condition were effective in reducing the percentage and the number of unprotected acts of vaginal sex with paying partners in the past 90 days. All three conditions demonstrated efficacy in reducing harmful alcohol use. No significant differences in effects were observed between conditions. Findings suggest that even low impact behavioral interventions can achieve considerable reductions of HIV/STI risk and harmful alcohol use with a highly vulnerable population in a low resourced setting. PMID:21739290

Altantsetseg, Batsukh; Aira, Toivgoo; Riedel, Marion; Chen, Jiehua; Potocnik, Katie; El-Bassel, Nabila; Wu, Elwin; Gilbert, Louisa; Carlson, Catherine; Yao, Hanfei

2014-01-01

159

Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women.  

PubMed Central

OBJECTIVES: The purpose of this study was to examine frequency of and attitudes toward Papanicolaou (Pap) test screening in women who have sex with women (WSW) and to determine prevalence of genital human papillomavirus (HPV). METHODS: Women were eligible if they reported having engaged in sex with another woman in the preceding year Medical and sexual histories were obtained. Cervical specimens for Pap tests and cervical and vaginal specimens for HPV DNA testing were collected. RESULTS: HPV DNA was detected in 31 of 248 WSW (13%). Women who had never had sex with men were less likely to have undergone pelvic examinations and had fewer recent Pap tests. Reasons for not undergoing Pap tests included lack of insurance, previous adverse experiences, and belief that Pap tests were unnecessary. CONCLUSIONS: Despite the occurrence of genital HPV, WSW do not receive adequate Pap test screening. Pap test screening recommendations should not differ for WSW, regardless of sexual history with men. PMID:11392939

Marrazzo, J M; Koutsky, L A; Kiviat, N B; Kuypers, J M; Stine, K

2001-01-01

160

Female sex workers and the social context of workplace violence in Tijuana, Mexico.  

PubMed

Gender-based violence in the workplace impacts the physical and emotional wellbeing of sex workers and may lead to other health problems, such as PTSD and depression, drug abuse, and a greater likelihood of sexually transmitted infections. This study examines the social context of workplace violence and risk avoidance in the context of legal regulations meant to reduce harms associated with the industry. Ethnographic research, including 18 months of extended field observations and interviews with 190 female sex workers, is used to illustrate how sex workers in Tijuana, Mexico, experience and manage workplace violence. Multiple subthemes emerge from this analysis, including deciding where to work, working with a third party, avoiding theft, and dealing with police. These findings support the idea that the risk of violence is part of a larger "hierarchy of risk" that can result in a "tradeoff" of harms. PMID:20949840

Katsulis, Yasmina; Lopez, Vera; Durfee, Alesha; Robillard, Alyssa

2010-09-01

161

Sex with women among men who have sex with men in China: prevalence and sexual practices.  

PubMed

Men who have sex with men and women (MSMW) are a potential bridge population for transmitting HIV to heterosexual women. This study assessed key characteristics of this subgroup of men who have sex with men (MSM) in China. Of 1141 eligible MSM, 45.6% reported bisexual behaviors. Besides marriage as a strong predictor (odds ratio: 23.90, 95% confidence interval: 14.29-39.98), older age (1.12, 1.10-1.15) and lower education (or no college education) (1.98, 1.52-2.59) were also independently associated with having ever had sex with women. MSMW reported higher proportions of alcohol drinking, heterosexual/bisexual orientation, and preference for an insertive role in anal sex than men who had sex with men only; but there was no statistically significant difference between two groups in prevalence of HIV and syphilis infections and in history of sexually transmitted infections. HIV prevention intervention programs should break the bridging role of HIV transmission in MSMW population. PMID:23931683

Tao, Jun; Ruan, Yuhua; Yin, Lu; Vermund, Sten H; Shepherd, Bryan E; Shao, Yiming; Qian, Han-Zhu

2013-09-01

162

Sex with Women Among Men Who Have Sex with Men in China: Prevalence and Sexual Practices  

PubMed Central

Abstract Men who have sex with men and women (MSMW) are a potential bridge population for transmitting HIV to heterosexual women. This study assessed key characteristics of this subgroup of men who have sex with men (MSM) in China. Of 1141 eligible MSM, 45.6% reported bisexual behaviors. Besides marriage as a strong predictor (odds ratio: 23.90, 95% confidence interval: 14.29–39.98), older age (1.12, 1.10–1.15) and lower education (or no college education) (1.98, 1.52–2.59) were also independently associated with having ever had sex with women. MSMW reported higher proportions of alcohol drinking, heterosexual/bisexual orientation, and preference for an insertive role in anal sex than men who had sex with men only; but there was no statistically significant difference between two groups in prevalence of HIV and syphilis infections and in history of sexually transmitted infections. HIV prevention intervention programs should break the bridging role of HIV transmission in MSMW population. PMID:23931683

Tao, Jun; Ruan, Yuhua; Yin, Lu; Vermund, Sten H.; Shepherd, Bryan E.; Shao, Yiming

2013-01-01

163

Have sex will travel: romantic ‘sex tourism’ and women negotiating modernity in the Sinai  

Microsoft Academic Search

Since the 1970s, studies on western women's ethnosexual tourist–local relationships have tended to focus on the beaches of the Caribbean and have come to one of two main conclusions – either they are no different from the overtly exploitative relationships of heterosexual male sex tourists or they are different because they involve a softer, caring element of romance. This article

Jessica Jacobs

2009-01-01

164

Subcommittee fails to recommend legal reforms needed to promote human rights of sex workers.  

PubMed

In December 2006, the House of Commons Subcommittee on Solicitation Laws released its longawaited report on the criminal laws related to prostitution in Canada, entitled The Challenge of Change: A Study of Canada's Criminal Prostitution Laws. The Subcommittee's report fails to call for amendments to the Criminal Code provisions which have been demonstrated to increase the health and safety threats faced by sex workers. The Canadian HIV/AIDS Legal Network and two sex worker organizations, Stella and Maggie's, jointly published an analysis of the report. PMID:17715519

Mar, Leon; Betteridge, Glenn

2007-05-01

165

‘Who is Helsinki?’ Sex workers advise improving communication for good participatory practice in clinical trials  

PubMed Central

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 ethical concerns. This study investigated sex workers’ knowledge and beliefs about research ethics and good participatory practices (GPP) and the perspectives of sex workers on research participation. A 33-question survey based on criteria identified by UNAIDS and AVAC was translated into three other languages. Participants were recruited through mailing lists and contacts with existing sex work networks. In total, 74 responses from Europe, the Americas and Asia were received. Thirty percent of respondents reported first-hand involvement in biomedical HIV prevention trials. Seventy percent indicated a lack of familiarity with codes of ethics for research. This paper focuses exclusively on communication issues described in survey responses. Communication was an important theme: the absence of clear communication between trial participants and investigators contributed to premature trial closures in at least two sites. Sex workers had recommendations for how researchers might implement GPP through improved communication, including consultation at the outset of planning, explaining procedures in non-technical terms and establishing clear channels for feedback from participants. PMID:21263066

Ditmore, Melissa Hope; Allman, Dan

2011-01-01

166

A Profile of HIV Risk Factors in the Context of Sex Work Environments among Migrant Female Sex Workers in Beijing, China  

PubMed Central

Migrant female sex workers (FSWs) are one of the most at-risk populations for HIV in China. This study demonstrates how multiple risk factors are situated and vary by types of sex work environments in a sample of 348 migrant FSWs in Beijing. Participants reported high rates of clients' refusal to use condoms (76%), unsafe sex with both clients (32%), non-paid regular partners (e.g., boyfriend or husband) (76%), and a STI symptom (79%) last year. Only 22% of FSWs had been tested for HIV. Risk factors were compared by three types of sex work environments: (1) entertainment establishments, (2) personal services sectors, and (3) street-based venues, including roadside brothels. Street-based FSWs, compared to the other FSWs, were more likely to be older, married with children, migrate from rural areas, and be arrested by police, and less likely to be educated, have contact with prevention services, be knowledgeable about HIV, and be tested for HIV. The FSWs in entertainment establishments were more likely than street-based FSWs to have reported being physically, verbally, and/or sexually abused by clients. Multiple discriminant analysis distinguished a profile of two different groups of risk factors: (1) police arrest, lack of protection from violence, access to prevention and health care, and HIV knowledge, and (2) verbal and physical abuse and clients' refusal of condom use. In the massive internal migration in China, disadvantages in economic sectors drive women to become involved in sex work. HIV prevention strategies must target socio-structural factors embedded in sex work environments. PMID:20391235

Yi, Huso; Mantell, Joanne E.; Wu, Rongrong; Lu, Zhao; Zeng, Jing; Wan, Yanhai

2010-01-01

167

Induced abortion, contraceptive use, and dual protection among female sex workers in Moscow, Russia  

PubMed Central

Objective To describe abortion history and current contraceptive use among female sex workers (FSWs) in Moscow, Russia. Methods A clinic-based survey was conducted among 147 FSWs in Moscow during an 8-month period in 2005. Results In total, 83 of 143 (58.0%) FSWs reported a history of abortion, with 45 of 143 (31.5%) indicating multiple abortions. Condoms were the primary form of contraception (145/146 [99.3%]); just 17 of 142 (12.0%) FSWs reported using non-barrier modern contraception. All women who reported using a non-barrier modern method also indicated condom use (i.e. dual protection). Non-barrier contraceptive use was associated with inconsistent condom use (odds ratio [OR] 3.10; 95% confidence interval [CI], 1.07–9.02) and multiple abortions (OR 4.71; 95% CI, 1.19–18.62). Conclusion The results illustrate substantial risk for unintended pregnancy among FSWs. Further research is needed regarding the dynamics of non-barrier contraception and condom use. Efforts to improve the health and wellbeing of FSWs should include access to safe and effective contraception, in addition to HIV prevention. PMID:23083495

Decker, Michele R.; Yam, Eileen A.; Wirtz, Andrea L.; Baral, Stefan D.; Peryshkina, Alena; Mogilnyi, Vladmir; Beyrer, Chris

2012-01-01

168

Violence, HIV risk behaviour and depression among female sex workers of eastern Nepal  

PubMed Central

Objectives The primary objective of the study was to estimate the prevalence of depression among female sex workers (FSWs) of eastern Nepal. The secondary objective was to search for an association between depression, violence and HIV risk behaviour. Design Cross-sectional/observational study. Study setting This study was carried out in five cities of eastern Nepal (Dharan, Itahari, Biratnagar, Damak and Birtamode). Both restaurant-based and street-based FSWs were recruited in the study. Participants Women who had been involved in commercial sex activity in the past 6?months and gave informed consent were included in the study. Primary outcome measure A score of more than or equal to 16 on the Centre for Epidemiological Studies Depression (CESD) scale was considered as depression. Methodology Face-to-face interviews were conducted with respondents who were sought through a snowball sampling technique. Information regarding their depression status, HIV high-risk behaviour and violence was recorded. The estimated sample size was 210. Results We interviewed 210 FSWs (both restaurant-based and street-based). The prevalence of depression among respondents was 82.4%. FSWs who had experienced violence were five times more likely to be depressed than those who were not victims of violence. The odds of depression were six times higher among respondents who were involved in any HIV risk behaviour compared with those who were not involved. Conclusions The present study reports a high prevalence of depression, HIV risk behaviours and violence among FSWs of eastern Nepal. The mental health of FSWs should also be regarded as an important aspect of HIV prevention efforts which can help to promote the overall health of this population. PMID:23794589

Sagtani, Reshu Agrawal; Bhattarai, Sailesh; Adhikari, Baikuntha Raj; Baral, Dharanidhar; Yadav, Deepak Kumar; Pokharel, Paras Kumar

2013-01-01

169

Internet Use Among Female Sex Workers in China: Implications for HIV\\/STI Prevention  

Microsoft Academic Search

Based on a cross-sectional survey with 1,022 female sex workers (FSWs) recruited from different types of commercial sex venues\\u000a in Southwest China, we examined their Internet-using behaviors and explored the feasibility of Internet-based HIV\\/STI intervention\\u000a in this population. About 75% of FSWs were Internet users; among them 57% were frequent users, and 40% had searched HIV\\/STI\\u000a information online. Internet use

Yan Hong; Xiaoming Li; Xiaoyi Fang; Xiuyun Lin; Chen Zhang

2011-01-01

170

HIV Risk and Social Networks Among Male-to-Female Transgender Sex Workers in Boston, Massachusetts  

PubMed Central

Male-to-female transgender individuals who engage in sex work constitute a group at high risk for HIV infection in the United States. This mixed-methods formative study examined sexual risk among preoperative transgender male-to-female sex workers (N = 11) in Boston. More than one third of the participants were HIV-infected and reported a history of sexually transmitted diseases. Participants had a mean of 36 (SD = 72) transactional male sex partners in the past 12 months, and a majority reported at least one episode of unprotected anal sex. Qualitative themes included (a) sexual risk, (b) motivations for engaging in sex work, (c) consequences of sex work, (d) social networks (i.e., “trans mothers,” who played a pivotal role in initiation into sex work), and (e) potential intervention strategies. Results suggest that interventions with transgender male-to-female sex workers must be at multiple levels and address the psychosocial and environmental contexts in which sexual risk behavior occurs. PMID:19732696

Reisner, Sari L.; Mimiaga, Matthew J.; Bland, Sean; Mayer, Kenneth H.; Perkovich, Brandon; Safren, Steven A.

2013-01-01

171

“Every Peasant Girl Knows How to Sweep!”: Sweeping Women Workers in Hefei, China  

Microsoft Academic Search

This paper is a qualitative study investigating the working lives of twenty-six Chinese sweeping women workers in Hefei, Anhui Province, in the P. R. of China. Most participants were illiterate peasant women called nongmingong, migrants from the Chinese countryside. The study's methodology was a project called reframing suggested by Tuhiwai-Smith (1999), used for researching indigenous populations. The sweeping workers suggested

Deirdre Mary Smythe

2004-01-01

172

HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia  

Microsoft Academic Search

Objectives: To establish the prevalence of HIV, syphilis, and sexual risk behaviour among three groups of men who have sex with men in Jakarta, Indonesia, and to investigate sexual links between these men and broader heterosexual populations.Methods: Anonymous, cross sectional surveys among community recruited transgender and male sex workers and self recognised men who have sex with men (MSM) were

E Pisani; P Girault; M Gultom; N Sukartini; J Kumalawati; S Jazan; E Donegan

2004-01-01

173

Women and Sex at Midlife: Desire, Dysfunction, and Diversity  

Microsoft Academic Search

Arewomen likely to experience more sexual and relationship satisfaction in midlife than in earlier periods of their lives?\\u000a Which women are, and why? Does a woman experience heterosexual partner sex more positively when she is no longer responsible\\u000a for birth control or parenting? In what ways, if any, do the sexual relations of aging lesbians improve over time? Arewomen\\u000a who

Maureen C. McHugh

174

Seductive father-daughter relationships and sex roles in women  

Microsoft Academic Search

The present study evaluated the relationship of three variables reportedly characteristic of families in which father-daughter incest occurs to women's sex-role functioning and attitudes toward heterosexual interactions. The results showed that a sexualized father-daughter relationship was correlated with negative male traits (e.g., arrogance), low levels of positive female traits (emotionality), and negative attitudes toward male sexuality and female competitiveness. Discord

Joseph D. LaBarbera

1984-01-01

175

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

PubMed

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. PMID:22293067

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

2012-01-01

176

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

ERIC Educational Resources Information Center

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…

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

2005-01-01

177

"Who Is Helsinki" Sex Workers Advise Improving Communication for Good Participatory Practice in Clinical Trials  

ERIC Educational Resources Information Center

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…

Ditmore, Melissa Hope; Allman, Dan

2011-01-01

178

Genital Chlamydia trachomatis (serotypes DK) infection in Jamaican commercial street sex workers  

Microsoft Academic Search

OBJECTIVES: To determine the prevalence of genital Chlamydia trachomatis infections in commercial street sex workers (CSSW) in Jamaica. METHODS: The prevalence of C trachomatis infection was determined in 129 Jamaican CSSW using the direct fluorescent antibody (DFA) method and the isolation techniques which utilise fluorescent and iodine staining of endocervical cytobrush specimens cultured in McCoy cells. The seroprevalence of C

G Dowe; S D King; A R Brathwaite; Z Wynter; R Chout

1997-01-01

179

Demographic Correlates of Constant Condom Use among Sex Workers in Tangail, Dhaka, Bangladesh  

ERIC Educational Resources Information Center

Consistent condom use, particularly by promiscuous individuals, is a major safeguard against sexually transmitted diseases, including HIV/AIDS. This study examines some demographic factors that may affect such use among Bangladeshi female commercial sex workers at a brothel in Tangail (n = 196; mean age = 23.44 years), and the streets of Dhaka (n…

Eva, Nilufar Akter; Munakata, Tsunetsugu; Onuoha, Francis N.

2007-01-01

180

Age Differences among Female Sex Workers in the Philippines: Sexual Risk Negotiations and Perceived Manager Advice  

PubMed Central

Consistent condom use among high risk groups such as female sex workers (FSWs) remains low. Adolescent female sex workers are especially at higher risk for HIV/STI infections. However, few published studies have compared the sexual risk negotiations among adolescent, emerging adult, and older age groups or the extent a manager's advice about condom use is associated with an FSW's age. Of 1,388 female bar/spa workers surveyed in the southern Philippines, 791 FSW who traded sex in the past 6 months were included in multivariable logistic regression models. The oldest FSWs (aged 36–48) compared to adolescent FSWs (aged 14–17) were 3.3 times more likely to negotiate condoms when clients refused condom use. However, adolescent FSWs received more advice from their managers to convince clients to use condoms or else to refuse sex, compared to older FSWs. Both adolescent and the oldest FSWs had elevated sexually transmitted infections (STIs) and inconsistent condom use compared to other groups. Having a condom rule at the establishment was positively associated with condom negotiation. Factors such as age, the advice managers give to their workers, and the influence of a condom use rule at the establishment need to be considered when delivering HIV/STI prevention interventions. PMID:22848800

Urada, Lianne A.; Malow, Robert M.; Santos, Nina C.; Morisky, Donald E.

2012-01-01

181

The Role of Sex Guilt in the Relationship Between Culture and Women’s Sexual Desire  

Microsoft Academic Search

A large body of literature demonstrates that East Asian women report lower sexual desire than Caucasian women. Although most\\u000a studies have explained these differences by referring to general culture-linked differences in sexual conservatism, none have\\u000a examined the potential role of specific constructs such as sex guilt. The goals of the current study were to examine the supposition\\u000a that sexual conservatism

Jane S. T. Woo; Lori A. Brotto; Boris B. Gorzalka

2011-01-01

182

Sex-ratio conflict between queens and workers in eusocial Hymenoptera: mechanisms, costs, and the evolution of split colony sex ratios.  

PubMed

Because workers in the eusocial Hymenoptera are more closely related to sisters than to brothers, theory predicts that natural selection should act on them to bias (change) sex allocation to favor reproductive females over males. However, selection should also act on queens to prevent worker bias. We use a simulation approach to analyze the coevolution of this conflict in colonies with single, once-mated queens. We assume that queens bias the primary (egg) sex ratio and workers bias the secondary (adult) sex ratio, both at some cost to colony productivity. Workers can bias either by eliminating males or by directly increasing female caste determination. Although variation among colonies in kin structure is absent, simulations often result in bimodal (split) colony sex ratios. This occurs because of the evolution of two alternative queen or two alternative worker biasing strategies, one that biases strongly and another that does not bias at all. Alternative strategies evolve because the mechanisms of biasing result in accelerating benefits per unit cost with increasing bias, resulting in greater fitness for strategies that bias more and bias less than the population equilibrium. Strategies biasing more gain from increased biasing efficiency whereas strategies biasing less gain from decreased biasing cost. Our study predicts that whether queens or workers evolve alternative strategies depends upon the mechanisms that workers use to bias the sex ratio, the relative cost of queen and worker biasing, and the rates at which queen and worker strategies evolve. Our study also predicts that population and colony level sex allocation, as well as colony productivity, will differ diagnostically according to whether queens or workers evolve alternative biasing strategies and according to what mechanism workers use to bias sex allocation. PMID:16526510

Helms, Ken R; Reuter, Max; Keller, Laurent

2005-12-01

183

Perceived stigma of purchasing sex among latino and non-latino male clients of female sex workers in tijuana, Mexico.  

PubMed

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. PMID:23979714

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

2015-02-01

184

Opening Pathways to Cancer Screening for Vietnamese-American Women: Lay Health Workers Hold a Key  

Microsoft Academic Search

Purpose.We describe a controlled trial of a community outreach intervention to promote recognition, receipt, and screening-interval maintenance of clinical breast examinations (CBE), mammograms, and Pap smears among Vietnamese-American women.Methods.Over a 3-year period, indigenous lay health workers conducted small-group sessions of Vietnamese women in a low-income district of San Francisco, California. Women in Sacramento, California, served as controls. Lay workers conducted

Joyce Adair Bird; Stephen J. McPhee; Ngoc-The Ha; Bich Le; Thomas Davis; Christopher N. H. Jenkins

1998-01-01

185

Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers?  

PubMed Central

Some quantitative behavioral studies in the USA have concluded that bisexually behaving Latino men are less likely than White men to disclose to their female partners that they have engaged in same-sex risk behavior and/or are HIV-positive, presumably exposing female partners to elevated risk for HIV infection. Nevertheless, very little theoretical or empirical research has been conducted to understand the social factors that promote or inhibit sexual risk disclosure among Latino men who have sex with men (MSM), and much of the existing literature has neglected to contextualize disclosure patterns within broader experiences of stigma and social inequality. This paper examines decisions about disclosure of sex work, same-sex behavior, and sexual risk for HIV among male sex workers in two cities in the Dominican Republic. Data derive from long-term ethnography and qualitative in-depth interviews with 72 male sex workers were used to analyze the relationships among experiences of stigma, social inequality, and patterns of sexual risk disclosure. Thematic analysis of interviews and ethnographic evidence revealed a wide range of stigma management techniques utilized by sex workers to minimize the effects of marginality due to their engagement in homosexuality and sex work. These techniques imposed severe constraints on men’s sexual risk disclosure, and potentially elevated their own and their female partners’ vulnerability to HIV infection. Based on the study’s findings, we conclude that future studies of sexual risk disclosure among ethnic minority MSM should avoid analyzing disclosure as a decontextualized variable, and should seek to examine sexual risk communication as a dynamic social process constrained by hierarchical systems of power and inequality. PMID:18410986

Padilla, Mark; Castellanos, Daniel; Guilamo-Ramos, Vincent; Reyes, Armando Matiz; Sánchez Marte, Leonardo E.; Soriano, Martha Arredondo

2010-01-01

186

Sex hormones in women in rural China and in Britain.  

PubMed Central

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group. PMID:2223580

Key, T. J.; Chen, J.; Wang, D. Y.; Pike, M. C.; Boreham, J.

1990-01-01

187

Managing the public health risk of a 'sex worker' with hepatitis B infection: legal and ethical considerations.  

PubMed

This paper examines the ethical issues faced by health workers managing a fictional case of a female sex worker who is hepatitis B positive with a high level of virus but is asymptomatic. According to guidelines she does not require treatment herself, but is potentially highly infectious to others. Recent legal cases in the UK show it can be criminal to pass on HIV or hepatitis B infection sexually if the risk is known and the partner has not been informed. However, there is no statute or case law showing that health workers are required to intervene to prevent such a potential 'crime', particularly when the partners are unknown, as in this case. The health workers could respond in various ways. They could do nothing, thus making further infection probable. They could advise the sex worker to use condoms and to inform her clients. They could treat the sex worker to reduce her level of infectivity, although there is no benefit to her. They could disclose the sex worker's status, although breaking confidentiality is a serious matter ethically and may be of no benefit to the unknown client group. Regulating prostitution might help; but sex workers with infection may work off licence. This paper discusses the clinical, moral and ethical issues associated with such a scenario and concludes that the most beneficial course is to target clients, through health education, to recognise the potential risks of infection from a sex worker and to take suitable precautions including immunisation against hepatitis B. PMID:21546521

Poll, Ray

2011-10-01

188

Nontraditional sex role aspirations, gender identity conflict, and disordered eating among college women  

Microsoft Academic Search

Many studies point directly to the role played by sex roles and indirectly to the role played by gender identity in the onset of disordered eating. In this study, women who report adhering to nontraditional sex role aspirations are almost twice as likely as other women to report purging or frequent bingeing. Women who exhibit gender identity conflict by drawing

Brett Silverstein; Shari Carpman; Deborah Perlick; Lauren Perdue

1990-01-01

189

Cues to the sex ratio of the local population influence women's preferences for facial symmetry  

E-print Network

Cues to the sex ratio of the local population influence women's preferences for facial symmetry-00762 Keywords: attraction dominance fluctuating asymmetry mate preference sex ratio within-sex competition intensifies within-sex competition. In two experiments, we tested for analogous effects in humans

Little, Tony

190

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

PubMed

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. PMID:25307025

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

2014-10-12

191

Prevalence and correlates of HIV infection and sexually transmitted infections in female sex workers (FSWs) in Shanghai, China.  

PubMed

SUMMARY In 2009, we examined HIV and sexually transmitted infections (STIs) in 750 female sex workers (FSWs) in Shanghai using a cross-sectional survey. Participants (mean age 27 years) were interviewed and tested for HIV and selected STIs. Prevalence was: HIV 0·13%, chlamydia 14·7%, gonorrhoea 3·5% and syphilis 1·3%. In a demographic multivariate model, younger age, higher income and originating from provinces other than Zhejiang and Shanghai were independently associated with STI. In a social and sexual behavioural model, women working in small venues with fewer clients per week, use of drugs, and higher price charged per sex act indicated a greater risk for STI. Although HIV appears rare in Shanghai FSWs, chlamydial infection is common, especially in women aged <25 years (prevalence 19·6%). Since STI and HIV share similar risk factors, preventive intervention measures should be implemented immediately based on the venues and characteristics of FSWs to prevent future spread of HIV. PMID:24759515

Remis, R S; Kang, L; Calzavara, L; Pan, Q; Liu, J; Myers, T; Ren, J; Tang, X

2015-01-01

192

A pragmatic intervention to promote condom use by female sex workers in Thailand.  

PubMed Central

An overview is presented of a multifaceted intervention to promote consistent condom use by female commercial sex workers in Thailand, in the context of the government's 100% condom use policy for preventing spread of human immunodeficiency virus (HIV) infection. The project is described with reference to a succession of stages including pre-programme needs assessment, intervention design, implementation and evaluation. The key elements of the intervention were video scenarios and discussions coordinated by health personnel, and video-depicted open-ended narratives aimed at helping sex workers to explore their personal and work-related dilemmas and concerns. A core objective was to enhance sex workers' self-esteem and perceived future with a view to strengthening their motivation to take preventive action against HIV infection. The intervention was evaluated using a combination of qualitative (process evaluation) and quantitative (outcome) methods. The outcome evaluation was undertaken using a pretest, post-test intervention and control group quasi-experimental design. There were significant increases in consistent condom use among the intervention groups but not among the controls. Pragmatic stability is advocated for the Thai sex industry and recommendations are offered for good quality HIV prevention activities. PMID:10612884

Ford, N.; Koetsawang, S.

1999-01-01

193

Setting Occupational Sex Segregation in Motion: Demand-Side Explanations of Sex Traditional Employment  

Microsoft Academic Search

The employment of women in female-dominated occupations and men in male-dominated occu- pations (sex traditional employment) is a fundamental source of economic sex inequality. Despite this, we know little about how organizational practices and policies link workers to sex traditional jobs. The author tests theoretically hypothesized determinants of sex traditional employment using data on the sex of the last hire

JULIE A. KMEC

2005-01-01

194

Who are the preferential targets for intervention programs related to the female condom among sex workers in southern China?  

PubMed

The authors used a cluster analysis approach to investigate which female sex workers (FSW) are preferential targets for female condom (FC) intervention programs in southern China. Cross-sectional 6-month (N = 316) and 12-month (N = 217) postintervention surveys of FSW were analyzed. Based on FC attitudes and beliefs, initially suggesting FC use to a partner, practicing insertion, total times ever used, and willingness to use in the future, cluster analysis apportioned women into two clusters, with 50.6% and 58.1% of participants in the likely future FC users group at 6 months and 12 months, respectively. Likely future FC users tended to be from boarding houses, older, currently or previously married, experienced with childbirth, with current multiple sex partners, longer history of sex work, and more unprotected sexual encounters. Focusing FC programs on sectors of the community with more FSW who are likely to use FC may be more cost-effective for enhancing FC acceptability and usage. PMID:23837812

Wang, Yanhong; Liao, Susu; Jiang, Jingmei; Weeks, Margaret R; Nie, Li; Li, Jianghong; He, Bin; Zhou, Yuejiao; Li, Fei; Dunn, Jennifer; Zhang, Qingning

2013-08-01

195

Reducing Intimate and Paying Partner Violence Against Women Who Exchange Sex in Mongolia: Results From a Randomized Clinical Trial  

PubMed Central

Women who exchange sex for money or other goods, that is, female sex workers, are at increased risk of experiencing physical and sexual violence from both paying and intimate partners. Exposure to violence can be exacerbated by alcohol use and HIV/STI risk. The purpose of this study is to examine the efficacy of a HIV/STI risk reduction and enhanced HIV/ STI risk reduction intervention at decreasing paying and intimate partner violence against Mongolian women who exchange sex and engage in harmful alcohol use. Women are recruited and randomized to either (a) four sessions of a relationship-based HIV/STI risk reduction intervention (n = 49), (b) the same HIV/STI risk reduction intervention plus two additional motivational interviewing sessions (n = 58), or (c) a four session control condition focused on wellness promotion (n = 59). All the respondents complete assessments at baseline (preintervention) as well as at immediate posttest, 3 and 6 months postintervention. A multilevel logistic model finds that women who participated in the HIV/STI risk reduction group (OR = 0.14, p < .00), HIV/STI risk reduction and motivational interview group (OR = 0.46, p = .02), and wellness (OR = 0.20, p < .00) group reduced their exposure to physical and sexual violence in the past 90 days. No significant differences in effects are observed between conditions. This study demonstrates the efficacy of a relationship-based HIV/STI risk reduction intervention, a relationship-based HIV/STI risk reduction intervention combined with motivational interviewing, and a wellness promotion intervention in reducing intimate and paying partner violence against women who exchange sex in Mongolia. The findings have significant implications for the impact of minimal intervention and the potential role of peer networks and social support in reducing women’s experiences of violence in resource poor settings. PMID:22366477

Carlson, Catherine E.; Chen, Jiehua; Chang, Mingway; Batsukh, Altantsetseg; Toivgoo, Aira; Riedel, Marion; Witte, Susan S.

2014-01-01

196

Understanding out-migration among female sex workers in South India  

PubMed Central

BACKGROUND Migrant sex workers are known to be vulnerable to HIV. There is substantial female sex worker (FSW) mobility between the borders of Maharashtra and Karnataka, but little programming emphasis on migrant FSWs in India. We sought to understand the individual/cultural, structural and contextual determinants of migration among FSWs from Karnataka. METHODS A cross sectional face-to-face interview of 1567FSWs from 142 villages in 3 districts of northern Karnataka, India was conducted from January–June 2008. Villages having 10+FSWs, a large number of whom were migrant, were selected following mapping of FSWs. Multinomial logistic regression was conducted to identify characteristics associated with migrant (travelled for ?2weeks outside the district past year) and mobile (travelled for <2weeks outside the district past year) FSWs; adjusting for age and district. RESULTS Compared to non-migrants, migrant FSWs were more likely to be brothel than street-based (AOR 5.7; 95%CI 1.6–20.0), have higher income from sex work (AOR 42.2; 12.6–142.1), speak >2languages (AOR 5.6%; 2.6–12.0), have more clients (AORper client 2.9; 1.2–7.2) and have more sex acts/day (AORper sex act 3.5; 1.3–9.3). Mobile FSWs had higher income from sex work (AOR=13.2; 3.9–44.6) relative to non-migrants, but not as strongly as for migrant FSWs. CONCLUSION Out-migration of FSWs in Karnataka was strongly tied to sex work characteristics; thus, the structure inherent in sex work should be capitalized on when developing HIV preventive interventions. The important role of FSWs in HIV epidemics, coupled with the potential for rapid spread of HIV with migration, requires the most effective interventions possible for mobile and migrant FSWs. PMID:23001264

Banandur, Pradeep; Ramnaik, Satyanarayana; Manhart, Lisa E.; Buzdugan, Raluca; Mahapatra, Bidhubhushan; Isac, Shajy; Halli, Shiva S; Washington, Reynold G; Moses, Stephen; Blanchard, James F

2012-01-01

197

Psychotherapy with Women Who Have Worked in the “Sex Industry”  

PubMed Central

Psychotherapy is effective for a myriad of mental health symptoms, with the clinical situation dictating the most applicable method. For episodes of severe stress including acute depression and anxiety, supportive mechanisms (crisis interventions and shoring up existing coping skills and strategies) may be the best fit. During periods of relatively milder symptomatology a psychodynamic approach may be utilized with the same patient (focusing on self-reflection and a more in-depth exploration). This article focuses on the use of psychotherapy with women working in the sex industry, whether indoor (such as strip clubs and cabarets) or outdoor (such as prostitution and escort services). These women frequently experience violence in various forms, and most report multiple traumatic experiences, both during their developmental years and while working in the industry. A composite case is included that illustrates some of the supportive and psychodynamic psychotherapy techniques that can be applied when treating these individuals. PMID:23198274

Anklesaria, Ariz

2012-01-01

198

Effects of hazardous and harmful alcohol use on HIV incidence and sexual behaviour: a cohort study of Kenyan female sex workers  

PubMed Central

Aims To investigate putative links between alcohol use, and unsafe sex and incident HIV infection in sub-Saharan Africa. Methods A cohort of 400 HIV-negative female sex workers was established in Mombasa, Kenya. Associations between categories of the Alcohol Use Disorders Identification Test (AUDIT) and the incidence at one year of unsafe sex, HIV and pregnancy were assessed using Cox proportional hazards models. Violence or STIs other than HIV measured at one year was compared across AUDIT categories using multivariate logistic regression. Results Participants had high levels of hazardous (17.3%, 69/399) and harmful drinking (9.5%, 38/399), while 36.1% abstained from alcohol. Hazardous and harmful drinkers had more unprotected sex and higher partner numbers than abstainers. Sex while feeling drunk was frequent and associated with lower condom use. Occurrence of condom accidents rose step-wise with each increase in AUDIT category. Compared with non-drinkers, women with harmful drinking had 4.1-fold higher sexual violence (95% CI adjusted odds ratio [AOR]?=?1.9-8.9) and 8.4 higher odds of physical violence (95% CI AOR?=?3.9-18.0), while hazardous drinkers had 3.1-fold higher physical violence (95% CI AOR?=?1.7-5.6). No association was detected between AUDIT category and pregnancy, or infection with Syphilis or Trichomonas vaginalis. The adjusted hazard ratio of HIV incidence was 9.6 comparing women with hazardous drinking to non-drinkers (95% CI?=?1.1-87.9). Conclusions Unsafe sex, partner violence and HIV incidence were higher in women with alcohol use disorders. This prospective study, using validated alcohol measures, indicates that harmful or hazardous alcohol can influence sexual behaviour. Possible mechanisms include increased unprotected sex, condom accidents and exposure to sexual violence. Experimental evidence is required demonstrating that interventions to reduce alcohol use can avert unsafe sex. PMID:24708844

2014-01-01

199

Association between exposure to rotating night shift versus day shift using levels of 6-sulfatoxymelatonin and cortisol and other sex hormones in women.  

PubMed

The present study aims to compare 6-sulfatoxymelatonin (aMT6s) secretion patterns and levels of cortisol and sex hormones (estradiol, progesterone, DHEA, DHEAS, and testosterone) among rotating night-shift workers and day-shift workers. We performed a cross-sectional study in Cantabria (northern Spain) including 136 women (73 day-shift workers and 63 rotating night-shift workers). Blood and urine samples were obtained after two consecutive working days. Differences in means were estimated using ANCOVA, stratified by menopausal status, ovulation phase, and adjusted for season, age, body mass index, consumption of cigarettes in the last 24?h. aMT6s circadian rhythm was analyzed using the cosinor analysis. The present study showed that rotating night-shift workers had lower excretion of aMT6s than day-shift workers (mesor?=?50.26?ng aMT6s/mg creatinine in women with rotating night shift versus 88.79?ng aMT6s/mg creatinine in women with day shift), lower fluctuation (amplitude?=?45.24?ng aMT6s/mg creatinine in rotating night-shift workers versus 79.71?ng aMT6s/mg creatinine in day-shift workers), and a later acrophase (aMT6s peak time: 08:31 in rotating night-shift workers versus 07:13?h in day-shift workers). Additionally, women with rotating night shift had higher estradiol and progesterone levels, compared to day workers, especially in the follicular phase on the menstrual cycle. PMID:25216206

Gómez-Acebo, Inés; Dierssen-Sotos, Trinidad; Papantoniou, Kyriaki; García-Unzueta, María Teresa; Santos-Benito, María Francisca; Llorca, Javier

2015-02-01

200

Condom use among female commercial sex workers and male clients in Hong Kong.  

PubMed

The use of condoms is an aid to protection against human immunodeficiency virus (HIV) infection and other sexually transmitted diseases (STDs). In a one-and-a-half month period in mid-1993, 190 commercial female sex workers and 633 male clients of 8 Social Hygiene Clinics in Hong Kong were interviewed on their practice in condom usage. For both sex workers and clients, 18.5% and 22.8% never and 55.3% and 50.3% seldom used condoms during sexual contacts with paying partners and non-paying partners respectively. The majority (86%) of male clients claimed that they would use a condom if they knew it could reduce risk of contracting HIV and other STD. Condom promotion activities are necessary, particularly for those at higher risk of infection because of their sexual behaviour. PMID:7948161

Wong, K H; Lee, S S; Lo, Y C; Lo, K K

1994-01-01

201

HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis  

Microsoft Academic Search

BACKGROUND: The Brazilian response towards AIDS epidemic is well known, but the absence of a systematic review of vulnerable populations ? men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) remains a main gap in the available literature. Our goal was to conduct a systematic review and meta-analysis of studies assessing HIV prevalence among

Monica Malta; Monica MF Magnanini; Maeve B Mello; Ana Roberta P Pascom; Yohana Linhares; Francisco I Bastos

2010-01-01

202

Sex work in the Caribbean Basin: Patterns of substance use and HIV risk among migrant sex workers in the US Virgin Islands  

Microsoft Academic Search

Drug use, commercial sex work, and migration each play a role in the spread of HIV in the Caribbean, yet the intersection of these factors in the region is not well understood. This paper explores the connections between substance use and HIV risk among migrant female sex workers in the US Virgin Islands. Participants were located through targeted sampling techniques

H. Surratt

2007-01-01

203

Use of Community Health Workers in Research With Ethnic Minority Women  

Microsoft Academic Search

Purpose: To explore roles and effectiveness of community health workers in research with ethnic minority tvomen in the United States (US). Methods: Medline (1966-2002) and CINAHL (Cumulative hidex to Nursing and Allied Health Literature; 1982-2002) databases were used to locate puhlished research studies on the use of community health workers with ethnic minority women in the VS. Key words for

Jeannette O. Andrews; Gwen Felton; Mary Ellen Wewers; Janie Heath

2004-01-01

204

HIV prevention needs among street-based male sex workers in Providence, Rhode Island.  

PubMed

We examined data derived from a needs assessment of the personal and social characteristics and HIV risk behavior of street-based male sex workers, in Providence, Rhode Island, who engage in transactional sexual intercourse with other men. Substance use, injected drugs, needle sharing, and psychosocial distress were highly prevalent among the sample. History of physical, sexual, and emotional abuse was associated with increased risk of condomless anal sexual intercourse with paying male clients. PMID:25211761

Landers, Stewart; Closson, Elizabeth F; Oldenburg, Catherine E; Holcomb, Richard; Spurlock, Shannon; Mimiaga, Matthew J

2014-11-01

205

Implications of PEPFAR's anti-prostitution pledge for HIV prevention among organizations working with sex workers.  

PubMed

Even though the United States President's Emergency Plan for AIDS Relief (PEPFAR) has facilitated access to treatment for people living with HIV/AIDS across the planet, sex workers are not as fortunate. In this article, based on an oral abstract presentation at AIDS 2010, Melissa Ditmore and Dan Allman present a case-story analysis of the implementation of PEPFAR's anti-prostitution pledge. PMID:21413636

Ditmore, Melissa; Allman, Dan

2010-10-01

206

The making of unwanted sex: gendered and neoliberal norms in college women's unwanted sexual experiences.  

PubMed

Building on extant research regarding the role of gendered norms in women's consent to unwanted sex with male partners as well as recent studies of how the sociopolitical discourse of neoliberalism shapes sexuality at the individual level, we conducted a thematic analysis of undergraduate women's (N = 22) descriptions of their experiences of unwanted sex. In accordance with previous research (Gavey, 2005; Martin, 1996; Phillips, 2000; Tolman, 2002), gendered norms (e.g., women's sexual passivity; subordination of women's sexual interests to those of men) played important roles (a) laying the foundation for unwanted sex, and (b) in-the-moment negotiations between partners. In an extension of the established literature regarding unwanted sex, we also noted the emergence of neoliberal norms (e.g., personal responsibility) in participants' discussions of unwanted sex after the fact. We use these results to argue that gender and neoliberal ideologies work in tandem to (re)produce women's consent to unwanted sex. PMID:18937130

Bay-Cheng, Laina Y; Eliseo-Arras, Rebecca K

2008-01-01

207

Mobilizing collective identity to reduce HIV risk among sex workers in Sonagachi, India: the boundaries, consciousness, negotiation framework.  

PubMed

The significantly low rate of HIV infection and high rate of condom use among sex workers in Kolkata, India is partially attributable to a community-led structural intervention called the Sonagachi Project which mobilizes sex workers to engage in HIV education, formation of community-based organizations and advocacy around sex work issues. This research examines how Sonagachi Project participants mobilize collective identity and the manner in which collective identity influences condom use. Using purposive sampling methods, 46 Sonagachi Project participants were selected in 2005 for in-depth qualitative interviews. Taylor and Whittier's (Taylor, V & Whittier, N (1992). Collective identities in social movement communities: lesbian feminist mobilization. In A. Morris & C. Mueller (Eds.) Frontiers in social movement theory. New Haven, CT: Yale University Press) model of identity-formation through boundaries, consciousness and negotiation was used to interpret results. Subjects mobilized collective identity by (1) building boundaries demarcating in-group sex workers from out-group members, (2) raising consciousness about sex work as legitimate labor and the transformative change that results from program participation, and (3) negotiating identity with out-group members. This research establishes a conceptual link between the boundaries, consciousness and negotiation framework of collective identity mobilization and condom use. Condom use among sex workers is motivated by each element of the boundaries, consciousness and negotiation model: condoms mark boundaries, enunciate the consciousness that sex with clients is legitimate labor, and help negotiate the identity of sex workers in interactions with clients. PMID:18455855

Ghose, Toorjo; Swendeman, Dallas; George, Sheba; Chowdhury, Debasish

2008-07-01

208

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

PubMed Central

Background 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. Methods 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. Results 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. Discussion and conclusion 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 and freedom from abuse requires a better understanding of the broad scope of laws, policies and enforcement practices in different cultural contexts and economic settings, alongside reviews of UN policies and human rights conventions. PMID:22376152

2011-01-01

209

Does scale matter? The costs of HIV-prevention interventions for commercial sex workers in India.  

PubMed Central

OBJECTIVE: To explore how the scale of a project affects both the total costs and average costs of HIV prevention in India. METHODS: Economic cost data and measures of scale (coverage and service volume indicators for number of cases of sexually transmitted infections (STIs) referred, number of STIs treated, condoms distributed and contacts made with target groups) were collected from 17 interventions run by nongovernmental organizations aimed at commercial sex workers in southern India. Nonparametric methods and regression analyses were used to look at the relationship between total costs, unit costs and scale. FINDINGS: Coverage varied from 250 to 2008 sex workers. Annual costs ranged from US$ 11 274 to US$ 52 793. The median cost per sex worker reached was US$ 19.21 (range = US$ 10.00-51.00). The scale variables explain more than 50% of the variation in unit costs for all of the unit cost measures except cost per contact. Total costs and unit costs have non-linear relationships to scale. CONCLUSION: Average costs vary with the scale of the project. Estimates of resource requirements based on a constant average cost could underestimate or overestimate total costs. The results highlight the importance of improving scale-specific cost information for planning. PMID:16283051

Guinness, Lorna; Kumaranayake, Lilani; Rajaraman, Bhuvaneswari; Sankaranarayanan, Girija; Vannela, Gangadhar; Raghupathi, P.; George, Alex

2005-01-01

210

Chinese Sex-Role Conceptions: A Double Edged Sword for Women.  

ERIC Educational Resources Information Center

Although Chinese government policies officially support the equality of the sexes, stereotyped views about the nature of men and women often serve to perpetuate discrimination and to keep women in inferior positions. Women are often segregated into lower paying jobs because of stereotypical views about what is natural for women to do. Despite…

Korabik, Karen

211

Prevalence and Risks for Bacterial Vaginosis in Women Who Have Sex With Women  

PubMed Central

Background Bacterial vaginosis (BV) is a common cause of vaginitis and, for unknown reasons, is common in lesbian and bisexual women. We defined risks for prevalent BV in lesbian and bisexual women with attention to detailed sexual risk history. Methods Women 16 to 35 years reporting sex with ?1 woman in prior year underwent computer-assisted self-interview with extensive sexual and medical history. BV was defined by Amsel criteria, and associations with subject characteristics were estimated by Poisson regression and generalized estimating equation to adjust for potential coenrollment of current sexual partners. Results Of 335 participants (median age, 25 years; 22% nonwhite race), 6% reported douching, 24% sex with men, and 91% any sex in the prior 3 months. 96 (29%) had BV, 40% of whom reported corresponding symptoms. BV was associated with reporting a partner with BV (39% vs. 12%; multivariate relative risk [MRR], 4.53 [2.59 –7.93]), vaginal lubricant use (59% vs. 21%; MRR, 1.86 [0.94 –3.68]), or sharing vaginal sex toys in prior 3 months (33% vs. 21%; MRR, 1.70 [0.96 –3.01]). No association was seen for age, race, smoking, hormone use, douching, vaginal, anal or oral sex, or numbers of new partners. Lubricant use and shared vaginal toys were correlated (Spearman 0.29). Conclusions BV is associated with practices that efficiently transmit vaginal fluid and with use of vaginal lubricant; since these are correlated, assessing independent effects will require further analysis. More research is required to understand relationships between role of transmission of BV-associated bacteria and vaginal lubricant on BV pathogenesis. PMID:20429087

Marrazzo, Jeanne M.; Thomas, Katherine K.; Agnew, Kathy; Ringwood, Kathleen

2012-01-01

212

Varicose Veins in Women Cotton Workers. An Epidemiological Study in England and Egypt  

Microsoft Academic Search

The prevalence of varicose veins was studied in 504 women cotton workers in England and 467 in Egypt, by a standardized questionary and a specially developed method of examination. The English mill population showed a much higher prevalence of varicose veins than the Egyptian, probably owing to environmental rather than ethnic reasons.Among the European women the prevalence of varicose veins

Siza Mekky; R. S. F. Schilling; Joan Walford

1969-01-01

213

Is Military Sexual Trauma Associated with Trading Sex Among Women Veterans Seeking Outpatient Mental Health Care?  

Microsoft Academic Search

A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks

Jennifer L. Strauss; Christine E. Marx; Julie C. Weitlauf; Karen M. Stechuchak; Kristy Straits-Tröster; Ayaba W. Worjoloh; Christina B. Sherrod; Maren K. Olsen; Marian I. Butterfield; Patrick S. Calhoun

2011-01-01

214

The effects of sex education on women with secondary orgasmic dysfunction  

Microsoft Academic Search

This study evaluated the effects of sex education on 48 couples in which the women reported secondary orgasmic dysfunction. None of the males had a problem with premature ejaculation or with erectile dysfunction. Couples received two, two-hour sessions of sex education during a one-week period. From measures administered before and after treatment, the women reported significantly increased orgasmic frequency and

Peter R. Kilmann; Katherine H. Mills; Bonnie Bella; Charlene Caid; Edward Davidson; Gerald Drose; Richard Wanlass

1983-01-01

215

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences  

PubMed Central

Background 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. Methods 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. Results 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. Conclusions 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 for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability. PMID:22448241

Urada, Lianne A.; Morisky, Donald E.; Pimentel-Simbulan, Nymia; Silverman, Jay G.; Strathdee, Steffanie A.

2012-01-01

216

Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study  

ERIC Educational Resources Information Center

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…

Huq, Nafisa Lira; Chowdhury, Mahbub Elahi

2012-01-01

217

Grant Title: DRUG ABUSE DISSERTATION RESEARCH: EPIDEMIOLOGY, PREVENTION, TREATMENT, SERVICES AND WOMEN AND SEX/GENDER DIFFERENCES (R36)  

E-print Network

AND WOMEN AND SEX/GENDER DIFFERENCES (R36) Funding Opportunity Number: PAR-10-020. CFDA Number(s):93/or women and sex/gender differences. Grant support is designed to encourage doctoral candidates from

Farritor, Shane

218

Sex/Gender Disparities and Women's Eye Health.  

PubMed

Abstract Our eyes are, both literally and figuratively, windows to the world, and ophthalmic approaches offer a tremendous space for conducting research to learn more. Male/female differences in ocular health and disease are prevalent but we know far too little about root causes to design and implement diagnostic, preventive, and treatment strategies to address sex- and gender-based disparities in eye health. Herein, we discuss several ophthalmic diseases and other conditions with ocular manifestations, with a focus upon those that disproportionately affect women. Because the vast majority of biomedical research in this area comes from studies of mixed-gender populations, or of male-predominant populations, there is a pressing need for sex- and/or gender-based research at various points along the basic to clinical biomedical research continuum. Moreover, the multitude of factors that affect eye health call for a balanced look at the influence of biology, culture, and societal contributors. As clinicians, we owe our patients the best care for their needs, and that care must be derived from research that shows what is effective, for whom, and under what conditions. PMID:25548854

Clayton, Janine A; Davis, Alison F

2015-02-01

219

Victimization in off-street sex industry work.  

PubMed

The victimization experienced by street-based sex workers has led many observers to argue that prostitution is inherently dangerous. However, street-based workers form the minority of sex workers in Canada. Can their experiences validly be generalized to other types of prostitution? The research presented in this article examines whether female off-street sex workers face the same degree of victimization as female street-based sex workers in Vancouver, British Columbia. The results of a victimization survey examining interpersonal violence and other forms of victimization indicate that although violence and exploitation do occur in the off-street industry, some women sell sex without experiencing violence. PMID:21665856

O'Doherty, Tamara

2011-07-01

220

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

PubMed

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. PMID:25162730

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

221

Sex-role orientation, marital status and mental health in working women  

Microsoft Academic Search

Summary  \\u000a The objectives of this study were to make a men-women comparison as to the effects of job stress and sex-role orientation\\u000a on mental health and to determine if marital status modifies effects of job stress and sex-role orientation on mental health\\u000a in women. Subjects were 644 men and 301 women who were working at two private companies and one

M. Mori; Y. Nakashima; Y. Yamazaki; H. Kurita

2002-01-01

222

Winners and losers in health insurance: access and type of coverage for women in same-sex and opposite-sex partnerships.  

PubMed

Using data from the American Community Survey, 2009 (N=580,754), we compared rates of health insurance coverage and types of coverage used between women in same-sex and opposite-sex partnerships. This large, national dataset also allowed us to investigate regional variation in insurance coverage for women in same-sex partnerships by comparing "gay-tolerant" states versus other states. Multivariate analyses revealed that women in same-sex partnerships consistently had lower rates of health insurance coverage than married women in opposite-sex partnerships, but always more than unmarried women in opposite-sex partnerships. We also found that state-level variation in gay tolerance did not contribute to the access or type of coverage used by women in same-sex partnerships. PMID:24400654

Pals, Heili; Waren, Warren

2014-01-01

223

A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.  

PubMed

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs. PMID:23970652

Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan

2014-03-01

224

Sex workers in HIV prevention: From Social Change Agents to Peer Educators.  

PubMed

We utilised a comparative ethnographic approach to study the implementation of a community mobilisation intervention addressing HIV risk among female sex workers (FSWs) in India, as implemented first by an non-governmental organisation and after oversight of the intervention was transitioned to the government. We demonstrate that the work of peer outreach workers changed from Social Change Agents within a community-led structural intervention (CLSI) to Peer Educators within a targeted intervention (TI). In the CLSI approach, built on the assumption that FSW risk for HIV is rooted in power inequality and structural vulnerability, peer outreach workers mobilised their peers through community-based organisations to address underlying conditions of inequality and vulnerability. In contrast, the TI approach, which views FSW risk as a function of limited knowledge and barriers to services, addressed peers' access to information and health services. Analysis of changes in the function of peer outreach workers reveals critical differences of which we discuss four: assumptions about conditions that produce HIV risk; degree of emphasis placed on collective mobilising and building collective power; extent to which community mobilisation and HIV prevention goals are linked; and the intervention's use of peer input. We discuss the implications of these findings for HIV prevention programming. PMID:25359518

George, Annie; Blankenship, Kim M; Biradavolu, Monica R; Dhungana, Nimesh; Tankasala, Nehanda

2015-01-01

225

Social Influence and Individual Risk Factors of HIV Unsafe Sex among Female Entertainment Workers in China  

PubMed Central

Female entertainment workers in China are at increased sexual risk of HIV, but causes of their unprotected sex remain poorly understood. We develop a model that integrates information-motivation-behavioral skills (IMB) with social influences and test the model in a venue-based sample of 732 female entertainment workers in Shanghai. Most IMB and social influence measures are statistically significant in bivariate relationships to condom use; only HIV prevention motivation and behavioral self-efficacy remain significant in the multiple regressions. Self-efficacy in condom use is the most proximate correlate, mediating the relationship between information and motivation and condom use. Both peer and venue supports are important, but their influences over condom use are indirect and mediated through prevention motivation and/or self-efficacy. Behavioral intervention is urgently needed and should take a multi-level approach, emphasizing behavioral skills training and promoting a supportive social/working environment. PMID:20166789

Yang, Xiushi; Xia, Guomei; Li, Xiaoming; Latkin, Carl; Celentano, David

2010-01-01

226

Exploring HIV Prevention Strategies among Street-Based Female Sex Workers in Chongqing, China  

PubMed Central

Background: Commercial sex plays an increasingly important role in China’s growing HIV and sexually transmitted infection (STI) epidemics. In China, street-based sex workers (SSWs) are a subgroup of female sex workers with a particularly high risk of HIV/STI infections but are neglected in responses to HIV. This study assesses changes in HIV voluntary counseling and testing (VCT) utilization and high-risk sexual behaviors following a three-month HIV preventive intervention among SSWs in Chongqing, China. Methods: A three-month intervention was conducted by a team of peer educators, outreach workers from community-based organizations and health professionals. It mainly included distribution of free pamphlets and condoms and delivery of onsite and clinic-based VCT. Cross-sectional surveys were conducted prior to (n = 100) and immediately following (n = 112) the intervention to assess its impact. In-depth interviews were conducted among 12 SSWs after the intervention to further explore potential barriers to HIV prevention. Results: The intervention significantly increased SSWs’ participation in VCT (from 2.0%–15.2%, P < 0.001). Despite participants’ improved HIV-related knowledge level (from 24.0%–73.2%, P < 0.001), there were minimal changes in the levels of condom use with clients. Qualitative research revealed that fear of police arrest and stigma were the main barriers to VCT utilization. Low condom use was associated with family financial constraints, inadequate power in condom negotiation, low awareness and misconceptions of HIV infection risks. Conclusion: HIV intervention improved VCT utilization and knowledge but we did not observe an increase in condom use after this short intervention. SSWs faced substantial economic, social and environmental barriers to VCT utilization and condom use. PMID:25602971

Zeng, Huan; Zhao, Yong; Meng, Siying; Tang, Xiaojun; Guo, Hang; Wang, Yang; Zhang, Lei

2015-01-01

227

Women Who Know Their Place Sex-Based Differences in Spatial Abilities  

E-print Network

spatial skill--wayfinding (the ability to plan routes and navigate a landscape)--in men and women for, men and women with equivalent experience perform equally well at complex navigation tasksWomen Who Know Their Place Sex-Based Differences in Spatial Abilities and Their Evolutionary

228

Coming of age on the streets: survival sex among homeless young women in Hollywood.  

PubMed

This study examined childhood physical or sexual abuse, involvement in dependency or delinquency systems, psychiatric hospitalization, and suicide as possible risk factors for survival sex among homeless young women. Homeless young women were found to have similarly high rates of childhood sexual abuse, dependency and delinquency systems involvement, and psychiatric hospitalization. Homeless young women involved in survival sex disclosed higher rates of attempted suicide and reported marginally higher rates of childhood physical abuse. Analysis of qualitative data showed that those engaged in survival sex were motivated primarily by desperation to meet basic needs including a place to stay, food and money, and one third mentioned that peers commonly were influential in decisions to engage in survival sex. Others were influenced by coercion (10%) or pursuit of drugs (10%). Young women engaged in survival sex generally experienced regret and shame about their experience. PMID:24215967

Warf, Curren W; Clark, Leslie F; Desai, Mona; Rabinovitz, Susan J; Agahi, Golnaz; Calvo, Richard; Hoffmann, Jenny

2013-12-01

229

HIV Risk Perception and Behavior among Sex Workers in Three Major Urban Centers of Mozambique  

PubMed Central

HIV risk perceptions and behaviors of 236 commercial sex workers from three major Mozambican urban centers were studied using the International Rapid Assessment, Response and Evaluation (I-RARE) methodology. All were offered HIV testing and, in Maputo, syphilis testing was offered as well. Sixty-three of the 236 opted for HIV testing, with 30 (48%) testing positive for HIV. In Maputo, all 30 receiving HIV tests also had syphilis testing, with 6 (20%) found to be positive. Results include interview excerpts and qualitative results using I-RARE methodology and AnSWR-assisted analyses of the interviews and focus group sessions. PMID:24736653

Langa, Judite; Sousa, César; Sidat, Mohsin; Kroeger, Karen; McLellan-Lemal, Eleanor; Belani, Hrishikesh; Patel, Shama; Shodell, Daniel; Shodell, Michael; Benech, Irene; Needle, Richard

2014-01-01

230

Immigration Status and HIV-risk Related Behaviors among Female Sex Workers in South America  

Microsoft Academic Search

This study compares immigrant (i.e., foreigner) with non-immigrant (i.e., local\\/native) HIV-related risk behaviors among female\\u000a sex workers (FSW) in South America. A total of 1,845 FSW were enrolled in Argentina, Bolivia, Ecuador, and Uruguay. According\\u000a to their nationality, 10.1% of participants were immigrant FSW. Immigrant FSW were more likely to be younger in Argentina;\\u000a to work in a disco\\/bar in

Christian T. Bautista; Carlos Mosquera; Margarita Serra; Alberto Gianella; Maria M. Avila; Victor Laguna-Torres; Jean K. Carr; Silvia M. Montano; José L. Sanchez

2008-01-01

231

Correlates of HIV risk and preventive behaviors in Armenian female sex workers.  

PubMed

This study describes HIV risk and preventive behaviors and their correlates among Armenian female commercial sex workers (CSWs) as a prerequisite to developing gender and culturally appropriate interventions. Ninety-eight CSWs from three Armenian cities were interviewed using a structured questionnaire. Quantitative findings were further elaborated by focus group discussions (N = 25) and key informant interviews (N = 8). Inconsistent condom use with all types of sexual partners was reported, as were condom tear/slippage, alcohol and drug use, and sex with drug injecting clients. Prominent misconceptions regarding HIV transmission, prevention and disease manifestations were noted. Correlates of condom use intentions included history of substance use, attitudes regarding condom use, risk perception, and comfort negotiating condom use. Intentions to use condoms were strongly associated with recent frequency of condom use. Understanding the relationship between condom use and its determinants is critical in the design and implementation of effective prevention programs tailored for Armenian CSWs. PMID:16823626

Markosyan, Karine M; Babikian, Talin; DiClemente, Ralph J; Hirsch, Jennifer S; Grigoryan, Samvel; del Rio, Carlos

2007-03-01

232

Toward an understanding of the context of anal sex behavior in ethnic minority adolescent women.  

PubMed

Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18 years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits. PMID:24963851

Dimmitt Champion, Jane; Roye, Carol F

2014-07-01

233

Risks, benefits and survival strategies-views from female sex workers in Savannakhet, Laos  

PubMed Central

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. PMID:23164407

2012-01-01

234

Reports of work related musculoskeletal injury among home care service workers compared with nursery school workers and the general population of employed women in Sweden.  

PubMed Central

OBJECTIVES--To describe the nationwide occurrence of work related musculoskeletal injuries among all home care service workers in Sweden, and to identify relative risks and risk factors of the injuries. METHODS--The study was based on work related injuries reported to the Swedish occupational injury information system in 1990-1. The work related musculoskeletal injuries were divided into overexertion accidents and musculoskeletal diseases. The incidence of the injuries in female home care service workers was compared with those in nursery school workers and all other employed women in Sweden. RESULTS--In home care service workers, the annual incidence of injury from overexertion accidents and musculoskeletal diseases were 19.2 and 15.1 per 1000 workers, respectively, which was higher than those in nursery school workers and all employed women in Sweden. For five injury locations including the back, all the age standardised relative risks (SRR) of overexertion accidents exceeded 4.0, and most of those for musculoskeletal diseases were 1.5 or more in home care service workers compared with all other employed women in Sweden. Total duration of sick leave due to overexertion accidents was 7.7 times, and musculoskeletal diseases 3.5 times, longer than in nursery school workers. National loss due to sick leave resulting from only musculoskeletal injuries in home care service workers was about 8.2% of the total work related sick leave in all employed women in Sweden, although the number of home care service workers represented only some 5% of this population. Lifting other people was most frequently reported as the main risk cause of overexertion accidents in both kinds of workers. CONCLUSIONS--The results support the hypothesis that home care service workers have higher annual injury incidence of musculoskeletal injuries than nursery school workers due to physically stressful tasks that are far less common in nursery school workers. PMID:7489060

Ono, Y; Lagerström, M; Hagberg, M; Lindén, A; Malker, B

1995-01-01

235

Epidemic Impacts of a Community Empowerment Intervention for HIV Prevention among Female Sex Workers in Generalized and Concentrated Epidemics  

PubMed Central

Introduction 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. Methods 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. Results 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. Discussion A community empowerment approach to HIV prevention and access to universal ART for female sex workers is a promising human rights-based solution to overcoming the persistent burden of HIV among female sex workers across epidemic settings. PMID:24516580

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

236

Syphilis infection among female sex workers in Nagaland, Northeast India: analysing their vulnerability to the infection.  

PubMed

This paper describes the sex work characteristics and factors associated with syphilis among female sex workers (FSWs) in Dimapur district of high HIV prevalence Indian state, Nagaland. The study recruited 426 FSWs in 2006 using respondent-driven sampling. The prevalence of syphilis was 21.1% and HIV prevalence was 11.7%. Approximately half were under 25 years of age. Clients were solicited mainly in public places (32.7%), while hotels/lodges/rented rooms were the most common places of entertainment (57.2%). Condom use during the last sex was 36.5% with occasional and 27% with regular clients. Being married, being widowed/divorced/separated, being illiterate or having a history of drug use increased the likelihood of syphilis infection. Entertaining clients in bars/booze joints decreased the probability of syphilis. FSWs who moved between soliciting in public places or bars/booze joints and then entertaining in hotels/lodges/rented rooms had a higher vulnerability to syphilis. In summary, we found that the vulnerability to syphilis among mostly young FSWs in Dimapur varied according to their sex work characteristics, marital and educational status and drug use habits. They may be more vulnerable to HIV and sexually transmitted infections (HIV/STIs) due to the low rate of condom use. The findings have direct implications for HIV/STI prevention programmes in Northeast India. PMID:23514833

Medhi, G K; Mahanta, J; Hazarika, I; Armstrong, G; Adhikary, R; Mainkar, M; Paranjape, R S

2013-03-01

237

HIV-related risk behaviors among female sex workers in Ho Chi Minh City, Vietnam.  

PubMed

This study quantitatively and qualitatively described HIV risk behaviors among Vietnamese female sex workers (FSWs) who work at three distinct venues in Ho Chi Minh City: street, massage parlors, and bars/clubs. Although 35% of the participants had never been tested for HIV, 18% of street and 7% of bar/club FSWs reported being positive. Almost all massage parlor FSWs had never used a condom for oral sex. Inconsistent condom use for vaginal sex with customers was more prevalent among bar/club FSWs (85%) than massage parlor (72%) and street FSWs (68%). Many participants reported difficulties in negotiating condom use with customers because of economic pressure, maintaining relationships, and lack of bargaining power. Bar/club FSWs revealed a difficult situation where drinking is part of their work. Thirty percent of street FSWs had injected drugs and reported addiction to heroin in relation to their helpless condition as FSWs. Street FSWs had the lowest levels of self-esteem and norms toward practicing safe sex and the highest levels of economic pressure. This study recommends future HIV prevention programs for FSWs in Vietnam that target their specific risk behaviors and work environments. PMID:18956984

Nemoto, Tooru; Iwamoto, Mariko; Colby, Donn; Witt, Samantha; Pishori, Alefiyah; Le, Mai Nhung; Vinh, Dang Thi Nhat; Giang, Le Truong

2008-10-01

238

Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan  

PubMed Central

Background We sought to describe differences in individual and structural vulnerabilities faced by female sex workers (FSWs) in Pakistan between 2006 and 2011, and to characterise risk factors for inconsistent condom use and HIV prevalence in this population. Methods To describe differences in vulnerabilities, we analysed behavioural data from serial cross-sectional surveys conducted across nine cities in 2006 and 2011. Using data from 12 cities in 2011, we used logistic regression to characterise risk factors for (a) inconsistent condom use in the past month (N=6987), and (b) HIV (N=4301). Results Compared to FSWs in 2006, FSWs in 2011 were significantly more likely to solicit clients via cell phones, and to report a larger client volume and anal sex with clients, but also consistent condom use with clients (30.0% vs 23.6% in 2006). In 2011, independent risk factors for inconsistent condom use with clients included: recent sexual violence, recent sex with a person who injects drugs, and absence of programme exposure. HIV prevalence was 0.63% (95% CI 0.43% to 0.92%) in 2011, and was associated with a recent history of injection drug use and absence of programme exposure. Conclusions While condom use with clients was higher in 2011, protective behaviours remained low and vulnerabilities related to sex work may have risen. HIV is emerging in this population and an adaptive HIV prevention programme that addresses different vulnerabilities and the intersection of sexual networks with injection drug use is needed. PMID:23413402

Mishra, Sharmistha; Thompson, Laura H; Sonia, Altaf; Khalid, Nosheen; Emmanuel, Faran; Blanchard, James F

2013-01-01

239

A Multilevel Analysis of Gatekeeper Characteristics and Consistent Condom Use Among Establishment-Based Female Sex Workers in Guangxi, China  

PubMed Central

Background Multilevel analytical techniques are being applied in condom use research to ensure the validity of investigation on environmental/structural influences and clustered data from venue-based sampling. The literature contains reports of consistent associations between perceived gatekeeper support and condom use among entertainments establishment-based female sex workers (FSWs) in Guangxi, China. However, the clustering inherent in the data (FSWs being clustered within establishment) has not been accounted in most of the analyses. We used multilevel analyses to examine perceived features of gatekeepers and individual correlates of consistent condom use among FSWs and to validate the findings in the existing literature. Methods We analyzed cross-sectional data from 318 FSWs from 29 entertainment establishments in Guangxi, China in 2004, with a minimum of 5 FSWs per establishment. The Hierarchical Linear Models program with Laplace estimation was used to estimate the parameters in models containing random effects and binary outcomes. Results About 11.6% of women reported consistent condom use with clients. The intraclass correlation coefficient indicated 18.5% of the variance in condom use could be attributed to their similarity between FSWs within the same establishments. Women’s perceived gatekeeper support and education remained positively associated with condom use (P < 0.05), after controlling for other individual characteristics and clustering. Conclusions After adjusting for data clustering, perceived gatekeeper support remains associated with consistent condom use with clients among FSWs in China. The results imply that combined interventions to intervene both gatekeepers and individual FSW may effectively promote consistent condom use. PMID:20539262

Li, Qing; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Zhao, Ran

2010-01-01

240

Transactional sex amongst young people in rural northern Tanzania: an ethnography of young women's motivations and negotiation  

Microsoft Academic Search

BACKGROUND: Material exchange for sex (transactional sex) may be important to sexual relationships and health in certain cultures, yet the motivations for transactional sex, its scale and consequences are still little understood. The aim of this paper is to examine young women's motivations to exchange sex for gifts or money, the way in which they negotiate transactional sex throughout their

Joyce Wamoyi; Daniel Wight; Mary Plummer; Gerry Hilary Mshana; David Ross

2010-01-01

241

The Prevalence and Risk Factors of Human Papillomavirus in Female Sex Workers  

PubMed Central

Objective: Human papillomavirus virus (HPV) is the major causative factor for cervical cancer, and sex workers are at high risk for HPV infection. In this study, we aimed to estimate the prevalence and risk factors of HPV infection among female sex workers (FSWs). Materials and Methods: The study included 239 brothel-based FSWs who work in Izmir, Turkey. A self-administered questionnaire for risk factors was completed, and cervical brush samples were taken for HPV detection and typing. HPV detection and typing were performed by multiplex polymerase chain reaction (PCR) and reverse hybridization methods. The risk factors related to HPV infection were determined by multivariate analysis. Results: The prevalence of HPV among FSWs was 20.1%. HPV18 was the most common type (40%), followed by HPV16 (17%) and HPV50 (15%). Logistic regression analysis revealed that being less than 30 years of age, having a high frequency of sexual contacts, smoking, and lack of condom use were significantly associated with HPV infection. Conclusion: FSWs have a high prevalence of HPV infection and are at increased risk for cervical cancer. As they are a priority group for active follow-up, national strategies for reducing HPV among FSWs and regular cervical cancer screening programs should be implemented for this population.

Ersan, Gursel; Kose, Sukran; Senger, Suheyla Serin; Gunes, Habibe; Sehirali, Salim; Gurbuz, Ilhan

2013-01-01

242

Hey girlfriend: an evaluation of AIDS prevention among women in the sex industry.  

PubMed

Increasingly, acquired immunodeficiency syndrome (AIDS) prevention programs have been developed to reach and influence street-based populations. Standard methods of evaluation do not fit the conditions of such programs. This article describes a process and outcome evaluation of an AIDS prevention program for sex workers in which qualitative and quantitative methods were combined in order to mediate research problems endemic to street-based populations. Methods included epidemiological questionnaires, open-ended interviews with participants, and ethnographic field notes. Process evaluation findings show that field staff who were indigenous to the neighborhood and population readily gained access to the community of sex workers and simultaneously became role models for positive behavior change. Outcome findings show that sex workers do feel at risk for AIDS, but usually from clients rather than from husbands or boyfriends. Accordingly, they use condoms more frequently with clients than with steady partners. Increasing condom use among sex workers with their steady partners remains an important challenge for AIDS prevention. Combining qualitative and quantitative research data provided a more comprehensive assessment of how to reach sex workers with effective AIDS risk reduction messages than either method could have provided alone. PMID:1568872

Dorfman, L E; Derish, P A; Cohen, J B

1992-01-01

243

Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia  

PubMed Central

Objectives HIV prevalence among Cambodian female sex workers (FSW) is among the highest in Southeast Asia. We describe HIV prevalence and associated risk exposures in FSW sampled serially in Phnom Penh, Cambodia (Young Women's Health Study (YWHS)), before and after the implementation of a new law designed to combat human trafficking and sexual exploitation. Design Cross-sectional analysis of baseline data from two prospective cohorts. Setting Community-based study in Phnom Penh, Cambodia. Participants Women aged 15–29?years, reporting ?2 sexual partners in the last month and/or engaged in transactional sex in the last 3?months, were enrolled in the studies in 2007 (N=161; YWHS-1), and 2009 (N=220; YWHS-2) following information sessions where 285 and 345 women attended. Primary outcomes HIV prevalence, sexual risk behaviour, amphetamine-type stimulant (ATS) and alcohol use, and work-related factors were compared in the two groups, enrolled before and after implementation of the new law. Results Participants in the two cohorts were similar in age (median 25?years), but YWHS-2 women reported fewer sex partners, more alcohol use and less ATS use. A higher proportion of YWHS-2 compared with YWHS-1 women worked in entertainment-based venues (68% vs 31%, respectively). HIV prevalence was significantly lower in the more recently sampled women: 9.2% (95% CI 4.5% to 13.8%) vs 23% (95% CI 16.5% to 29.7%). Conclusions Sex work context and risk have shifted among young FSW in Phnom Penh, following implementation of anti-prostitution and anti-trafficking laws. While both cohorts were recruited using the same eligibility criteria, more recently sampled women had lower prevalence of sexual risk and HIV infection. Women engaging more directly in transactional sex have become harder to sample and access. Future prevention research and programmes need to consider how new policies and demographic changes in FSW impact HIV transmission. PMID:24022389

Page, Kimberly; Stein, Ellen; Sansothy, Neth; Evans, Jennifer; Couture, Marie-Claude; Sichan, Keo; Cockroft, Melissa; Mooney-Somers, Julie; Phlong, Pisith; Kaldor, John; Maher, Lisa

2013-01-01

244

Benefits and constraints of intimate partnerships for HIV positive sex workers in Kibera, Kenya  

PubMed Central

Introduction 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. Methods 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. Results 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. Conclusions Intimacy and transactional relations are bound up with one another and intersect with the structural realities and vulnerabilities; this is the case for sex workers in well-resourced and resourced-constrained countries alike. Rather than treating intimate partnerships as distinct from transactional relationships, FSWs’ relationships should be viewed on a continuum of risk and support. PMID:24006868

2013-01-01

245

Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia  

PubMed Central

Cambodia's 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an important interplay between the meanings of condom use and the meanings of women's relationships. Commercial relationships were characterised as inherently risky and necessitated condom use. Despite a similar lack of sexual fidelity, sweetheart relationships were rarely construed as risky and typically did not involve condom use. Husbands and wives constructed their sexual interactions with each other differently, making agreement on condom use difficult. The lack of improvement in condom use in FSWs' non-commercial sexual relationships needs to be understood in relation to both sex work and the broader Cambodian sexual culture within which these relationships are embedded. PMID:23432108

Maher, Lisa; Mooney-Somers, Julie; Phlong, Pisith; Couture, Marie-Claude; Kien, Serey Phal; Stein, Ellen; Bates, Anna Juong; Sansothy, Neth; Page, Kimberly

2013-01-01

246

The effects of childhood trauma on sex trading in substance using women.  

PubMed

This article presents a model developed to understand the relationship between childhood victimization, perpetration of violence, and later cocaine dependence and adult sex trading among drug using women. A cohort of heavy drinking and drug using women (N=594) recruited for two on-going community based HIV prevention studies in St. Louis City was analyzed to evaluate this association using path analysis. The women were stratified into two groups: sex traders and non-sex traders. Sex traders were more likely than non-sex traders to report being forced to kiss or touch someone in a sexual way before age 15 (35% vs. 22%), being kissed or touched in a sexual way by others when they did not want to be (42% vs. 31%), and being forced to have sexual intercourse (30% vs. 21%). Sex traders were more likely than non-sex traders to use a weapon or threaten someone with a weapon (29% vs. 18%) and physically hurt others on purpose before age 15 (9% vs. 5%). Path analysis confirmed that childhood victimization had a significant and direct association with both adult cocaine dependence and sex trading. However, the association between childhood perpetration and adult sex trading was mediated by cocaine dependence. This analysis concludes that childhood victimization was the strongest predictor of cocaine dependence and sex trading in adulthood. PMID:16900413

Vaddiparti, Krishna; Bogetto, Jane; Callahan, Catina; Abdallah, Arbi B; Spitznagel, Edward L; Cottler, Linda B

2006-08-01

247

Global epidemiology of HIV among female sex workers: influence of structural determinants.  

PubMed

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 ?L 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

Shannon, Kate; Strathdee, Steffanie A; Goldenberg, Shira M; Duff, Putu; Mwangi, Peninah; Rusakova, Maia; Reza-Paul, Sushena; Lau, Joseph; Deering, Kathleen; Pickles, Michael R; Boily, Marie-Claude

2015-01-01

248

HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China  

PubMed Central

Objectives To assess the prevalence and risk factors of HIV among male clients of female sex workers in China. Methods Convenience sampling methods were used to recruit 315 clients using FSW-client and client-client networks. Subjects provided information on socio-demographic characteristics and sexual and drug behavior patterns. Blood samples were collected for HIV testing and urine samples for opiate testing. Results Overall HIV prevalence was 6.0%; among drug users it was 30.8%. 33.7% of respondents reported that they always use condoms in commercial sex and 63.5% that they used a condom in the last commercial sex episode. Drug use (OR: 6.1; 95% CI: 1.7–21.4) and lack of a regular sexual partner (OR: 6.3; 95% CI: 1.8–21.9) were significantly associated with HIV infection. Conclusions Clients of FSWs serve as potential bridges for HIV transmission from the high-risk FSWs to the low-risk general population, making them a key target for intervention. High HIV prevalence rates among clients in Kaiyuan is particularly alarming given their risk behavior patterns including high rates of partner exchange, low condom use rates, and drug using behaviors. Innovative interventions are needed to reduce the risk of HIV among clients and reduce the bridge of transmission to the general population. PMID:19730110

Jin, Xia; Smith, Kumi; Chen, Ray Y.; Ding, Guowei; Yao, Yan; Wang, Haibo; Qian, Han-Zhu; Chang, Dongfang; Wang, Guixiang; Wang, Ning

2009-01-01

249

Hombre Seguro (Safe Men): a sexual risk reduction intervention for male clients of female sex workers  

PubMed Central

Background Male clients of female sex workers (FSWs) are at risk of HIV and other sexually transmitted infections (STIs). We conducted a two-arm randomized controlled trial to test the efficacy of a sexual risk reduction intervention for male clients of FSWs in Tijuana, Mexico. Methods/Design Male clients of FSWs who were at least 18, were HIV-negative at baseline, and reported recent unprotected sex with FSWs were randomized to the Hombre Seguro sexual risk reduction intervention, or a time-attention didactic control condition. Each condition lasted approximately one hour. Participants underwent interviewer-administered surveys and testing for HIV and other STIs at baseline, and at 4, 8, and 12 month follow-ups. Combined HIV/STI incidence and unprotected vaginal and anal sex acts with FSWs were the primary outcomes. Discussion A total of 400 participants were randomized to one of the two conditions. Analyses indicated that randomization was successful; there were no significant differences between the participants in the two conditions at baseline. Average follow-up was 84% across both conditions. This is the first study to test the efficacy of a sexual risk reduction intervention for male clients of FSWs using the rigor of a randomized controlled trial. Trial registration NCT01280838, Date of registration: January 19, 2011. PMID:24885949

2014-01-01

250

A Comparison of Relationship Satisfaction, Social Support, and Stress Between Women with First and Prior Same-Sex Relationships  

Microsoft Academic Search

The purpose of this Internet-based study was to determine differences between women in their first same-sex relationships and women who have had same-sex relationships prior to their current relationship. Participants included 754 women within the United States and Canada who were at least 18 years of age and were in an ongoing same-sex relationship of at least six months. Women

Teresa Reeves; Sharon G. Horne

2009-01-01

251

Prevalence and Characteristics of Abuse Experiences and Depression Symptoms among Injection Drug-Using Female Sex Workers in Mexico  

PubMed Central

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. PMID:23737808

Ulibarri, Monica D.; Hiller, Sarah P.; Lozada, Remedios; Rangel, M. Gudelia; Stockman, Jamila K.; Silverman, Jay G.; Ojeda, Victoria D.

2013-01-01

252

Safety and Adherence to Intermittent Pre-Exposure Prophylaxis (PrEP) for HIV-1 in African Men Who Have Sex with Men and Female Sex Workers  

PubMed Central

Background Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present safety and adherence data from the first trial of an intermittent PrEP regimen among Kenyan men who have sex with men (MSM) and female sex workers (FSW). Methods/Principal Findings MSM and FSW were randomized to daily oral FTC/TDF or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day) oral FTC/TDF or placebo in a 2?1?2?1 ratio; volunteers were followed monthly for 4 months. Adherence was assessed with the medication event monitoring system (MEMS). Sexual activity data were collected via daily text message (SMS) queries and timeline followback interviews with a one-month recall period. Sixty-seven men and 5 women were randomized into the study. Safety was similar among all groups. Median MEMS adherence rates were 83% [IQR: 63–92] for daily dosing and 55% [IQR:28–78] for fixed intermittent dosing (p?=?0.003), while adherence to any post-coital doses was 26% [IQR:14–50]. SMS response rates were low, which may have impaired measurement of post-coital dosing adherence. Acceptability of PrEP was high, regardless of dosing regimen. Conclusions/Significance Adherence to intermittent dosing regimens, fixed doses, and in particular coitally-dependent doses, may be more difficult than adherence to daily dosing. However, intermittent dosing may still be appropriate for PrEP if intracellular drug levels, which correlate with prevention of HIV acquisition, can be attained with less than daily dosing and if barriers to adherence can be addressed. Additional drug level data, qualitative data on adherence barriers, and better methods to measure sexual activity are necessary to determine whether adherence to post-coital PrEP could be comparable to more standard regimens. Trial Registration ClinicalTrials.gov NCT00971230 PMID:22511916

Mugo, Peter; Anzala, Omu; Haberer, Jessica E.; Bangsberg, David; Barin, Burc; Rooney, James F.; Mark, David; Chetty, Paramesh; Fast, Patricia; Priddy, Frances H.

2012-01-01

253

Evaluation of vaginal cytology in female sex-workers: A study in a tertiary hospital of eastern India  

PubMed Central

Background: Papanicolaou (Pap) test is an important and easy diagnostic tool to detect any abnormalities on vaginal cytology. Pap test is routinely done in women of reproductive age group in many countries. Aim: The aim of this study was to detect spectrum of abnormalities in female sex workers (FSWs) on vaginal cytology. Materials and Methods: A total of 60 cases were included over a period of 1 year (July, 2011-June, 2012). The age range of the patients was 14-61 years. Pap stained slides were evaluated by two consultant cytopathologists and reported as normal smear, inflammatory smear, specific infection, low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL), atypical squamous cell of undetermined significance (ASCUS), squamous cell carcinoma (SCC) and atypical glandular cell of undetermined significance (AGUS). Results: Most of the smears were abnormal accounting for 86.7% of total cases (52/60). Incidence of HSIL was very high in FSWs. Out of 60 cases, 8 normal smears (13.3%), 12 inflammatory smears (20%), 3 cases of infections (5%), 9 cases of LSIL (15%), 23 cases of HSIL (38.3%), 2 cases (3.3%) each of ASCUS and SCC and 1 case (1.3%) AGUS were encountered. Conclusions: Close follow-up and histologic examinations are necessary to avoid unnecessary spread of the neoplastic disease and untimely death of the patients. Awareness about diseases in FSWs and diagnostic utility of Pap test are also a must. PMID:25190976

Mondal, Santosh Kumar; Basak, Bijan; Roy, Dipanwita Nag; Mandal, Palash Kumar; Sinha, Simanti

2014-01-01

254

Appropriating social citizenship: women's labour, poverty, and entrepreneurship in the manual workers union of Botswana.  

PubMed

Interrogating critiques of the 'African labour aristocracy' thesis, the article proposes that public service industrial-class manual workers in Botswana form, if not a labour 'aristocracy' in the sense first defined by Saul and Arrighi, then a marginal worker 'elite'. They are privileged in having a regular salary above minimum pay, augmented by periodic lump-sum gratuity payments. This sets them apart from the other low-paid workers in the private sector, casual workers in the informal economy and a vast army of unemployed job seekers. In the absence of a national unemployment benefit scheme in Botswana, the article explores some of the strategies deployed by women members of the Manual Workers Union in their attempts to contend with the spectre of future unemployment and impoverishment. In gender terms, the article highlights the independence, autonomy and decision-making capacity of women trade unionist leaders, who straddle the worlds of workers' rights and citizens' rights, and manoeuvre their way through the maze of rules and regulations they encounter in both. PMID:20879188

Werbner, Pnina

2010-01-01

255

Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review  

Microsoft Academic Search

Sex work remains an important contributor to HIV transmission within early, advanced and regressing epidemics in sub-Saharan\\u000a Africa, but its social and behavioral underpinnings remain poorly understood, limiting the impact of HIV prevention initiatives.\\u000a This article systematically reviews the socio-demographics of female sex workers (FSW) in this region, their occupational\\u000a contexts and key behavioral risk factors for HIV. In total

Fiona ScorgieMatthew; Matthew F. Chersich; Innocent Ntaganira; Antonio Gerbase; Frank Lule; Ying-Ru Lo

256

Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator  

PubMed Central

Background Physical and sexual violence heighten STI/HIV risk for women in sex work. Against this backdrop, we describe the nature of abuse against women in sex work, and its STI/HIV implications, across perpetrators. Methods Adult women involved in sex work (n?=?35) in Baltimore, MD participated in an in-depth interview and brief survey. Results Physical and sexual violence were prevalent, with 43% reporting past-month abuse. Clients were the primary perpetrators; their violence was severe, compromised women’s condom and sexual negotiation, and included forced and coerced anal intercourse. Sex work was a factor in intimate partner violence. Police abuse was largely an exploitation of power imbalances for coerced sex. Conclusions Findings affirm the need to address physical and sexual violence, particularly that perpetrated by clients, as a social determinant of health for women in sex work, as well as a threat to safety and wellbeing, and a contextual barrier to HIV risk reduction. PMID:24060235

2013-01-01

257

An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.  

PubMed

Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders. PMID:24151086

Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F

2013-12-01

258

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

PubMed

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. PMID:23343641

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

2014-03-01

259

Relationship between mobility, violence and HIV/STI among female sex workers in Andhra Pradesh, India  

PubMed Central

Background Violence and mobility have been identified as critical factors contributing to the spread of HIV worldwide. This study aimed to assess the independent and combined associations of mobility and violence with sexual risk behaviors and HIV, STI prevalence among female sex workers (FSWs) in India. Methods Data were drawn from a cross-sectional, bio-behavioral survey conducted among 2042 FSWs across five districts of southern India in 2005–06. Regression models were used to estimate odds ratios and 95% confidence intervals (CIs) for sexual risk behaviors and HIV infection based on experience of violence and mobility after adjusting for socio-demographic and sex work related characteristics. Results One-fifth of FSWs (19%) reported experiencing violence; 68% reported travelling outside their current place of residence at least once in the past year and practicing sex work during their visit. Mobile FSWs were more likely to report violence compared to their counterparts (23% vs. 10%, p?sex with occasional (adjusted OR: 2.86, 95% CI: 1.76–4.65) and regular clients (adjusted OR: 2.07, 95% CI: 1.40–3.06). Conclusions The findings indicate that mobility and violence were independently associated with HIV infection. Notably, the combined effect of mobility and violence posed greater HIV risk than their independent effect. These results point to the need for the provision of an enabling environment and safe spaces for FSWs who are mobile, to augment existing efforts to reduce the spread of HIV/AIDS. PMID:22967276

2012-01-01

260

A study of HIV/STD infections amongst commercial sex workers in Kolkata (India). Part-III, clinical features of sexually transmitted diseases.  

PubMed

The clinical features of sexually transmitted disease (STD) infection in female sex workers found in a community based study in different red light areas of Kolkata are discussed in this paper. Out of 867 sex workers clinically examined in the clinics in their respective areas, 80.16% were having different signs and symptoms of sexually transmitted diseases. The vaginal discharge was the commonest feature present in 49.6% sex workers. The chronic vaginal discharge of more than a month was found in 47.44%, while 37.90% sex workers had vaginal discharge of less than one month. The genital ulcer was present in 25.03% (217) sex workers. The other sexually transmitted infection that was found includes genital warts 13.73%, scabies 12.11 and Inguinal bubo in 1.73% sex workers. The sex workers were also having other symptoms e.g. chronic weight loss, prolonged fever and chronic diarrhoea in 13.73% (119), 10.03% (87) and in 1.96% (17) sex workers respectively. PMID:15909751

Raut, D K; Pal, D; Das, A

2003-12-01

261

Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: longitudinal analysis from a randomized controlled trial  

PubMed Central

Background Data on risk factors of recurrent bacterial vaginosis (RBV) are still scarce. We used data from female sex workers (FSW) participating in a randomized controlled microbicide trial to examine predictors of BV recurrence. Methods Trial’s participants with at least an episode of BV which was treated and/or followed by a negative BV result and at least one subsequent visit offering BV testing were included in the analysis. Behavioural and medical data were collected monthly while laboratory testing for STI and genital tract infections were performed quarterly. The Andersen-Gill proportional hazards model was used to determine predictors of BV recurrence both in bivariate and multivariate analyses. Results 440 women were included and the incidence rate for RBV was 20.8 recurrences/100 person-months (95% confidence interval (CI) =18.1–23.4). In the multivariate analysis controlling for the study site, recent vaginal cleansing as reported at baseline with adjusted hazard-ratio (aHR)=1.30, 95% CI = 1.02-1.64 increased the risk of BV recurrence, whereas consistent condom use (CCU) with the primary partner (aHR=0.68, 95% CI=0.49-0.93) and vaginal candidiasis (aHR=0.70, 95% CI=0.53-0.93), both treated as time-dependent variables, were associated with decreased risk of RBV. Conclusion This study confirms the importance of counselling high-risk women with RBV about the adverse effects of vaginal cleansing and the protective effects of condom use with all types of partners for the prevention of sexually transmitted infections, including BV. More prospective studies on risk factors of BV recurrence are warranted. Trial registration Trial registration: NCT00153777 PMID:23657072

2013-01-01

262

SEED GRANTS for Biological/Medical Research on Sex Differences and/or Women's Health The Stanford WSDM* (Women and Sex Differences in Medicine) Center aims to promote basic &  

E-print Network

SEED GRANTS for Biological/Medical Research on Sex Differences and/or Women's Health The Stanford, and population health research on sex differences and women's health at Stanford University School of Medicine/or in women's health. This year, we are particularly eager for School of Medicine faculty to collaborate

Bogyo, Matthew

263

Children of female sex workers and drug users: a review of vulnerability, resilience and family-centred models of care  

PubMed Central

Background Injection drug users and female sex workers are two of the populations most at risk for becoming infected with HIV in countries with concentrated epidemics. Many of the adults who fall into these categories are also parents, but little is known about the vulnerabilities faced by their children, their children's sources of resilience, or programmes providing services to these often fragile families. This review synthesizes evidence from disparate sources describing the vulnerabilities and resilience of the children of female sex workers and drug users, and documents some models of care that have been put in place to assist them. Review A large literature assessing the vulnerability and resilience of children of drug users and alcoholics in developed countries was found. Research on the situation of the children of sex workers is extremely limited. Children of drug users and sex workers can face unique risks, stigma and discrimination, but both child vulnerability and resilience are associated in the drug use literature with the physical and mental health of parents and family context. Family-centred interventions have been implemented in low- and middle-income contexts, but they tend to be small, piecemeal and struggling to meet demand; they are poorly documented, and most have not been formally evaluated. We present preliminary descriptive data from an organization working with pregnant and new mothers who are drug users in Ukraine and from an organization providing services to sex workers and their families in Zambia. Conclusions Because parents' drug use or sex work is often illegal and hidden, identifying their children can be difficult and may increase children's vulnerability and marginalization. Researchers and service providers, therefore, need to proceed with caution when attempting to reach these populations, but documentation and evaluation of current programmes should be prioritized. PMID:20573288

2010-01-01

264

Racial Disparities in Metabolism, Central Obesity, and Sex Hormone-Binding Globulin in Postmenopausal Women  

Microsoft Academic Search

Increased total and intraabdominal fat (IAF) obesity as well as other metabolic conditions associated with the insulin resistance syn- drome (IRS) are related to low levels of sex hormone-binding globulin (SHBG) in young and older Caucasian (CAU) and young African- American (AA) women. We examined whether postmenopausal AA women, a population with a high incidence of obesity and IRS despite

DORA M. BERMAN; LORI M. RODRIGUES; BARBARA J. NICKLAS; ALICE S. RYAN; KAREN E. DENNIS; ANDREW P. GOLDBERG

2010-01-01

265

Empowered Positions? Listening to Sexually Experienced Young Women Talking about Sex, Disappointments, and Compromise  

ERIC Educational Resources Information Center

Purpose: This paper aims to discuss how sex and relationship education (SRE) could benefit from considering current levels of young women's empowerment in (hetero)sexual relationships and challenge popular notions of twenty-first century young women "having it all" and occupying powerful relational and sexual positions.…

Sieg, Ellen

2008-01-01

266

The Effects of Childhood Trauma on Sex Trading in Substance Using Women  

Microsoft Academic Search

This article presents a model developed to understand the relationship between childhood victimization, perpetration of violence, and later cocaine dependence and adult sex trading among drug using women. A cohort of heavy drinking and drug using women (N=594) recruited for two on-going community based HIV prevention studies in St. Louis City was analyzed to evaluate this association using path analysis.

Krishna Vaddiparti; Jane Bogetto; Catina Callahan; Arbi B. Abdallah; Edward L. Spitznagel; Linda B. Cottler

2006-01-01

267

Strategies for Recruiting Steady Male Partners of Female Sex Workers for HIV Research.  

PubMed

Steady male partners of female sex workers (FSW) are a key population for HIV prevention, but researchers face challenges finding and recruiting this population. We conducted 40 in-depth interviews with FSW and steady male partners of FSW in Santo Domingo, Dominican Republic about how to engage steady male partners in HIV research. Participants cautioned that male partners might be unwilling to participate because of discomfort disclosing intimate information and cultural norms of masculinity. They recommended inviting male partners to research offices, instead of venue-based recruitment, because it was more private and trust-promoting. Most participants suggested that FSW could refer their partners or men could refer their friends who have FSW partners. Participants emphasized that referrals could break down trust-related barriers that prevent male partners from participating. Establishing an environment of respect and trust in the research setting can aid referral processes as individuals who participate communicate their positive experiences to their networks. PMID:25192901

Fleming, Paul J; Barrington, Clare; Perez, Martha; Donastorg, Yeycy; Kerrigan, Deanna

2014-09-01

268

Coverage of HIV Prevention Services for Female Sex Workers in Seven Cities of Myanmar  

PubMed Central

Cross-sectional surveys of female sex workers using time-location sampling in seven cities of Myanmar gauged coverage of HIV prevention programs. HIV testing in last year ranged from 28 to 73 %; attending peer educator talks ranged from 15 to 50 %; exposure to media campaigns varied by city and materials (e.g., lower for TV and radio, higher for printed materials). Consistent condom use with clients in last week was high (88–99 %) across all cities. The largest city, Yangon, lagged behind others in coverage of most programs. Such data are necessary for planning, targeting, and evaluating the prevention response for this key population disproportionately affected by HIV. PMID:23695521

Aung, Tin; Paw, Ethi; Aye, Nyo Me

2013-01-01

269

Social support and recovery among Mexican female sex workers who inject drugs  

PubMed Central

This qualitative study describes social support that female sex workers who inject drugs (FSW-IDUs) receive and recovery efforts in the context of relationships with family and intimate partners. We conducted thematic analysis of in-depth interviews with 47 FSW-IDUs enrolled in an intervention study to reduce injection/sexual risk behaviors in Tijuana, Mexico. FSW-IDUs received instrumental and emotional social support, which positively and negatively influenced recovery efforts. Participants reported how some intimate partners provided conflicting positive and negative support during recovery attempts. Problematic support (i.e., well-intended support with unintended consequences) occurred in strained family relationships, limiting the positive effects of support. Mexican drug treatment programs should consider addressing social support in recovery curricula through evidence-based interventions that engage intimate partners, children and family to better reflect socio-cultural and contextual determinants of substance abuse. PMID:23375570

Hiller, Sarah; Syvertsen, Jennifer; Lozada, Remedios; Ojeda, Victoria D.

2013-01-01

270

Coverage of HIV prevention services for female sex workers in seven cities of Myanmar.  

PubMed

Cross-sectional surveys of female sex workers using time-location sampling in seven cities of Myanmar gauged coverage of HIV prevention programs. HIV testing in last year ranged from 28 to 73 %; attending peer educator talks ranged from 15 to 50 %; exposure to media campaigns varied by city and materials (e.g., lower for TV and radio, higher for printed materials). Consistent condom use with clients in last week was high (88-99 %) across all cities. The largest city, Yangon, lagged behind others in coverage of most programs. Such data are necessary for planning, targeting, and evaluating the prevention response for this key population disproportionately affected by HIV. PMID:23695521

Aung, Tin; Paw, Ethi; Aye, Nyo Me; McFarland, Willi

2014-01-01

271

Gender and Sexual Economics: Do Women View Sex as a Female Commodity?  

PubMed

In the study reported here, data from implicit and behavioral choice measures did not support sexual economics theory's (SET's) central tenet that women view female sexuality as a commodity. Instead, men endorsed sexual exchange more than women did, which supports the idea that SET is a vestige of patriarchy. Further, men's sexual advice, more than women's, enforced the sexual double standard (i.e., men encouraged men more than women to have casual sex)-a gender difference that was mediated by hostile sexism, but also by men's greater implicit investment in sexual economics. That is, men were more likely to suppress female sexuality because they resisted female empowerment and automatically associated sex with money more than women did. It appears that women are not invested in sexual economics, but rather, men are invested in patriarchy, even when it means raising the price of sexual relations. PMID:24855018

Rudman, Laurie A; Fetterolf, Janell C

2014-05-21

272

Children of female sex workers and drug users: a review of vulnerability, resilience and family-centred models of care  

Microsoft Academic Search

BACKGROUND: Injection drug users and female sex workers are two of the populations most at risk for becoming infected with HIV in countries with concentrated epidemics. Many of the adults who fall into these categories are also parents, but little is known about the vulnerabilities faced by their children, their children's sources of resilience, or programmes providing services to these

Jennifer Beard; Godfrey Biemba; Mohamad I Brooks; Jill Costello; Mark Ommerborn; Megan Bresnahan; David Flynn; Jonathon L Simon

2010-01-01

273

Is military sexual trauma associated with trading sex among women veterans seeking outpatient mental health care?  

PubMed

A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks and seroprevalence among women receiving outpatient mental health care at a Veterans Affairs (VA) medical center. Each woman completed an assessment interview composed of validated measures that queried childhood sexual trauma; substance use; and risk behaviors, including trading sex for money, drugs, shelter, food, or other things. History of MST was derived from mandated VA screening results and chart notes. Overall, 19.7% reported a history of trading sex. Those who reported trading sex had a higher rate of MST than those who did not report trading sex (87.2% vs. 62.9%, respectively). A multivariable logistic regression model examined the relationship between trading sex and MST, controlling a priori for substance abuse and childhood sexual trauma (both associated with trading sex in civilian samples) and education, which was associated with trading sex in our sample. In this adjusted model, MST was associated with trading sex: odds ratio = 3.26, p = .025, 95% confidence interval = [1.16, 9.18]. To our knowledge, this is the 1st report of an association between MST and trading sex. Results extend previously observed associations between sexual trauma and trading sex in civilian cohorts and underscore the pernicious influence of sexual victimization across the lifespan. PMID:21534097

Strauss, Jennifer L; Marx, Christine E; Weitlauf, Julie C; Stechuchak, Karen M; Straits-Troster, Kristy; Worjoloh, Ayaba W; Sherrod, Christina B; Olsen, Maren K; Butterfield, Marian I; Calhoun, Patrick S

2011-01-01

274

Alcohol use and sexual risks: use of the Alcohol Use Disorders Identification Test (AUDIT) among female sex workers in China.  

PubMed

The association between alcohol use and sexual risks among female sex workers (FSWs) has been insufficiently studied. This article reports a cross-sectional study of the relationship between alcohol use risk, measured by the Alcohol Use Disorders Identification Test (AUDIT), and sexual risk behaviors among 1,022 FSWs in Guangxi, China. Bivariate analysis showed that FSWs at higher AUDIT levels tended to have earlier sexual initiation, became involved in the sex trade at a younger age, and were more vulnerable to sex under the influence of alcohol. Multivariate analysis revealed an independent association of problem drinking with both unprotected sex and a history of sexually transmitted diseases (STDs). Alcohol use in commercial sex shall be considered as an occupational hazard that requires immediate intervention. Future longitudinal studies are needed to confirm the association between alcohol use and sexual risks among this most-at-risk population. PMID:23311906

Chen, Yiyun; Li, Xiaoming; Zhang, Chen; Hong, Yan; Zhou, Yuejiao; Liu, Wei

2013-01-01

275

Sex affects health: women are different than men  

E-print Network

depression in part because women's brains Smoking has a more negative effect on cardiovascular health in women than men. Women are also less successful quitting smoking and have more severe withdrawal symptoms,270 will be diagnosed w/ melanoma this year; it will cause 8,650 deaths this year Cause ­ UV light induced mutations

Dever, Jennifer A.

276

Characteristics of activities that affect the development of women's same-sex relationships.  

PubMed

The author utilized semistructured interviews with 56 women to explore how a wide range of activities affected the development of the participants' same-sex attractions and relationships. The researcher was able to identify and describe some aspects of the process by which eight characteristics of activities that are more or less present in various social contexts have the potential to impact whether these contexts are more or less conducive or hindering to the development of women's same-sex attractions and relationships. Activities were more apt to nurture the development of the participants' same-sex attractions and relationships when the activity (a) included lesbians, (b) was composed primarily of women, (c) affirmed women, (d) facilitated bonding, (e) featured a climate of acceptance of lesbians/gays/bisexuals, (f) did not feature a climate that emphasized heteronormativity, (g) was perceived as gender neutral, and (h) generated or drew participants who were similar to each other. PMID:24885468

Davis-Delano, Laurel R

2014-01-01

277

Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India  

PubMed Central

Objectives Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. Methods and Findings The District Level Household Survey (2007–08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%–72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. Conclusion A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of their socioeconomic status. PMID:23028688

Singh, Abhishek; Pallikadavath, Saseendran; Ram, Faujdar; Ogollah, Reuben

2012-01-01

278

Outreach syphilis testing services by different health providers to female sex workers in southern China.  

PubMed

Health providers have played important roles on delivering prevention and care services to control syphilis in China. The current study was aimed to evaluate the performance of different health providers in providing outreach syphilis testing services to female sex workers (FSWs). The current study carried out during April to August 2009 in Liuzhou was aimed to investigate the services delivered by two different types of clinics in China. A total of 1,808 FSWs recruited from sex work venues were included in the study. Prevalence of positive syphilis test (6.4%) among FSWs accessed by the local center for disease control outreach teams (CDC teams) was significantly lower than that (9.3%) among FSWs accessed by the local reproductive health hospital outreach teams (RHH teams). As compared with CDC teams, RHH teams had more FSWs to be successfully referred to the designated STD clinics for further syphilis confirmation and intervention (85.7% vs. 26.7%, P<0.001). These findings indicate that RHH teams may be more efficient than CDC teams to provide outreach-based services to FSWs. Participation of the reproductive health providers or other medical facilities in outreach services to FSWs should be considered in developing intervention programs in China. PMID:23637755

Chen, Xiang-Sheng; Yin, Yue-Ping; Liu, Guo-Gu; Wei, Wan-Hui; Wang, Hong-Chun; Yu, Yuan-Lin; Mabey, David C; Peeling, Rosanna W

2013-01-01

279

Condom Use Among Female Sex Workers in China: Role of Gatekeepers  

PubMed Central

Objective 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. Goals 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. Study The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Results 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. Conclusions 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. PMID:16118607

YANG, HONGMEI; LI, XIAOMING; STANTON, BONITA; FANG, XIAOYI; ZHAO, RAN; DONG, BAIQING; LIU, WEI; LIANG, SHAOLING; ZHOU, YUEJIAO; HONG, YAN

2007-01-01

280

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

PubMed Central

Summary Negotiation for condom use by female sex workers (FSWs) with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 FSWs; 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 seven days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street based FSWs respectively. Overall, 28.1% of FSWs 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 HIV infection (AOR, 1.8 95% CI, 1.6–2.1) were positive predictors for condom negotiation. Compared to the hotel based FSWs, street (AOR, 0.6; 95% CI, 0.4–0.9), and brothel based FSWs (AOR, 0.7; 95% CI, 0.5–0.9) were less likely to negotiate for condom use. FSWs in Bangladesh are at high risk for STI/HIV infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by FSWs, and should be strengthened in commercial sex venues. PMID:23970599

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

2013-01-01

281

A qualitative study on HIV risk behaviors and medical needs of sex workers in a China/Myanmar border town.  

PubMed

Ruili is a small border town between China and Myanmar where drugs and commercial sex are common, and rates of sexually transmitted diseases (STDs) including HIV, are high. A qualitative study was carried out on 89 commercial sex workers there in 2001 to understand more about their HIV awareness, medical-seeking behaviors and needs. We found that the sex workers were young and the turnover rates were high. Contrary to common belief, many came from nearby villages or cities, but were probably reluctant to participate in organized activities. Their medical knowledge was very limited, often acquired from peers and self-medication was common. The contraception they used was inappropriate and screening for cervical cancer was nonexistent. They were very stigma conscious. Condoms were purchased in small quantities when required and used only if the clients were agreeable. These findings have strong implications for the future planning of services and HIV/STD prevention. PMID:13678543

Wong, William C W; Yilin, Wang

2003-08-01

282

HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil.  

PubMed

Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5-9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1-2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention. PMID:24617659

Fernandes, Fernanda R P; Mousquer, Gina J; Castro, Lisie S; Puga, Marco A; Tanaka, Tayana S O; Rezende, Grazielli R; Pinto, Clarice S; Bandeira, Larissa M; Martins, Regina M B; Francisco, Roberta B L; Teles, Sheila A; Motta-Castro, Ana R C

2014-01-01

283

Hepatitis C antibody prevalence and risk factors of some female sex workers in Thailand.  

PubMed

One high risk group for hepatitis C virus (HCV) infection is female sex workers (FSWs). A study of HCV antibody prevalence and group risk factors was conducted in 200 FSWs in Ratchaburi Province, Thailand, during June to December 1995. FSWs were interviewed and their blood specimens were collected for determining HCV antibody by second generation EIA (ABBOTT). After the laboratory results, the FSWs were divided into 2 groups, anti-HCV positive and anti-HCV negative. The variables obtained from interviews were analysed by X2-test and Odds Ratio. Prevalence of HCV antibody positives was 9.5%. It tended to be increased by the longer duration of working in the sex trade. The anti-HCV prevalence of FSWs working 9 years or more in the sex trade was significantly higher than that of FSWs working 4 years or less by about 3.5 times (23.08% vs 6.67%, p = 0.008). The anti-HCV positive FSWs had a higher percentage of anti-HIV positivity, but it was not of statistical significance (p = 0.078). The factors associated with high risk for HCV infection in this group were (a) Domicile (Northeast): OR = 3.07, (p = 0.0182), (b) Duration of working (> or = 4 years): OR = 3.13 (p = 0.0216), (c) Having a tattoo: OR = 4.12 (p = 0.0406), and (d) Having a history of STDs in the last 4 years: OR = 3.46 (p = 0.0165). PMID:9561600

Luksamijarulkul, P; Deangbubpha, A

1997-09-01

284

Epidemiology of HIV among female sex workers, their clients, men who have sex with men and people who inject drugs in West and Central Africa  

PubMed Central

Introduction The West and Central Africa (WCA) sub-region is the most populous region of sub-Saharan Africa (SSA), with an estimated population of 356 million living in 24 countries. The HIV epidemic in WCA appears to have distinct dynamics compared to the rest of SSA, being more concentrated among key populations such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and clients of FSWs. To explore the epidemiology of HIV in the region, a systematic review of HIV literature among key populations in WCA was conducted since the onset of the HIV epidemic. Methods We searched the databases PubMed, CINAHL and others for peer-reviewed articles regarding FSWs, MSM and PWID in 24 countries with no date restriction. Inclusion criteria were sensitive and focused on inclusion of any HIV prevalence data among key populations. HIV prevalence was pooled, and in each country key themes were extracted from the literature. Results The search generated 885 titles, 214 abstracts and 122 full articles, of which 76 met inclusion and exclusion criteria providing HIV prevalence data. There were 60 articles characterizing the burden of disease among FSWs, eight for their clients, one for both, six for MSM and one for PWID. The pooled HIV prevalence among FSWs was 34.9% (n=14,388/41,270), among their clients was 7.3% (n=435/5986), among MSM was 17.7% (n=656/3714) and among PWID from one study in Nigeria was 3.8% (n=56/1459). Conclusions The disproportionate burden of HIV among FSWs appears to be consistent from the beginning of the HIV epidemic in WCA. While there are less data for other key populations such as clients of FSWs and MSM, the prevalence of HIV is higher among these men compared to other men in the region. There have been sporadic reports among PWID, but limited research on the burden of HIV among these men and women. These data affirm that the HIV epidemic in WCA appears to be far more concentrated among key populations than the epidemics in Southern and Eastern Africa. Evidence-based HIV prevention, treatment and care programmes in WCA should focus on engaging populations with the greatest burden of disease in the continuum of HIV care. PMID:24321113

Papworth, Erin; Ceesay, Nuha; An, Louis; Thiam-Niangoin, Marguerite; Ky-Zerbo, Odette; Holland, Claire; Dramé, Fatou Maria; Grosso, Ashley; Diouf, Daouda; Baral, Stefan D

2013-01-01

285

Drug-using male clients of female sex workers who report being paid for sex: HIV/STI, demographic and drug use correlates  

PubMed Central

Background Research has focused on male clients of female sex workers (FSWs) and their risk for HIV/STIs. Yet, it is unclear whether the commercial sex behaviors of these men are limited to paying for sex, or whether they may also be paid for sex themselves. Methods We analyzed interview data and HIV/STI test results from 170 drug-using male clients of FSWs in Tijuana, Mexico, to determine the extent to which these men report being paid for sex and the association with positive HIV/STI results. Results Over one-quarter of men reported having been paid for sex in the past four months. In a multivariate logistic regression model, reporting having been paid for sex was significantly associated with testing positive for any HIV/STI (Adjusted Odds Ratio [AdjOR] 3.53, 95% C.I. 1.33–9.35), being bisexual (AdjOR 15.59, 95% C.I. 4.81–50.53), injection drug use in the past four months (AdjOR 2.65, 95% C.I. 1.16–6.03), and cocaine use in the past four months (AdjOR 2.93, 95% C.I. 1.22–7.01). Conclusions Findings suggest that drug-using male clients of FSWs may be characterized by unique risk profiles that require tailored HIV prevention interventions. PMID:23863514

Wagner, Karla D.; Pitpitan, Eileen V.; Chavarin, Claudia V.; Magis-Rodriguez, Carlos; Patterson, Thomas L.

2013-01-01

286

The mothering experiences of sex-trafficked women: between here and there.  

PubMed

This qualitative study focuses on the mothering experiences of women from the former Soviet Union (FSU) who were sex-trafficked to Israel. In-depth interviews were conducted with 8 women who gave birth either in the FSU or in Israel. The women's stories reflect 3 experiential spheres, those of "the good mother," "the sacrificing mother," and "the mother who wants for herself." These mothering spheres were found to exist against the backdrop of a life between 2 countries, where the women's mothering is split between "here" and "there." Furthermore, it was found that the women's sex-trafficking experience continually threatened to invade the 3 mothering spheres and destabilize the balance among them. The splits and conflicts among the mothering spheres are examined from a gendered perspective with emphasis on mother-daughter relationships and on the social constructions of mothering and prostitution. PMID:24164529

Peled, Einat; Parker, Ayelet

2013-10-01

287

Prevalence of HIV, Sexually Transmitted Infections, and Risk Behaviours Among Female Sex Workers in Nairobi, Kenya: Results of a Respondent Driven Sampling Study.  

PubMed

We conducted a respondent driven sampling survey to estimate HIV prevalence and risk behavior among female sex workers (FSWs) in Nairobi, Kenya. Women aged 18 years and older who reported selling sex to a man at least once in the past 3 months were eligible to participate. Consenting FSWs completed a behavioral questionnaire and were tested for HIV and sexually transmitted infections (STIs). Adjusted population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS analysis tool. Factors significantly associated with HIV infection were assessed using log-binomial regression analysis. A total of 596 eligible participants were included in the analysis. Overall HIV prevalence was 29.5 % (95 % CI 24.7-34.9). Median age was 30 years (IQR 25-38 years); median duration of sex work was 12 years (IQR 8-17 years). The most frequent client-seeking venues were bars (76.6 %) and roadsides (29.3 %). The median number of clients per week was seven (IQR 4-18 clients). HIV testing was high with 86.6 % reported ever been tested for HIV and, of these, 63.1 % testing within the past 12 months. Of all women, 59.7 % perceived themselves at 'great risk' for HIV infection. Of HIV-positive women, 51.0 % were aware of their infection. In multivariable analysis, increasing age, inconsistent condom use with paying clients, and use of a male condom as a method of contraception were independently associated with unrecognized HIV infection. Prevalence among STIs was low, ranging from 0.9 % for syphilis, 1.1 % for gonorrhea, and 3.1 % for Chlamydia. The data suggest high prevalence of HIV among FSWs in Nairobi. Targeted and routine HIV and STI combination prevention strategies need to be scaled up or established to meet the needs of this population. PMID:25428282

Musyoki, Helgar; Kellogg, Timothy A; Geibel, Scott; Muraguri, Nicholas; Okal, Jerry; Tun, Waimar; Fisher Raymond, H; Dadabhai, Sufia; Sheehy, Meredith; Kim, Andrea A

2014-11-27

288

Selling sex in the time of AIDS: the psycho-social context of condom use by sex workers on a Southern African mine  

Microsoft Academic Search

This paper provides a detailed account of the social organisation of commercial sex work in a squatter camp in a South African gold mining community. On the basis of in-depth interviews with 21 women, living in conditions of poverty and violence, the paper examines factors which might serve to help or hinder a newly implemented community-based peer education and condom

Catherine Campbell

2000-01-01

289

The organization of sex work in low and high-priced venues with a focus on the experiences of ethnic minority women working in these venues  

PubMed Central

Prior research on female sex workers (FSW) in China, and their risk for HIV and STI, neglects the nuanced experiences of ethnic minority FSW. We conducted participant observations and in-depth interviews with 33 FSW and six venue bosses to describe the experiences of FSW and management structures in high and low-priced sex work venues in Liuzhou, China. In low-priced venues, FSW had more autonomy and stronger relationships with their ethnic minority peers. Mid and high-priced venues had more formal management structures. Ethnic minority FSW working in higher priced venues experienced less support and kinship with their peers. HIV/STI prevention outreach activities occurred in all of the venues, but they were not tailored for different venue types or for ethnic minority FSW. Our findings provide guidance for tailoring public health programs that meet the needs of ethnic minority women working in different types of sex work venues. PMID:23912337

Qian, Liu; Zhuang, Kongshao; Henderson, Gail E.; Shenglong, Quzhen; Fang, Jingwen; Yao, Huiqin; Qin, Jingxin; Yang, Yanzhen; Abler, Laurie

2013-01-01

290

Disjunctures for Women and Frontline Workers: Implementation of the Family Violence Option  

PubMed Central

This research uses analysis of qualitative interviews with 10 battered welfare clients and 15 frontline welfare workers to examine the implementation of the Family Violence Option (FVO) under welfare reform. States adopting the FVO agree to screen for domestic violence, refer identified victims to community resources, and waive program requirements that would endanger the women or with which they are unable to comply. The analyses find that none of the 10 clients in this study received these services. This lack of services reflects four critical disjunctures between the formal policy and the policy experienced by the clients. It also reveals several more basic structural factors that provide conflicting mandates to frontline workers. Frontline workers’ discretionary behaviors enforce core rules related to welfare eligibility and reduce welfare caseloads but do not provide violencerelated services to victims. PMID:18270548

Lindhorst, Taryn; Padgett, Julianna D.

2007-01-01

291

Sex differences in attraction to familiar and unfamiliar opposite-sex faces: men prefer novelty and women prefer familiarity.  

PubMed

Familiarity is attractive in many types of stimuli and exposure generally increases feelings of liking. However, men desire a greater number of sexual partners than women, suggesting a preference for novelty. We examined sex differences in preferences for familiarity. In Study 1 (N = 83 women, 63 men), we exposed individuals to faces twice and found that faces were judged as more attractive on the second rating, reflecting attraction to familiar faces, with the exception that men's ratings of female faces decreased on the second rating, demonstrating attraction to novelty. In Studies 2 (N = 42 women, 28 men) and 3 (N = 51 women, 25 men), exposure particularly decreased men's ratings of women's attractiveness for short-term relationships and their sexiness. In Study 4 (N = 64 women, 50 men), women's attraction to faces was positively related to self-rated similarity to their current partner's face, while the effect was significantly weaker for men. Potentially, men's attraction to novelty may reflect an adaptation promoting the acquisition of a high number of sexual partners. PMID:23740467

Little, Anthony C; DeBruine, Lisa M; Jones, Benedict C

2014-07-01

292

Where Sex Ends and Emotions Begin: Love and HIV Risk among Female Sex Workers and their Intimate, Non-Commercial Partners along the Mexico-U.S. Border  

PubMed Central

This study explores the affective dimensions of female sex workers’ relationships with their intimate, non-commercial partners and assesses how emotions shape each partner’s sexual and drug-related risk within their relationship. We draw on qualitative data from a study of HIV, sexually transmitted infections, and high risk behaviours among female sex workers and their non-commercial partners in Tijuana and Ciudad Juárez, Mexico, to illustrate that these couples share relationships based on love, trust, respect, and emotional and material support. These relationships ranged in emotional intensity, which shaped partners’ decisions not to use condoms with each other. Drugs were important in most couples’ relationships. Among injectors, syringe sharing was common and represented both a sign of care and a pragmatic reaction to conditions of material scarcity. Our findings suggest that couple-based HIV interventions to address dual sexual and drug-related risks should be tailored to the emotional dynamics of sex workers’ intimate relationships. PMID:23473586

Syvertsen, Jennifer L.; Robertson, Angela M.; Palinkas, Lawrence A.; Rangel, M. Gudelia; Martinez, Gustavo; Strathdee, Steffanie A.

2013-01-01

293

"Differently normal" and "normally different": negotiations of female embodiment in women's accounts of 'atypical' sex development.  

PubMed

During recent decades numerous feminist scholars have scrutinized the two-sex model and questioned its status in Western societies and medicine. Along the same line, increased attention has been paid to individuals' experiences of atypical sex development, also known as intersex or 'disorders of sex development' (DSD). Yet research on individuals' experiences of finding out about their atypical sex development in adolescence has been scarce. Against this backdrop, the present article analyses 23 in-depth interviews with women who in their teens found out about their atypical sex development. The interviews were conducted during 2009-2012 and the interviewees were all Swedish. Drawing on feminist research on female embodiment and social scientific studies on diagnosis, I examine how the women make sense of their bodies and situations. First, I aim to explore how the women construe normality as they negotiate female embodiment. Second, I aim to investigate how the divergent manners in which these negotiations are expressed can be further understood via the women's different access to a diagnosis. Through a thematic and interpretative analysis, I outline two negotiation strategies: the "differently normal" and the "normally different" strategy. In the former, the women present themselves as just slightly different from 'normal' women. In the latter, they stress that everyone is different in some manner and thereby claim normalcy. The analysis shows that access to diagnosis corresponds to the ways in which the women present themselves as "differently normal" and "normally different", thus shedding light on the complex role of diagnosis in their negotiations of female embodiment. It also reveals that the women make use of what they do have and how alignments with and work on norms interplay as normality is construed. PMID:24331903

Guntram, Lisa

2013-12-01

294

Sex Work and Drug Use in a Subculture of Violence  

ERIC Educational Resources Information Center

This article examines the subculture of violence thesis as it relates to female street sex workers in Miami. Interview and focus group methods were used to study the intersections of childhood trauma, drug use, and violent victimization among 325 women. Using targeted sampling, crack- and heroin-using sex workers were recruited through street…

Surratt, Hilary L.; Inciardi, James A.; Kurtz, Steven P.; Kiley, Marion C.

2004-01-01

295

Sex affects health: women are different I. Body composition & metabolism  

E-print Network

. Cardiovascular Disease III. Chronic Conditions A. Osteoporosis B. Autoimmune conditions C. Alzheimer's Disease inactivity #12;3 Women & Cardiovascular Disease n Heart disease is the #1 killer of women q Since 1984 States die of heart disease, stroke and other cardiovascular diseases as from all forms of cancer

Dever, Jennifer A.

296

Women with Intellectual Disabilities Talk about Their Perceptions of Sex  

ERIC Educational Resources Information Center

Background: Sexuality is learned through sexual socialisation that women with intellectual disabilities (IDs) understand and express. Rules of sexual engagement for these women can include barriers for their socialisation, intimate partner selection, and sexual expression. These rules can become more limiting when coupled with rules of femininity…

Bernert, D. J.; Ogletree, R. J.

2013-01-01

297

Client demands for unsafe sex: the socio-economic risk environment for HIV among street and off-street sex workers  

PubMed Central

Objective 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. Design Cross-sectional study using baseline (February/10-October/11) data from a longitudinal cohort of 510 SWs. Methods A two-part multivariable regression model was used to identify factors associated with two separate outcomes: (1) being offered and (2) accepting more money for sex without a condom in the last six months, among those who had been offered more money. Results 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 use less than daily (vs. none), and less likely for SWs who solicited for clients mainly indoors (vs. outdoor/public places). Conclusions 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 work spaces are urgently required. PMID:23614990

DEERING, Kathleen N; LYONS, Tara; FENG, Cindy X; NOSYK, Bohdan; STRATHDEE, Steffanie A; MONTANER, Julio SG; SHANNON, Kate

2013-01-01

298

The effects of sex education on women with secondary orgasmic dysfunction.  

PubMed

This study evaluated the effects of sex education on 48 couples in which the women reported secondary orgasmic dysfunction. None of the males had a problem with premature ejaculation or with erectile dysfunction. Couples received two, two-hour sessions of sex education during a one-week period. From measures administered before and after treatment, the women reported significantly increased orgasmic frequency and decreased sexual anxiety. The males reported a significant increase in the duration of intercourse and in oral-genital sexual stimulation. None of the subject characteristics significantly predicted overall change. The findings underscored the important role of sex education in facilitating positive changes in a woman's orgasmic frequency and in a sexual relationship. Future research should assess the relative meaningfulness of the various components of the sex education package. PMID:6663641

Kilmann, P R; Mills, K H; Bella, B; Caid, C; Davidson, E; Drose, G; Wanlass, R

1983-01-01

299

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.  

PubMed

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. PMID:25301669

Navani-Vazirani, Sonia; Solomon, Davidson; Gopalakrishnan; Heylen, Elsa; Srikrishnan, Aylur Kailasom; Vasudevan, Canjeevaram K; Ekstrand, Maria L

2015-02-01

300

Gender inequity in the lives of women involved in sex work in Kampala, Uganda  

PubMed Central

Background Gender inequity is manifested in the social and economic burden women carry in relation to men. We investigate women's experiences of gender relations from childhood to adult life and how these may have led to and kept women in sex work. Methods Participants were drawn from an ongoing epidemiological cohort study of women working in high HIV/STI risk environments in Kampala. From over 1000 enrolled women, we selected 101 for a qualitative sub-study. This analysis focuses on 58 women who engaged in sex work either as a main job or as a side job. In-depth life history interviews were conducted to capture points of vulnerability that enhance gender inequity throughout their lives. Results Most participants were young, single parents, poorly educated, who occupied low skilled and poorly paying jobs. All women knew their HIV status and they disclosed this in the interview; 31 were uninfected while 27 said they were infected. Parental neglect in childhood was reported by many. Participants described experiences of violence while growing up sometimes perpetuated by relatives and teachers. Early unwanted pregnancies were common and for many led to leaving school. Some women stated a preference for multiple and short-term money-driven sexual relationships. Needing to earn money for child care was often the main reason for starting and persisting with sex work. Violence perpetrated by clients and the police was commonly reported. Alcohol and drug use was described as a necessary “evil” for courage and warmth, but sometimes this affected clear decision making. Many felt powerless to bargain for and maintain condom use. Leaving sex work was considered but rarely implemented. Conclusions Inequities in gender and power relations reduce economic and social opportunities for better lives among women and increase risky sexual behaviour. Interventions focused on these inequities that also target men are crucial in improving safer practices and reducing risk. PMID:22713353

Mbonye, Martin; Nalukenge, Winifred; Nakamanya, Sarah; Nalusiba, Betty; King, Rachel; Vandepitte, Judith; Seeley, Janet

2012-01-01

301

Men (and women) as "sellers" of sex in alcohol-serving venues in Cape Town, South Africa.  

PubMed

The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7 vs. 5.8 %). Overall, men who traded sex were similar to their female counterparts. Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men. PMID:23494405

Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Watt, Melissa H; Sikkema, Kathleen J; Skinner, Donald; Pieterse, Desiree; Cain, Demetria

2014-06-01

302

Interactions between sex steroid hormones and leptin in women. Studies in vivo and in vitro  

Microsoft Academic Search

OBJECTIVE: To investigate the associations between sex hormones and leptin. In addition, to investigate the direct effect of sex hormones by incubations of human subcutaneous adipose tissue explants, in vitro.DESIGN: Cross-sectional study and an experimental in vitro study.SUBJECTS: 36 women (age, 23–65 y; body mass index, BMI, 19–65 kg\\/m2) participated in the cross-sectional study. Subcutaneous abdominal biopsies were taken from

K Kristensen; SB Pedersen; B Richelsen

2000-01-01

303

Contraceptive Utilization and Pregnancy Termination Among Female Sex Workers in Afghanistan  

PubMed Central

Abstract Background To determine the prevalence and correlates of prior pregnancy termination and unmet need for contraception among female sex workers (FSWs) in Afghanistan. Methods FSWs in Jalalabad, Kabul, and Mazar-i-Sharif were recruited between June 2006 and December 2007 through outreach programs. Participants completed an interviewer-administered survey describing demographics, behaviors associated with risk of sexually transmitted infections (STIs) and unplanned pregnancy, and medical history. Correlates of prior pregnancy termination and current unmet need for contraception were assessed with logistic regression analysis, controlling for site. Results Of 520 FSWs, most (82.3%) had been pregnant at least once (mean 4.9?±?2.7, range 1–17), among whom unplanned pregnancy (36.9%) and termination (33.2%) were common. Jalalabad participants were more likely to report both prior unplanned pregnancy (60.6% vs. 48.3% in Kabul or 20.7% in Mazar, p?sex outside their city of residence (adjusted odds ratio [AOR] 1.88, 95% confidence interval [CI] 1.28-2.77) and inversely associated with illicit drug use (AOR 0.41, 95% CI 0.31-0.53). Conclusions Although FSWs in Afghanistan report high rates of contraceptive use, unplanned pregnancy is common. Reproductive health services should be included in programming for FSWs to reduce unplanned pregnancies and to reduce HIV/STI risks. PMID:20879869

Nasir, Abdul; Raza Stanekzai, Mohammad; Scott, Paul T.; Strathdee, Steffanie A.; Botros, Boulos A.; Tjaden, Jeffrey

2010-01-01

304

Sexual assertiveness in low-income African American women: unwanted sex, survival, and HIV risk.  

PubMed

The objective of this study was to determine the relationship of social variables related to sexual relationships in African American women. The study used a quantitative descriptive design to gather data from a convenience sample of 524 African American women aged 18 to 49 who dwelled in the southeastern United States. The study utilized the HIV Risk Behavior Questionnaire to determine the participant's level of HIV risk. Results indicated substantial levels of sex in the women due to violence or fear of violence, relationship loss, lost shelter, and high levels of unwanted sex. There was a positive correlation between level of survival sex and high-risk behavior (R = .651, p < .01). Multiple correlations indicated associations between history of forced sex and sex due to fear of violence (R = .604, p < .01). Further correlations indicated a pattern of association between poverty, age, and sex out of fear of relationship loss or shelter loss. The study indicates a need for a broader definition of HIV-related risk in high-risk populations. PMID:17064233

Whyte Iv, James

2006-01-01

305

Sexually transmitted infections and sexual behaviour among youth clients of hotel-based female sex workers in Dhaka, Bangladesh.  

PubMed

A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them. PMID:22930291

Haseen, F; Chawdhury, F A H; Hossain, M E; Huq, M; Bhuiyan, M U; Imam, H; Rahman, D M M; Gazi, R; Khan, S I; Kelly, R; Ahmed, J; Rahman, M

2012-08-01

306

Psychological Fears among Low-Paid Female Sex Workers in Southwest China and Their Implications for HIV Prevention  

PubMed Central

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. PMID:25330242

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

2014-01-01

307

Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa  

PubMed Central

Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs’ health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa. PMID:24916010

2014-01-01

308

Sex hormones and skin collagen content in postmenopausal women.  

PubMed Central

Skin biopsy specimens were taken from 29 postmenopausal women who had not been given hormone replacement therapy and from 26 women who had been treated with oestrogen and testosterone implants for two to 10 years. The mean hydroxyproline content and therefore the mean collagen content in the skin was found to be 48% greater in the treated than the untreated women, who were matched for age. This difference was significant (p less than 0.01). The implication of this finding is that oestrogen or testosterone, or both, prevents the decrease in skin collagen content that occurs with aging and protects skin in the same way as it protects bone in postmenopausal women. PMID:6416400

Brincat, M; Moniz, C F; Studd, J W; Darby, A J; Magos, A; Cooper, D

1983-01-01

309

The Relation Between Sex Drive and Sexual Attraction to Men and Women: A Cross-National Study of Heterosexual, Bisexual, and Homosexual Men and Women  

Microsoft Academic Search

Recent research suggests that, for most women, high sex drive is associated with increased sexual attraction to both women\\u000a and men. For men, however, high sex drive is associated with increased attraction to one sex or the other, but not to both,\\u000a depending on men's sexual orientation (Lippa, R. A., 2006, Psychological Science, 17, 46–52). These findings were replicated in

Richard A. Lippa

2007-01-01

310

Influence of sex hormones and phytoestrogens on heart disease in men and women  

PubMed Central

Cardiovascular disease (CVD) is the number one cause of morbidity and mortality in men and women worldwide. According to the WHO, by 2015, almost 20 million people will die from CVD each year. It is well established that men and women differ not only in baseline cardiac parameters, but also in the clinical presentation, diagnosis and treatment outcomes of CVD. Women tend to develop heart disease later in life than men. This difference has been attributed to the loss of estrogen during the menopausal transition; however, the biological explanations for the sexual dimorphism in CVD are more complex and seem unlikely to be due to estrogen alone. The current controversy that has arisen regarding the effects of HRT on CVD in women is a case in point. In this review, the sex-based differences in cardiac (patho-) physiology are discussed with emphasis on the impact of sex hormones, hormone receptors and diet on heart disease. PMID:20088732

Bhupathy, Poornima; Haines, Christopher Dean; Leinwand, Leslie Anne

2010-01-01

311

Navigating the Risk Environment: Structural Vulnerability, Sex, and Reciprocity Among Women Who Use Meth  

PubMed Central

Drug users’ risky sexual practices contribute to their increased risk for contracting HIV and other sexually transmitted infections. Use of methamphetamine has been associated with a number of high-risk sexual practices such as frequent sexual contacts, multiple sex partners, unprotected sex, and exchange sex. The media construct women who use meth as engaging in exchange sex to support their drug habit. Despite an abundance of data on exchange sex among heroin and crack users that suggest the importance of examining these practices in context, they remain understudied among female methamphetamine users. This article draws on preliminary findings from ongoing ethnography with female meth users to highlight the risk environment(s) that contribute to structural vulnerability and shape behaviour. While their sexual practices may be deemed transactional and risky, understanding their embeddedness in structural context and networks of reciprocity is essential to understanding implications for policy and harm reduction. PMID:24140170

McKenna, Stacey A.

2013-01-01

312

Challenges to recruiting population representative samples of female sex workers in China using Respondent Driven Sampling.  

PubMed

We explore the network coverage of a sample of female sex workers (FSWs) in China recruited through Respondent Drive Sampling (RDS) as part of an effort to evaluate the claim of RDS of population representation with empirical data. We take advantage of unique information on the social networks of FSWs obtained from two overlapping studies - RDS and a venue-based sampling approach (PLACE) - and use an exponential random graph modeling (ERGM) framework from local networks to construct a likely network from which our observed RDS sample is drawn. We then run recruitment chains over this simulated network to assess the assumption that the RDS chain referral process samples participants in proportion to their degree and the extent to which RDS satisfactorily covers certain parts of the network. We find evidence that, contrary to assumptions, RDS oversamples low degree nodes and geographically central areas of the network. Unlike previous evaluations of RDS which have explored the performance of RDS sampling chains on a non-hidden population, or the performance of simulated chains over previously mapped realistic social networks, our study provides a robust, empirically grounded evaluation of the performance of RDS chains on a real-world hidden population. PMID:24834869

Merli, M Giovanna; Moody, James; Smith, Jeffrey; Li, Jing; Weir, Sharon; Chen, Xiangsheng

2015-01-01

313

Microbicide Acceptability among Female Sex Workers in Beijing, China: Results from a Pilot Study  

PubMed Central

Abstract Objectives To explore attitudes toward hypothetical vaginal microbicides and willingness to use them among female sex workers (FSWs) in a district of Beijing, China, and to identify factors likely to affect acceptability and use of microbicides for HIV prevention among this population. Methods An exploratory cross-sectional study using convenience sampling was conducted. A total of 54 FSWs were recruited from Shijingshan District in Beijing for a face-to-face interview. Main outcome variables were measured by a microbicide acceptability score, perception of HIV/STI risk and self-reported high-risk sexual behaviors, condom use, HIV/STI history, and self-reported experience of vaginal product use. Results Mean score of microbicide acceptability in FSWs was 2.73, with a standard deviation (SD) of 0.46 (ranging from 1 to 4). Acceptability score varied by partner types (p?=?0.025), history of HIV testing (p?=?0.037), and concern about contracting an STI (p?=?0.042). Covert use of microbicides in FSWs with various sexual partners was statistically different (p?=?0.001). FSWs preferred to pay for microbicides and to use them covertly. Conclusions In general, FSWs in Shijinghsan District might have a positive response to microbicides across all hypothetical characteristics. Further study is needed for comprehensive understanding of the contextual factors of microbicide use. PMID:19743909

Han, Lin; Lv, Fan; Xu, Peng; Zhang, Guolei; Juniper, Naomi S.

2009-01-01

314

Outcomes of a behavioral intervention to reduce HIV risk among drug-involved female sex workers.  

PubMed

Although street-based female sex workers (FSWs) are highly vulnerable to HIV, they often lack access to needed health services and medical care. This paper reports the results of a recently completed randomized intervention trial for FSWs in Miami, Florida, which tested the relative efficacy of two case management interventions that aimed to link underserved FSWs with health services and to reduce risk behaviors for HIV. Participants were recruited using targeted sampling strategies and were randomly assigned to: a Strengths-Based/Professional Only (PO) or a Strengths-Based/Professional-Peer condition (PP). Follow-up data were collected 3 and 6 months post-baseline. Outcome analyses indicated that both intervention groups displayed significant reductions in HIV risk behaviors and significant increases in services utilization; the Professional-Peer condition provided no added benefit. HIV seropositive FSWs responded particularly well to the interventions, suggesting the utility of brief strengths-based case management interventions for this population in future initiatives. PMID:24558098

Surratt, Hilary L; O'Grady, Catherine; Kurtz, Steven P; Levi-Minzi, Maria A; Chen, Minxing

2014-04-01

315

Grassroots Participation, Peer Education, and HIV Prevention by Sex Workers in South Africa  

PubMed Central

Objectives. This microqualitative case study of a community-based peer education program led by sex workers at a South African mine examined the role of grassroots participation in sexual health promotion. Methods. The study involved in-depth interviews with 30 members of the target community. The interviews were analyzed in terms of social capital, empowerment, and identity. Results. The study yielded a detailed analysis of the way in which community dynamics have shaped the peer education program's development in a deprived, violent community where existing norms and networks are inconsistent with ideal criteria for participatory health promotion. Conclusions. Much remains to be learned about the complexities of translating theoretically and politically vital notions of “community participation” into practice among hard-to-reach groups. The fabric of local community life is shaped by nonlocal structural conditions of poverty and sexual inequality in ways that challenge those seeking to theorize the role of social capital in community development in general and in sexual health promotion in particular. PMID:11726380

Campbell, Catherine; Mzaidume, Zodwa

2001-01-01

316

Vulnerability to sexual violence and participation in sex work among high-end entertainment centre workers in Hunan Province, China  

PubMed Central

Background China has seen a proliferation of entertainment centres that are frequented by business people. Employees at these centres often are young, female rural-to-urban migrants who may be vulnerable to sexual violence and exploitation. Methods Data for this study were collected using a self-administered survey among male and female employees in two high-end entertainment centres in Changsha, Hunan Province, China. We used logistic regression to examine predictors of violent and potentially exploitative experiences (partner violence, forced sex and transactional sex). Predictors included gender, ever having a same-sex partner, migration variables and employment characteristics. Results Participants reported high levels of partner violence (16.0% ever and 9.0% in the past 3 months) and forced sex (13.9% ever and 5.5% in the past 3 months). Nineteen percent reported sex work in the past 3 months. In the multivariate regressions, ever having had a same-sex partner was associated with higher odds of ever having experienced partner violence (odds ratio (OR) = 7.8, P < 0.001), partner violence in the past 3 months (OR = 9.0, P < 0.001), ever having had transactional sex (OR = 6.0, P < 0.001) and transactional sex in the past 3 months (OR = 5.2, P = 0.001). After adjusting for transactional sex, the association between having had a same-sex partner and partner violence remained significant. Neither gender nor migration status was associated with any of the outcomes. Conclusion High-end entertainment centre workers in China are at risk for sexual violence and should be targeted with employment-based interventions. PMID:23809910

Kelvin, Elizabeth A.; Sun, Xiaoming; Mantell, Joanne E.; Zhou, Jianfang; Mao, Jingshu; Peng, Yanhui

2013-01-01

317

Relationship between Insulin and Sex Hormone-Binding Globulin Levels during Weight Loss in Obese Women  

Microsoft Academic Search

Objective: The aim of this study was to assess the impact of insulin sensitivity on the relationship between sex hormone-binding globulin (SHBG) and insulin levels during active weight loss in euthyroid obese women. Research Design and Methods: The study population comprised 80 premenopausal overweight and obese (BMI ?27) women (mean age 41.44 ± 10.03 years). Seventy patients were considered eligible

Fulya Akin; Mehmet Bastemir; Bunyamin Kaptanoglu

2007-01-01

318

Sexuality Information Seeking and Sexual Function Among Women Attending In-Home Sex Toy Parties  

Microsoft Academic Search

ABSTRACT. Outside traditional risk-oriented public health campaigns, few sexuality education opportunities exist for adult women, particularly those in partnered relationships, that address issues related to sexual desire and pleasure. Data were collected from 677 women attending in-home sex toy parties to assess whether they sought sexuality-related information at a recent party they attended. Participants reported asking 765 questions at parties.

Kristen N. Jozkowski; Vanessa Schick; Debby Herbenick; Michael Reece

2012-01-01

319

Biomarker validation of recent unprotected sexual intercourse in a prospective study of young women engaged in sex work in Phnom Penh, Cambodia  

PubMed Central

Summary A study of female sex workers in Phnom Penh, Cambodia found self-reported condom use to be of questionable validity, particularly among amphetamine-type stimulant (ATS) users and those with multiple partners. Background Accurate measurement of unprotected sex is essential in HIV prevention research. Since 2001, the 100% Condom Use Program targeting female sex workers (FSW) has been a central element of the Cambodian National HIV/AIDS Strategy. We sought to assess the validity of self-reported condom use using the rapid prostate-specific antigen (PSA) test among Cambodian FSW. Methods From 2009 to 2010 we enrolled 183 FSW in Phnom Penh in a prospective study of HIV risk behavior. PSA test results from the OneStep ABAcard® were compared to self-reported condom use in the past 48 hours at quarterly follow-up visits. Results Among women positive for seminal fluid at the first follow-up visit, 42% reported only protected sex or no sex in the detection period. Discordant results were more likely among brothel and street-based FSW vs. entertainment (56% vs. 17%), recent (last 3 months) ATS users (53% vs. 20%), and those with >5 partners in the past month (58% vs. 13%). In multivariable regression models, positive PSA results were associated with recent ATS use (Adjusted Risk Ratio (ARR) = 1.5; 95% confidence interval (CI):1.1 – 2.2), having a non-paying last sex partner (ARR=1.7; CI:1.2 – 2.5), and sex work venue (ARR=3.0; CI:1.4 – 6.5). Correspondingly, women with a non-paying last sex partner were more likely to report unprotected sex (ARR=1.5; CI:1.1 – 2.2), but no associations were found with sex work venue or ATS use. Conclusions Results confirm the questionable validity of self-reported condom use among FSW. The PSA biomarker assay is an important monitoring tool in HIV/STI research including prevention trials. PMID:23680902

Evans, Jennifer L.; Couture, Marie-Claude; Stein, Ellen S.; Sansothy, Neth; Maher, Lisa; Page, Kimberly

2014-01-01

320

Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia  

PubMed Central

Aims: To determine the relation between sick leave and selected exposure variables among women semiconductor workers. Methods: This was a cross sectional survey of production workers from 18 semiconductor factories. Those selected had to be women, direct production operators up to the level of line leader, and Malaysian citizens. Sick leave and exposure to physical and chemical hazards were determined by self reporting. Three sick leave variables were used; number of sick leave days taken in the past year was the variable of interest in logistic regression models where the effects of age, marital status, work task, work schedule, work section, and duration of work in factory and work section were also explored. Results: Marital status was strongly linked to the taking of sick leave. Age, work schedule, and duration of work in the factory were significant confounders only in certain cases. After adjusting for these confounders, chemical and physical exposures, with the exception of poor ventilation and smelling chemicals, showed no significant relation to the taking of sick leave within the past year. Work section was a good predictor for taking sick leave, as wafer polishing workers faced higher odds of taking sick leave for each of the three cut off points of seven days, three days, and not at all, while parts assembly workers also faced significantly higher odds of taking sick leave. Conclusion: In Malaysia, the wafer fabrication factories only carry out a limited portion of the work processes, in particular, wafer polishing and the processes immediately prior to and following it. This study, in showing higher illness rates for workers in wafer polishing compared to semiconductor assembly, has implications for the governmental policy of encouraging the setting up of wafer fabrication plants with the full range of work processes. PMID:12660374

Chee, H; Rampal, K

2003-01-01

321

Contentious issues in research on trafficked women working in the sex industry: Study design, ethics, and methodology  

Microsoft Academic Search

The trafficking of women and children for work in the globalized sex industry is a global social problem. Quality data is needed to provide a basis for legislation, policy, and programs, but first, numerous research design, ethical, and methodological problems must be addressed. Research design issues in studying women trafficked for sex work (WTSW) include how to (a) develop coalitions

Julie Cwikel; Elizabeth Hoban

2005-01-01

322

Sex, desire and pleasure: considering the experiences of older Australian women  

PubMed Central

Older age is often associated with asexuality. That is, older individuals are not viewed as desiring of sex, nor as sexually desirable to others. Broader social and cultural norms that downplay women's sexual desire and agency further compound these phenomena. Whether this popular image accurately reflects older women's sexual desires, behaviour and capacity to experience pleasure is unclear. Drawing on semi-structured interviews with 43 partnered Australian women aged 55–81, this article considers women's sexual experiences and desires in older age. The findings of our research confirm that older women's experiences of sex and sexual desire are diverse and fluid. Some of the factors that influenced participants’ sexual behaviour and desire will be considered in this article, as will their understandings of what “counts” as sexual satisfaction and “successful sex”. The factors affecting sexual behaviour and desire also influence the way in which women are able to negotiate sexual interaction with their partners. Participants expressed a need for education and resources in order to gain greater control and to make autonomous choices over their sexual experiences, desire and ability to give and receive pleasure. The implications of these findings for practitioners are also considered. PMID:25544829

Fileborn, Bianca; Thorpe, Rachel; Hawkes, Gail; Minichiello, Victor; Pitts, Marian; Dune, Tinashe

2015-01-01

323

Circular Migration by Mexican Female Sex Workers Who are Injection Drug Users: Implications for HIV in Mexican Sending Communities  

Microsoft Academic Search

Circular migration and injection drug use increase the risk of HIV transmission in sending communities. We describe female\\u000a sex workers who are injection drug users’ (FSW-IDUs) circular migration and drug use behaviors. Between 2008-2010, 258 migrant\\u000a FSW-IDUs residing in Tijuana and Ciudad Juarez, Mexico responded to questionnaires. 24% of FSW-IDUs were circular migrants.\\u000a HIV prevalence was 3.2% in circular migrants

Victoria D. Ojeda; José Luis Burgos; Sarah P. Hiller; Remedios Lozada; Gudelia Rangel; Alicia Vera; Irina Artamonova; Carlos Magis-Rodriguez

324

Comparative views of the public, sex workers, businesses and residents on establishing managed zones for prostitution: analysis of a consultation in Liverpool.  

PubMed

Drug addiction, violence and anti-social behaviour are characteristics of street prostitution. An alternative approach to zero tolerance is establishing a managed zone where sex workers operate according to regulations and can access health services. Using a consultation with sex workers (n=50), businesses (n=51), residents (n=179) and the public (n=789) we examined where a zone might be established in a UK city (Liverpool) and characteristics of the zone required by these stakeholders. All groups believed a zone would improve sex workers' safety and reduce prostitution elsewhere. Sex workers (96%) agreed to work in a zone. Location criteria from all groups were used to identify two potential business areas to host a zone but businesses in or near these areas rejected plans through fear for staff safety and reduced business. We discuss the consultation process, difficulties in locating services for marginalised groups in cities and the implications for health and judicial policy relating to prostitution. PMID:17029923

Bellis, Mark A; Watson, Fay L D; Hughes, Sara; Cook, Penny A; Downing, Jennifer; Clark, Peter; Thomson, Rod

2007-09-01

325

More Women Than Men: Implications of the Changing Sex Ratio.  

ERIC Educational Resources Information Center

Texas, like the rest of the nation, is undergoing a shift toward an excess of females. Review of the changing balance of the sexes reveals that there were only 95.9 males per 100 females in 1970 with a projected drop to 93.8 by 1980. In 1950 Texas had an excess of 15,000 males, but by 1960 females outnumbered males by 90,000 and by 234,000 in…

Skrabanek, R. L.

326

Women's autonomy in negotiating safer sex to prevent HIV: findings from the 2011 Nepal Demographic and Health Survey.  

PubMed

Women with greater autonomy have higher HIV-related knowledge and condom use. Inability to negotiate safer sex in high-risk situations might increase HIV infection. This study examined the relationship between women's autonomy and ability to negotiate safer sex practices among married women. The 2011 Nepal Demographic and Health Survey data were used. The data were collected by two-stage stratified cluster sampling and face-to-face interviews. Autonomy was measured in Decision-Making Participation and Assets Ownership, while ability to negotiate safer sex consists of Refusal of Sex and Ask for Condom Use. Among 12,674 women of 15-49 years, married women were analyzed (n = 8,896). Women with greater autonomy in decision-making participation were more likely to negotiate safer sex. After controlling for socio-demographic factors, odds ratios (OR) for refusal of sex was 2.70 (95% CI [2.14, 3.40]) in women with the highest decision-making participation. These women showed higher OR for 'ask for condom use' in high risk situations (2.10, 95% CI [1.81, 2.44]). Assets ownership also demonstrated a positive statistical relationship with asking for a condom use (OR 1.31, 95% CI [1.10, 1.56]). The results point to the importance of women's autonomy on sexual health. It emphasizes women's empowerment-based approach to curbing HIV/AIDS in developing countries. PMID:24450274

Atteraya, Madhu Sudhan; Kimm, Heejin; Song, In Han

2014-02-01

327

Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting  

PubMed Central

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 (<18 years old) and constructed confounder models examining the independent effect of early initiation on HIV and 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

GOLDENBERG, Shira M.; CHETTIAR, Jill; SIMO, Annick; SILVERMAN, Jay G.; STRATHDEE, Steffanie A.; MONTANER, Julio; SHANNON, Kate

2014-01-01

328

A Gap in Science's and the Media Images of People who use Drugs and Sex Workers: Research on Organizations of the Oppressed.  

PubMed

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. PMID:25544256

Dziuban, Agata; Friedman, Samuel R

2015-03-01

329

Love and Risk: Intimate Relationships among Female Sex Workers who Inject Drugs and their NonCommercial Partners in Tijuana, Mexico  

Microsoft Academic Search

This dissertation examines the influence of love and other emotions on sexual and drug-related HIV risk among female sex workers who inject drugs and their intimate, non-commercial partners in Tijuana, Mexico. My work on a public health study along the Mexico-U.S. border and independent ethnographic research in Tijuana suggests the importance of emotions in shaping sex workers' relationships and health

Jennifer L. Syvertsen

2012-01-01

330

What Schoolteachers Think about the Rights of Women and Equality of the Sexes  

ERIC Educational Resources Information Center

The present article represents an attempt to single out the gender aspect of schoolteachers' perceptions of the law and to analyze the specific nature of their views as to the problem of women's rights and equality of the sexes. The analysis is based on the findings of a study focusing on schoolteachers' perceptions that are conditioned not only…

Osetrova, N. V.

2004-01-01

331

When It Comes to Sex Partners, Men Prefer Younger Women: Study  

MedlinePLUS

... page, please enable JavaScript. When It Comes to Sex Partners, Men Prefer Younger Women: Study Researchers found ... Preidt Tuesday, September 30, 2014 Related MedlinePlus Page Sexual Health TUESDAY, Sept. 30, 2014 (HealthDay News) -- In books ...

332

Relationship Quality and Domestic Violence in Women's Same-Sex Relationships: The Role of Minority Stress  

ERIC Educational Resources Information Center

Despite a large body of literature addressing relationship quality and domestic violence in women's same-sex relationships, few studies have empirically examined how stress specific to living as a lesbian or bisexual woman might correlate with these relationship variables. Degree of outness, internalized homophobia, lifetime and recent experiences…

Balsam, Kimberly F.; Szymanski, Dawn M.

2005-01-01

333

FEDERALLY EMPLOYED WOMEN In October 1967, Executive Order 11375 added sex to other prohibited forms of  

E-print Network

FEDERALLY EMPLOYED WOMEN In October 1967, Executive Order 11375 added sex to other prohibited forms into the overall Equal Employment Opportunity (EEO) Program and placed the FWP under the Directors of Equal Employment Opportunity. Federal Personnel Manual 713 was issued to carry out Executive Order 11478

334

Invisible Victims: Same-Sex IPV in the National Violence against Women Survey  

ERIC Educational Resources Information Center

With intimate partner violence (IPV) among same-sex couples largely ignored by policy makers and researchers alike, accurately estimating the size of the problem is important in determining whether this minimal response is justified. As such, the present study is a secondary data analysis of the National Violence Against Women Survey and…

Messinger, Adam M.

2011-01-01

335

Sex Preferences, Marital Dissolution and the Economic Status of Women  

ERIC Educational Resources Information Center

American society is confronting the consequences of increase in divorce rates. There is substantial increase in households that are headed by a single female. The possible reasons for the rise in divorces and the labor market outcomes for women are analyzed. It is also noted that if the first-born is a girl, the marriage is less likely to…

Bedard, Kelly; Deschenes, Olivier

2005-01-01

336

[Shoes stitched, workers unstitched: a study on working and health conditions among women factory workers in the footwear industry in Franca, São Paulo State, Brazil].  

PubMed

This study aimed to analyze associations between working conditions and health problems reported by women workers assigned to mechanical stitching in the footwear industry in Franca, São Paulo State, Brazil. The qualitative study's theory and methodology were based on historical and dialectical materialism and combined sociological and ethnographic research techniques. Data were collected with taped interviews, focusing on the workers' life and work stories, systematic observation of the work process, consultation of historical documents, and imagistic production. Analysis of the data revealed the effects of work in mechanical stitching on the health of women workers employed in the factory and at home, who experience precarious labor conditions involving workday intensification and extension, preset production targets, job insecurity, and unhealthy workplaces. PMID:22031197

Prazeres, Taísa Junqueira; Navarro, Vera Lucia

2011-10-01

337

Association of Endogenous Sex Hormones with Adipokines and Ghrelin in Postmenopausal Women.  

PubMed

Context: Sex hormones, adipokines, and ghrelin have been implicated in central control of appetite, energy homeostasis, maintenance of fat mass, and inflammation. Women tend to gain weight after menopause and adipose tissue is a major source of sex steroid postmenopause. Understanding the dynamics of these analytes are of particular importance in postmenopausal women, who are at greater risk for cardiometabolic diseases. Objectives: To evaluate the associations of adipokines and ghrelin with sex hormone concentrations in postmenopausal women. Design: Cross-sectional Setting: Atherosclerosis Research Center Participants: Baseline data from 634 postmenopausal women participating in an ongoing clinical trial, the Early vs. Late Intervention Trial of Estrogen (ELITE). Participants had no history of chronic illness in the past five years, and were not taking exogenous hormone therapy. Main Outcome Measures: Serum levels of estrone (E1), total estradiol (E2), free estradiol (FE2), free testosterone (FT), total testosterone (T), and sex steroid-binding globulin (SHBG). Results: Adjusted for age, race, time since menopause, and BMI, leptin concentrations were significantly positively associated with E1, E2, FE2, and FT and inversely associated with SHBG levels. Only the associations of adiponectin with FE2 (inverse) and SHBG (positive) remained significant after controlling for BMI. The inverse associations of adiponectin with E1, E2, and FT were substantially mediated by BMI. Associations of ghrelin with E1, E2, FE2 and SHBG were not independent of BMI. WHR was not a mediator in any of the associations. Conclusions: In postmenopausal women, leptin and adiponectin concentrations are substantially correlated with sex hormone and SHBG concentrations regardless obesity status. PMID:25405497

Karim, Roksana; Stanczyk, Frank Z; Brinton, Roberta D; Rettberg, Jamaica; Hodis, Howard N; Mack, Wendy J

2014-11-18

338

Low prevalence of hepatitis B markers among Mexican female sex workers  

PubMed Central

OBJECTIVES: To estimate the prevalence and associated risk factors of hepatitis B virus (HBV) serological markers in female sex workers (FSW) in Mexico City. METHODS: The study population consisted of 1498 FSW who attended a detection centre for human immunodeficiency virus (HIV) in Mexico City, between January and October 1992. Study participants responded to a standardised questionnaire and provided a blood sample for serology of syphilis, HIV, and HBV. RESULTS: A total of 0.2% (95% CI 0.1-0.3) of the population were hepatitis B surface antigen (HBsAg) carriers. The general prevalence of antibodies to hepatitis B core antigen (anti-HBc) was 6.3% (95% CI 5.5-7.1). This marker of previous exposition to HBV, was independently associated by logistic regression multivariate analysis with age, working in the street, and history of blood transfusion (BT) before 1987 (OR 4.8, 95% CI 2.1-11.3). Syphilis prevalence was 7.6% (95% CI 6.2-8.9) and HIV prevalence was 0.1% (95% CI 0-0.3). CONCLUSIONS: The prevalence of HBV infection in this group of Mexican FSW is lower than previously reported in other countries. In addition, the frequency of HBsAg carriers is similar to that in the general Mexican population. The absence of two major risk factors for HBV transmission in this group of FSW--that is, injecting drug use and anal intercourse, could help to explain this finding. However, the positive association between anti-HBc and history of blood transfusion demonstrated here, highlights the need to reinforce strict control of blood supplies in Mexico. ????? PMID:10195057

Juarez-Figueroa, L.; Uribe-Salas, F.; Conde-Glez, C.; Hernandez-Avila, M.; Olamendi-Portugal, M.; Uribe-Zuniga, P.; Calderon, E.

1998-01-01

339

Tricks of the trade: sexual health behaviors, the context of HIV risk, and potential prevention intervention strategies for male sex workers.  

PubMed

Sex work is a significant risk for HIV and sexually transmitted infection (STI) among men who have sex with men (MSM); however, there is a dearth of knowledge about how to reduce risk in this group. MSM sex workers (N = 32) completed a semistructured qualitative interview and a close-ended quantitative assessment. Analyses focused on themes relevant to intervention development. Participants reported an average of 46 male sex partners in the prior 12 months; 31% of participants were HIV-infected. Male sex workers frequently used substances during sex and had elevated levels of psychological distress. Qualitative findings suggest that trauma-informed mental health and substance abuse treatment, ready access to HIV/STI testing and treatment and condoms/informational materials, support groups to address isolation/loneliness, skill-building for risk reduction with sex partners, and paid incentives as add-ons to effective behavior change interventions may be valuable intervention components. Targeting consumers of paid/exchanged sex may assist with changing community norms regarding the practice of transactional sex. Multipronged interventions to decrease sexual risk taking among male sex workers would also benefit from addressing the unique socioeconomic and legal needs of this population. PMID:19928046

Reisner, Sari L; Mimiaga, Matthew J; Mayer, Kenneth H; Tinsley, Jake P; Safren, Steven A

2008-01-01

340

Police sexual coercion and its association with risky sex work and substance use behaviors among female sex workers in St. Petersburg and Orenburg, Russia  

PubMed Central

Background Extensive research documents that female sex workers (FSWs) in Russia are very vulnerable to abuses from police, including police sexual coercion. However, despite qualitative data suggesting abusive policing practices are more likely for FSWs contending with substance abuse issues and risky sex work contexts, there is a paucity of quantitative study evaluating these associations specifically in terms of police sexual coercion. Such research is needed to guide structural interventions to improve health and safety for FSWs in Russia and globally. Objective The purpose of this study is to assess the prevalence of police sexual coercion among FSWs from two Russian cities, St. Petersburg and Orenburg, and to determine whether riskier sex work behaviors and contexts and substance use behaviors, including both IDU and risky alcohol use, are associated with increased risk for sexual coercion from police Method FSWs in St. Petersburg and Orenburg were recruited via time-location and convenience sampling and completed structured surveys on demographics (age, education), sex work risks (e.g., violence during sex work) and substance use. Logistic regression analyses assessed associations of substance use and risky sex work with police sexual coercion, adjusting for demographics. Results Participants (N=896) were aged 15 and older (94% were 20+ years). Most (69%) reported past year binge alcohol use, and 48% reported IDU the day before. Half (56%) reported 4+ clients per day. Rape during sex work ever was reported by 64%. Police sexual coercion in the past 12 months was reported by 38%. In the multivariate model, both current IDU (AOR=2.09, CI=1.45–3.02) and past year binge alcohol use (AOR=1.46, CI=1.03–2.07) were associated with police sexual coercion, as was selling sex on the street (not in venues) (AOR=7.81, CI=4.53–13.48) and rape during sex work (AOR=2.04, CI=1.43–2.92). Conclusion Current findings document the substantial role police sexual violence plays in the lives of FSWs in Russia. These findings also highlight heightened vulnerability to such violence among self-managed and substance abusing FSWs in this context. Structural interventions addressing police violence against FSWs may be useful to improve the health and safety of this population. PMID:23916802

Odinokova, Veronika; Rusakova, Maia; Urada, Lianne A; Silverman, Jay G; Raj, Anita

2014-01-01

341

Love, Suspense, Sex, and Violence: Men’s and Women’s Film Predilections, Exposure to Sexually Violent Media, and their Relationship to Rape Myth Acceptance  

Microsoft Academic Search

This investigation addressed the relationship between men’s and women’s predilections for film with a love story, suspense, or sex and violence theme and how that predilection related to rape myth acceptance (RMA). Also examined was how men’s and women’s predilections, as they related to RMA, were moderated by exposure to different levels of sexually violent media based on a true

Tara M. Emmers-Sommer; Perry Pauley; Alesia Hanzal; Laura Triplett

2006-01-01

342

Prevalence of Rape and Client-Initiated Gender-Based Violence Among Female Sex Workers: Kampala, Uganda, 2012.  

PubMed

We utilized data from the 2012 Crane Survey in Kampala, Uganda to estimate prevalence of rape among female sex workers (FSWs) and to identify risk factors for and prevalence of client-initiated gender-based violence (GBV) among FSWs. Participants were recruited using respondent-driven sampling. Analyses were weighted using RDSAT-generated individualized weights for each of the five dependent GBV outcomes. Analyses were conducted utilizing SAS 9.3. Among 1,467 FSWs who were interviewed, 82 % (95 % CI: 79-84) experienced client-initiated GBV and 49 % (95 % CI: 47-53) had been raped at least once in their lifetime. GBV risk increased with increasing frequency of client demands for unprotected sex, length of time engaged in sex work, and FSW alcohol consumption. Risk decreased when sex with clients occurred at the FSW's or client's house or a hotel compared to when sex occurred in open spaces. Our findings demonstrate a high prevalence of GBV among FSWs. This research reinforces the urgent need for GBV prevention and response strategies to be integrated into FSW programming and the continuing need for GBV research among key populations. PMID:25432876

Schwitters, Amee; Swaminathan, Mahesh; Serwadda, David; Muyonga, Michael; Shiraishi, Ray W; Benech, Irene; Mital, Sasha; Bosa, Rose; Lubwama, George; Hladik, Wolfgang

2014-11-29

343

International Migration from Non-endemic Settings as a Protective Factor for HIV/STI Risk Among Female Sex Workers in Vancouver, Canada.  

PubMed

Given heterogeneous evidence regarding the impacts of migration on HIV/sexually transmitted infections (STIs) among female sex workers (FSWs), we explored factors associated with international migration among FSWs in Vancouver, Canada. We draw on baseline questionnaire and HIV/STI testing data from a community-based cohort, AESHA, from 2010-2012. Logistic regression identified correlates of international migration. Of 650 FSWs, 163 (25.1 %) were international migrants, who primarily worked in formal indoor establishments. HIV/STI prevalence was lower among migrants than Canadian-born women (5.5 vs. 25.9 %). In multivariate analysis, international migration was positively associated with completing high school, supporting dependents, and paying a third party, and negatively associated with HIV, injecting drugs and inconsistent condom use with clients. Although migrants experience lower workplace harms and HIV risk than Canadian-born women, they face concerning levels of violence, police harassment, and HIV/STIs. Research exploring structural and socio-cultural factors shaping risk mitigation and migrants' access to support remains needed. PMID:24700025

Goldenberg, Shira M; Liu, Vivian; Nguyen, Paul; Chettiar, Jill; Shannon, Kate

2015-02-01

344

Social and Structural Factors Associated with Consistent Condom Use Among Female Entertainment Workers Trading Sex in the Philippines  

PubMed Central

This paper examined socio-structural factors of consistent condom use among female entertainment workers at high risk for acquiring HIV in Metro Manila, Quezon City, Philippines. Entertainers, aged 18 and over, from 25 establishments (spa/saunas, night clubs, karaoke bars), who traded sex during the previous 6 months, underwent cross-sectional surveys. The 143 entertainers (42% not always using condoms, 58% always using condoms) had median age (23), duration in sex work (7 months), education (9 years), and 29% were married/had live-in boyfriends. In a logistic multiple regression model, social-structural vs. individual factors were associated with inconsistent condom use: being forced/deceived into sex work, less manager contact, less STI/HIV prevention knowledge acquired from medical personnel/professionals, not following a co-workers’ condom use advice, and an interaction between establishment type and alcohol use with establishment guests. Interventions should consider the effects of physical (force/deception into work), social (peer, manager influence), and policy (STI/HIV prevention knowledge acquired from medical personnel/professionals) environments on consistent condom use. PMID:22223297

Morisky, Donald E.; Hernandez, Laufred I.; Strathdee, Steffanie A.

2014-01-01

345

MARITAL AND FAMILY CHARACTERISTICS OF WORKERS, MARCH 1966. SPECIAL LABOR FORCE REPORT NUMBER 80.  

ERIC Educational Resources Information Center

THE THRIVING ECONOMY'S DEMAND FOR WORKERS RESULTED IN DECREASED UNEMPLOYMENT RATES IN 1966 FOR WHITE AND NEGRO WOMEN AND WHITE MEN. THE INCREASED NUMBER OF WOMEN WORKERS RESULTED NOT ONLY FROM THE EXPANDING JOB MARKET BUT ALSO FROM FEDERAL LEGISLATION OUTLAWING SEX DISCRIMINATION IN EMPLOYMENT. IN THIS DECADE, THE MOST SIGNIFICANT INCREASE IN…

WALDMAN, ELIZABETH

346

Risk factors for homelessness and sex trade among incarcerated women: A Structural equation model.  

PubMed

Incarcerated women are among the most vulnerable and perhaps the least studied populations in the US. Significant proportions of female inmates are substance users, and many living in unstable housing conditions or being homeless. Female inmates are often at high risk of engaging in sex exchange for drugs or housing needs. While a disproportionate number of incarcerated women have experienced childhood household adversities and maltreatments, the effects of these childhood experiences on psychosocial and behavioral outcomes of this population in later life. We apply a life course perspective to examine these pathways in a sample of incarcerated women in Cook County, Illinois. Findings demonstrated lasting, but differential, effects of household adversities and childhood abuse on subsequent life risks and opportunities among these women. PMID:22162944

Kim, Seijeoung; Johnson, Timothy P; Goswami, Samir; Puisis, Michael

2011-01-01

347

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

PubMed

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. PMID:25059938

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

2014-07-21

348

Associations between endogenous sex hormone levels and mammographic and bone densities in premenopausal women  

Microsoft Academic Search

Purpose  Mammographic breast and bone mineral densities (BMD) have been associated with luteal phase hormone concentrations in premenopausal\\u000a women. We assessed the associations of breast and bone densities with follicular phase hormones and sex hormone binding globulin\\u000a (SHBG) in premenopausal women, given that follicular phase hormones have been shown to be positively associated with premenopausal\\u000a breast cancer risk.\\u000a \\u000a \\u000a \\u000a Methods  One hundred and

Mellissa Yong; Charlotte Atkinson; Katherine M. Newton; Erin J. Aiello Bowles; Frank Z. Stanczyk; Kim C. Westerlind; Victoria L. Holt; Stephen M. Schwartz; Wendy M. Leisenring; Johanna W. Lampe

2009-01-01

349

Predictors of Consistent Condom Use Among Chinese Female Sex Workers: An Application of the Protection Motivation Theory.  

PubMed

We utilized Protection Motivation Theory to assess predictors of intention and behavior of consistent condom use among Chinese female sex workers (FSWs). A self-administered questionnaire was used in a cross-sectional survey among 700 FSWs in Guangxi, China. Multivariate logistic regression analysis indicated that extrinsic and intrinsic rewards, self-efficacy, and response costs predicted consistent condom use intention and behavior among FSWs. Sexually transmitted infection/ HIV prevention programs need to reduce FSWs' perceptions of positive extrinsic rewards and intrinsic rewards for engaging in consistent condom use, reduce FSWs' perception of response costs for using a condom, and increase condom use self-efficacy among FSWs. PMID:25061932

Zhang, Liying; Li, Xiaoming; Zhou, Yuejiao; Lin, Danhua; Su, Shaobing; Zhang, Chen; Stanton, Bonita

2014-07-25

350

Sex tourism in Thailand.  

PubMed

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. PMID:12286018

Van Kerkwijk, C

1992-01-01

351

Characteristics of Female Sex Workers in Southern India Willing and Unwilling to Participate in a Placebo Gel Trial  

PubMed Central

Respondent-Driven Sampling was used to recruit female sex workers (FSWs) for a community survey conducted in southern India. After survey completion, participants were given a brochure describing a clinical trial that entailed daily use of a placebo vaginal gel for four months. This study assessed predictors of screening among survey respondents, predictors of enrollment among those eligible for the trial, and predictors of visit attendance and retention among those enrolled. FSWs who reported STI symptoms, engaging in sex work in the past month, and living in a subdistrict easily accessible by public transportation with a high concentration of FSWs, were more likely to screen. FSWs never before tested for HIV were more likely to enroll. This analysis suggests that the primary reason FSWs participated in the trial was a desire for health care—not other factors hypothesized to be important, e.g., HIV risk perception and poverty status. PMID:22907287

Mensch, Barbara S.; Friedland, Barbara A.; Abbott, Sharon A.; Katzen, Lauren L.; Tun, Waimar; Kelly, Christine A.; Sarna, Avina; Srikrishnan, Aylur K.; Solomon, Suniti

2012-01-01

352

PEPFAR's evolving HIV prevention approaches for key populations--people who inject drugs, men who have sex with men, and sex workers: progress, challenges, and opportunities.  

PubMed

In most countries, the burden of HIV among people who inject drugs, men who have sex with men, and sex workers is disproportionately high compared with that in the general population. Meanwhile, coverage rates of effective interventions among those key populations (KPs) are extremely low, despite a strong evidence base about the effectiveness of currently available interventions. In its first decade, President's Emergency Plan for AIDS Relief (PEPFAR) is making progress in responding to HIV/AIDS, its risk factors, and the needs of KPs. Recent surveillance, surveys, and size estimation activities are helping PEPFAR country programs better estimate the HIV disease burden, understand risk behavior trends, and determine coverage and resources required for appropriate scale-up of services for KPs. To expand country planning of programs to further reduce HIV burden and increase coverage among KPs, PEPFAR has developed a strategy consisting of technical documents on the prevention of HIV among people who inject drugs (July 2010) and prevention of HIV among men who have sex with men (May 2011), linked with regional meetings and assistance visits to guide the adoption and scale-up of comprehensive packages of evidence-based prevention services for KPs. The implementation and scaling up of available and targeted interventions adapted for KPs are important steps in gaining better control over the spread and impact of HIV/AIDS among these populations. PMID:22797736

Needle, Richard; Fu, Joe; Beyrer, Chris; Loo, Virginia; Abdul-Quader, Abu S; McIntyre, James A; Li, Zhijun; Mbwambo, Jessie K K; Muthui, Mercy; Pick, Billy

2012-08-15

353

When sex doesn't sell: using sexualized images of women reduces support for ethical campaigns.  

PubMed

Images of scantily clad women are used by advertisers to make products more attractive to men. This "sex sells" approach is increasingly employed to promote ethical causes, most prominently by the animal-rights organization PETA. Yet sexualized images can dehumanize women, leaving an unresolved paradox--is it effective to advertise an ethical cause using unethical means? In Study 1, a sample of Australian male undergraduates (N = 82) viewed PETA advertisements containing either sexualized or non-sexualized images of women. Intentions to support the ethical organization were reduced for those exposed to the sexualized advertising, and this was explained by their dehumanization of the sexualized women, and not by increased arousal. Study 2 used a mixed-gender community sample from the United States (N = 280), replicating this finding and extending it by showing that behaviors helpful to the ethical cause diminished after viewing the sexualized advertisements, which was again mediated by the dehumanization of the women depicted. Alternative explanations relating to the reduced credibility of the sexualized women and their objectification were not supported. When promoting ethical causes, organizations may benefit from using advertising strategies that do not dehumanize women. PMID:24367591

Bongiorno, Renata; Bain, Paul G; Haslam, Nick

2013-01-01

354

When Sex Doesn't Sell: Using Sexualized Images of Women Reduces Support for Ethical Campaigns  

PubMed Central

Images of scantily clad women are used by advertisers to make products more attractive to men. This “sex sells” approach is increasingly employed to promote ethical causes, most prominently by the animal-rights organization PETA. Yet sexualized images can dehumanize women, leaving an unresolved paradox – is it effective to advertise an ethical cause using unethical means? In Study 1, a sample of Australian male undergraduates (N?=?82) viewed PETA advertisements containing either sexualized or non-sexualized images of women. Intentions to support the ethical organization were reduced for those exposed to the sexualized advertising, and this was explained by their dehumanization of the sexualized women, and not by increased arousal. Study 2 used a mixed-gender community sample from the United States (N?=?280), replicating this finding and extending it by showing that behaviors helpful to the ethical cause diminished after viewing the sexualized advertisements, which was again mediated by the dehumanization of the women depicted. Alternative explanations relating to the reduced credibility of the sexualized women and their objectification were not supported. When promoting ethical causes, organizations may benefit from using advertising strategies that do not dehumanize women. PMID:24367591

Bongiorno, Renata; Bain, Paul G.; Haslam, Nick

2013-01-01

355

Dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS) compared with women with non-PCOS-related infertility.  

PubMed

The present study investigated dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS). A total of forty-five women (aged 25–40 years) with PCOS and 161 control women (aged 25–43 years) with non-PCOS-related infertility were recruited. Anthropometry, glucose tolerance and sex hormones were determined and dietary intake was assessed. Women with PCOS had lower serum sex hormone-binding globulin and increased BMI, waist:hip ratio, luteinising hormone, ratio of luteinising hormone: follicle-stimulating hormone, testosterone and free androgen index (FAI). Postprandial glucose, fasting insulin and insulin resistance were elevated in women with PCOS. Women with PCOS had reduced energy and carbohydrate intake but higher fat intake. Serum sex hormone-binding globulin level was negatively associated with BMI in both groups and negatively correlated with macronutrient intake in the PCOS group with hyperandrogenism. However, FAI was positively correlated with BMI, waist circumference and glucose metabolic parameters in both groups. Therefore, women with PCOS consume lower energy and carbohydrate compared with those with non-PCOS-related infertility and macronutrient intake is only negatively associated with serum sex hormone-binding globulin level in the PCOS group with hyperandrogenism. PMID:23046530

Tsai, Ya-Hui; Wang, Ting-Wen; Wei, Hsiao-Jui; Hsu, Chien-Yeh; Ho, Hsin-Jung; Chen, Wen-Hua; Young, Robert; Liaw, Chian-Mey; Chao, Jane C-J

2013-06-28

356

Chlamydia prevalence and associated behaviours among female sex workers in Vanuatu: results from an integrated bio-behavioural survey, 2011.  

PubMed

There is insufficient data on sexually transmitted infections (STI) and related behaviours among key populations, including female sex workers (FSW), in the Pacific region. Using respondent driven sampling, we conducted an integrated bio-behavioural survey with FSW in Vanuatu (aged ?18 years) to investigate risk behaviours associations with Chlamydia trachomatis (CT). Weighted population estimates and correlates of CT infection were calculated. Among 149 FSW, prevalence of CT was 36 % (95 % CI 26-48 %). Few FSW reported consistent condom use with recent transactional sex partners (TSP) (8 %; 95 % CI 2-13 %). CT infection was positively associated with increasing number of TSP (adjusted odds ratio [AOR] 1.1; 95 % CI 1.0-1.2) and group sex (AOR 2.9; 95 % CI 1.1-8.2). CT was negatively associated with increasing age of first sex (AOR 0.6; 95 % CI 0.5-0.9) and previous STI treatment (AOR 0.1; 95 % CI 0.0-0.4). A comprehensive public health strategy for prevention and treatment of STI among FSW, incorporating community empowerment strategies, FSW-targeted health services and periodic presumptive treatment, is urgently needed in Vanuatu. PMID:24833521

van Gemert, Caroline; Stoove, Mark; Kwarteng, Tamara; Bulu, Siula; Bergeri, Isabel; Wanyeki, Ian; Badman, Steve; Malverus, Jayline; Vella, Alyce; Tarivonda, Len; Johnston, Lisa Grazina

2014-10-01

357

Personality Profiles of Noncollege-degreed Women in Male and Female Typical Occupations.  

ERIC Educational Resources Information Center

Research on women in atypical occupations has generally focused on highly educated women and has neglected to compare atypically employed women to equally educated women in sex-typical occupations. Since the median American worker has only 13.6 years of schooling, the lack of research on the personality characteristics of noncollege-degreed women

Mazen, A. Magid

358

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

PubMed Central

Background 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. Methods 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. Results 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. Conclusions 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 prevent violence against sex workers and reduce HIV transmission. PMID:23968148

2013-01-01

359

Men and things, women and people: a meta-analysis of sex differences in interests.  

PubMed

The magnitude and variability of sex differences in vocational interests were examined in the present meta-analysis for Holland's (1959, 1997) categories (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional), Prediger's (1982) Things-People and Data-Ideas dimensions, and the STEM (science, technology, engineering, and mathematics) interest areas. Technical manuals for 47 interest inventories were used, yielding 503,188 respondents. Results showed that men prefer working with things and women prefer working with people, producing a large effect size (d = 0.93) on the Things-People dimension. Men showed stronger Realistic (d = 0.84) and Investigative (d = 0.26) interests, and women showed stronger Artistic (d = -0.35), Social (d = -0.68), and Conventional (d = -0.33) interests. Sex differences favoring men were also found for more specific measures of engineering (d = 1.11), science (d = 0.36), and mathematics (d = 0.34) interests. Average effect sizes varied across interest inventories, ranging from 0.08 to 0.79. The quality of interest inventories, based on professional reputation, was not differentially related to the magnitude of sex differences. Moderators of the effect sizes included interest inventory item development strategy, scoring method, theoretical framework, and sample variables of age and cohort. Application of some item development strategies can substantially reduce sex differences. The present study suggests that interests may play a critical role in gendered occupational choices and gender disparity in the STEM fields. PMID:19883140

Su, Rong; Rounds, James; Armstrong, Patrick Ian

2009-11-01

360

Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection  

PubMed Central

Background Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia. Methods We conducted a cross-sectional study among 220 young women (15–29?years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection. Results The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection. Conclusions This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia. PMID:22839728

2012-01-01

361

Relation of demographic factors, menstrual history, reproduction and medication use to sex hormone levels in postmenopausal women  

Microsoft Academic Search

In postmenopausal women, levels of estrogens, androgens, and perhaps prolactin have been related to risk of breast and other\\u000a hormonal cancers in women. However, the determinants of these hormone concentrations have not been firmly established. Associations\\u000a among various demographic, menstrual, and reproductive factors, medication use and endogenous sex hormone concentrations (estradiol,\\u000a free estradiol, estrone, estrone sulfate, testosterone, free testosterone, sex

Anne McTiernan; LieLing Wu; Vanessa M. Barnabei; Chu Chen; Susan Hendrix; Francesmary Modugno; Thomas Rohan; Frank Z. Stanczyk; C. Y. Wang

2008-01-01

362

The WHISK (Women's Health: Increasing the Awareness of Science and Knowledge) Pilot Project: Recognizing Sex and Gender Differences in Women's Health and Wellness  

PubMed Central

Women's health encompasses a continuum of biological, psychological, and social challenges that di?er considerably from those of men. Despite the remarkable advances in science, women's health and sex di?erences research is slowly gaining recognition and acceptance. It is important that women's health gain attention as women are usually the gatekeepers of care for the family. Women's health and health outcomes are strongly influenced by sex and gender di?erences as well as geography. Around the world, the interplay of biology and culture brings about di?erences in men's and women's health, which have been largely overlooked. The Women's Health: Increasing the Awareness of Science and Knowledge (WHISK) Pilot Project was a multidisciplinary project aimed to increase the awareness of sex and gender di?erences in women's health and research among healthcare professionals. Theater expression and creative art were used to translate knowledge, enhance understanding, and increase the awareness of sex di?erences. Findings from this project clearly showed an apparent increase in knowledge and cultivation of new insights. PMID:24416695

Dennis, Sabriya; Weaks, Francesca

2013-01-01

363

High Prevalence and Partner Correlates of Physical and Sexual Violence by Intimate Partners among Street and Off-Street Sex Workers  

PubMed Central

Objectives Intimate partner violence (IPV) is associated with increased risk of HIV among women globally. There is limited evidence and understanding about IPV and potential HIV risk pathways among sex workers (SWs). This study aims to longitudinally evaluate prevalence and correlates of IPV among street and off-street SWs over two-years follow-up. Methods Longitudinal data were drawn from an open prospective cohort, AESHA (An Evaluation of Sex Workers Health Access) in Metro Vancouver, Canada (2010–2012). Prevalence of physical and sexual IPV was measured using the WHO standardized IPV scale (version 9.9). Bivariate and multivariable logistic regression using Generalized Estimating Equations (GEE) were used to examine interpersonal and structural correlates of IPV over two years. Results At baseline, 387 SWs had a male, intimate sexual partner and were eligible for this analysis. One-fifth (n?=?83, 21.5%) experienced recent physical/sexual IPV at baseline and 26.2% over two-years follow-up. In multivariable GEE analysis, factors independently correlated with physical/sexual IPV in the last six months include: childhood (<18 years) sexual/physical abuse (adjusted odds ratio [AOR]?=?2.05, 95% confidence interval [CI]: 1.14–3.69), inconsistent condom use for vaginal and/or anal sex with intimate partner (AOR?=?1.84, 95% CI: 1.07–3.16),

Argento, Elena; Muldoon, Katherine A.; Duff, Putu; Simo, Annick; Deering, Kathleen N.; Shannon, Kate

2014-01-01

364

“Money talks, bullshit walks” interrogating notions of consumption and survival sex among young women engaging in transactional sex in post-apartheid South Africa: a qualitative enquiry  

PubMed Central

Background Transactional sex is believed to be a significant driver of the HIV epidemic among young women in South Africa. This sexual risk behaviour is commonly associated with age mixing, concurrency and unsafe sex. It is often described as a survival- or consumption-driven behaviour. South Africa’s history of political oppression as well as the globalization-related economic policies adopted post-apartheid, are suggested as the underlying contexts within which high risk behaviours occur among Black populations. What remains unclear is how these factors combine to affect the particular ways in which transactional sex is used to negotiate life among young Black women in the country. In this paper we explore the drivers of transactional sex among young women aged 16–24, who reside in a peri-urban community in South Africa. We also interrogate prevailing constructions of the risk behaviour in the context of modernity, widespread availability of commodities, and wealth inequalities in the country. Methods Data were collected through 5 focus group discussions and 6 individual interviews amongst young women, men, and community members of various age groups in a township in the Western Cape, South Africa. Findings Young women engaged in transactional sex to meet various needs: some related to survival and others to consumption. In this poverty-stricken community, factors that created a high demand for transactional sex among young women included the pursuit of fashionable images, popular culture, the increased availability of commodities, widespread use of global technologies, poverty and wealth inequalities. Transactional sex encounters were characterized by sexual risk, a casual attitude towards HIV, and male dominance. However, the risk behaviour also allowed women opportunities to adopt new social roles as benefactors in sexual relationships with younger men. Conclusion Transactional sex allows poor, young women to access what young people in many parts of the world also prioritize: fashionable clothing and opportunities for inclusion in popular youth culture. In the context of high HIV prevalence in South Africa, strategies are needed that present young women with safer economic gateways to create and consume alternative symbols of modernity and social inclusion. PMID:23866170

2013-01-01

365

Assessing the Impact of the Women's Movement on Sex-Based Differences in the Handling of Adult Criminal Defendants  

Microsoft Academic Search

The purpose of this report is to evaluate the argument that, with changes in sex roles and the contemporary women's movement, sex differences in the handling of criminal defendants are diminishing. After a review of the empirical evidence, five factors are suggested as helping to account for the apparently consistent finding of preferential treatment (though of small magnitude) of female

Darrell J. Steffensmeier

1980-01-01

366

Community-based HIV prevention research among substance-using women in survival sex work: The Maka Project Partnership  

Microsoft Academic Search

Substance-using women who exchange sex for money, drugs or shelter as a means of basic subsistence (ie. survival sex) have remained largely at the periphery of HIV and harm reduction policies and services across Canadian cities. This is notwithstanding global evidence of the multiple harms faced by this population, including high rates of violence and poverty, and enhanced vulnerabilities to

Kate Shannon; Vicki Bright; Shari Allinott; Debbie Alexson; Kate Gibson; Mark W Tyndall

2007-01-01

367

The Relationship between Sex Guilt and Sexual Desire in a Community Sample of Chinese and Euro-Canadian Women  

Microsoft Academic Search

Many studies have documented significant differences in sexual desire between individuals of European and Chinese descent, but few have examined the mechanisms that underlie these differences. A recent study of university students found that sex guilt is one mechanism by which culture influences sexual desire among Chinese and Euro-Canadian women. The goal of this study was to examine whether sex

Jane S. T. Woo; Lori A. Brotto; Boris B. Gorzalka

2012-01-01

368

Determinants of sex hormone—binding globulin blood concentrations in premenopausal and postmenopausal women with different estrogen status  

Microsoft Academic Search

In women, sex hormone—binding globulin (SHBG) concentrations are the result of a balanced effect of stimulatory and inhibitory factors. Estrogens represent the principal stimulatory hormones, whereas androgens, insulin, excess body fat, and the pattern of body fat distribution have inhibitory effects. Menopause is characterized by major changes in blood sex steroid concentrations, notably a marked reduction of estradiol levels. In

Renato Pasquali; Valentina Vicennati; Doriana Bertazzo; Francesco Casimirri; Giancarlo Pascal; Ornella Tortelli; Antonio Maria Morselli Labate

1997-01-01

369

"Women's bodies are shops": beliefs about transactional sex and implications for understanding gender power and HIV prevention in Tanzania.  

PubMed

Although transactional sex has been linked to undesirable sexual health outcomes, there is a lack of clarity as to the meaning of the practice, which appears to extend beyond behaviors related to women's economic circumstances. This article explored the perspectives of parents and unmarried young people on motivations for, and beliefs about, transactional sex in rural Tanzania using an ethnographic research design. Data collection involved 17 focus groups and 46 in-depth interviews with young people aged 14-24 years and parents/caregivers. Transactional sex was widely accepted by both parents and young people. Male parents equated sexual exchange to buying meat from a butcher and interpreted women's demand for exchange before sex with personal power. Young men referred to transactional sex as the easiest way to get a woman to satisfy their sexual desires while also proving their masculinity. Young women perceived themselves as lucky to be created women as they could exploit their sexuality for pleasure and material gain. They felt men were stupid for paying for "goods" (vagina) they could not take away. Mothers were in agreement with their daughters. Although young women saw exploitation of the female body in positive terms, they were also aware of the health risks but ascribed these to bad luck. Interventions aimed at tackling transactional sex in the interests of women's empowerment and as a strategy for HIV prevention need to understand the cultural beliefs associated with the practice that may make it thrive despite the known risks. PMID:20652390

Wamoyi, Joyce; Fenwick, Angela; Urassa, Mark; Zaba, Basia; Stones, William

2011-02-01

370

Sexually Transmitted Infections among Heterosexual Male Clients of Female Sex Workers in China: A Systematic Review and Meta-Analysis  

PubMed Central

Background Female sex workers have been the target of numerous sexually transmitted infection (STI) prevention strategies in China, but their male clients have attracted considerably less public health attention and resources. We sought to systematically assess the prevalence of HIV, syphilis, gonorrhea, and chlamydia among heterosexual male clients of female sex workers in China. Methods/Principal Findings Original research manuscripts were identified by searching Chinese and English language databases, and 37 studies analyzing 26,552 male clients were included in the review. Client STI prevalence across studies was heterogeneous. Pooled prevalence estimates and 95% confidence intervals were 0.68% (0.36–1.28%) for HIV, 2.91% (2.17–3.89%) for syphilis, 2.16% (1.46–3.17%) for gonorrhea, and 8.01% (4.94–12.72%) for chlamydia. Conclusions/Significance The pooled prevalence estimates of HIV, syphilis, gonorrhea, and chlamydia among clients in this review exceed the prevalences previously reported among population-representative samples and low-risk groups in China. However, heterogeneity across studies and sampling limitations prevent definitive conclusions about how the prevalence of STIs in this population compares to the general population. These findings suggest a need for greater attention to clients’ sexual risk and disease prevalence in China’s STI research agenda in order to inform effective prevention policies. PMID:23951153

McLaughlin, Megan M.; Chow, Eric P. F.; Wang, Cheng; Yang, Li-Gang; Yang, Bin; Huang, Jennifer Z.; Wang, Yanjie; Zhang, Lei; Tucker, Joseph D.

2013-01-01

371

HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis  

PubMed Central

Background The Brazilian response towards AIDS epidemic is well known, but the absence of a systematic review of vulnerable populations ? men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) remains a main gap in the available literature. Our goal was to conduct a systematic review and meta-analysis of studies assessing HIV prevalence among MSM, FSW and DU, calculating a combined pooled prevalence and summarizing factors associated the pooled prevalence for each group. Methods Nine electronic databases (MEDLINE via PubMed, EMBASE, Cochrane CENTRAL, AIDSLINE, AMED, CINAHL, TOXNET, SciELO, and ISI-Web of Science) were searched for peer-reviewed papers published in English, French, Spanish or Portuguese, from 1999 to 2009. To be included in the review, studies had to measure HIV prevalence and/or incidence as the primary outcome among at least one specific population under analysis. Results The studies targeting the three populations analyzed mostly young participants aged 30 years or less. Among FSW, eight studies were selected (3,625 participants), consistently identifying higher condom use with sexual clients than with occasional and stable partners. The combined HIV prevalence for FSW was 6.2 (95% CI: 4.4-8.3). Ten studies targeting MSM were identified (6,475 participants). Unprotected anal intercourse was commonly reported on those studies, but with great variability according to the nature of the relationship - stable vs. occasional sex partners - and sexual practice - receptive vs. insertive anal sex. Pooled HIV prevalence for MSM was 13.6 (95% CI: 8.2-20.2). Twenty nine studies targeting DU were identified (13,063 participants). Those studies consistently identified injection drug use and syringe/needle sharing as key predictors of HIV-infection, as well as engagement in sex work and male-to-male sex. The combined HIV prevalence across studies targeting DU was 23.1 (95% CI: 16.7-30.2). Conclusions FSW, MSM and DU from Brazil have a much risk of acquiring HIV infection compared to the general population, among which HIV prevalence has been relatively low (~0.6%). Those vulnerable populations should be targeted by focused prevention strategies that provide accurate information, counseling and testing, as well as concrete means to foster behavior change (e.g. access to condoms, drug abuse treatment, and clean syringes in the case of active injecting drug users), tailored to gender and culture-specific needs. Programs that provide these services need to be implemented on public health services throughout the country, in order to decrease the vulnerability of those populations to HIV infection. PMID:20529289

2010-01-01

372

HIV-Related Risk Behaviors among Kathoey (Male-to-Female Transgender) Sex Workers in Bangkok, Thailand  

PubMed Central

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 alcohol use, as well as having had sex with customers under the influence of alcohol. The prevalence of marijuana and ecstasy use in the past 12 months was high (32% and 36%, respectively); as was for ketamine (20%) and non-injecting methamphetamine (yaba) use (10%). A multiple regression analysis showed that the participants who were post-operative status, had used illicit drugs, or had been abused by their father and brothers were less likely to use condoms for anal sex with customers. Three quarters of the participants sent money to their families and 35% of the participants expressed their willingness to engage in unsafe sex when customers offer extra money. The qualitative interviews revealed that many identified as girl or kathoey in early age and had been exposed to transphobia and violence from father and brothers. Some reported support for gender transition from their mothers. More than half of the participants currently had difficulties in living as kathoey, such as challenges in job market and relationship with family members. Family obligation for sending money and the Buddhist concept of karma were discussed in relation to risk behaviors among KSWs. The study provided implications for facilitating HIV testing and developing future HIV prevention intervention programs for KSWs in Thailand. PMID:21780964

Nemoto, Tooru; Iwamoto, Mariko; Perngparn, Usaneya; Areesantichai, Chitlada; Kamitani, Emiko; Sakata, Maria

2011-01-01

373

Ergonomic evaluation of conventional and improved methods of aonla pricking with women workers.  

PubMed

Conventional and improved methods of aonla pricking were evaluated ergonomically on an experiment conducted for 20 minute with women workers. The working heart rate, energy expenditure rate, total cardiac cost of work and physiological cost of work with conventional tools varied from 93-102 beats.min-1, 6-7.5 kJ.min-1, 285-470 beats, 14 -23 beats.min-1 while with machine varied from 96-105 beats.min-1, 6.5-8 kJ.min-1 , 336-540 beats, 16-27 beats.min-1 respectively. OWAS score for conventional method was 2 indicating corrective measures in near future while with machine was 1 indicating no corrective measures. Result of Nordic Musculoskeletal Questionnaire revealed that subjects complaint of pain in back, neck, right shoulder and right hand due to unnatural body posture and repetitive movement with hand tool. Moreover pricking was carried out in improper lighting conditions (200-300 lux) resulting into finger injuries from sharp edges of hand tool, whereas with machine no such problems were observed. Output with machine increased thrice than hand pricking in a given time. Machine was found useful in terms of saving time, increased productivity, enhanced safety and comfort as involved improved posture, was easy to handle and operate, thus increasing efficiency of the worker leading to better quality of life. PMID:22316889

Rai, Arpana; Gandhi, Sudesh; Sharma, D K

2012-01-01

374

Association of rotating shiftwork with preterm births and low birth weight among never smoking women textile workers in China  

Microsoft Academic Search

1035 married women workers in three modern textile mills in Anhui, China were surveyed to investigate the association of rotating shiftwork with low birth weight and preterm birth in 1992. Information on reproductive health, occupational exposure history, and other covariates including age at pregnancy, time and duration of leave from job since pregnancy, and mill location was obtained by trained

X Xu; M Ding; B Li; D C Christiani

1994-01-01

375

Promoting health, promoting women: the construction of female and professional identities in the discourse of community health workers  

Microsoft Academic Search

Community health worker (CHW) programs are implemented in the third world and among racial minorities in the U.S. by public health professionals with the goal of improving people's access to basic health services. There is a shared view that women's roles as mothers make them effective CHWs because most health practices are located within the realm of the family. The

Jesus Ramirez-Valles

1998-01-01

376

Tailored Lay Health Worker Intervention Improves Breast Cancer Screening Outcomes in Non-Adherent Korean-American Women  

ERIC Educational Resources Information Center

Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an…

Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

2009-01-01

377

Filling the Knowledge Gap: Measuring HIV Prevalence and Risk Factors among Men Who Have Sex with Men and Female Sex Workers in Tripoli, Libya  

PubMed Central

Background Publications on Libya’s HIV epidemic mostly examined the victims of the tragic nosocomial HIV outbreak in the 1990s and the related dispute about the detention of foreign medical workers. The dispute resolution in 2003 included an agreement with the European Union on humanitarian cooperation and the development of Libya’s first National HIV Strategy. As part of this we conducted Libya’s first bio-behavioural survey among men having sex with men (MSM) and female sex workers (FSW). Methods Using respondent-driven sampling, we conducted a cross-sectional study to estimate the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and related risk factors among 227 MSM and 69 FSW in Tripoli (FSW recruitment ended prematurely due to the political events in 2011). Results For MSM we estimated an HIV prevalence of 3.1%, HBV prevalence of 2.9%, and HCV prevalence of 7.3%, and for FSW an HIV prevalence of 15.7%, HBV prevalence of 0%, and HCV prevalence of 5.2%. We detected high levels of risk behaviours, poor HIV-related knowledge, high stigma and lack of prevention programmes. These results must be interpreted in the context of the political situation which prohibited reaching an ideal sample size for FSW. Conclusion There is urgent need to implement an effective National HIV Strategy informed by the results of this research. The risk of transmission within different risk groups and to the general population may be high given the recent military events that led to increased violence, migration, and the disruption of essential HIV-related services. PMID:23840521

Valadez, Joseph J.; Berendes, Sima; Jeffery, Caroline; Thomson, Joanna; Ben Othman, Hussain; Danon, Leon; Turki, Abdullah A.; Saffialden, Rabea; Mirzoyan, Lusine

2013-01-01

378

Sex workers in Chennai, India: negotiating gender and sexuality in the time of AIDS   

E-print Network

etc, the Indian government, state level AIDS prevention bodies, and the local NGOs, have constructed ‘sex work’ as an epidemiological category rather than treating it as a social concept. Based on fieldwork in HIV prevention NGOs, and participant...

Sariola, Salla

379

Practices of receptive and insertive anal sex among transgender women in relation to partner types, sociocultural factors, and background variables.  

PubMed

It is urgent to develop efficacious HIV prevention programs to curb the reported extremely high HIV prevalence and incidence among transgender women (male-to-female transgender persons) who reside in large cities in the USA. This study aimed to describe unprotected receptive anal sex (URAS) and unprotected insertive anal sex (UIAS) among high-risk transgender women in relation to partner types, psychosocial factors, and background variables. Based on purposive sampling from the targeted communities and AIDS service organizations in San Francisco and Oakland, a total of 573 transgender women who had a history of sex work were recruited and individually interviewed using a structured survey questionnaire. Significant correlates with URAS with primary, casual, and commercial sex partners were found (e.g., needs for social support, frequency of social support received, exposure to transphobia, self-esteem, economic pressure, norms toward practicing healthy behaviors, and self-efficacy toward practicing safe sex). Multiple logistic regression analyses revealed that transgender women who had engaged in URAS with commercial partners were more likely to have higher levels of transphobia or lower levels of the norms or self-efficacy to practice safe sex. Among the participants who did not have vaginoplasty (preoperative transgender women), 16.4% had engaged in insertive anal sex (IAS) with commercial partners in the past 30 days. The participants who were HIV positive and had engaged in IAS were more likely to be African-American or Caucasians, coinfected with sexually transmitted infections, or identified themselves as homosexual. Practices of IAS among transgender women have not been thoroughly investigated in relation to sexual and gender identity. UIAS with homosexual and bisexual men in addition to URAS may be a cause for high HIV incidence among transgender women. An HIV prevention intervention study must be developed and evaluated, which aims to reduce HIV-positive and -negative transgender women's URAS and UIAS. PMID:24160715

Nemoto, Tooru; Bödeker, Birte; Iwamoto, Mariko; Sakata, Maria

2014-04-01

380

The effects of rape myth pornography on women's attitudes and the mediating role of sex role stereotyping  

Microsoft Academic Search

This study tested several hypotheses regarding (1) the effects of reading pornography on women's self-esteem and attitudes about rape and interpersonal violence and (2) how these effects were mediated by subject's degree of sex role stereotyping (SRS). Women high and low in SRS read one of three sexually explicit stories portraying different combinations of a woman's consent (or no consent)

Suzin E. Mayerson; Dalmas A. Taylor

1987-01-01

381

China's One?Child Policy and the Mystery of Missing Women: Ethnic Minorities and Male?Biased Sex Ratios  

Microsoft Academic Search

AbstractRecent estimates suggest that as many as 40 million women are missing in China. We exploit a special provision in the Chinese one?child policy (OCP; allowing for preferential treatment of ethnic minority groups) to revisit the mystery of these missing women, and in particular to explore the contribution of China's OCP in distorting sex ratios. Our results imply that preference

Erwin Bulte; Nico Heerink; Xiaobo Zhang

2011-01-01

382

Young Women's Adolescent Experiences of Oral Sex: Relation of Age of Initiation to Sexual Motivation, Sexual Coercion, and Psychological Functioning  

ERIC Educational Resources Information Center

Research examining oral sex during adolescence tends to investigate only potential negative consequences without considering its place in sexual development or distinctions between cunnilingus and fellatio. Using retrospective reports from 418 undergraduate women, we examined the relations among young women's ages of initiation of both cunnilingus…

Fava, Nicole M.; Bay-Cheng, Laina Y.

2012-01-01

383

Associations of Endogenous Sex Hormones with the Vasculature in Menopausal Women: The Study of Women’s Health Across the Nation (SWAN)  

PubMed Central

Objective As associations between endogenous sex hormones and the vasculature are not well characterized, the objective was to examine the cross-sectional associations of menopausal status and endogenous sex hormones with vascular characteristics. Design Common carotid artery adventitial diameter and intima-media thickness were determined using B-mode ultrasound among 483 middle-aged women enrolled in the Pittsburgh and Chicago sites of the Study of Women’s Health Across the Nation. Results Sixty-two percent of women were pre- or early perimenopausal (<3 months amenorrhea), 12% were late perimenopausal (3-12 months amenhorrhea), and 27% were postmenopausal (?12 months amenorrhea). After adjustment for age, compared to pre-/early perimenopause, late perimenopause was associated with a 0.28 mm larger adventitial diameter (p=0.001), while postmenopause was associated with a 0.15 mm larger adventitial diameter (p=0.040). Adjustment for traditional cardiovascular risk factors slightly attenuated these associations, but the association with late perimenopause remained statistically significant (p=0.001). Each standard deviation lower log estradiol value was associated with a 0.07 mm larger adventitial diameter after adjustment for traditional cardiovascular risk factors (p=0.023), while other endogenous hormones showed no associations. Intima-media thickness values were not significantly associated with menopausal status or endogenous sex hormones after adjustment for age. Conclusions The menopausal transition and declining estrogen levels are associated with alterations of the peripheral vasculature, which may help to explain the increased risk of cardiovascular disease with postmenopause. PMID:18209686

Wildman, Rachel P.; Colvin, Alicia B.; Powell, Lynda H.; Matthews, Karen A.; Everson-Rose, Susan A.; Hollenberg, Steven; Johnston, Janet M.; Sutton-Tyrrell, Kim

2010-01-01

384

An integrated individual, community, and structural intervention to reduce HIV/STI risks among female sex workers in China  

PubMed Central

Background We assessed the effectiveness of an integrated individual, community, and structural intervention to reduce risks of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs). Methods The integration individual, community, and structural intervention was implemented from 2004 to 2009 in six counties of Shandong Province. Post-intervention cross-sectional surveys were conducted in six intervention counties and 10 control counties. Results Of 3326 female sex workers were recruited and analyzed in the post-intervention survey with 1157 from intervention sites and 2169 from control sites. No HIV positive was found in both intervention and control counties. The rate of syphilis was 0.17% for intervention sites and 1.89% for control sites (OR?=?11.1, 95% CI: 2.7, 46.1). After adjusted for age, marital status, education, economic condition, recruitment venues, the rates of condom use in the last sex with clients(AOR?=?2.7; 95% CI: 1.9, 3.8), with regular sex partners(AOR?=?1.5; 95% CI: 1.1, 1.9) and consistent condom use in the last month with clients (AOR?=?3.3; 95% CI: 2.6, 4.1) and regular sex partners (AOR?=?1.7; 95% CI: 1.3, 2.3) were significantly higher in intervention sites than that in control sites. The proportion of participants correctly answered at least six out of eight HIV-related questions (83.3%) in intervention sites is significant higher than that (21.9%) in control sites (AOR?=?24.7; 95% CI: 2.5, 42.7), the five indicators related to HIV-related intervention services ever received in the last year including HIV testing(AOR?=?4.9; 95% CI: 2.8, 6.7), STD examination and/or treatment(AOR?=?5.1; 95% CI: 4.2, 6.4), free condom(AOR?=?20.3; 95% CI: 14.3, 28.9), peer education(AOR?=?4.3; 95% CI: 3.5, 5.4), education materials(AOR?=?19.8; 95%CI: 13.1, 29.8) were significantly higher in intervention sites than that in control sites, the participants in the intervention sites are more likely to seek medical treatment when they had any disorders (AOR?=?3.2; 95% CI: 2.5, 4.2). Conclusion This study found that the integrated individual, community, and structural intervention showed positive impact in reducing HIV and STI risks among FSWs. PMID:23914824

2013-01-01

385

Health benefits of legal services for criminalized populations: the case of people who use drugs, sex workers and sexual and gender minorities.  

PubMed

Social exclusion and legal marginalization are important determinants of health outcomes for people who use illicit drugs, sex workers, and persons who face criminal penalties because of homosexuality or transgenderism. Incarceration may add to the health risks associated with police repression and discrimination for these persons. Access to legal services may be essential to positive health outcomes in these populations. Through concrete examples, this paper explores types of legal problems and legal services linked to health outcomes for drug users, sex workers, and sexual minorities and makes recommendations for donors, legal service providers, and civil society organizations. PMID:21105945

Csete, Joanne; Cohen, Jonathan

2010-01-01

386

Sex worker-led structural interventions in India: a case study on addressing violence in HIV prevention through the Ashodaya Samithi collective in Mysore  

PubMed Central

Background & objectives: Structural interventions have the capacity to improve the outcomes of HIV/AIDS interventions by changing the social, economic, political or environmental factors that determine risk and vulnerability. Marginalized groups face disproportionate barriers to health, and sex workers are among those at highest risk of HIV in India. Evidence in India and globally has shown that sex workers face violence in many forms ranging from verbal, psychological and emotional abuse to economic extortion, physical and sexual violence and this is directly linked to lower levels of condom use and higher levels of sexually transmitted infections (STIs), the most critical determinants of HIV risk. We present here a case study of an intervention that mobilized sex workers to lead an HIV prevention response that addresses violence in their daily lives. Methods: This study draws on ethnographic research and project monitoring data from a community-led structural intervention in Mysore, India, implemented by Ashodaya Samithi. Qualitative and quantitative data were used to characterize baseline conditions, community responses and subsequent outcomes related to violence. Results: In 2004, the incidence of reported violence by sex workers was extremely high (> 8 incidents per sex worker, per year) but decreased by 84 per cent over 5 years. Violence by police and anti-social elements, initially most common, decreased substantially after a safe space was established for sex workers to meet and crisis management and advocacy were initiated with different stakeholders. Violence by clients, decreased after working with lodge owners to improve safety. However, initial increases in intimate partner violence were reported, and may be explained by two factors: (i) increased willingness to report such incidents; and (ii) increased violence as a reaction to sex workers’ growing empowerment. Trafficking was addressed through the establishment of a self-regulatory board (SRB). The community's progressive response to violence was enabled by advancing community mobilization, ensuring community ownership of the intervention, and shifting structural vulnerabilities, whereby sex workers increasingly engaged key actors in support of a more enabling environment. Interpretation & conclusions: Ashodaya's community-led response to violence at multiple levels proved highly synergistic and effective in reducing structural violence. PMID:22382190

Reza-Paul, Sushena; Lorway, Rob; O’Brien, Nadia; Lazarus, Lisa; Jain, Jinendra; Bhagya, M.; Fathima, Mary P; Venukumar, KT; Raviprakash, K.N.; Baer, James; Steen, Richard

2012-01-01

387

The Roles of Perceived Identity Compatibility and Social Support for Women in a Single-Sex STEM Program at a Coeducational University  

Microsoft Academic Search

Single-sex programs have been implemented in a variety of educational settings to help promote greater engagement of women\\u000a in STEM fields. However, the mechanisms through which single-sex programs increase women’s engagement in STEM fields are unclear.\\u000a Drawing from research in social and health psychology, we examined two theoretically-guided predictors of women’s sense of\\u000a belonging in their STEM majors and belonging

Lisa Rosenthal; Bonita London; Sheri Robin Levy; Marci Lobel

388

The influence of having children on HIV-related risk behaviors of female sex workers and their intimate male partners in two Mexico-US border cities.  

PubMed

Among female sex workers who use drugs, the experience of having children and its effect on HIV risk behaviors remains underexplored. We draw from a study of 214 female sex workers and their intimate non-commercial partners in Tijuana and Ciudad Juárez, México (n = 428), approximately 30% of whom have children living with them. During qualitative interviews with 41 of these couples, having children emerged as an important topic. Children influenced partners' lives and HIV-related risk behaviors in positive and negative ways. Couples perceived that children strengthened their relationships. Concern for children's well-being motivated couples to contemplate healthier lifestyle changes. However, childrearing costs motivated sex work and structural constraints prevented couples from enacting lifestyle changes. Case studies illustrate these themes and highlight implications for couple- and family-based harm reduction interventions. Specifically, our results suggest a need for economic alternatives to sex work while working with families to develop risk reduction skills. PMID:23418131

Rolon, Maria Luisa; Syvertsen, Jennifer L; Robertson, Angela M; Rangel, M Gudelia; Martinez, Gustavo; Ulibarri, Monica D; Servin, Argentina; Strathdee, Steffanie A

2013-06-01

389

Peer training of community health workers to improve heart health among african american women.  

PubMed

Introduction. Training community health workers (CHWs) builds a workforce that is essential to addressing the chronic disease crisis. This article describes a highly replicable CHW training program that targets heart disease risk among African American women. Background. African American women suffer disproportionately from heart disease mortality and morbidity. Well-trained CHWs are uniquely positioned to close this disparity gap. Method. We used a Learning Circle approach to train CHWs in heart health education. The curriculum blended web-based, self-directed learning and in-person peer coaching. CHWs learned through (a) peer-to-peer sharing, (b) problem solving and brainstorming, and (c) leadership and experiential activities. Training evaluation measures were CHWs' (a) self-confidence, (b) heart health knowledge, (c) satisfaction with training, (d) training retention, and (e) replication of training within 90 days after training. Results. This training resulted in appreciable effects on four of five outcome measures. Heart health knowledge increased significantly among experienced CHWs (p = .011). CHWs were satisfied with training and retention was 100%. CHWs initiated and subsequently delivered 122 person hours of community heart health education and CHW training in their communities. Discussion/Conclusion. CHW heart health training using Learning Circles is a practical and replicable method of training CHWs and holds significant potential for building capacity in resource-poor community organizations. PMID:24891525

Josiah Willock, Robina; Mayberry, Robert M; Yan, Fengxia; Daniels, Pamela

2015-01-01

390

Socioeconomic Correlates of Contraceptive Use among the Ethnic Tribal Women of Bangladesh: Does Sex Preference Matter?  

PubMed Central

Objective To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter. Materials and methods The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data. Results The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women. Conclusion The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones. PMID:24971107

Hassan, Che Hashim

2013-01-01

391

Sexual risk and substance use behaviors among African American men who have sex with men and women.  

PubMed

African American men who have sex with men and women (MSMW), but who do not form a sexual identity around same-sex behavior, may experience risk for HIV infection and transmission. This paper reports cross-sectional survey findings on sexual behaviors and substance use of urban non-gay- or non-bisexual-identified African American MSMW (n = 68), who completed behavior assessment surveys using audio-computer assisted self-interviewing technology. Overall, 17.6% reported being HIV-positive. In the past 3 months, 70.6% had unprotected insertive sex with a female, 51.5% had unprotected insertive anal sex (UIAS) with a male, 33.8% had unprotected receptive anal sex (URAS) with a male, 25% had UIAS with a transgender female, and 10.3% had URAS with a transgender female. Findings indicated a bridging potential for HIV and sexually transmitted infections across groups, such that 38.2% reported concurrent unprotected sex with female and male partners and 17.6% reported concurrent unprotected sex with female and transgender female partners. In the past 3 months, 70.6% used alcohol before sex and 85% used drugs before sex. Men who used drugs before sex had a tenfold increased likelihood for unprotected sex with male partners, and men who injected drugs had a nearly fivefold increased likelihood for unprotected sex with a transgender female. Interventions to address sexual risk behaviors, especially partner concurrency, and substance use behavior for these men are warranted. PMID:19572194

Operario, Don; Smith, Carla Dillard; Arnold, Emily; Kegeles, Susan

2011-04-01

392

Impact of Intimate Partner Forced Sex on HIV Risk Factors in Physically Abused African American and African Caribbean Women.  

PubMed

We examined associations between intimate partner forced sex (IPFS) and HIV sexual risk behaviors among physically abused Black women. Women aged 18-55 in intimate relationships were interviewed in health clinics in Baltimore, MD and St. Thomas and St. Croix, US Virgin Islands (USVI). Of 426 physically abused women, 38 % experienced IPFS; (Baltimore = 44 and USVI = 116). USVI women experiencing IPFS were more likely to have 3+ past-year sex partners (AOR 2.06, 95 % CI 1.03-4.14), casual sex partners (AOR 2.71, 95 % CI 1.42-5.17), and concurrent sex partners (AOR 1.94, 95 % CI 1.01-3.73) compared to their counterparts. Baltimore women reporting IPFS were more likely to have exchanged sex (AOR 3.57, 95 % CI 1.19-10.75). Women experiencing IPFS were more likely to report their abuser having other sexual partners in Baltimore (AOR 3.30, 95 % CI 1.22-8.88) and USVI (AOR 2.03, 95 % CI 1.20-3.44). Clinicians should consider the influence of IPFS on individual and partnership HIV sexual risk behaviors. PMID:25248623

Draughon, Jessica E; Lucea, Marguerite B; Campbell, Jacquelyn C; Paterno, Mary T; Bertrand, Desiree R; Sharps, Phyllis W; Campbell, Doris W; Stockman, Jamila K

2014-09-24

393

Endogenous Sex Hormones Impact the Progression of Subclinical Atherosclerosis in Women during the Menopausal Transition  

PubMed Central

Objective To determine whether endogenous sex hormones (estradiol (E2), testosterone (T), sex hormone binding globulin (SHBG), and follicle-stimulating hormone (FSH)) are longitudinally associated with progression of atherosclerosis among women at midlife. Methods 249 Pre- or early peri-menopausal women (42–57 years) from the Study of Women’s Health Across the Nation (SWAN) were followed for up to 9 years (median=3.7 years) and had up to 5 repeated measures of common carotid intima-media thickness (IMT) and adventitial diameter (AD). Linear mixed models were used for statistical analysis. Final models included age at baseline, time since baseline, cycle day of blood draw, race, income, SBP, BMI, insulin resistance index, lipids, C-reactive protein and co-morbidity. Results In final models for IMT, each one log unit decrease in SHBG was associated with a 0.005 mm/year increase in IMT progression (P=0.003). E2, T, and FSH were not associated with level or progression of IMT. For AD, each one log unit decrease in E2 was associated with a 0.012 mm/year increase in AD progression (P=0.04) and each one log unit increase in FSH was associated with a 0.016 mm/year increase in AD progression (P=0.003). T and SHBG were not associated with progression or level of AD. Conclusions Independent of SBP, BMI, lipids and other covariates, lower E2 and SHBG, and higher FSH were associated with increased subclinical atherosclerosis progression in women at midlife. PMID:22981430

El Khoudary, Samar R.; Wildman, Rachel P.; Matthews, Karen; Thurston, Rebecca C.; Bromberger, Joyce T.; Sutton-Tyrrell, Kim

2012-01-01

394

The state's "sharp line between the sexes": women, alcohol and the law in the United States, 1850-1980.  

PubMed

Beginning in the 1850s, American case and statute law established alcohol policies that applied specifically to women, which aimed broadly to promote temperance among both sexes. These measures reflected the powerful hold of a middle-class Victorian ideology that stigmatized female drinking, associated women with temperance, and kept women legally dependent in general. American laws on women and alcohol fell into two broad categories. The first was access laws, which restricted women's ability to purchase alcohol, patronize liquor outlets and work in the alcohol trade. These measures aimed to protect women from becoming drunkards, and depleted their legal power. The second group was domestic laws, including marriage, divorce and civil liability statutes. They aimed to protect women from drunken family members, especially husbands, and actually bestowed legal authority on women. Although both sets of laws promoted temperance, they did so both by expanding and contracting women's legal influence. These measures survived until the 1970s, when a series of court decisions overturned them on the basis of sex discrimination. The evolution of these laws shows how middle-class attitudes about female drinking were codified into sex-specific alcohol policy for most of the nation's history. PMID:8828248

Nicolaides, B M

1996-08-01

395

Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review  

PubMed Central

Background 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 is known about similar approaches in African settings. We systematically reviewed community empowerment processes within FSW SRH projects in Africa, and assessed them using a framework developed by Ashodaya, an Indian sex worker organisation. Methods In November 2012 we searched Medline and Web of Science for studies of FSW health services in Africa, and consulted experts and websites of international organisations. Titles and abstracts were screened to identify studies describing relevant services, using a broad definition of empowerment. Data were extracted on service-delivery models and degree of FSW involvement, and analysed with reference to a four-stage framework developed by Ashodaya. This conceptualises community empowerment as progressing from (1) initial engagement with the sex worker community, to (2) community involvement in targeted activities, to (3) ownership, and finally, (4) sustainability of action beyond the community. Results Of 5413 articles screened, 129 were included, describing 42 projects. Targeted services in FSW ‘hotspots’ were generally isolated and limited in coverage and scope, mostly offering only free condoms and STI treatment. Many services were provided as part of research activities and offered via a clinic with associated community outreach. Empowerment processes were usually limited to peer-education (stage 2 of framework). Community mobilisation as an activity in its own right was rarely documented and while most projects successfully engaged communities, few progressed to involvement, community ownership or sustainability. Only a few interventions had evolved to facilitate collective action through formal democratic structures (stage 3). These reported improved sexual negotiating power and community solidarity, and positive behavioural and clinical outcomes. Sustainability of many projects was weakened by disunity within transient communities, variable commitment of programmers, low human resource capacity and general resource limitations. Conclusions Most FSW SRH projects in Africa implemented participatory processes consistent with only the earliest stages of community empowerment, although isolated projects demonstrate proof of concept for successful empowerment interventions in African settings. PMID:24916108

2014-01-01

396

Transactional sex amongst young people in rural northern Tanzania: an ethnography of young women's motivations and negotiation  

PubMed Central

Background Material exchange for sex (transactional sex) may be important to sexual relationships and health in certain cultures, yet the motivations for transactional sex, its scale and consequences are still little understood. The aim of this paper is to examine young women's motivations to exchange sex for gifts or money, the way in which they negotiate transactional sex throughout their relationships, and the implications of these negotiations for the HIV epidemic. Method An ethnographic research design was used, with information collected primarily using participant observation and in-depth interviews in a rural community in North Western Tanzania. The qualitative approach was complemented by an innovative assisted self-completion questionnaire. Findings Transactional sex underlay most non-marital relationships and was not, per se, perceived as immoral. However, women's motivations varied, for instance: escaping intense poverty, seeking beauty products or accumulating business capital. There was also strong pressure from peers to engage in transactional sex, in particular to consume like others and avoid ridicule for inadequate remuneration. Macro-level factors shaping transactional sex (e.g. economic, kinship and normative factors) overwhelmingly benefited men, but at a micro-level there were different dimensions of power, stemming from individual attributes and immediate circumstances, some of which benefited women. Young women actively used their sexuality as an economic resource, often entering into relationships primarily for economic gain. Conclusion Transactional sex is likely to increase the risk of HIV by providing a dynamic for partner change, making more affluent, higher risk men more desirable, and creating further barriers to condom use. Behavioural interventions should directly address how embedded transactional sex is in sexual culture. PMID:20429913

2010-01-01

397

Women and men with intellectual disabilities who sell or trade sex: voices from the professionals.  

PubMed

The phenomenon of women and men with intellectual disabilities (ID) selling or exchanging sexual services is poorly understood. In this study, the authors explored the knowledge and perceptions of this phenomenon shared by professionals working in the field. Focus group discussions demonstrated broad familiarity with the phenomenon. Different motives and contributing factors were identified for the behavior, blurring the boundary line between free choice and exploitation. Two distinct discourses emerged from the interviews based on the assumed "rationality" of the sex transaction and its rewards: Those with ID who traded sexual favors were presented as either conscious and autonomous agents or unaware and exploited victims. PMID:21827299

Kuosmanen, Jari; Starke, Mikaela

2011-01-01

398

Confidentiality, Privacy, and Respect: Experiences of Female Sex Workers Participating in HIV Research in Andhra Pradesh, India  

PubMed Central

Female sex workers (FSW) from Andhra Pradesh, India who had participated in HIV research were interviewed to examine participant perspectives on research ethics. Content analysis indicated that aspects of the consent process, staff gender and demeanor, study environment, survey content, time requirements for study participation, and perceived FSW community support for research were key factors influencing whether FSW perceived their confidentiality and privacy had been maintained, and whether they felt the study was conducted respectfully. Findings suggest that partnership with community-based organizations and investigation of participant’s experiences in HIV prevention research can provide critical information to best inform research ethics protocols, a particular priority among research studies with highly stigmatized populations, such as FSW. PMID:24572080

Reed, Elizabeth; Khoshnood, Kaveh; Blankenship, Kim M.; Fisher, Celia B.

2014-01-01

399

Confidentiality, privacy, and respect: experiences of female sex workers participating in HIV research in Andhra Pradesh, India.  

PubMed

Female sex workers (FSWs) from Andhra Pradesh, India, who had participated in HIV research were interviewed to examine participant perspectives on research ethics. Content analysis indicated that aspects of the consent process, staff gender and demeanor, study environment, survey content, time requirements for study participation, and perceived FSW community support for research were key factors influencing whether FSWs perceived their confidentiality and privacy had been maintained, and whether they felt the study was conducted respectfully. Findings suggest that partnership with community-based organizations and investigation of participant's experiences in HIV prevention research can provide critical information to best inform research ethics protocols, a particular priority among research studies with highly stigmatized populations, such as FSWs. PMID:24572080

Reed, Elizabeth; Khoshnood, Kaveh; Blankenship, Kim M; Fisher, Celia B

2014-02-01

400

Age and menopause affect the expression of specific cytokines/chemokines in plasma and cervical lavage samples from female sex workers in Nairobi, Kenya  

PubMed Central

Background Aging of the immune system, known as immunosenescence, is associated with profound changes in both innate and adaptive immune responses, resulting in increased susceptibility to infection and a decreased ability to respond to vaccination. The purpose of this study was to investigate the effect of age and menopause on the expression of 22 different cytokines/chemokines in both plasma and cervical lavage samples from female sex-worker cohort from Nairobi, Kenya (age range 20–65). Results Cytokine/chemokine levels were measured using a Miliplex multiplex assay (Millipore). We found that age positively correlated with MCP-1 (p?=?0.0002) and IP-10 (p?=?0.03) systemic cytokine expression, and that women over 50 expressed the highest levels of these cytokines, but also had elevated expression of MIG (ANOVA p?=?0.0096) and MIP-3?(ANOVA p?=?0.0434). We also found that IL-8 (p?=?0.047) and sCD40L (p?=?0.01