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Sample records for women sex workers

  1. Pacar and Tamu: Indonesian women sex workers' relationships with men.

    PubMed

    Wolffers, I; Triyoga, R S; Basuki, E; Yudhi, D; Deville, W; Hargono, R

    1999-01-01

    This article reports on research on the multiple identities and behavior of female prostitutes in Indonesia as they relate to different players in their lives. It is introduced with a review of the literature, which reveals an underlying research bias that prostitutes are a hazard to society and a lack of attention to how they negotiate various aspects of their daily lives. The next sections review the various degrees to which Indonesian women engage in sex work and the concept of multiple identities. The prostitutes support their moves from one identity to another (mother, lover, daughter, sister, sex worker) with various rituals and codes that govern degrees of emotional involvement. The description of the study methodology notes that sex workers from Jakarta (486), Bandung (342), and Surabaya (658) were studied using a variety of means and that this report draws mainly on qualitative findings. The report then discusses why the women begin sex work, the problems that arise when the women attempt to keep their disparate roles discreet, relationships with casual clients and rituals performed with casual clients to enhance cleanliness and prevent disease, relationships with regular clients, relationships with boyfriends, and relationships of older women with men who consider them their "secret wives." The study concludes that the different roles and expected behaviors of these women must be understood to expose their sexual identities. Furthermore, programs to prevent disease must recognize that women who sell sex have complex identities and various types of relationships with men. PMID:12295114

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

    PubMed

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

    2015-01-17

    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

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

    PubMed Central

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

    2015-01-01

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

  4. Women Clerical Workers: Sex-Role Socialization, Work Attitudes, and Values.

    ERIC Educational Resources Information Center

    Pearson, Hilary M.; Kahn, Sharon E.

    1989-01-01

    Explored differences in sex-role socialization, personality orientation, and work attitudes and values of two groups of women clerical workers (N=91) who made their initial career choices in different historical time frames (the 1950s and 1970s). Results suggest that women clerical workers with differing sex-role socialization experiences may have…

  5. Comparison of Abnormal Cervical Cytology from HIV Positive Women, Female Sex Workers and General Population

    PubMed Central

    Vafaei, Homeira; Asadi, Nasrin; Foroughinia, Leila; Salehi, Alireza; Kuhnavard, Safieh; Akbarzadeh, Mojgan; Ravanbod, Hamid Reza; Mohamadalian, Ferdos; Kasraeian, Maryam

    2015-01-01

    Background Sex workers and HIV seropositive women are at high risk of abnormal cervical cytology. The objective of this study was to compare the cervical cytology among three groups of women: active sex workers, HIV-infected women, and general population in Iran. Methods This was a cross-sectional study performed in Hazrat Zeinab, Lavan clinics and drop in center (DIC) in Shiraz, Iran. This study was performed from October 2009 to October 2011. A total of 266 patients were assigned into three groups: sex-workers (85), HIV positive patients (100), and general population (81). Pap smear was performed for all participants from the exocervix and endocervix, using a plastic Ayres’s spatula and cytobrush. The samples were sent to a pathology center, using a liquid-based media.  Results The risk of cervical infection in sex workers and HIV positive women was greater than the general population (OR=5.47, 95% confidence interval [CI]:2.24, 13.40), (OR=3.71, 95% CI:1.52, 9.09), respectively. The frequency of abnormal cervical cytology in the HIV positive and sex worker groups was higher than the general population (OR=6. 76, 95% CI:2.25, 20.32), (OR=3. 80, 95% CI:1.19, 12.07), respectively. Low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) were associated with CD4 cell count<200Í106/L, P=0.021 and P<0.001, respectively. Conclusion Vaginal infections were seen more often in the sex worker group, and abnormal cervical cytology was greater in the HIV positive group. PMID:26005687

  6. HIV risk, seropositivity and predictors of infection among homeless and non-homeless women sex workers in Miami, Florida, USA.

    PubMed

    Surratt, H L; Inciardi, J A

    2004-07-01

    Although homelessness has frequently been associated with substance abuse, and has been established as a predictor of HIV risk among substance abusers, little is known about the impact of homelessness on HIV risk among female sex workers. This analysis investigated the contribution of homelessness to sexual risk taking among a sample of 485 female sex workers recruited into an HIV prevention programme in Miami, Florida, 41.6% of whom considered themselves to be currently homeless. Findings indicated that in comparison to non-homeless sex workers, significantly more homeless sex workers were daily users of alcohol and crack, and their past month sex work reflected significantly more frequent vaginal and oral sex acts, higher levels of unprotected vaginal sex and more numerous sexual activities while 'high' on drugs. At the same time, a significantly greater proportion of homeless sex workers encountered customers that refused to use condoms than did the non-homeless sex workers. There were no significant differences in HIV seropositivity between the homeless and non-homeless women (22.5 and 24.9%, respectively), primarily because the majority of the women in the study cycled in and out of homelessness. PMID:15223529

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

    PubMed Central

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

    2016-01-01

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

  8. "... But then he became my sipa": the implications of relationship fluidity for condom use among women sex workers in Antananarivo, Madagascar.

    PubMed

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

    2009-05-01

    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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2009-01-01

    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

  11. Towards 'reflexive epidemiology': Conflation of cisgender male and transgender women sex workers and implications for global understandings of HIV prevalence.

    PubMed

    Perez-Brumer, Amaya G; Oldenburg, Catherine E; Reisner, Sari L; Clark, Jesse L; Parker, Richard G

    2016-01-01

    The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. 'Male sex workers' have been identified as a 'key population' in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within this group. To assess these potential implications, this study employs self-critique and reflection to grapple with the empiric and conceptual implications of shifting understandings of sexuality and gender within the externally re-created etic category of 'MSM' and 'transgender women' in epidemiologic HIV research. We conducted a sensitivity analysis of our previously published meta-analysis which aimed to identify the scope of peer-reviewed articles assessing HIV prevalence among male sex workers globally between 2004 and 2013. The inclusion of four studies previously excluded due to non-differentiation of cisgender male from transgender women participants (studies from Spain, Thailand, India, and Brazil: 421 total participants) increased the overall estimate of global HIV prevalence among 'men' who engage in sex work from 10.5% (95% CI 9.4-11.5%) to 10.8% (95% CI 9.8-11.8%). The combination of social science critique with empiric epidemiologic analysis represents a first step in defining and operationalising 'reflexive epidemiology'. Grounded in the context of sex work and HIV prevention, this paper highlights the multiplicity of genders and sexualities across a range of social and cultural settings, limitations of existing categories (i.e. 'MSM', 'transgender'), and their global implications for epidemiologic estimates of HIV prevalence. PMID:27173599

  12. Women of courage: commercial sex workers mobilize for HIV / AIDS prevention in Nigeria.

    PubMed

    Williams, E E

    1994-05-01

    The Calabar Project in Nigeria, which seeks to reduce the vulnerability of prostitutes to HIV infection, began informally in 1987. By 1988, a formal, community-based intervention was created to promote condom use, provide health education as well as literacy and vocational training, and seek better working and living conditions for the prostitutes. The first task of the Calabar Project was to overcome the resistance of the hotel owners and managers where the prostitutes work and to win the confidence of the women. The owners and managers had to be convinced that it was in their best interest for the women to insist on condom use by their clients. The women had to be informed about the nature of HIV/AIDS and to be convinced that the project sought improvements in their general welfare. This was accomplished by helping the prostitutes improve both their relationship with the local police and their access to health services. Negotiations with hotel owners stabilized the prostitutes' rent for a year to enable the women to increase their charges for services and reduce the number of clients they needed so they could insist on condom use. Peer educators were trained to provide health education and to teach prostitutes techniques to get clients to use condoms. Clients were reached through the prostitutes and by providing information to small groups in hotel bars. Condoms were initially distributed for free and eventually were sold through a social marketing program. Peer educators also encouraged prostitutes and their clients to use a clinic the project established to diagnose and treat sexually transmitted diseases. In 1993, the Calabar Project helped create a vocational and literacy training center to improve the women's ability to understand the complex issues related to HIV/AIDS and to give the women a way to supplement their income and improve their self-esteem. By this time, more than 60% of the women reported using condoms for all sex acts. PMID:12345902

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    2011-12-01

    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

  15. Trafficked female sex workers awaiting deportation: comparison with brothel workers.

    PubMed

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

    2004-10-01

    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 therefore decided to study a second sample obtained by different referral methods. The sample consisted of 49 women in a detention center who are awaiting judicial hearings for deportation. This prison sample of sex workers is strikingly similar to the previously studied sample of sex workers working in brothels in terms of demographic features and working conditions. A higher percentage of the prison sample reported depression and somatic symptoms. However, this finding is consistent with a reaction to being arrested and awaiting deportation. Guided by a life course perspective, in the combined sample, we examined whether early exposure to trauma, motherhood and early entry into sex work affected current health and mental health. Those who were mothers were likely to have entered sex work at a later age but no other aspect of their working conditions differed from the non-mothers suggesting that motherhood per se did not appreciably change the experience of these mostly trafficked women sex workers. Early exposure to trauma increased the likelihood for work-related trauma, poor health and mental health outcomes. PMID:15480861

  16. 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

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

    2014-08-15

    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

  17. Risk and risk management for Australian sex workers.

    PubMed

    Harris, Margaret; Nilan, Pam; Kirby, Emma

    2011-03-01

    In this article, we address the experiences of female sex workers in urban Australia through analysis of interviews using a feminist approach. Although many previous studies have been conducted, our focus was on the voices of sex workers in an area that was rapidly gentrifying, leading to local community tensions. Intensive analysis of interview transcripts was employed to derive thematic codes for understanding how the women viewed and managed everyday risk in sex work. They were well aware of the health risks associated with sex work. For women working on premises, domain separation between sex work and other life domains was an important management strategy for maintaining self-esteem. For women working on the street, instincts honed by years of dangerous work provided a measure of safety. Our findings have implications for health and other agencies dealing with sex workers in situations in which community pressure is exerted to move sex workers away from the area. PMID:20952601

  18. HIV and female sex workers.

    PubMed Central

    Estébanez, P.; Fitch, K.; Nájera, R.

    1993-01-01

    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

  19. Women Workers' History.

    ERIC Educational Resources Information Center

    Huck, Gary; Gilmore, Peter

    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…

  20. Another Look at Women Workers.

    ERIC Educational Resources Information Center

    Goodson, R.

    1986-01-01

    Women now comprise 30 percent of trade union membership worldwide. The International Labour Organisation's Workers' Education Branch is attempting to improve the status of women workers and increase their participation in union activities and labor education. (SK)

  1. HIV prevention among female sex workers in Africa.

    PubMed

    Scheibe, A; Drame, F M; Shannon, K

    2012-01-01

    Sex work occurs to meet the demand for sexual services and is a universal phenomenon. In Africa sex work takes many forms and is an important source of income for many women. Yet sex worker reproductive health needs remain largely unmet. The criminalisation of sex work; community and service provider stigma; violence; substance use and limited access to health services and prevention commodities contribute to the high HIV burden evident among female sex workers in Africa. Following UNAIDS' three pillar approach to HIV prevention and sex work we present an overview of current opportunities, barriers and suggestions to improve HIV prevention policy and programming for sex work in Africa. Universal access to a comprehensive package of HIV services is the first pillar. Reproductive health commodities; voluntary and anonymous HIV counselling and testing; treatment of sexually transmitted infections, HIV and opportunistic infections; harm reduction for substance use and psychosocial support services make up the recommended package of services. The second pillar is a sex worker-supportive environment. The inclusion of sex worker programmes within national HIV strategic planning; sex worker-led community mobilisation and the establishment of sex work community networks (comprised of sex workers, health service providers, law enforcers and other stakeholders) enable effective programme implementation and are recommended. The reduction of sex worker vulnerability and addressing structural issues form the final pillar. The decriminalisation of sex work; development of supportive policy; gender equality and economic development are key factors that need to be addressed to increase sex worker resilience. Evidence supports the public health benefit of human rights based approaches to HIV prevention; moralistic and restrictive policy and laws towards sex work are harmful and should be removed. The establishment of these pillars will increase sex worker safety and enhance the

  2. Women Youth Workers and Outdoor Education.

    ERIC Educational Resources Information Center

    Collins, Di

    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…

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

    PubMed

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

    2016-01-01

    Sex work is rarely an occupation of choice for Iranian women and is often described as a last resort. While several factors play a role in creating an environment where individuals become involved in sex work, female sex workers' experiences regarding entry into sex work in Iran are poorly understood. In this qualitative study, a convenience sample of 24 participants was recruited from a drop-in centre for vulnerable women in Kerman, Iran. Through in-depth interviews, participants were asked about their personal lived experiences of initiating sex work. Grounded theory was used to analyse findings from this research. We learned that major factors impacting on women's initiation into sex work circulated around their vulnerability and chronic poverty. Participants continued to sell sex due to their limited opportunities, drug dependence and financial needs. Improving sex workers' economic status could be a vital intervention in providing vulnerable women with options other than sex work. Female sex workers should be provided with government support and educational programmes delivered through special centres. Despite the illegal status of their work, sex workers' needs should be recognised across all aspects of policy and legislation. PMID:26317368

  4. HPV knowledge, vaccine acceptance, and vaccine series completion among female entertainment and sex workers in Phnom Penh, Cambodia: the Young Women's Health Study

    PubMed Central

    Wadhera, Priya; Evans, Jennifer L; Stein, Ellen; Gandhi, Monica; Couture, Marie-Claude; Sansothy, Neth; Sichan, Keo; Maher, Lisa; Kaldor, John; Page, Kimberly

    2015-01-01

    Human papillomavirus (HPV) is a common sexually transmitted infection (STI) and the causative agent for cervical cancer, a frequently occurring malignant disease among women in developing countries. We assessed HPV awareness prior to the delivery of a brief information and education intervention, and HPV vaccine provision to female entertainment and sex workers (N=220). At baseline, only 23.6% of women had heard of HPV. Following the educational intervention, 90% answered all the HPV knowledge questions correctly. Of 192 participants attending the first quarterly cohort visit where vaccine was offered, 149 (78%) were eligible for vaccination; HIV-positive (n=32) and pregnant (n=11) women were excluded. Acceptance of vaccine among eligible women was universal, and 79.2% completed the three-dose vaccination series. Women who reported use of amphetamine type stimulants (ATS) had significantly and independently lower odds of vaccine completion (Adjusted OR 0.24; 95% CI 0.08, 0.69). New pregnancies also had an impact on vaccine completion: 5.4% (8/149 5.4%) who started the series had to stop due to new pregnancy. Results demonstrate the effectiveness of a simple education intervention designed to increase HPV knowledge and the feasibility of successful HPV vaccine in a population that is often difficult to engage in preventive health care. PMID:25505042

  5. Human papillomavirus knowledge, vaccine acceptance, and vaccine series completion among female entertainment and sex workers in Phnom Penh, Cambodia: the Young Women's Health Study.

    PubMed

    Wadhera, Priya; Evans, Jennifer L; Stein, Ellen; Gandhi, Monica; Couture, Marie-Claude; Sansothy, Neth; Sichan, Keo; Maher, Lisa; Kaldor, John; Page, Kimberly; Kien

    2015-10-01

    Human papillomavirus is a common sexually transmitted infection and the causative agent for cervical cancer, a frequently occurring malignant disease among women in developing countries. We assessed human papillomavirus awareness prior to the delivery of a brief information and education intervention, and human papillomavirus vaccine provision to female entertainment and sex workers (N = 220). At baseline, only 23.6% of women had heard of human papillomavirus. Following the educational intervention, 90% answered all the human papillomavirus knowledge questions correctly. Of 192 participants attending the first quarterly cohort visit where vaccine was offered, 149 (78%) were eligible for vaccination; HIV-positive (n = 32) and pregnant (n = 11) women were excluded. Acceptance of vaccine among eligible women was universal, and 79.2% completed the three-dose vaccination series. Women who reported use of amphetamine-type stimulants had significantly and independently lower odds of vaccine completion (adjusted odds ratio [AOR] 0.24; 95% confidence interval [CI] 0.08, 0.69). New pregnancies also had an impact on vaccine completion: 5.4% (8/149 5.4%) who started the series had to stop due to new pregnancy. Results demonstrate the effectiveness of a simple education intervention designed to increase human papillomavirus knowledge and the feasibility of successful human papillomavirus vaccine in a population that is often difficult to engage in preventive health care. PMID:25505042

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

    PubMed Central

    2012-01-01

    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

  7. Towards ‘reflexive epidemiology’: Conflation of cisgender male and transgender women sex workers and implications for global understandings of HIV prevalence

    PubMed Central

    Perez-Brumer, Amaya G.; Oldenburg, Catherine E.; Reisner, Sari L.; Clark, Jesse L.; Parker, Richard G.

    2016-01-01

    The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. ‘Male sex workers’ have been identified as a ‘key population’ in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within this group. To assess these potential implications, this study employs self-critique and reflection to grapple with the empiric and conceptual implications of shifting understandings of sexuality and gender within the externally recreated etic category of ‘MSM’ and ‘transgender women’ in epidemiologic HIV research. We conducted a sensitivity analysis of our previously published meta-analysis which aimed to identify the scope of peer-reviewed articles assessing HIV prevalence among male sex workers globally between 2004–2013. The inclusion of four studies previously excluded due to non-differentiation of cisgender male from transgender women participants (studies from Spain, Thailand, India, and Brazil: 421 total participants) increased the overall estimate of global HIV prevalence among “men” who engage in sex work from 10.5% (95% CI 9.4–11.5%) to 10.8% (95% CI 9.8–11.8%). The combination of social science critique with empiric epidemiologic analysis represents a first step in defining and operationalizing ‘reflexive epidemiology’. Grounded in the context of sex work and HIV prevention, this paper highlights the multiplicity of genders and sexualities across a range of social and cultural settings, limitations of existing categories (i.e., ‘MSM’, ‘transgender’), and their global implications for epidemiologic estimates of HIV prevalence. PMID:27173599

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

    PubMed

    Lutnick, Alexandra; Cohan, Deborah

    2009-11-01

    Sex work is a criminal offence in San Francisco, USA, and sex work advocates have so far unsuccessfully campaigned for decriminalizing it. Some groups argue that the decriminalization movement does not represent the voices of marginalized sex workers. Using qualitative and quantitative data from the Sex Worker Environmental Assessment Team Study, we investigated the perspectives and experiences of a range of female sex workers regarding the legal status of sex work and the impact of criminal law on their work experiences. Forty women were enrolled in the qualitative phase in 2004 and 247 women in the quantitative phase in 2006-07. Overall, the women in this study seemed to prefer a hybrid of legalization and decriminalization. The majority voiced a preference for removing statutes that criminalize sex work in order to facilitate a social and political environment where they had legal rights and could seek help when they were victims of violence. Advocacy groups need to explore the compromises sex workers are willing to make to ensure safe working conditions and the same legal protections afforded to other workers, and with those who are most marginalized to better understand their immediate needs and how these can be met through decriminalization. PMID:19962636

  9. 1969 Handbook on Women Workers.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    This handbook on American women workers, a ready reference source, includes information that has become available since 1965. Part 1 deals with women in the labor force; Part 2 is concerned with the laws governing women's employment and status; Part 3 tells about the Interdepartmental Committee, the Citizens' Advisory Council, and the State…

  10. An action agenda for HIV and sex workers.

    PubMed

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

    2015-01-17

    The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere. PMID:25059950

  11. Outplacement for Underserved Women Workers.

    ERIC Educational Resources Information Center

    Freeman, Suzanne C.; Haring-Hidore, Marilyn

    1988-01-01

    Describes an outplacement program for hourly women workers that assisted participants in identifying skills, interests, and values; identified community resources; taught job hunting skills; and encouraged participation in a support group. (JOW)

  12. Sex work venue and condom use among female sex workers in Senggigi, Indonesia.

    PubMed

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

    2013-01-01

    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 modelling was used to examine condom use among female sex workers who solicited clients at three types of sex work venues: (1) freelance locations, (2) brothels and (3) 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

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

    PubMed Central

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

    2013-01-01

    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

  14. Women as Workers.

    ERIC Educational Resources Information Center

    Barrett, Nancy S.

    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…

  15. Sex worker health: San Francisco style

    PubMed Central

    Cohan, D; Lutnick, A; Davidson, P; Cloniger, C; Herlyn, A; Breyer, J; Cobaugh, C; Wilson, D; Klausner, J

    2006-01-01

    Objectives To describe the characteristics of sex workers accessing care at a peer based clinic in San Francisco and to evaluate predictors of sexually transmitted infections (STI). Methods We conducted an observational study of sex workers at St James Infirmary. Individuals underwent an initial questionnaire, and we offered screening for STI at each clinic visit. We performed univariate, bivariate, and multivariable analyses to assess for predictors of STI in this population. Results We saw 783 sex workers identifying as female (53.6%), male (23.9%), male to female transgender (16.1%), and other (6.5%). 70% had never disclosed their sex work to a medical provider. Participants represented a wide range of ethnicities, educational backgrounds, and types of sex work. The most common substance used was tobacco (45.8%). Nearly 40% reported current illicit drug use. Over half reported domestic violence, and 36.0% reported sex work related violence. Those screened had gonorrhoea (12.4%), chlamydia (6.8%), syphilis (1.8%), or herpes simplex virus 2 (34.3%). Predictors of STI included African‐American race (odds ratio (OR) 3.3), male gender (OR 1.9), and sex work related violence (OR 1.9). In contrast, participants who had only ever engaged in collective sex work were less likely to have an STI (OR 0.4). Conclusions The majority of sex workers have never discussed their work with a medical provider. Domestic violence is extremely prevalent as is work related violence. Working with other sex workers appears to be protective of STIs. STI prevention interventions should target African‐American and male sex workers. Addressing violence in the workplace and encouraging sex workers to work collectively may be effective prevention strategies. PMID:16854996

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

    PubMed

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

    2014-11-01

    This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with 26 displaced individuals who had done sex work: 14 were men who have sex with men and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed. PMID:24464550

  17. Violence against women migrant workers in Thailand.

    PubMed

    Chaiyanukij, Charnchao

    2004-10-01

    A paper on "Violence against Women Migrant Workers in Thailand" will show the situation of women migrant workers in Thailand, why they have to come to Thailand, what kind of job they do, how they are abused and exploited by employer in many types of violence and how the Thai government manages to solve the problems and assist them. The term or definition of "violence against women-VAW" and "discrimination against women" is provided and based on the definition stated in the Declaration on the Elimination of Violence Against Women and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). Readers will see that violence against women is a form of discrimination committed on a basis of sex. In other words, VAW is a clear violation of women's inherent human rights including the rights to life, liberty, and security of person, equality, equal protection under the law and freedom from all forms of discrimination. More than one hundred thousands of women illegal migrant workers work in Thailand. They come from countries in the Mekong Sub-region namely Myanmar Lao PDR, Cambodia, Vietnam and China (Yunnan province). As they come illegally and have low level of education and working skills, they are vulnerable to exploitation, abuse or face violence. In general, they work in small factories, domestic work and restaurant. They are forced begging, forced prostitution or work in a slavery-like condition. Root causes of illegal migration and VAW are interrelated and occur in both sending and receiving countries of migrant workers. Poverty, demand and supply sides of labor, level of education, no knowledge of their own rights, impact of capitalism and gender issues, are mentioned as original factors of migration and VAW. The Thai government has national policy, plan, instrument and measures to cope with in- migration of illegal workers. Not only government agencies are active to solve the problems and assist the women migrant workers, but also non

  18. Abortion services for sex workers in Uganda: successful strategies in an urban clinic.

    PubMed

    Marlow, Heather M; Shellenberg, Kristen; Yegon, Erick

    2014-01-01

    Sex workers' need for safe abortion services in Uganda is greater than that of the population of women of reproductive age because of their number of sexual contacts, the inconsistent use of contraception and their increased risk of forced sex, rape or other forms of physical and sexual violence. We sought to understand sex workers' experiences with induced abortion services or post-abortion care (PAC) at an urban clinic in Uganda. We conducted nine in-depth interviews with sex workers. All in-depth interviews were audiotaped, transcribed, translated, computer recorded and coded for analysis. We identified several important programmatic considerations for safe abortion services for sex workers. Most important is creating community-level interventions in which women can speak openly about abortion, creating a support network among sex workers, training peer educators, and making available a community outreach educator and community outreach workshops on abortion. At the health facility, it is important for service providers to treat sex workers with care and respect, allow sex workers to be accompanied to the health facility and guarantee confidentiality. These programmatic elements help sex workers to access safe abortion services and should be tried with all women of reproductive age to improve women's access to safe abortion in Uganda. PMID:24945605

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

    PubMed

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

    2013-12-11

    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

  20. Availability and Quality of Size Estimations of Female Sex Workers, Men Who Have Sex with Men, People Who Inject Drugs and Transgender Women in Low- and Middle-Income Countries

    PubMed Central

    Sabin, Keith; Zhao, Jinkou; Garcia Calleja, Jesus Maria; Sheng, Yaou; Arias Garcia, Sonia; Reinisch, Annette; Komatsu, Ryuichi

    2016-01-01

    Objective To assess the availability and quality of population size estimations of female sex workers (FSW), men who have sex with men (MSM), people who inject drug (PWID) and transgender women. Methods Size estimation data since 2010 were retrieved from global reporting databases, Global Fund grant application documents, and the peer-reviewed and grey literature. Overall quality and availability were assessed against a defined set of criteria, including estimation methods, geographic coverage, and extrapolation approaches. Estimates were compositely categorized into ‘nationally adequate’, ‘nationally inadequate but locally adequate’, ‘documented but inadequate methods’, ‘undocumented or untimely’ and ‘no data.’ Findings Of 140 countries assessed, 41 did not report any estimates since 2010. Among 99 countries with at least one estimate, 38 were categorized as having nationally adequate estimates and 30 as having nationally inadequate but locally adequate estimates. Multiplier, capture-recapture, census and enumeration, and programmatic mapping were the most commonly used methods. Most countries relied on only one estimate for a given population while about half of all reports included national estimates. A variety of approaches were applied to extrapolate from sites-level numbers to national estimates in two-thirds of countries. Conclusions Size estimates for FSW, MSM, PWID and transgender women are increasingly available but quality varies widely. The different approaches present challenges for data use in design, implementation and evaluation of programs for these populations in half of the countries assessed. Guidance should be further developed to recommend: a) applying multiple estimation methods; b) estimating size for a minimum number of sites; and, c) documenting extrapolation approaches. PMID:27163256

  1. Examining the Sociocultural Context of HIV-related Risk Behaviors Among Kathoey (Male-to-female Transgender Women) Sex Workers in Bangkok, Thailand.

    PubMed

    Nemoto, Tooru; Cruz, Taylor; Iwamoto, Mariko; Trocki, Karen; Perngparn, Usaneya; Areesantichai, Chitlada; Suzuki, Sachiko; Roberts, Colin

    2016-01-01

    Kathoey (male-to-female transgender) sex workers (KSW) in Thailand are at high risk for sexually transmitted infections; however, few qualitative studies have been conducted to understand the sociocultural context of engaging in HIV risk behaviors. A total of 24 participants were purposively sampled in Bangkok based on KSW work venues and substance use. Results revealed the importance of participants' understanding of the self in relation to establishing economic independence through sex work, which could then be used to re-establish support from family, who often have not accepted a son's gender transition. Participants linked being kathoey to a belief in fate but did not view engagement in sex work in the same way. Different sex work venues exposed KSW to different risky situations. HIV prevention programs for kathoey must address the importance of economic security and its relation to social support and gender transition within a cultural- and work-environment-specific framework. PMID:26856798

  2. Women workers in the health service industry.

    PubMed

    Brown, C A

    1975-01-01

    The health service industry is unusual in that most of the skilled as well as unskilled workers are women, although the industry is largely controlled by men. Women are hired because they constitute an inexpensive, available, and seemingly powerless work force. Women enter health service because they have few alternatives to the low-paying, dead-end jobs found there. Health service occupations are organized like craft unions, with rigid hierarchical separations and control by the top occupation. Conflicts between men and women-between management and workers-are often played out as conflicts between occupations. Challenges to physicians come from various nursing specialties as well as from technical professions. Physicians in turn create lower-level occupations which challenge the nurses' status. Increasing industrialization alters the pattern of conflict, creating opportunities for individual bureaucratic mobility as well as favorable conditions for unionization drives. Unionism is often held back by sex, race, and professional conflicts, which must be overcome if the status of women is to be changed in the industry. PMID:1181296

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

    PubMed

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

    2015-08-01

    Social support can affect health outcomes of female sex workers. In this inductive feminist grounded theory study based on 20 in-depth interviews, we explore how establishment-based female sex workers in Tijuana perceive the impact of the connections among women on their lives and health. Participants elected to discuss the importance of social support from mothers, sisters, friends, and co-workers, and the empowering and disempowering aspects of these relationships. In previous studies, scholars demonstrated the efficacy of formal organization of female sex workers in promoting the mitigation of sexual and HIV risk. We show the importance of informal ties with other women. Some participants mentioned competitive relationships, others talked about cooperation and the desire for a venue to learn from one another. Social interactions with other women are especially empowering when female sex workers can openly engage in "woman talk" that may contribute to the mitigation of sexual and HIV risk. PMID:25991735

  4. Testing commercial sex workers for chlamydia and gonorrhoea on outreach.

    PubMed

    Macauley, S; Creighton, S

    2009-06-01

    To assess the feasibility of testing indoor commercial sex workers (CSW) for Chlamydia trachomatis and Neisseria gonorrhoeae in an outreach setting. All CSW seen on outreach over a 6-week period were offered self-taken vulval swabs for chlamydia and gonorrhoea testing. Feasibility was assessed by all the outreach workers on a standardised proforma. Of the 93 women offered the service, 40 accepted, of whom five (12%) had not previously accessed sexual health services. The majority of women declining the service had recently attended a sexual health clinic. Three cases of chlamydia and one of gonorrhoea were diagnosed. The cost per sexually transmitted infection (STI) was pound 392.50. Most of this group of women were knowledgeable about sexual health and were already having regular check-ups, but a significant minority did not know how to access STI care. Offering STI testing on outreach was feasible and cost effective. PMID:19155241

  5. Measuring perceived stigma in female sex workers in Chennai, India.

    PubMed

    Liu, Su-Hsun; Srikrishnan, A K; Zelaya, Carla E; Solomon, Suniti; Celentano, David D; Sherman, Susan G

    2011-05-01

    Although sex work is highly stigmatized throughout the world, a limited body of research has examined stigma among female sex workers (FSWs). We developed a Sex Worker Stigma (SWS) Index to measure perceived stigma among 150 FSWs in Chennai, India. These women were at a median age of 35 years and reported, on average, having engaged in sex work for nine out of the previous 12 months. The two-factor structure of the index was verified in both exploratory and confirmatory factor analyses with acceptable goodness of fit. The final 10-item index comprises of two domains of perceived stigma from the community and perceived stigma from one's family. Cronbach's α coefficients were 0.87 and 0.88 for each domain, respectively. In regression analysis, we found that income from jobs other than sex work was correlated with decreased levels of perceived stigma from both the community (β = - 0.16; 95% CI: -0.30 and -0.02) and the family (β = - 0.24; 95% CI: -0.40 and -0.07); prior experience of accessing health care system increased perceived stigma from the community while heavier financial responsibility for the family was associated with lower perceived stigma from women's family. With the proposed SWS Index, we have a valid and reliable metric to document and track levels of perceived stigma among FSWs to assess the impact of stigma reduction interventions. PMID:21293991

  6. Cisgender male and transgender female sex workers in South Africa: gender variant identities and narratives of exclusion.

    PubMed

    Samudzi, Zoe; Mannell, Jenevieve

    2016-01-01

    Sex workers are often perceived as possessing 'deviant' identities, contributing to their exclusion from health services. The literature on sex worker identities in relation to health has focused primarily on cisgender female sex workers as the 'carriers of disease', obscuring the experiences of cisgender male and transgender sex workers and the complexities their gender identities bring to understandings of stigma and exclusion. To address this gap, this study draws on 21 interviews with cisgender male and transgender female sex workers receiving services from the Sex Workers Education and Advocacy Taskforce in Cape Town, South Africa. Our findings suggest that the social identities imposed upon sex workers contribute to their exclusion from public, private, discursive and geographic spaces. While many transgender female sex workers described their identities using positive and empowered language, cisgender male sex workers frequently expressed shame and internalised stigma related to identities, which could be described as 'less than masculine'. While many of those interviewed felt empowered by positive identities as transgender women, sex workers and sex worker-advocates, disempowerment and vulnerability were also linked to inappropriately masculinised and feminised identities. Understanding the links between gender identities and social exclusion is crucial to creating effective health interventions for both cisgender men and transgender women in sex work. PMID:26242843

  7. A Descriptive Profile of Abused Female Sex Workers in India

    PubMed Central

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

    2010-01-01

    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

  8. Never innocent victims: street sex workers in Canadian print media.

    PubMed

    Strega, Susan; Janzen, Caitlin; Morgan, Jeannie; Brown, Leslie; Thomas, Robina; Carriére, Jeannine

    2014-01-01

    Over the past decade, street sex workers and their families garnered considerable media attention through extensive coverage of disappeared and murdered women in Western Canada. The research presented here examines whether recent media accounts differ from past coverage given that families and friends of disappeared and unaccounted for women inserted themselves into media discussions and circulated alternative readings of their stories. We found that coverage was dominated by two discourses: Vermin-victim discourse demonstrates the tensions between historically dominant conceptualizations and more recent ideas promulgated by families; and risky lifestyle discourse is related to neo-liberal ideologies about personal choice and responsibility. PMID:24476757

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

    PubMed

    Tucker, Joseph; Ren, Xin; Sapio, Flora

    2010-01-01

    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

  10. The condom conundrum: barriers to condom use among commercial sex workers in Durban, South Africa.

    PubMed

    Varga, C A

    1997-03-01

    We examined socio-cultural and economic determinants of condom use among 100 female South African commercial sex workers. The symbolism and dynamics of condom use between sex workers and their clientele were explored. These issues were also investigated when sex workers negotiated sex with their personal partners. An additional focus was the extent to which HIV/AIDS influences women's condom use in these situations. Results demonstrate considerable contrast between factors influencing condom use in professional versus private sex situations. With clients, practical issues such as financial strain were the major obstacles to condom use. With personal sex partners, sex workers avoided condoms due to their negative symbolism. Condoms were seen as suggestive of filth, disease, infidelity, and mistrust. HIV/AIDS awareness had minimal impact on condom use. HIV/AIDS was viewed as a remote threat, overridden by immediate practical and emotional concerns. The intervention implications of condom symbolism and differential barriers to condom use are discussed. PMID:10214405

  11. Alcohol Use, Unprotected Sex, and Sexually Transmitted Infections Among Female Sex Workers in China

    PubMed Central

    Wang, Bo; Li, Xiaoming; Stanton, Bonita; Zhang, Lei; Fang, Xiaoyi

    2010-01-01

    Background and Objective Alcohol use has been suggested to interfere with condom use and to increase sexual risk behaviors. However, data on the prevalence of this practice among female sex workers and its association with condom use and sexually transmitted infections (STIs) are limited. Methods Data were collected through the baseline survey of an HIV prevention project among 454 establishment-based female sex workers in Guangxi, China, in 2004. Both global association and situational analysis were performed using 2 measures of alcohol use (alcohol intoxication and drinking alcohol before having sex with a client). Multiple logistic regression analyses were performed to examine the association of alcohol use with women's condom use and STIs. Results One-third of women reported being intoxicated with alcohol at least once a month during the previous 6 months, and about 30% reported using alcohol before having sex with clients. In comparison with women who did not use alcohol before engaging in sex with clients, women who did so reported significantly less consistent condom use and higher rates of both current STIs and a history of STI. However, alcohol intoxication was not associated with condom use and STIs. These findings indicate event-specific rather than global associations of alcohol use with inconsistent condom use and STIs. Conclusion Alcohol use before commercial sex is associated with unprotected sex and increased risk for STIs. Interventions that address both alcohol use and HIV risk behaviors in the context of commercial sex may have a great impact in preventing the spread of HIV in China. PMID:20601927

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

    PubMed

    Arps, F S E Freddie; Golichenko, Mikhail

    2014-01-01

    The existing legal framework in Russia makes sex work and related activities punishable offenses, leaving sex workers stigmatized, vulnerable to violence, and disproportionally affected by HIV and other sexually transmitted infections. In 2013, the Ministry of Justice, supported by the courts, refused registration and official recognition to the first all-Russia association of sex workers, referring to the fact that sex work is under administrative and criminal punitive bans and therefore the right of association for sex workers is unjustified. In light of international human rights standards, in particular the jurisprudence of the European Court of Human Rights, we examine in this paper whether the overall punitive legal ban on sex work in Russia is discriminatory. The government's positive obligations concerning discrimination against sex workers whose activities are consensual and between adults, and whose working conditions leave them among society's most vulnerable, should outweigh their punitive laws and policies around sex work. The scope of legal criminalization is narrow: it should apply only in exceptional cases where it is clearly justified. PMID:25569722

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

    PubMed Central

    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

    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

  14. The lives of female sex workers in Vietnam: Findings from a qualitative study.

    PubMed

    Ngo, Anh D; McCurdy, Sheryl A; Ross, Michael W; Markham, Christine; Ratliff, Eric A; Pham, Hang T B

    2007-01-01

    To facilitate better understanding of the environment and power structures in which sex work in Vietnam takes place, this study examined the sex workers' social and economic lives, their working environment, social relationships and presentation of self in everyday social contacts and interactions. Thirty in-depth interviews and 14 focus groups were conducted with street-based and venue-based sex workers in the cities of Da Nang and Hanoi. Results show that sex workers live and work within a complex system involving multiple relationships. In any of these relations, women have limited power to protect their personal security and secure payment for services rendered. Economic hardship is a major problem facing street-level sex workers and contributes to unsafe sexual practices. Venue-based sex workers worry less about economic hardships as such, but frequently incur gambling debts. Women also reported incidents of abuse and experiences of social stigma. Although many women exhibited a strong desire to leave sex work, they found themselves trapped in the sex industry by the lack of alternative employment options. This study provides evidence that socio-psychological factors must be addressed along with risky behaviours to promote women's well-being and social integration. PMID:17963096

  15. Reframing the interpretation of sex worker health: a behavioral-structural approach.

    PubMed

    Tucker, Joseph D; Tuminez, Astrid S

    2011-12-01

    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

  16. HIV risk practices by female sex workers according to workplace.

    PubMed

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

    2014-06-01

    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

  17. HIV risk practices by female sex workers according to workplace

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    1996-02-01

    This study analyzes data on all female sex workers who attended the Sydney Sexual Health Center for a first visit for a sexually transmitted disease (STD) screening during June 1, 1991, and May 31, 1993. International sex workers were identified as women who do not speak English at home and were born outside Australia. Diseases were confirmed clinically, by specimen or culture or by antibody or serological tests. Results apply to 91 local and 123 international prostitutes. 47% of international prostitutes and 34% of local prostitutes were aged 21-25 years. Most international sex workers spoke Thai or a Chinese dialect. 10% of local prostitutes were born in Asia. 90% of international prostitutes were born in Thailand, Malaysia, or China. Local prostitutes were better educated. 7% of the local prostitutes and none of the international sex workers had a history of injectable drug use. Local prostitutes tended to use condoms for birth control, and international prostitutes tended to use oral contraceptives. One international prostitute tested HIV positive. 1 in 7 international prostitutes had gonorrhea and the same proportion had chlamydia. Viral STDs (chronic hepatitis B, HIV infection, and genital warts) were more prevalent, but uncommon among international prostitutes. More international prostitutes had multiple STDs. 79 international sex workers and only 9 local sex workers had an STD. 47% of international sex workers and only 10% of local sex workers had worked overseas as a prostitute in the preceding 12 months. Over half of local sex workers and only 8% of international sex workers consistently used condoms. Failure to use condoms was associated with being an international sex worker. Inconsistent use of condoms among local prostitutes was related to increased age. PMID:8655167

  19. Women Workers as Users of Computer Technology.

    ERIC Educational Resources Information Center

    Larwood, Laurie

    1992-01-01

    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…

  20. Typology of older female sex workers and sexual risks for HIV infection in China: a qualitative study

    PubMed Central

    Hao, Chun; Sherman, Susan G.; Jiang, Baofa; Li, Xiaojing; Xu, Yongfang; Jiang, Zhenxia; Zang, Chunpeng

    2013-01-01

    The HIV epidemic continues to develop among older adults in China, including older female sex workers. Yet, few studies have been conducted among this relatively hidden population. The objectives of this study were to investigate the reasons for women's entry into sex work during their thirties and to develop typology of older women sex workers. Semi-structured in-depth interviews with sixty-three older women sex workers and six focus groups interviews with stakeholders were conducted in three cities in China in 2012. Data were analysed inductively using constant comparative method. The mean age of participants was 43 years old and the mean age of entry into sex work was 39 years old. The primary reasons for entry into sex work include heavy economic burdens, limited employment opportunities, and the appealing nature of sex work. Street-based and venue-based older sex workers were identified based on where they solicited clients. Street-based older sex workers were more likely to engage in unsafe commercial sex due to financial incentives, whereas those in entertainment venues were unlikely to use condoms with regular clients. The development of effective HIV interventions needs to consider older women sex workers unique characteristics and target factors that impede safer sex practices. PMID:23998493

  1. Female Sex Worker Social Networks and STI/HIV Prevention in South China

    PubMed Central

    Tucker, Joseph D.; Peng, Hua; Wang, Kaidi; Chang, Helena; Zhang, Sen-Miao; Yang, Li-Gang; Yang, Bin

    2011-01-01

    Background Reducing harm associated with selling and purchasing sex is an important public health priority in China, yet there are few examples of sustainable, successful programs to promote sexual health among female sex workers. The limited civil society and scope of nongovernmental organizations circumscribe the local capacity of female sex workers to collectively organize, advocate for their rights, and implement STI/HIV prevention programs. The purpose of this study was to examine social networks among low-income female sex workers in South China to determine their potential for sexual health promotion. Methods/Principal Findings Semi-structured interviews with 34 low-income female sex workers and 28 health outreach members were used to examine how social relationships affected condom use and negotiation, STI/HIV testing and health-seeking behaviors, and dealing with violent clients. These data suggested that sex worker's laoxiang (hometown social connections) were more powerful than relationships between women selling sex at the same venue in establishing the terms and risk of commercial sex. Female sex workers from the same hometown often migrated to the city with their laoxiang and these social connections fulfilled many of the functions of nongovernmental organizations, including collective mobilization, condom promotion, violence mitigation, and promotion of health-seeking behaviors. Outreach members observed that sex workers accompanied by their laoxiang were often more willing to accept STI/HIV testing and trust local sexual health services. Conclusions/Significance Organizing STI/HIV prevention services around an explicitly defined laoxiang social network may provide a strong foundation for sex worker health programs. Further research on dyadic interpersonal relationships between female sex workers, group dynamics and norm establishment, and the social network characteristics are needed. PMID:21931856

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

    PubMed Central

    Tuminez, Astrid S.

    2011-01-01

    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

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

    ERIC Educational Resources Information Center

    Karandikar, Sharvari; Prospero, Moises

    2010-01-01

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

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

    PubMed

    Izugbara, Chimaraoke O

    2012-12-01

    It is still a small body of research that directly addresses female sex workers' relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi's FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers' practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer. PMID:22434396

  5. Core groups and the transmission of HIV: learning from male sex workers.

    PubMed

    Parker, Melissa

    2006-01-01

    A growing and substantial body of research suggests that female sex workers play a disproportionately large role in the transmission of HIV in many parts of the world, and they are often referred to as core groups by epidemiologists, mathematical modellers, clinicians and policymakers. Male sex workers, by contrast, have received little attention and it is not known whether it is helpful to conceptualize them as a core group. This paper draws upon ethnographic research documenting social and sexual networks in London and looks at the position of five male sex workers within a network comprising 193 men and seven women (as well as 1378 anonymous sexual contacts and 780 commercial contacts). In so doing, it suggests that there is no evidence to show that male sex workers are more or less likely to acquire or transmit HIV in the course of commercial sex compared with other types of sexual relationships. In addition, men engaging in non-commercial sex all reported having unprotected sex in a variety of contexts and relationships and there is no evidence to suggest that men who are not sex workers play less of a role in the transmission of HIV. In short, these data suggest that it would be inappropriate to conceptualize male sex workers as a core group. This is not to suggest that public policy should continue to overlook male sex workers. New and inventive approaches are required to reach out to a vulnerable but diverse group of men, selling sex for a variety of reasons; even if these men are no more vulnerable to acquiring and/or transmitting HIV than other men and women that form part of their network. PMID:16321168

  6. Sex workers in Kenya, numbers of clients and associated risks: an exploratory survey.

    PubMed

    Elmore-Meegan, Michael; Conroy, Ronán M; Agala, C Bernard

    2004-05-01

    In Kenya in 1999, an estimated 6.9% of women nationally said they had exchanged sex for money, gifts or favours in the previous year. In 2000 and 2001, in collaboration with sex workers who had formed a network of self-help groups, we conducted an exploratory survey among 475 sex workers in four rural towns and three Nairobi townships, regarding where they worked, the number of clients they had and the risks they were exposed to. Participants were identified by a network of social contacts in the seven centres. Most of the women (88%) worked from bars, hotels, bus stages and discos; 57% lived with a stable partner and almost 90% had dependent children. In the previous month, 17% had been assaulted and 35% raped by clients. Unwanted pregnancy was common; 86% had had at least one abortion. Compared with women in rural towns, township sex workers were younger (median age 22 vs. 26), saw more clients (median 9 vs. 4 per week) and earned more from sex work (up to 63-90 euros vs. 12 euros per week). Issues of alternative sources of income, safety for sex workers and the conditions which create the necessity for sex work are vital to address. The question of number of clients and the nature of sex work have obvious implications for HIV/STI prevention policy. PMID:15242210

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

    PubMed

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

    2012-05-01

    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

  8. Partners and clients of female sex workers in an informal urban settlement in Nairobi, Kenya.

    PubMed

    Ngugi, Elizabeth; Benoit, Cecilia; Hallgrimsdottir, Helga; Jansson, Mikael; Roth, Eric Abella

    2012-01-01

    This paper compares and contrasts number of partners and condom use behaviour for female sex workers and a sample of women working in other economic activities, with both samples drawn from the large informal settlement of Kibera, Nairobi. As expected, univariate analysis revealed much higher numbers of overall sexual partners and higher levels of condom use among female sex workers compared to Kibera women in other occupations. An unexpected finding, however, was that female sex workers with a romantic partner had significantly fewer sexual partners per unit time than female sex workers without such a partner. This finding held for multivariate analysis, with negative binomial regression analyses showing that having a romantic partner was significantly associated with reductions in total number of both sexual partners overall and with sexual partners who did not use condoms. In contrast, HIV status, education, number of immediate family members and levels of alcohol consumption were non-significant factors for both regression analyses. Results suggest that female sex workers' romantic partners act as more than sources of possible HIV infection; rather, romantic partners appear to have an important positive impact on health. We discuss this finding in light of possible harm-reduction programmes focusing on female sex workers and their romantic partners. PMID:21936649

  9. Generational Sex And HIV Risk Among Indigenous Women In A Street-Based Urban Canadian Setting

    PubMed Central

    Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio

    2014-01-01

    In Canada, indigenous women are overrepresented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women’s HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work; and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal. In multivariate logistic regression model, Aboriginal women remained 3 times more likely to experience generational sex work (aOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (aOR=3.01, 95%CI: 1.67–4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and 3-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV prevention initiatives are required for Indigenous sex workers. PMID:24654881

  10. Preferences for ARV-based HIV prevention methods among men and women, adolescent girls and female sex workers in Gauteng Province, South Africa: a protocol for a discrete choice experiment

    PubMed Central

    Eakle, Robyn; Cabrera, Maria; Vickerman, Peter; Tsepe, Motlalepule; Cianci, Fiona; Delany-Moretlwe, Sinead; Terris-Prestholt, Fern

    2016-01-01

    Introduction For the past few decades, condoms have been the main method of HIV prevention. Recent advances in antiretroviral (ARV)-based prevention products have substantially changed the prevention landscape, yet little is known about how popular these products will be among potential users, or whether new methods might be used in conjunction with, or instead of, condoms. This study will use a discrete choice experiment (DCE) to (1) explore potential users' preferences regarding HIV prevention products, (2) quantify the importance of product attributes and (3) predict the uptake of products to inform estimates of their potential impact on the HIV epidemic in South Africa. We consider preferences for oral pre-exposure prophylaxis; a vaginal microbicide gel; a long-acting vaginal ring; a SILCS diaphragm used in concert with gel; and a long-acting ARV-based injectable. Methods and analysis This study will gather data from 4 populations: 200 women, 200 men, 200 adolescent girls (aged 16–17 years) and 200 female sex workers. The DCE attributes and design will be developed through a literature review, supplemented by a thematic analysis of qualitative focus group discussions. Extensive piloting will be carried out in each population through semistructured interviews. The final survey will be conducted using computer tablets via a household sample (for women, men and adolescents) and respondent-driven sampling (for female sex workers), and DCE data analysed using a range of multinomial logit models. Ethics and dissemination This study has been approved by the University of the Witwatersrand Human Research Ethics Committee and the Research Ethics Committee at the London School of Hygiene and Tropical Medicine. Findings will be presented to international conferences and peer-reviewed journals. Meetings will be held with opinion leaders in South Africa, while results will be disseminated to participants in Ekurhuleni through a public meeting or newsletter. PMID:27354071

  11. High prevalence of forced sex among non-brothel based, wine shop centered sex workers in Chennai, India.

    PubMed

    Go, Vivian F; Srikrishnan, Aylur K; Parker, Corette Breeden; Salter, Megan; Green, Annette M; Sivaram, Sudha; Johnson, Sethulakshmi C; Latkin, Carl; Davis, Wendy; Solomon, Suniti; Celentano, David D

    2011-01-01

    Sexual violence has been shown to increase women's risk of HIV infection. India is a country where the HIV epidemic is growing among women and intimate partner violence (IPV) is pervasive. This study examined prevalence of and factors associated with forced sex among female sex workers (FSWs) in Chennai, India. We conducted a probability survey among FSWs in 24 slum venues and identified predictive factors for recent forced sex using univariate and multivariable proportional odds models. Among 522 FSWs, 28% reported having forced sex with one partner and 35% with 2+ partners. In the final multivariable model, women who had a high number of partners who had a strong tendency to drink alcohol before sex were more likely to have experienced forced sex, and women who had both unprotected sex with a nonspousal partner and > 20 days of alcohol consumption in the last 30 days were more likely to have experienced forced sex. Discussion about family violence with larger social networks was independently associated with lower odds of forced sex among FSWs. HIV interventions for FSWs and their clients aimed at reducing alcohol consumption and encouraging condom use could be enhanced by violence prevention interventions to facilitate discourse about sexual violence. PMID:20628897

  12. Female commercial sex workers in Kramat Tunggak, Jakarta, Indonesia.

    PubMed

    Sedyaningsih-Mamahit, E R

    1999-10-01

    Indonesia is predicted to face a severe AIDS epidemic in the near future. More than 60% of the reported HIV-positive cases in Indonesia can be attributed to heterosexual transmission; therefore, by the nature of their work, female commercial sex workers (FCSWs) constitute one of the communities at risk. No meaningful or effective STD/HIV prevention programs for FCSWs can be planned if there is no contextual understanding of these women as persons, the nature and the risks of their job and their relations with their clients and managers. Just as it is incorrect to assume that all women enter prostitution for the same reasons, educational approaches that are modeled on shallow stereotypes will be ineffective. Interweaving qualitative and quantitative methods, this research investigates the FCSWs in an 'official' brothel complex in Jakarta, Indonesia. Results of this study give insights of four typologies of FCSWs observed in Kramat Tunggak. The personal, professional, social and other differences which influenced the women into full-time sex work and affected their willingness and ability to engage in healthy and protective behaviors, are presented. Finally, based on those findings a recommendation on how to deliver health messages to the FCSWs is offered. PMID:10475673

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

    ERIC Educational Resources Information Center

    Sircar, Oishik; Dutta, Debolina

    2011-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

  15. Minority Women Workers: A Statistical Overview. (Revised.)

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    The status of minority women workers in 1976 is examined, particularly in relationship to their white counterparts, under the following topic headings: (1) labor force participation; (2) unemployment status; (3) reasons for unemployment; (4) unemployment during the recession; (5) occupations; (6) marital status; (7) women heads of families; (8)…

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

    PubMed Central

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

    2006-01-01

    Background The majority of sex work in India is clandestine due to unfavorable legal environment and discrimination against female sex workers (FSWs). We report data on who these women are and when they get involved with sex work that could assist in increasing the reach of HIV prevention activities for them. Methods Detailed documentation of demography and various aspects of sex work was done through confidential interviews of 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. The demography of FSWs was compared with that of women in the general population. Results A total of 5010 (75.4%), 1499 (22.5%), and 139 (2.1%) street-, home-, and brothel-based FSWs, respectively, participated. Comparison with women of Andhra Pradesh revealed that the proportion of those aged 20–34 years (75.6%), belonging to scheduled caste (35.3%) and scheduled tribe (10.5%), illiterate (74.7%), and of those separated/divorced (30.7%) was higher among FSWs (p < 0.001). The FSWs engaged in sex work for >5 years were more likely to be non-street-based FSWs, illiterate, living in small urban towns, and to have started sex work between 12–15 years of age. The mean age at starting sex work (21.7 years) and gap between the first vaginal intercourse and the first sexual intercourse in exchange for money (6.6 years) was lower for FSWs in the rural areas as compared with those in large urban areas (23.9 years and 8.8 years, respectively). Conclusion These data highlight that women struggling with illiteracy, lower social status, and less economic opportunities are especially vulnerable to being infected by HIV, as sex work may be one of the few options available to them to earn money. Recommendations for actions are made for long-term impact on reducing the numbers of women being infected by HIV in addition to the current HIV prevention efforts in India. PMID:16615869

  17. Sex Roles and Fertility in College Women.

    ERIC Educational Resources Information Center

    Falbo, Toni; And Others

    1978-01-01

    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.…

  18. Sex with Sex Workers among Latino Day Laborers in Suburban Maryland

    PubMed Central

    Reisen, Carol A.; Gonzales, Felisa A.; Arroyo, Juan C.; Zea, Maria Cecilia; Poppen, Paul J.

    2016-01-01

    Using the structural-environmental conceptual framework, this study employed mixed methods to address the question of whether sex with female sex workers contributes to HIV risk among male immigrant Latino day laborers in suburban Maryland. Because contextual factors can greatly affect HIV risk for both sex workers and their clients, this study investigated the organizational structure of sex work, factors that predicted men’s hiring of sex workers, sexual behaviors performed with sex workers, and the use of condoms. Qualitative research was conducted to inform the development of a quantitative survey, but also provided crucial descriptions about the motivations, locations, arrangements, and sexual activities related to sex work. Key informant interviews (N= 10), in-depth interviews with day laborers (N= 10) and Latina female sex workers (N = 4), and two focus groups with day laborers (N= 11) were conducted, and a quantitative survey administered via Audio-enhanced Computer-assisted Self-interviewing (N = 174). Condom use was nearly universal in encounters with female sex workers, thus indicating that the sex workers were not an important source of HIV transmission in this context. Logistic regression was performed to test a model predicting sex with sex workers. Latino day laborers who reported more immigrant stress and who did not have a partner in the U.S. were more likely to have had sex with a sex worker, as were men who reported binge drinking. Structural and social conditions influenced the hiring of sex workers. Further research is warranted to better understand the interrelationships among these circumstances and to inform the development of programs to address them. PMID:23070528

  19. Sex with sex workers among latino day laborers in Suburban Maryland.

    PubMed

    Bianchi, Fernanda T; Reisen, Carol A; Gonzales, Felisa A; Arroyo, Juan C; Zea, Maria Cecilia; Poppen, Paul J

    2013-07-01

    Using the structural-environmental conceptual framework, this study employed mixed methods to address the question of whether sex with female sex workers contributes to HIV risk among male immigrant Latino day laborers in suburban Maryland. Because contextual factors can greatly affect HIV risk for both sex workers and their clients, this study investigated the organizational structure of sex work, factors that predicted men's hiring of sex workers, sexual behaviors performed with sex workers, and the use of condoms. Qualitative research was conducted to inform the development of a quantitative survey, but also provided crucial descriptions about the motivations, locations, arrangements, and sexual activities related to sex work. Key informant interviews (N = 10), in-depth interviews with day laborers (N = 10) and Latina female sex workers (N = 4), and two focus groups with day laborers (N = 11) were conducted, and a quantitative survey administered via Audio-enhanced Computer-assisted Self-interviewing (N = 174). Condom use was nearly universal in encounters with female sex workers, thus indicating that the sex workers were not an important source of HIV transmission in this context. Logistic regression was performed to test a model predicting sex with sex workers. Latino day laborers who reported more immigrant stress and who did not have a partner in the U.S. were more likely to have had sex with a sex worker, as were men who reported binge drinking. Structural and social conditions influenced the hiring of sex workers. Further research is warranted to better understand the interrelationships among these circumstances and to inform the development of programs to address them. PMID:23070528

  20. Sex worker activism, feminist discourse and HIV in Bangladesh.

    PubMed

    Sultana, Habiba

    2015-01-01

    This paper explores the relationship between sex worker activism and HIV-related discourse in Bangladesh, relating recent developments in activism to the influence of feminist thought. Following their eviction in 1991 from brothels from red light areas, Bangladeshi sex workers started a social movement, at just about the same time that programmes started to work with sex workers to reduce the transmission of HIV. This paper argues that both sex worker activism and HIV-prevention initiatives find impetus in feminist pro-sex-work perspectives, which place emphasis on individual and collective agency. However, by participating in these programmes, sex workers failed to contest the imagery of themselves as 'vectors' of HIV. In this way, they were unwittingly complicit in reproducing their identity as 'polluting others'. Moreover, by focusing on individual behaviour and the agency of sex workers, HIV programmes ignored the fact that the 'choices' made by sex workers are influenced by a wide range of structural and discursive factors, including gender norms and notions of bodily purity, which in turn have implications for the construction of HIV-related risk. PMID:25588539

  1. Sex worker activism, feminist discourse and HIV in Bangladesh

    PubMed Central

    Sultana, Habiba

    2015-01-01

    This paper explores the relationship between sex worker activism and HIV-related discourse in Bangladesh, relating recent developments in activism to the influence of feminist thought. Following their eviction in 1991 from brothels from red light areas, Bangladeshi sex workers started a social movement, at just about the same time that programmes started to work with sex workers to reduce the transmission of HIV. This paper argues that both sex worker activism and HIV-prevention initiatives find impetus in feminist pro-sex-work perspectives, which place emphasis on individual and collective agency. However, by participating in these programmes, sex workers failed to contest the imagery of themselves as ‘vectors’ of HIV. In this way, they were unwittingly complicit in reproducing their identity as ‘polluting others’. Moreover, by focusing on individual behaviour and the agency of sex workers, HIV programmes ignored the fact that the ‘choices’ made by sex workers are influenced by a wide range of structural and discursive factors, including gender norms and notions of bodily purity, which in turn have implications for the construction of HIV-related risk. PMID:25588539

  2. Women--Sex Objects in Ancient Egypt.

    ERIC Educational Resources Information Center

    Mutimer, Brian T. P.

    Although it has been said that the women in Ancient Egypt enjoyed a reasonable state of social and professional equality with men, this paper presents an alternate theory--that women were second-class citizens whose physical prowess was secondary to their role as sex objects. It appears that men and women in Ancient Egypt often participated in the…

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

    PubMed

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

    2016-09-01

    Despite reports of high levels of violence among women migrants in Central America, limited evidence exists regarding the health and safety of migrant sex workers in Central America. This study is based on 16 months of field research (November 2012-February 2014), including ethnographic fieldwork, in-depth interviews, and focus groups conducted with 52 internal and international migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, key transit and destination communities for both international and internal migrants. The analysis explored migration-related determinants of susceptibility to violence experienced by migrant sex workers across different phases of migration. Violence in home communities and economic considerations were key drivers of migration. Unsafe transit experiences (eg undocumented border crossings) and negative interactions with authorities in destination settings (eg extortion) contributed to migrant sex workers' susceptibility to violence, while enhanced access to information on immigration policies and greater migration and sex work experience were found to enhance agency and resilience. Findings suggest the urgent need for actions that promote migrant sex workers' safety in communities of origin, transit, and destination, and programmes aimed at preventing and addressing human rights violations within the context of migration and sex work. PMID:27439656

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

    PubMed

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

    2015-01-01

    The Bolivian indigenous Ayoreo ethnic people are vulnerable to sexually transmitted infections and HIV. Ayoreo women who also work in sex trades belong to an extremely high-risk group, and prevention programs are not delivering effective outcomes for them. The aim of our study was to explore, describe, and understand behavioral and cultural patterns related to sexual and reproductive health in Ayoreo sex workers. A qualitative-ethnographic study was designed; data were collected through participant observation and in-depth interviews with sex workers and key informants. Two fundamental themes contributing to HIV risk for female Ayoreo sex workers in Bolivia emerged: reproductive/sexual freedom and sociocultural risk determinants. We concluded that the in-depth examination of the sexual-reproductive culture amongst the Ayoreo has provided useful information, which might contribute to the cultural adaptation and design of future policies and prevention programs for sexually transmitted infections and HIV in this group. PMID:26329475

  5. Human papillomaviruses and cervical cancer in Bangkok. III. The role of husbands and commercial sex workers.

    PubMed

    Thomas, D B; Ray, R M; Kuypers, J; Kiviat, N; Koetsawang, A; Ashley, R L; Qin, Q; Koetsawang, S

    2001-04-15

    Between September 1991 and September 1993, husbands of women with and without cervical neoplasia and commercial sex workers in one brothel and one massage parlor in Bangkok, Thailand, were interviewed; serologic tests for sexually transmitted infections were performed; and cervical and penile scrapings were tested for human papillomavirus (HPV) DNA. The risks of cervical carcinoma in monogamous women and of oncogenic HPV in their husbands were associated with the men's having unprotected intercourse with prostitutes. The prevalence of oncogenic HPV was higher in commercial sex workers than in women attending gynecologic and family planning clinics. Oncogenic HPV prevalence declined with age in human immunodeficiency virus (HIV)-negative, but not in healthy HIV-positive, commercial sex workers and was weakly associated with hepatitis B antigenemia, suggesting that persistence of HPV infection is due to subtle changes in immunity. Associations of HPV with recent pregnancy and oral contraceptive use suggest that hormonal factors may increase the risk of cervical neoplasia by enhancing persistence of HPV infection. The prevalence of high-grade squamous intraepithelial lesions was strongly related to oncogenic HPV types and weakly to HIV infection only in their presence. Commercial sex workers in Bangkok are reservoirs of oncogenic HPV, and cervical cancer in monogamous Thai women develops in part as a result of transmission of these viruses to them by their husbands from prostitutes. PMID:11296145

  6. Migrant and seasonal farm worker women.

    PubMed

    Lambert, M I

    1995-01-01

    Migrant and seasonal farm worker women are part of a population whose health care needs are underserved. This article provides some definition of this population and reviews some of the health needs specific to them. The significant need for outreach to and assessment of this population is addressed. The significance of the nurse's role is addressed. The need for health care services being delivered in a culturally sensitive manner is discussed. Resources to assist health care providers in providing more effective interventions and referrals for care of migrant and seasonal farm worker women are identified. PMID:7782960

  7. Circumstances, experiences and processes surrounding women's entry into sex work in India.

    PubMed

    McClarty, Leigh M; Bhattacharjee, Parinita; Blanchard, James F; Lorway, Robert R; Ramanaik, Satyanarayana; Mishra, Sharmistha; Isac, Shajy; Ramesh, B M; Washington, Reynold; Moses, Stephen; Becker, Marissa L

    2014-01-01

    Evidence suggests that in India, the early stages of a woman's career as a sex worker may be an important period to target for HIV and sexually transmitted infection prevention. Before such an intervention is designed and implemented, it is necessary to first understand the life circumstances of women at the start of their sex work careers. We performed a review to bring together available literature pertaining to entry into sex work in India and to highlight knowledge gaps. We found that historical traditions of dedication into sex work, financial insecurity, family discord, violence and coercion, and desire for financial independence are commonly reported reasons for entering into sex work. We also found that families and the broader sex worker community play an important role in the early stages of a woman's sex work career. We suggest that HIV-prevention programmes in India would substantially benefit from a deeper understanding of the life circumstances of new and young women sex workers. Further research should be conducted focusing on family and community involvement in women's entry into sex work, and on the important period of time after a woman's first commercial sex encounter, but before self-identification as a sex worker. PMID:24236895

  8. Female condom acceptability among sex workers in Costa Rica.

    PubMed

    Madrigal, J; Schifter, J; Feldblum, P J

    1998-04-01

    This study measured short-term female condom acceptability among 51 female sex workers in San José, Costa Rica. Each woman was trained in use of the female condom and was asked to use the device if clients refused to use male condoms during a 2-week study period (male condoms were also distributed). Two follow-up visits with short interviews were scheduled, including questions on general reaction to the female condom by the participants and their clients, ease and comfort of use, and preferences for male or female devices. At the first follow-up visit, 51% of the women reported they "liked the female condom very much" and 45% reported they "liked it somewhat." Similar results were reported after the second follow-up phase. Sixty-seven percent of the participants preferred the female condom over the male condom, and, according to the the women, over half of their clients liked the female condom "very much" or "somewhat." The most common problems during the first phase were difficulty to insert (61%) and discomfort (43%). However, during the second study phase a reduction in these problems (22% and 25%, respectively) and other use-related problems were noted. Although this new method is not yet available throughout Costa Rica, these results should encourage sexually transmitted diseases and HIV service organizations to make this method accessible to women. PMID:9573433

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

    PubMed

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

    2013-01-01

    This study aimed to build formative knowledge regarding HIV risks in female migrant sex workers in Moscow, focusing on gender and power. This was a collaborative ethnographic study, informed by the theory of gender and power, in which researchers conducted minimally structured interviews with 24 female sex workers who were migrants to Moscow and who provided sexual services to male migrant laborers. Overall, the female migrant sex workers engaged in HIV risk behaviors and practiced inadequate HIV protection with their clients. These behaviors were shaped by gender and power factors in the realms of labor, behavior, and cathexis. In the labor realm, because some female migrants were unable to earn enough money to support their families, they were pushed or pulled into sex work providing service to male migrants. In the behavior realm, many female migrant sex workers were intimidated by their male clients, feared violence, and lacked access to women's health care and prevention. In the cathexis realm, many had a sense of shame, social isolation, emotional distress, and lacked basic HIV knowledge and prevention skills. To prevent HIV transmission requires addressing the gender and power factors that shape HIV/AIDS risks among female migrant sex workers through multilevel intervention strategies. PMID:23421339

  10. United States: Funding restrictions threaten sex workers' rights.

    PubMed

    Schleifer, Rebecca

    2005-08-01

    Recent developments concerning the US government's restrictive policies on HIV/AIDS funding have drawn attention to how the government's mandatory "anti-prostitution pledge" endangers the lives of sex workers and trafficking victims. PMID:16365969

  11. Factors related to condom use among four groups of female sex workers in Bali, Indonesia.

    PubMed

    Ford, K; Wirawan, D N; Fajans, P

    1998-02-01

    This article tests a behavioral model of condom use for four groups of female commercial sex workers. Data were drawn from a study of 614 female sex workers conducted in Bali, Indonesia. AIDS knowledge, risk behaviors, and factors related to condom use varied substantially among the four groups of women and reflect the social context of their work. Interventions for each group need to reflect these differences. Important factors to consider include the level of AIDS and STD knowledge in their environment, the characteristics of the clients served, and the degree of supervision that they receive. PMID:9505097

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

    PubMed

    Sardana, Srishti; Marcus, Marina; Verdeli, Helen

    2016-08-01

    This study explores the narratives of psychological distress and resilience among a group of female sex workers who use residential spaces to attend to clients in rural India. The narratives reflect the lived experiences of these women. They describe the women's reasons for opting into sex work; guilt, shame, and stigma related to their sex worker status; experiences with intimate partner and domestic violence; health-related problems; communication with their family members about their sex worker status; mental health referral practices among the women; and elements of resilience and strength that they experience within themselves and within their community of fellow sex workers. The article also offers elements of our own experiences of recruiting the women to participate in the focus group, training local outreach workers in conducting focus group discussions, and forging a collaboration with a local community-based organization to highlight important barriers, challenges, and strategies for planning a group-based discussion to explore the mental health needs of home-based sex workers. PMID:27463830

  13. Sex and Women with Cancer -- Overview

    MedlinePlus

    ... get older. Many men and women keep having sex until the end of their lives. It’s true that age may change your sexual response. But if you want to keep your sex life active, you probably can. Last Medical Review: ...

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

    PubMed Central

    Wong, William CW; Holroyd, Eleanor; Chan, Emily Y; Griffiths, Sian; Bingham, Amie

    2008-01-01

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

  15. Douching practices among female sex workers in Phnom Penh, Cambodia.

    PubMed

    Bui, Thanh Cong; Tran, Ly T H; Ross, Michael W; Markham, Christine M

    2015-03-01

    Several studies indicate that douching has few benefits but numerous adverse health outcomes, including increased risk for sexually transmitted infections and HIV. No published study explores douching practices among Cambodian female sex workers. This report provides preliminary data about the prevalence and frequency of douching among female sex workers in Phnom Penh, Cambodia. Survey data were obtained from 81 female sex workers who were taken into custody due to engagement in commercial sex from March to June 2011. Results showed that 91% of participants douched. The mean numbers of times douched before sex and after sex per 10 sex episodes were 4.43 (SD = 3.87) and 4.63 (SD = 3.94), respectively. Half of the participants thought that douching could help to prevent sexually transmitted infections including HIV; 24% were unsure about this. Usually, douching after sex was associated with ever obtaining an HIV test (p = .012) and was marginally associated (although not statistically significant) with a higher average number of clients per week (p =. 063) and consistent condom use with clients (p = .053). This suggests that these practices may be related to individual perceptions of sexually transmitted infections/HIV risk or susceptibility. Given the commonness of douching and related misperceptions among Cambodian female sex workers, future studies and interventions are needed to prevent adverse health problems. PMID:24810219

  16. Training of Women Instructors in Workers' Education.

    ERIC Educational Resources Information Center

    Solorzano, Irene Brenes

    1987-01-01

    Describes development and implementation of a training program for women in workers' education. The three-course program focused on teaching methodology. Benefits gained by the participants included (1) cultural appreciation, (2) cultivation of the study habit, and (3) improved teaching competence. (CH)

  17. Facts on Women Workers of Minority Races.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    This booklet on women workers of minority races includes all races in a minority other than white, Negroes constituting about 90 percent of all persons other than white in the United States; Spanish-speaking persons are included in the white population. The following topics are encompassed; labor force participation; unemployment; marital status;…

  18. Occupational health and safety among commercial sex workers.

    PubMed

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

    2012-03-01

    The concept of occupational health and safety (OHS) for commercial sex workers has rarely been investigated, perhaps because of the often informal nature of the workplace, the associated stigma, and the frequently illegal nature of the activity. We reviewed the literature on health, occupational risks, and safety among commercial sex workers. Cultural and local variations and commonalities were identified. Dimensions of OHS that emerged included legal and policing risks, risks associated with particular business settings such as streets and brothels, violence from clients, mental health risks and protective factors, alcohol and drug use, repetitive strain injuries, sexually transmissible infections, risks associated with particular classes of clients, issues associated with male and transgender commercial sex workers, and issues of risk reduction that in many cases are associated with lack of agency or control, stigma, and legal barriers. We further discuss the impact and potential of OHS interventions for commercial sex workers. The OHS of commercial sex workers covers a range of domains, some potentially modifiable by OHS programs and workplace safety interventions targeted at this population. We argue that commercial sex work should be considered as an occupation overdue for interventions to reduce workplace risks and enhance worker safety. PMID:21808944

  19. BACKGROUND FACTS ON WOMEN WORKERS IN THE UNITED STATES.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    DATA FROM THE U.S. DEPARTMENT OF LABOR, THE MANPOWER REPORT OF THE PRESIDENT, AND THE U.S. DEPARTMENT OF COMMERCE DESCRIBE WOMEN WORKERS. IN 1966, THERE WERE 27.8 MILLION AMERICAN WOMEN WORKERS, AN INCREASE OF 4.2 MILLION SINCE 1960. OF ALL WORKERS, 36 PERCENT WERE WOMEN. NEARLY HALF OF ALL WOMEN 18 TO 64 YEARS OF AGE WERE WORKERS, AND THE MEDIAN…

  20. Sexual and health behaviour of commercial sex workers in Benin City, Edo State, Nigeria.

    PubMed

    Asowa-Omorodion, F I

    2000-06-01

    In this paper, examined are the sexual and health behaviours of commercial sex workers in Nigeria, a high-risk group in this era of the acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) epidemic. The aim is to provide in-depth knowledge of their sexual networking and the prevalence rate of sexually transmitted diseases (STDs). This analysis is intended to highlight their implications in the spread and control of AIDS and HIV infection. The results of the study show the extensive sexual networking of these commercial sex workers, the health implications, and the utilisation of nonorthodox health services in diagnosing STDs. The implications of these results are the likely drain on the limited health resources of the Nigerian government and the harmful effects on the women, fetuses, children, and other sexual partners of clients of these commercial sex workers. PMID:11813779

  1. A Qualitative Exploration of Barriers to Condom Use among Female Sex Workers in China

    PubMed Central

    Ciyong, Lu; Hui, Wang; Lingyao, Hong; Xueqing, Deng

    2012-01-01

    Background Sex workers in China continue to engage in unprotected sex acts that put them at risk for contracting HIV (Human Immunodeficiency Virus) and other STIs (Sexually Transmitted Infections). The purpose of this study was to explore women’s work history, the context of sex work, condom use, HIV testing services, and potential barriers to condom use in a sample of FSWs (female sex workers) in Guangzhou, China. Methodology/Principal Findings In-depth, semi-structured, face-to-face interviews were conducted with 24 FSWs in Guangzhou, China. Informants were recruited using a purposive sampling technique. Qualitative data were coded and analyzed using NVivo 8.0. The majority of respondents were internal economic migrants who had entered the sex industry in pursuit of greater financial reward. Most women in the study were married or had steady boyfriends, and were young, with secondary education and limited knowledge about HIV and STIs. Most were not satisfied with their current living conditions and expressed a desire to leave the sex industry. Women reported that they were more likely to use condoms during sex acts with commercial partners than with non-commercial partners. The potential stigma of being seen as a sex worker prevented many from accessing HIV testing. Three key factors put these FSWs at risk for HIV and STIs: unreasonable trust toward clients, stereotypes and assumptions about customers, and financial incentives. Conclusions/Significance These findings suggest that social and economic factors play an important role in shaping sexual decision-making among female sex workers in Guangzhou. We argue that greater insight into and attention to these factors could enhance the success of HIV prevention efforts. PMID:23056452

  2. Importance of the Sex of Worker and Client

    ERIC Educational Resources Information Center

    Schwartz, Mary C.

    1974-01-01

    The author surveys the writings of the last eight years of "Social Work" in order to study the profession's attitude toward the sex factor (sex of case worker and of client groups), and to determine whether and how this factor has been interpreted in professional thinking. (Author/EAK)

  3. Opportunities for Woman-Initiated HIV Prevention Methods among Female Sex Workers in Southern China

    PubMed Central

    Weeks, Margaret R.; Liao, Susu; Abbott, Maryann; He, Bin; Zhou, Yuejiang; Jiang, Jingmei; Wei, Liu; Yu, Wang

    2010-01-01

    Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women’s knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China. PMID:17599276

  4. Symbolic capital and health: the case of women's sex work in Antananarivo, Madagascar.

    PubMed

    Stoebenau, Kirsten

    2009-06-01

    Public health research on sex work has been criticized both for representing sex work as a monolithic entity and for focusing only on individual behavioral determinants of health. When broader determinants are acknowledged, they are often described in solely economic terms (ie, comparing health risks of higher class versus lower class sex workers). Drawing from Pierre Bourdieu, I describe women's sex work in Antananarivo, Madagascar as a social 'field' and demonstrate that this field is both highly complex and highly structured. Fourteen months of ethnographic fieldwork (December 2002-December 2003; May-June 2004) in Antananarivo with women sex workers (n approximately 60) and community members (n approximately 85) informed a description of the community's understanding of the sex work field and its contrast to the lived experience of key informant sex workers. Women who sell sex were categorized by their communities into three social positions--ambony (high), antonony (middle) and ambany (low)--which were differentiated by economic capital (earnings per sexual exchange) and symbolic capital (prestige associated with race, ethnicity and moral demeanor). Women who occupied the antonony social position held the greatest volumes of symbolic capital both because they were identified as belonging to the local dominant ethnic group, and because they demonstrated discretion and shame in their sex work practice. Alternatively, women who occupied the ambony and ambany positions openly practiced their sex work and were associated with ethnic or racial minority identities, contributing to their lower volumes of symbolic capital. Symbolic capital influenced unique health vulnerabilities, such as to sexually transmitted disease, by social position through mechanisms operating from the institutional to the interpersonal level. This analysis illustrates the value of examining sex work as a social field, specifically the importance of capturing more than economic capital in order

  5. A systematic review and metasynthesis of barriers and facilitators to negotiating consistent condom use among sex workers in Asia.

    PubMed

    Tan, Si Ying; Melendez-Torres, G J

    2016-01-01

    Female sex work accounts for about 15% of the global HIV burden in women. Asia is the region with the second highest attributable fraction of the HIV epidemic after sub-Saharan Africa. This review synthesises studies that depict the barriers and facilitators encountered by sex workers in Asia when negotiating consistent condom use. A total of 18 studies published between January 1989 and May 2015 were included in the review. Data were extracted, critically appraised and analysed using a thematic analysis approach. Individual-level factors related to sex workers' knowledge, perception and power, as well as interpersonal-level factors that encompassed dynamics with clients and peer-related factors, presented as both barriers and facilitators to sex workers' condom negotiation process. In addition, the structural environment of sex work, access to resources, poverty, stigma, the legal environment and the role of media were also identified as factors in influencing the condom negotiation process of sex workers. A multisectoral interventional approach that addresses the multilevel barriers encountered by sex workers in condom negotiation is needed. Awareness of safe-sex practice should be collectively enhanced among sex workers, clients and brothel managers. PMID:26325239

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

    PubMed

    Gysels, M; Pool, R; Bwanika, K

    2001-06-01

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

  7. Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting.

    PubMed

    Socías, M E; Deering, K; Horton, M; Nguyen, P; Montaner, J S; Shannon, K

    2015-10-01

    In light of the emphasis on enforcement-based approaches towards sex work, and the well-known negative impacts of these approaches on women's health, safety and well-being, we conducted a study to investigate the prevalence and correlates of recent incarceration among a cohort of women sex workers in Vancouver, Canada. Data were obtained from an open prospective community cohort of female and transgender women sex workers, known as An Evaluation of Sex Workers' Health Access (AESHA). Bivariate and multivariable logistic regression analyses, using generalized estimating equations (GEE), were used to model the effect of social and structural factors on the likelihood of incarceration over the 44-month follow-up period (January 2010-August 2013). Among 720 sex workers, 62.5 % (n = 450) reported being incarcerated in their lifetime and 23.9 % (n = 172) being incarcerated at least once during the study period. Of the 172 participants, about one third (36.6 %) reported multiple episodes of incarceration. In multivariable GEE analyses, younger age (adjusted odds ratio [AOR] = 1.04 per year younger, 95 % confidence interval [CI] 1.02-1.06), being of a sexual/gender minority (AOR = 1.62, 95 % CI 1.13-2.34), heavy drinking (AOR = 1.99, 95 % CI 1.20-3.29), being born in Canada (AOR = 3.28, 95 % CI 1.26-8.53), living in unstable housing conditions (AOR = 4.32, 95 % CI 2.17-8.62), servicing clients in public spaces (versus formal sex work establishments) (AOR = 2.33, 95 % CI 1.05-5.17) and experiencing police harassment without arrest (AOR = 1.82, 95 % CI 1.35-2.45) remain independently correlated with incarceration. This prospective study found a very high prevalence and frequency of incarceration among women sex workers in Vancouver, Canada, with the most vulnerable and marginalized women at increased risk of incarceration. Given the well-known social and health harms associated with incarceration, and associations between police harassment

  8. Sex trafficking of women and girls.

    PubMed

    Deshpande, Neha A; Nour, Nawal M

    2013-01-01

    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

  9. Sex workers and the control of sexually transmitted disease.

    PubMed Central

    Day, S; Ward, H

    1997-01-01

    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

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

    PubMed

    Wilson, David

    2015-06-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work. PMID:26079267

  11. [Progress in research of reasons for women engaging in commercial sex].

    PubMed

    Du, Yihui; Wang, Zhiping; Fu, Jihua

    2016-01-01

    With the development of economy, increase of cultural exchanges and changes of people's ideology in China, the number of female sex workers (FSWs) increased rapidly under the influence of various social factors. The diverse motivations for women engaging in commercial sex have been observed. Foreign researchers have conducted some surveys of factors associated with female commercial sex, while few such studies were conducted among FSWs in China. This paper summarizes the progress in the research of reasons for women engaging in commercial sex both at home and abroad to provide evidence for future study. PMID:26822661

  12. The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe

    PubMed Central

    Elmes, Jocelyn; Nhongo, Kundai; Ward, Helen; Hallett, Timothy; Nyamukapa, Constance; White, Peter J.; Gregson, Simon

    2014-01-01

    Background. Higher prices for unprotected sex threaten the high levels of condom use that contributed to the decline in Zimbabwe's human immunodeficiency virus (HIV) epidemic. To improve understanding of financial pressures competing against safer sex, we explore factors associated with the price of commercial sex in rural eastern Zimbabwe. Methods. We collected and analyzed cross-sectional data on 311 women, recruited during October–December 2010, who reported that they received payment for their most-recent or second-most-recent sex acts in the past year. Zero-inflated negative binomial models with robust standard errors clustered on female sex worker (FSW) were used to explore social and behavioral determinants of price. Results. The median price of sex was $10 (interquartile range [IQR], $5–$20) per night and $10 (IQR, $5–$15) per act. Amounts paid in cash and commodities did not differ significantly. At the most-recent sex act, more-educated FSWs received 30%–74% higher payments. Client requests for condom use significantly predicted protected sex (P < .01), but clients paid on average 42.9% more for unprotected sex. Conclusions. Within a work environment where clients' preferences determine condom use, FSWs effectively use their individual capital to negotiate the terms of condom use. Strengthening FSWs' preferences for protected sex could help maintain high levels of condom use. PMID:25381377

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

    PubMed Central

    Wilson, David

    2015-01-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection “Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers” highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work. PMID:26079267

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

    PubMed Central

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

    2011-01-01

    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

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

    ERIC Educational Resources Information Center

    Meaghan, Diane

    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…

  16. Dyspareunia: Painful Sex for Women

    MedlinePlus

    MENU Return to Web version Dyspareunia Overview What is dyspareunia? Dyspareunia (say: "dis-par-oon-ya") is painful sexual intercourse for women. The pain can be in the genital area or deep inside the pelvis. The pain is often described as sharp, burning or similar to menstrual cramps. It can have ...

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

    PubMed

    Wojcicki, J M; Malala, J

    2001-07-01

    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 clients' reluctance to use condoms in sexual exchanges. We emphasize sex-worker's agency and use a broader, Foucauldian understanding of power, which couples power with resistance. Further, this paper examines other elements of the sex industry that contribute to unsafe sex such as competition between women for clients and violence in the industry. Finally, this paper suggests that HIV-prevention programs take cognizance that power negotiations between men and women cannot be simplistically understood as men having power and women being powerless. Rather, this article contributes to a growing body of literature in medical anthropology, which elucidates the complexities of sexual negotiations between men and women. This focus on agency is important in trying to lessen the stigma and discrimination that sex-workers face at the hands of clients, pimps/managers, police and health care workers. PMID:11380165

  18. Single-Sex Counseling Groups and Minicourses for Women Students.

    ERIC Educational Resources Information Center

    Kidd, Nancy V.; Hudson, George R.

    1978-01-01

    Women students in a community college were studied to determine the effects of single-sex counseling groups and two single-sex minicourses on reducing alienation and increasing self-regard and inner direction in women. (Author)

  19. Sexual Relationship Power and Intimate Partner Violence Among Sex Workers with Non-Commercial Intimate Partners in a Canadian Setting

    PubMed Central

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

    2014-01-01

    There is little information on the private lives of women engaged in sex work, particularly how power dynamics within intimate relationships may affect intimate partner violence (IPV). Using baseline data of sex workers enrolled in a longitudinal cohort, ‘AESHA’ (An Evaluation of Sex Workers’ Health Access), 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. Bivariate and multivariate 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 gender-focused and coupled-based interventions tailored to noncommercial intimate partnerships of sex workers. PMID:25402720

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

    PubMed Central

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

    1995-01-01

    OBJECTIVES. The social context within which women engaged in sex work at a popular truck stop in South Africa are placed at risk of human immunodeficiency virus (HIV) infection and the factors that influence their ability to reduce their risk were assessed. METHODS. Using qualitative and quantitative techniques, an elected sex worker from within the group collected all data. RESULTS. Given the various pressing needs for basic survival, the risk of HIV infection is viewed as one more burden imposed on these women by their lack of social, legal, and economic power. Violence, or the threat thereof, plays an important role in their disempowerment. In the few instances in which sex workers were able to insist on condom use, it resulted in a decrease in earnings, loss of clients, and physical abuse. CONCLUSIONS. Recommendations to reduce the sex workers' risk for HIV infection include negotiation and communication skills to enable them to persuade their clients to use condoms; development of strategies through which they can maximally use their group strength to facilitate unified action; and accessibility of protective methods they can use and control, such as intravaginal microbicides. PMID:7485664

  1. Relationship dynamics and sexual risk behaviour of male partners of female sex workers in Kampala, Uganda.

    PubMed

    Mbonye, Martin; Siu, Godfrey E; Kiwanuka, Thadeus; Seeley, Janet

    2016-07-01

    Regular male partners of female sex workers (FSWs) represent an important population to reach with HIV-prevention interventions. This paper discusses the relationship dynamics and HIV/sexually transmitted infection risk behaviour of men involved with self-identified FSWs in Kampala. Between 2011 and 2014 we conducted repeat in-depth interviews with 42 male partners of FSWs attending a clinic for women at high risk of HIV-infection in Kampala. Men publicly struggled with the stigma of dating women who are considered to be engaged in a shamed profession, but privately saw meaning in these relationships. In coping with the stigma, some described the work of their partners in terms that distanced them from sex work, while others struggled to have the control that "being a man" demanded since they could not monitor all movements of their partners. Dealing with HIV disclosure was hard and seeking support was difficult for some of the men, leading to missed opportunities and guilt. Despite challenges, relationships with sex workers offered men some benefits such as access to much needed care and treatment. A few men also admitted to being motivated by material and financial benefits from sex workers who they perceived as being rich and this was one factor that helped them sustain the relationships. These findings offer insights into the complex relationship dynamics within high risk sexual partnerships. However, the findings suggest that effective interventions that are couple centred can be established to promote better health. PMID:27399044

  2. Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections.

    PubMed

    Chersich, M F; Luchters, S M F; Malonza, I M; Mwarogo, P; King'ola, N; Temmerman, M

    2007-11-01

    This study examined patterns of alcohol use and its association with unsafe sex and related sequelae among female sex workers in Mombasa, Kenya. A community-based cross-sectional study was conducted using snowball sampling. Binge drinkers (> or =5 alcoholic drinks on > or =1 occasion in the previous month) were compared with non-binge drinkers. Of 719 participants, 22.4% were lifetime-alcohol abstainers, 44.7% non-binge and 33.0% binge drinkers. Compared with non-binge drinkers, binge drinkers were more likely to report unprotected sex (adjusted odds ratio (AOR)=1.59, 95% confidence interval [CI]=1.00-2.53; P=0.047) and sexual violence (AOR=1.85, 95% CI=1.27-2.71; P=0.001) and to have either syphilis, Neisseria gonorrhoeae or Trichomonas vaginalis infection (AOR=1.56, 95% CI=1.00-2.41; P=0.048). HIV prevalence was higher among women having ever drunk (39.9%) than lifetime abstainers (23.2%; P<0.001), but was not associated with drinking patterns. Interventions are needed to assist female sex workers adopt safer drinking patterns. Investigation is needed for the effectiveness of such interventions in reducing unprotected sex, sexual violence and sexually transmitted infections. PMID:18005511

  3. Sex Trafficking of Women and Girls

    PubMed Central

    Deshpande, Neha A; Nour, Nawal M

    2013-01-01

    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

  4. Multiple risks among male and transgender sex workers in Pakistan.

    PubMed

    Collumbien, Martine; Chow, Jaime; Qureshi, Ayaz Ahmed; Rabbani, Aliya; Hawkes, Sarah

    2008-01-01

    Using data from a qualitative study and a subsequent quantitative survey among 918 male and transgender sex workers (MTSW), we explore the context of multiple risks they face. We show that over one-fifth of MTSW have sex with IDU clients. Combined with high levels of risk behavior and very low levels of risk reduction and knowledge, the extent of sexual networking with men who inject drugs contributes further to the sex workers' health risks. Our findings suggest that isolated interventions with single-risk groups are unlikely to be sufficient to control the spread of the epidemic in Pakistan. We highlight the need for integrated approaches to risk reduction programs among MTSW and IDUs. PMID:19856740

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

    PubMed

    Beckerleg, Susan

    2008-07-01

    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

  6. `Sex' – It's not only Women's Work: A Case for Refocusing on the Functional Role that Sex Plays in Work for both Women and Men

    PubMed Central

    Uretsky, Elanah

    2014-01-01

    Mention of the term sex work often invokes images of marginalized women at risk for HIV infection. Such images, however, are counterintuitive to the functional role intended by the movement that spawned use of the terms `sex work' and `sex worker'. This article looks at the sexual practices of men in urban China to argue for a return to a functional definition of `sex work', which was originally meant to legitimize the role sex plays in work. The progenitors of this movement intended to use `sex work' as a means to legitimize sex as an income generating activity for women involved in prostitution. I show that sex can also serve a functional role in the work-related duties of men seeking economic and political success in contemporary urban China. Men in China utilize sex as one way for demonstrating the loyalty necessary to access state-owned and controlled resources in a market economy governed under a Leninist system. Overall the article demonstrates that reclaiming perception of sex work as a functional rather than behavioral category can expand its use for preventing HIV among the broad subset of people who engage in sex as part of their work. PMID:25642103

  7. TANF workers' responses to battered women and the impact of brief worker training: what survivors report.

    PubMed

    Saunders, Daniel G; Holter, Mark C; Pahl, Lisa C; Tolman, Richard M; Kenna, Colleen E

    2005-02-01

    Battered women (n = 159) report on their experiences with their Temporary Assistance to Needy Families (TANF) case workers. Workers most often ask about physical harm, feelings of fear, and police involvement. They least often create a safety plan, give information about work exemptions, and ask whether the partner had a gun. Women's major reasons for not talking about abuse are that the worker did not ask and a fear of negative outcomes. Workers who attended 1-day training are more likely than untrained workers to discuss the women's fear and physical harm, to help develop a safety plan, and to be viewed as generally helpful. PMID:16043548

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

    PubMed

    1996-02-01

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

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

    PubMed Central

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

    2012-01-01

    Objective: The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). Materials and Methods: The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Results: Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. Conclusion: The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP. PMID:22529447

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

    PubMed

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

    2015-10-01

    HIV prevalence is disproportionately high among female sex workers compared to the general population. Many African countries lack useful data on the size of female sex worker populations to inform national HIV programmes. A female sex worker size estimation exercise using three different venue-based methodologies was conducted among female sex workers in all provinces of Rwanda in August 2010. The female sex worker national population size was estimated using capture-recapture and enumeration methods, and the multiplier method was used to estimate the size of the female sex worker population in Kigali. A structured questionnaire was also used to supplement the data. The estimated number of female sex workers by the capture-recapture method was 3205 (95% confidence interval: 2998-3412). The female sex worker size was estimated at 3348 using the enumeration method. In Kigali, the female sex worker size was estimated at 2253 (95% confidence interval: 1916-2524) using the multiplier method. Nearly 80% of all female sex workers in Rwanda were found to be based in the capital, Kigali. This study provided a first-time estimate of the female sex worker population size in Rwanda using capture-recapture, enumeration, and multiplier methods. The capture-recapture and enumeration methods provided similar estimates of female sex worker in Rwanda. Combination of such size estimation methods is feasible and productive in low-resource settings and should be considered vital to inform national HIV programmes. PMID:25336306

  11. Police-related experiences and HIV risk among female sex workers in Andhra Pradesh, India.

    PubMed

    Erausquin, Jennifer Toller; Reed, Elizabeth; Blankenship, Kim M

    2011-12-01

    Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police-FSW interactions to reduce HIV vulnerability among FSWs. PMID:22043036

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

    PubMed Central

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

    2013-01-01

    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

  13. Acceptability and feasibility of continuous diaphragm use among sex workers in Madagascar

    PubMed Central

    Behets, F; Turner, A; Van Damme, K; Rabenja, N; Ravelomanana, N; Zeller, K; Rasolofomanana, J

    2005-01-01

    Objectives: The diaphragm, a woman controlled, reusable contraceptive device, might prevent some sexually transmitted infections (STIs). We assessed the acceptability and feasibility of use of silicone Wide-Seal Arcing Diaphragms (Milex Products, Chicago, IL, USA) by sex workers in Madagascar. Methods: Over 8 weeks, we evaluated method acceptability by examining patterns of and problems with women's diaphragm use. We also evaluated several measures of study feasibility, including recruitment and follow up methods. Results: 91 women from three cities (Antananarivo, Tamatave, and Mahajanga) participated, and 87 (96%) completed follow up. At enrolment, participants reported a median of six sex acts with five clients in the previous week. During the follow up period, participants reported a median of three sex acts with three clients during the previous 2 days, and self reported continuous diaphragm use during the previous day increased from 87% to 93%. Seven women became pregnant (incidence 53 pregnancies per 100 woman years). Self reported use of male condoms and diaphragms was fairly constant over the study period: women reported condom use in 61% to 70% of acts and diaphragms in 95% to 97% of acts. The number of participants reporting diaphragm problems decreased from 15 (16%) at the first visit to six (7%) at the final visit. 20 women (22%) needed replacement devices during follow up because their original diaphragms were lost, were the wrong size, or became seriously damaged. Conclusions: Given the high use and steady decrease in reported problems during the study, we believe diaphragms are acceptable and feasible in this resource poor, low education sex worker population. PMID:16326849

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

    PubMed

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

    2015-01-17

    Male sex workers who sell or exchange sex for money or goods encompass a very diverse population across and within countries worldwide. Information characterising their practices, contexts where they live, and their needs is limited, because these individuals are generally included as a subset of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. Male sex workers, irrespective of their sexual orientation, mostly offer sex to men and rarely identify as sex workers, using local or international terms instead. Growing evidence indicates a sustained or increasing burden of HIV among some male sex workers within the context of the slowing global HIV pandemic. Several synergistic facilitators could be potentiating HIV acquisition and transmission among male sex workers, including biological, behavioural, and structural determinants. Criminalisation and intersectional stigmas of same-sex practices, commercial sex, and HIV all augment risk for HIV and sexually transmitted infections among male sex workers and reduce the likelihood of these people accessing essential services. These contexts, taken together with complex sexual networks among male sex workers, define this group as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights. Evidence-based and human rights-affirming services dedicated specifically to male sex workers are needed to improve health outcomes for these men and the people within their sexual networks. PMID:25059939

  15. Sex Education Attitudes and Outcomes among North American Women

    ERIC Educational Resources Information Center

    Williams, Monnica T.; Bonner, Laura

    2006-01-01

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

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

    PubMed Central

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

    2016-01-01

    Objective Peer-led outreach is a critical element of HIV and STI-reduction interventions aimed at sex workers. We study the association between peer-led outreach to sex workers and the time to utilize health facilities for timely STI syndromic-detection and treatment. Using data on the timing of peer-outreach interventions and clinic visits, we utilize an Extended Cox model to assess whether peer educator outreach intensity is associated with accelerated clinic utilization among sex workers. Methods Our data comes from 2705 female sex workers registered into Pragati, a women-in-sex-work outreach program, and followed from 2008 through 2012. We analyze this data using an Extended Cox model with the density of peer educator visits in a 30-day rolling window as the key predictor, while controlling for the sex workers’ age, client volume, location of sex work, and education level. The principal outcome of interest is the timing of the first voluntary clinic utilization. Results More frequent peer visit is associated with earlier first clinic visit (HR: 1.83, 95% CI, 1.75–1.91, p < .001). In addition, 18% of all syndrome-based STI detected come from clinic visits in which the sex worker reports no symptoms, underscoring the importance of inducing clinic visits in the detection of STI. Additional models to test the robustness of these findings indicate consistent beneficial effect of peer educator outreach. Conclusions Peer outreach density is associated with increased likelihood of–and shortened duration to–clinic utilization among female sex workers, suggesting potential staff resourcing implications. Given the observational nature of our study, however, these findings should be interpreted as an association rather than as a causal relationship. PMID:27467124

  17. Reducing Intimate and Paying Partner Violence against Women Who Exchange Sex in Mongolia: Results from a Randomized Clinical Trial

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

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

    PubMed

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

    2016-04-01

    This study aims to evaluate condom use, sexually transmitted infection (STI) screening, and knowledge of STI symptoms among female sex workers in Peru associated with sex work venues and a community randomised trial of STI control. One component of the Peru PREVEN intervention conducted mobile-team outreach to female sex workers to reduce STIs and increase condom use and access to government clinics for STI screening and evaluation. Prevalence ratios were calculated using multivariate Poisson regression models with robust standard errors, clustering by city. As-treated analyses were conducted to assess outcomes associated with reported exposure to the intervention. Care-seeking was more frequent in intervention communities, but differences were not statistically significant. Female sex workers reporting exposure to the intervention had a significantly higher likelihood of condom use, STI screening at public health clinics, and symptom recognition compared to those not exposed. Compared with street- or bar-based female sex workers, brothel-based female sex workers reported significantly higher rates of condom use with last client, recent screening exams for STIs, and HIV testing. Brothel-based female sex workers also more often reported knowledge of STIs and recognition of STI symptoms in women and in men. Interventions to promote STI detection and prevention among female sex workers in Peru should consider structural or regulatory factors related to sex work venues. PMID:25941053

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

    PubMed Central

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

    2008-01-01

    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 "Red Light Area", during a four-week period in 1999 were invited to participate in a survey involving the provision of a saliva sample for anonymous HCV testing and the self-completion of a questionnaire seeking demographic, sexual and injecting practice data. Results Of the 223 women who attended, 51% agreed to participate. Of the 98 women who provided a sufficient saliva sample, 64% (95% CI: 54%–74%) tested HCV antibody positive; 98% of those who tested positive had ever injected drugs. Adjusting for the 85% sensitivity of the saliva test, the HCV antibody prevalence among IDU sex workers sampled was 81%; a rate which is considerably higher than those recorded, contemporaneously, among Glasgow IDUs generally. Two factors were independently associated with HCV antibody positivity in saliva: ever shared needles and syringes (adjusted OR 5.7, 95% CI 2–16) and number of times imprisoned (adjusted OR 7.3, 95% CI 1.4–39, for more than five times compared to zero times). Conclusion Women who engage in street sex work to finance their drug habit are a particularly desperate, chaotic and vulnerable population. This study demonstrates that their HCV infection risk may be greater than that for other IDUs. Those responsible for designing interventions to prevent HCV infection among IDUs should consider the special needs of this group. PMID:18355407

  20. Time of Change: 1983 Handbook on Women Workers. Bulletin 298.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    This handbook on women workers, revised from the 1975 edition, provides current data related to worklife experiences of women and their economic and legal status, especially during the last half of the 1970s. In addition, historical data provide a perspective on trends in the labor force, experiences of women, and the effects of legislation on…

  1. Women migrant workers' vulnerability to HIV infection in Hong Kong.

    PubMed

    Bandyopadhyay, M; Thomas, J

    2002-08-01

    Research on population mobility and HIV/AIDS risk among migrant populations is quite limited, and research on migrant women workers' vulnerability is further limited. Hong Kong, the Special Administrative Region of China, has currently about 200,000 women migrant workers working as domestic helps. This paper reports migrant women worker's access to AIDS-related health information and health care facilities, perceptions about vulnerability, and risk behaviour profile. Data was collected through a pre-tested questionnaire from a random sample of 2,010 women migrant workers. A majority of the migrant women workers (63.6%) have been living and working in Hong Kong for between 4-10 years. Fifty-four per cent of the respondents felt that being a female they were vulnerable to HIV infection. Overall, the knowledge regarding HIV/AIDS and its route of transmission is inadequate amongst the migrant women workers in Hong Kong. It appears that AIDS-related information education and communication needs of women migrants workers are not met by the current HIV prevention and care activities in Hong Kong. The study indicates that migrant women workers who experienced sexual violence (9%) in Hong Kong perceive themselves to be 'at risk' of HIV infection. Seventy per cent of the respondents reported that they have felt discriminated against in Hong Kong, of which 42% felt discriminated against in Hong Kong hospitals. Addressing discrimination in health care settings is an essential element of AIDS prevention. The discussion urges researchers and policy makers to pay more attention to the vulnerability of migrant women workers. PMID:12204153

  2. Substance Use and HIV Among Female Sex Workers and Female Prisoners: Risk Environments and Implications for Prevention, Treatment, and Policies

    PubMed Central

    Strathdee, Steffanie A.; West, Brooke S.; Reed, Elizabeth; Moazan, Babak; Azim, Tasnim; Dolan, Kate

    2015-01-01

    Female sex workers (FSWs) and female prisoners experience elevated HIV prevalence relative to the general population because of unprotected sex and unsafe drug use practices, but the antecedents of these behaviors are often structural in nature. We review the literature on HIV risk environments for FSWs and female prisoners, highlighting similarities and differences in the physical, social, economic, and policy/legal environments that need to be understood to optimize HIV prevention, treatment, and policy responses. Sex work venues, mobility, gender norms, stigma, debt, and the laws and policies governing sex work are important influences in the HIV risk environment among FSWs, affecting their exposure to violence and ability to practice safer sex and safer drug use behaviors. Female prisoners are much more likely to have a drug problem than do male prisoners and have higher HIV prevalence, yet are much less likely to have access to HIV prevention and treatment and access to drug treatment in prison. Women who trade sex or are imprisoned and engage in substance use should not be considered in separate silos because sex workers have high rates of incarceration and many female prisoners have a history of sex work. Repeated cycles of arrest, incarceration, and release can be socially and economically destabilizing for women, exacerbating their HIV risk. This dynamic interplay requires a multisectoral approach to HIV prevention and treatment that appreciates and respects that not all women are willing, able, or want to stop sex work or drug use. Women who engage in sex work, use drugs, or are imprisoned come from all communities and deserve sustained access to HIV prevention and treatment for substance use and HIV, helping them and their families to lead healthy and satisfying lives. PMID:25978477

  3. Substance Use and HIV Among Female Sex Workers and Female Prisoners: Risk Environments and Implications for Prevention, Treatment, and Policies.

    PubMed

    Strathdee, Steffanie A; West, Brooke S; Reed, Elizabeth; Moazen, Babak; Moazan, Babak; Azim, Tasnim; Dolan, Kate

    2015-06-01

    Female sex workers (FSWs) and female prisoners experience elevated HIV prevalence relative to the general population because of unprotected sex and unsafe drug use practices, but the antecedents of these behaviors are often structural in nature. We review the literature on HIV risk environments for FSWs and female prisoners, highlighting similarities and differences in the physical, social, economic, and policy/legal environments that need to be understood to optimize HIV prevention, treatment, and policy responses. Sex work venues, mobility, gender norms, stigma, debt, and the laws and policies governing sex work are important influences in the HIV risk environment among FSWs, affecting their exposure to violence and ability to practice safer sex and safer drug use behaviors. Female prisoners are much more likely to have a drug problem than do male prisoners and have higher HIV prevalence, yet are much less likely to have access to HIV prevention and treatment and access to drug treatment in prison. Women who trade sex or are imprisoned and engage in substance use should not be considered in separate silos because sex workers have high rates of incarceration and many female prisoners have a history of sex work. Repeated cycles of arrest, incarceration, and release can be socially and economically destabilizing for women, exacerbating their HIV risk. This dynamic interplay requires a multisectoral approach to HIV prevention and treatment that appreciates and respects that not all women are willing, able, or want to stop sex work or drug use. Women who engage in sex work, use drugs, or are imprisoned come from all communities and deserve sustained access to HIV prevention and treatment for substance use and HIV, helping them and their families to lead healthy and satisfying lives. PMID:25978477

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

    PubMed Central

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

    2014-01-01

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

  5. Engagement with HIV Prevention Treatment and Care among Female Sex Workers in Zimbabwe: a Respondent Driven Sampling Survey

    PubMed Central

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

    2013-01-01

    Objective(S) To determine the HIV prevalence and extent of engagement with HIV prevention and care among a representative sample of Zimbabwean sex workers working in Victoria Falls, Hwange and Mutare. Design Respondent driven sampling (RDS) surveys conducted at each site. Methods Sex workers were recruited using respondent driven sampling with each respondent limited to recruiting 2 peers. Participants completed an interviewer-administered questionnaire and provided a finger prick blood sample for HIV antibody testing. Statistical analysis took account of sampling method. Results 870 women were recruited from the three sites. HIV prevalence was between 50 and 70%. Around half of those confirmed HIV positive were aware of their HIV status and of those 50-70% reported being enrolled in HIV care programmes. Overall only 25-35% of those with laboratory-confirmed HIV were accessing antiretroviral therapy. Among those reporting they were HIV negative, 21-28% reported having an HIV test in the last 6 months. Of those tested HIV negative, most (65-82%) were unaware of their status. Around two-thirds of sex workers reported consistent condom use with their clients. As in other settings, sex workers reported high rates of gender based violence and police harassment. Conclusions This survey suggests that prevalence of HIV is high among sex workers in Zimbabwe and that their engagement with prevention, treatment and care is sub-optimal. Intensifying prevention and care interventions for sex workers has the potential to markedly reduce HIV and social risks for sex workers, their clients and the general population in Zimbabwe and elsewhere in the region. PMID:24143203

  6. The female condom: a promising but unavailable method for Dominican sex workers, their clients, and their partners.

    PubMed

    van Dijk, Marieke G; Pineda, Diana Lara; Grossman, Daniel; Sorhaindo, Annik; García, Sandra G

    2013-01-01

    Despite evidence of the potential of the female condom as a method that effectively protects against sexually transmitted infections (STIs), HIV, and pregnancy, it is still not widely available. We conducted in-depth interviews with 18 sex workers, 15 male clients, and seven partners in the Dominican Republic to assess the acceptability of the female condom. The majority of the sex workers found the female condom acceptable and welcomed the option of a female-controlled method. Clients and partners of the sex workers were also positive about the female condom and, particularly with regard to pleasure; almost all preferred it to the male condom. These findings suggest that the female condom offers an acceptable option for protection against HIV, STIs, and pregnancy. The positive attitudes of women and men could be developed into messages in marketing campaigns for the female condom, targeting not only vulnerable groups but also the general population. PMID:23465398

  7. The lived experience of UK street-based sex workers and the health consequences: an exploratory study.

    PubMed

    Mellor, Rebecca; Lovell, Andrew

    2012-09-01

    The complex, difficult lives and subsequent health issues of street-based female sex workers are well documented. This paper explores the health needs of a group of sex workers in one geographical locality in the north-west of England. Interviews were conducted with a number of women currently engaged in sex work, with the aim of identifying factors maintaining them in this work and examining their experience of health and health-related services. A thematic analysis revealed considerable life circumstance complexity, with violence, drugs, alcohol and housing problems being prevalent factors. The combination of such factors compounds the likelihood of the women's social exclusion. Other themes related to the casual perception the women had of their own health needs, their generally poor experience of services and the demonstrable impact of one specific service in supporting a group so reluctant to engage. The study suggests poor understanding of the complex needs of street-based sex workers by both services and professionals, particularly a failure to engage with the reality of these women's lives and the factors that maintain them in this work. PMID:21727076

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

    PubMed

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

    2013-01-01

    Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange) contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31) in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1) reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2) mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3) provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings. PMID:24023661

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

    PubMed Central

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

    2013-01-01

    Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange) contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010–2011, we conducted in-depth interviews with sex workers (n = 31) in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1) reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2) mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3) provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings. PMID:24023661

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

    PubMed Central

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

    2016-01-01

    Introduction Sex workers are disproportionately infected with HIV worldwide. Significant focus has been placed on understanding the structural determinants of HIV and designing related interventions. Although there is growing international evidence that policing is an important structural HIV determinant among sex workers, the evidence has not been systematically reviewed. Methods We conducted a systematic review of quantitative studies to examine the effects of policing on HIV and STI infection and HIV-related outcomes (condom use; syringe use; number of clients; HIV/STI testing and access) among cis and trans women sex workers. Databases included PubMed, Embase, Scopus, Sociological Abstracts, Popline, Global Health (OVID), Web of Science, IBSS, IndMed and WHOLIS. We searched for studies that included police practices as an exposure for HIV or STI infection or HIV-related outcomes. Results Of the 137 peer-reviewed articles identified for full text review, 14 were included, representing sex workers' experiences with police across five settings. Arrest was the most commonly explored measure with between 6 and 45% of sex workers reporting having ever been arrested. Sexual coercion was observed between 3 and 37% of the time and police extortion between 12 and 28% across studies. Half the studies used a single measure to capture police behaviours. Studies predominantly focused on “extra-legal policing practices,” with insufficient attention to the role of “legal enforcement activities”. All studies found an association between police behaviours and HIV or STI infection, or a related risk behaviour. Conclusions The review points to a small body of evidence that confirms policing practices as an important structural HIV determinant for sex workers, but studies lack generalizability with respect to identifying those police behaviours most relevant to women's HIV risk environment. PMID:27435716

  11. Risk and Protective Factors Associated with Personal Mastery Among Sexual Minority African American Female Sex Workers

    PubMed Central

    Buttram, Mance E.; Surratt, Hilary L.; Kurtz, Steven P.

    2014-01-01

    Research among sexual minorities has traditionally examined problems such as substance use, HIV risk, mental health problems, and victimization. Among sexual minority street-based female sex workers, these vulnerabilities can be magnified. Grounded in theories of resilience, this study examines risk and protective factors associated with a high level of personal mastery among a vulnerable population of women. Data are drawn from baseline interviews from street-based African American female sex workers enrolled in a randomized intervention trial in Miami, Florida. We compare sexual minority (N=197) and heterosexual (N=365) women on measures of risk and protective factors; among sexual minority women we present logistic regression analyses which reveal that severe mental distress and HIV transmission risk are associated with low levels of personal mastery, while protective factors of transportation access and social support are associated with high levels of personal mastery. These findings suggest that these protective factors may potentially facilitate the development of personal mastery and represent beneficial avenues for intervention efforts. PMID:25530691

  12. How stigma affects healthcare access for transgender sex workers.

    PubMed

    Roche, Kirsten; Keith, Corey

    Stigmatisation of transgender sex workers (TSWs) has been recognised as contributing to illness and poorer health outcomes for this population. It could be argued that part of this stigma comes from nurses. With their frequent face-to-face interactions with their clients, nurses come from a unique place of power to influence the health outcomes and the feelings and thoughts that transgender sex workers have about the healthcare system in general, and whether or not they feel safe accessing it. Because there is very limited literature that explores stigmatisation of TSWs on the part of nurses, the needs of TSWs are scarcely being addressed. This article addresses why a higher proportion of transgender people participate in sex work compared with people in the general population; how stigmatisation by nurses affects access to healthcare resources for TSWs; why nurses experience stigmatising thoughts and beliefs; and how nurses can create a positive impact on TSW clients. The authors have found that, although there are a number of complex reasons for bias and stigma, it is extremely important for the health of these clients that nurses put empathy, sensitivity and compassion at the forefront of their practice. PMID:25426530

  13. Factors associated with establishment-based female sex workers accessing health care services in Shanghai.

    PubMed

    Pan, Rong; Mao, Limin; He, Na; Zhang, Jing; Chen, Kun; Liao, Cuiqin; Tang, Xian; Gong, Xiangzhen; Blaxland, Megan; de Wit, John

    2015-01-01

    Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18-52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32-4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84-7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21-0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20-0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05-0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds

  14. Predictors of Sexual Risk Reduction Among Mexican Female Sex Workers Enrolled in a Behavioral Intervention Study

    PubMed Central

    Strathdee, Steffanie A.; Mausbach, Brent; Lozada, Remedios; Staines-Orozco, Hugo; Semple, Shirley J.; Abramovitz, Daniela; Fraga-Vallejo, Miguel; de la Torre, Adela; Amaro, Hortensia; Martínez-Mendizábal, Gustavo; Magis-Rodríguez, Carlos; Patterson, Thomas L.

    2009-01-01

    Objective We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico–United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention. Methods Four hundred nine HIV-negative FSWs aged ≥18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies). Results Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users. Conclusions Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation. PMID:19384101

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2011-06-01

    The objective of this study was to assess the factors associated with methamphetamine (MA) use, syphilis, and unprotected sex among female sex workers from different type of venues in Qingdao City, Shandong Province of China. Three consecutive cross-sectional surveys provided information on demographics, sexual and drug use behaviors, and HIV-related services. Of 1187 participants, 3.0% were infected with syphilis; 30.2% ever used MA; 58.3% ever had unprotected commercial sex in the past month. The prevalence rates of syphilis and MA use were 2.5% and 33.0% for participants recruited from saunas, night clubs, bars or hotels; 2.7% and 28.3% for hair/beauty salon-based participants; and 4.5% and 15.8% for street-based participants. Street-based MA users were more likely to be single, non-Shandong residents, have first lifetime sex act at younger age, and recruited in 2008 (vs. 2006). Saunas, night clubs, bars, or hotels-based MA users were more likely to be younger, sex debut at younger age, have longer duration of sex work, have unprotected commercial sex, and be syphilis-infected. Hair/beauty salon-based MA users were more likely to be non-Shandong residents, younger, and to have unprotected commercial sex. Syphilis among the sauna-, night club-, bar-, or hotel-based participants was associated with MA use and ever receipt of HIV testing. Syphilis among the hair/beauty salon-based participants was associated with longer duration of sex work. MA users who frequent commercial sex venues are engaging in high-risk behaviors and are at risk for syphilis/other sexually transmitted diseases. Better-targeted intervention efforts to curtail the epidemics of MA use and HIV/syphilis should therefore take cognizance of the role of commercial sex venues as focal points of MA use and syphilis/sexually transmitted disease transmission. PMID:21660748

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

    PubMed Central

    Deschamps, Marie Marcelle; Zorrilla, Carmen D.; Morgan, Cecilia A.; Donastorg, Yeycy; Metch, Barbara; Madenwald, Tamra; Joseph, Patrice; Severe, Karine; Garced, Sheyla; Perez, Marta; Escamilia, Gina; Swann, Edith; Pape, Jean William

    2014-01-01

    Objective To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. Methods A prospective cohort study was conducted in 2009–2012 among 799 female commercial sex workers in the Dominican Republic, Haiti, and Puerto Rico. Minimum eligibility criteria included exchange of sex for goods, services, or money in the previous 6 months and unprotected vaginal or anal sex with a man in the previous 6 months. Sites used local epidemiology to develop more stringent eligibility criteria and recruitment strategies. Participants were asked questions about HIV/AIDS and their level of concern about participating in an HIV vaccine trial. Logistic regression modeling was used to assess predictors of prevalent HIV infection and willingness to participate in a future HIV vaccine study. Results HIV prevalence at screening was 4.6%. Crack cocaine use [odds ratio (OR) = 4.2, 95% confidence interval (CI) (1.8–9.0)] was associated with and having sex with clients in a hotel or motel [OR = 0.5, CI (0.3–1.0)] was inversely associated with HIV infection. A total of 88.9% of enrolled women were definitely or probably willing to participate in a future HIV vaccine trial. Conclusions This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial. PMID:24096973

  18. Gender relations and risks of HIV transmission in South India: the discourse of female sex workers' clients.

    PubMed

    Aubé-Maurice, Joanne; Clément, Michèle; Bradley, Janet; Lowndes, Catherine M; Gurav, Kaveri; Alary, Michel

    2012-01-01

    In South India, where the majority of the country's cases of HIV are concentrated, transmission of infection occurs mainly within networks composed of female sex workers, their clients and the other sexual partners of the latter. This study aims to determine how gender relations affect the risks of HIV transmission in this region. Semi-structured interviews were carried out with 30 clients and analysed qualitatively. Results show that clients perceive sexual relations with female sex workers as a vice involving loss of control and contact with women at the bottom of the social ladder. Paradoxically, this sometimes allows them to conform to the masculine ideal, in giving sexual satisfaction to a woman, in a context of incompatibility between the idealised and actual masculine and feminine archetypes. Attitudes to condoms, affected by various facets of the client-female sex worker relationship, are indicators of the link between this relationship and the risks of contracting HIV. The results suggest that there is a need for expanding targeted HIV prevention towards clients and female sex workers alongside more general interventions on gender issues, particularly among young people, focusing on the structural elements moulding current relations between men and women, with particular consideration of local cultural characteristics. PMID:22574910

  19. The rates of HIV-1 superinfection and primary HIV-1 infection are similar in female sex workers in Uganda

    PubMed Central

    Vandepitte, Judith; Wendel, Sarah K.; Ndembi, Nicaise; Bukenya, Justine; Nakubulwa, Susan; Grosskurth, Heiner; Parry, Chris M.; Martens, Craig; Bruno, Daniel; Porcella, Stephen F.; Quinn, Thomas C.; Kaleebu, Pontiano

    2016-01-01

    Objective To determine and compare the rates of HIV superinfection and primary HIV infection in high-risk female sex workers in Kampala, Uganda. Design A retrospective analysis of individuals who participated in a clinical cohort study among high-risk female sex workers in Kampala, Uganda. Methods Plasma samples from HIV-infected female sex workers (FSW) in Kampala, Uganda were examined with next-generation sequencing of the p24 and gp41HIV genomic regions for the occurrence of superinfection. Primary HIV incidence was determined from initially HIV-uninfected FSW from the same cohort, and incidence rate ratios were compared. Results The rate of superinfection in these women (7/85; 3.4/100py) was not significantly different from the rate of primary infection in the same population (3.7/100py; IRR=0.91, p=0.42). Seven women also entered the study dual infected (16.5% either dual or superinfected). The women with any presence of dual infection were more likely to report sex work as their only source of income (p=0.05), and trended to be older and more likely to be widowed (p=0.07). Conclusions In this cohort of female sex workers, HIV superinfection occurred at a high rate and was similar to that of primary HIV infection. These results differ from a similar study of high-risk female bar-workers in Kenya that found the rate of superinfection to be significantly lower than the rate of primary HIV infection. PMID:25265078

  20. Sex Differences in Relationship between Stress Responses and Lifestyle in Japanese Workers

    PubMed Central

    Suzuki, Akiko; Akamatsu, Rie

    2014-01-01

    Background This study examined the relationships between stress responses and lifestyle, including sleeping and eating behaviors, in Japanese workers according to sex. Methods Questionnaires about stress responses and lifestyle were completed by 3,017 workers in a financial enterprise (41.5% men, 58.5% women). Data were collected in Japan in August 2011. Participants were classified into stress and nonstress groups. Relationships between stress responses and lifestyle were investigated using logistic regression analysis with stress response as a dependent variable. Results There were 254 (8.4%) participants in the stress group and 2,763 (91.6%) in the nonstress group. The results showed that sleeping for shorter periods [odds ratio (OR) = 2.97, 95% confidence interval (CI): 1.58–5.60] was associated with stress responses in women, whereas we found no relationship between stress responses and lifestyle among men. However, working overtime was associated with stress responses in men (OR = 2.71, 95% CI: 1.43–5.15). Eating at night was associated with stress responses in the univariate analysis (men: OR = 2.10, 95% CI: 1.16–3.80; women: OR = 1.61, 95% CI: 1.09–2.39). Conclusion This study showed that stress responses were related to lifestyle among women but not among men. Among women, stress responses were related to sleeping for shorter periods, whereas they were related to working long hours among men. In addition, stress responses were related to eating at night in the univariate analysis, although this relationship was not seen in the multivariate analysis, in either sex. PMID:24932418

  1. Vaginal Douching, Condom Use, and Sexually Transmitted Infections Among Chinese Female Sex Workers

    PubMed Central

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

    2007-01-01

    Background and Objective Vaginal douching has been hypothesized to increase a woman’s risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited. Study A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county. Results Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV. Conclusion Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women’s misconception about the effectiveness of douching and discourage women from douching through educational activities. PMID:16254545

  2. Women's Work, Men's Work. Sex Segregation on the Job.

    ERIC Educational Resources Information Center

    Reskin, Barbara F., Ed.; Hartmann, Heidi I., Ed.

    The literature on sex segregation in the workplace was reviewed to determine how it could be used in formulating policy in the area of sex fairness in the American labor market. The committee found that although women's occupational options have increased dramatically in the past decade, sex segregation is still widespread. Among those factors…

  3. University Student Beliefs about Sex: Men vs. Women

    ERIC Educational Resources Information Center

    Knox, David; Zusman, Marty; McNeely, Andrea

    2008-01-01

    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…

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

    PubMed

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

    2010-10-01

    The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pleasure or "sensation seeking", and freedoms from the burden of marriage as perceived benefits of sex work. We also found that penile-vaginal sex was not universal in male-female sexual encounters; and motivation by sex workers for non-condom use included intention to earn more money from unprotected sex, desire for sexual pleasure, and not having time to use condoms. Many sex workers expressed doubts over an alternative lifestyle, even if that change afforded them money to meet their daily necessities. The findings from this study suggest that treating sex workers as a homogenous group that is driven into, or maintain sex work only because of poverty may be problematic, and could hamper HIV-relevant interventions aimed at reducing their vulnerability to sexually transmitted infections. PMID:21409304

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

    PubMed

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

    2014-04-01

    Agricultural work is hazardous, and immigrant workers perform the majority of production tasks, yet there are few data describing agricultural work and use of protective measures by demographic characteristics. We examined cross-sectionally the influence of region of birth (Mexico vs. Central America) and sex on agricultural work and use of protective measures in the MICASA cohort of immigrant Latino farm workers in Mendota, California. Of 445 participants, 293 (65.8%) were born in Mexico (163 men, 130 women) and 152 (34.2%) were born in Central America (80 men, 72 women). Men worked on average 74.4 more days than women (95% CI 62.0, 86.9) and were more likely to perform tasks requiring high levels of training or strength, such as machine operation, pruning, picking, planting, and irrigation; more likely to work in dusty conditions; and more likely to work directly with pesticides. Women predominated in packing. Respondents from Mexico were more likely to work with tomatoes and less likely to work with melon and lettuce. Central America-born respondents were less likely to engage in planting, irrigation, and pesticide use. Use of task-appropriate personal protective measures on at least a half-time basis was rare, with the exception of persons working with pesticides (a group limited to men) and for facial scarves among Central American women. Further work should focus on identifying barriers to use of preventive measures and programs to further their use. Educational models accounting for cultural factors and driving social norm change, employer engagement, and use of community health workers (promotores) may be helpful in promoting use of preventive measures. PMID:24897916

  6. Correlates of partner violence among female street-based sex workers: substance abuse, history of childhood abuse, and HIV risks.

    PubMed

    El-Bassel, N; Witte, S S; Wada, T; Gilbert, L; Wallace, J

    2001-01-01

    This study examines the prevalence of physical and sexual abuse by intimate and commercial sexual partners among street-based sex workers and explores correlates of partner abuse by commercial partners using the following factors: sociodemographics, substance abuse, sexual behavior, and physical and sexual childhood abuse. One hundred thirteen street sex workers were recruited from December 1996 through May 1997 while receiving services from the Foundations for Research on Sexually Transmitted Diseases (FROST'D), a nonprofit organization based in New York City. Partner abuse is a common occurrence among street sex workers. Two of three street prostitutes have experienced lifetime physical or sexual abuse by either an intimate or commercial partner. In addition, one of eight reported physical and sexual abuse by both intimate and commercial partners during her lifetime. Women who were homeless in the last year, those who reported exchanging for drugs and money as their main source of income, used injection drugs in the past year and had sex in crack houses, and who were human immunodeficiency virus (HIV)-positive were more likely to be report combined physical and sexual abuse. Understanding the relationship between partner violence, victim's substance abuse, and HIV-risk behavior is important for the development of public policies and treatment and prevention strategies to address the constellation of problems that drug-using female street sex workers face. PMID:11177587

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

    PubMed

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

    2004-11-01

    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

  8. "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

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

    2015-01-01

    Worldwide, female sex workers (FSWs) have high rates of HIV. Many factors that escalate their risk lay outside of their control, primarily in the environments in which they practice sex. An understudied yet powerful risk environment is that of police. We qualitatively explored sex workers' interactions with police in their personal and professional lives. Thirty-five FSWs were purposively sampled in Baltimore, MD, in 2012. Women discussed experiences of police verbal harassment, sexual exploitation, extortion, and a lack of police responsiveness to 911 calls in emergencies, largely partner violence. Women's mistrust of police was often developed at an early age and further reinforced by interactions in their personal and professional lives. The study underscores the need for targeting police in reducing sex workers' HIV and other risks. The case for police's role in generating risk is evident, which could be addressed through structural interventions targeting both police practices and policies. PMID:25360822

  9. Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk.

    PubMed

    Gysels, Marjolein; Pool, Robert; Nnalusiba, Betty

    2002-01-01

    Little is known about the background of commercial sex workers in Africa. This study investigated how women in a trading town on the trans-Africa highway in southwest Uganda become involved in commercial sex work, which factors contribute to their economic success or lack of success, and what effect life trajectories and economic success have on negotiating power and risk behaviour. Over the course of two years detailed life histories of 34 women were collected through recording open, in-depth interviews, the collection of sexual and income and expenditure diaries, visits to the women's native villages, and participant observation. The women share similar disadvantaged backgrounds and this has played a role in their move into commercial sex. They have divergent experiences, however, in their utilisation of opportunities and in the level of success they achieve. They have developed different life styles and a variety of ways of dealing with sexual relationships. Three groups of women were identified: (1) women who work in the back-street bars, have no capital of their own and are almost entirely dependent on selling sex for their livelihood; (2) waitresses in the bars along the main road who engage in a more institutionalised kind of commercial sex, often mediated by middlemen and (3) the more successful entrepreneurs who earn money from their own bars as well as from commercial sex. The three groups had different risk profiles. Due partly to their financial independence from men, women in the latter group have taken control of sexual relationships and can negotiate good sexual deals for themselves, both financially and in terms of safe sex. The poorer women were more vulnerable and less able to negotiate safer sex. A disadvantaged background and restricted access to economic resources are the major reasons for women gravitating to commercial sex work. Various aspects of personality play a role in utilising income from commercial sex to set up an economic basis that

  10. Efficacy of a Brief Behavioral Intervention to Promote Condom Use Among Female Sex Workers in Tijuana and Ciudad Juarez, Mexico

    PubMed Central

    Mausbach, Brent; Lozada, Remedios; Staines-Orozco, Hugo; Semple, Shirley J.; Fraga-Vallejo, Miguel; Orozovich, Prisci; Abramovitz, Daniela; de la Torre, Adela; Amaro, Hortensia; Martinez, Gustavo; Magis-Rodríguez, Carlos; Strathdee, Steffanie A.

    2008-01-01

    Objectives. We examined the efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. Methods. We randomized 924 female sex workers 18 years or older without known HIV infection living in Tijuana and Ciudad Juarez who had recently had unprotected sex with clients to a 30-minute behavioral intervention or a didactic control condition. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia. Results. We observed a 40% decline in cumulative sexually transmitted illness incidence (P = .049) in the intervention group. Incidence density for the intervention versus control groups was 13.8 versus 24.92 per 100 person-years for sexually transmitted illnesses combined (P = .034) and 0 versus 2.01 per 100 person-years for HIV (P < .001). There were concomitant increases in the number and percentage of protected sex acts and decreases in the number of unprotected sex acts with clients (P < .05). Conclusions. This brief behavioral intervention shows promise in reducing HIV and sexually transmitted illness risk behaviors among female sex workers and may be transferable to other resource-constrained settings. PMID:18799768

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

    PubMed

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

    2016-07-01

    The attrition of rape cases from the criminal justice system (CJS) remains high and there is a paucity of research in relation to marginalized groups. Sex workers (SWs) are vulnerable to sexual violence due to the nature of their work. They are also unlikely to report such violence to police for a range of reasons. Two stages of research sought to describe the victim, perpetrator, and offense characteristics of SW rape and to examine the attrition of these cases. All rapes and attempted rapes (N = 1,146) reported to police in a large city in the South West of England over a 21-year period were examined; 67 cases involved SWs. Data were extracted from police files in line with the variables of interest. Secondary analysis of the total number of SW rapes (n = 67) resulted in a profile of these cases. A matched pairs study revealed significant differences in victim, perpetrator, and assault characteristics between SW (n = 62) and non-sex-worker (NSW) samples (n = 62). Although no significant difference was found in terms of attrition from the CJS, SW cases were observed to secure more convictions for rape than NSW cases. The implications of the findings for practice and future research are discussed. PMID:25724877

  12. "He can be good and still have AIDS". Peer education prevents AIDS in Thai women workers.

    PubMed

    Cash, K

    1993-01-01

    Focus group discussions and interviews with 240 single adolescent women who had migrated to northern Thailand to work in the garment industry revealed a high incidence of unprotected premarital sex and widespread misinformation about the risk of acquired immunodeficiency syndrome (AIDS). Many believed that "good people" could not get AIDS and that condoms were men's concern, for use with prostitutes rather than girlfriends. In response, an educational program was designed for these young factory workers with the aim of providing accurate information and encouraging women to insist on protected sex. Peer education was selected as the strategy most likely to promote participatory learning, skill acquisition, and emotional support. Educational materials were interactive and based on problem-solving. A comic book featured an invisible flying condom that instructed young women how to negotiate condom use; a romantic novel about a young migrant factory worker addressed the false notion that "good men" cannot become infected with AIDS. The peer education program lasted for 3 months, after which participants received a certificate. Post-program evaluation indicated widespread acceptance of condoms as a contraceptive option for women and enhanced relational skills in negotiating for safe sex. PMID:12345370

  13. HIV-related risk perception among female sex workers in Nigeria

    PubMed Central

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

    2011-01-01

    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

  14. Determinants of condom use in female sex workers in Surabaya, Indonesia.

    PubMed

    Joesoef, M R; Kio, D; Linnan, M; Kamboji, A; Barakbah, Y; Idajadi, A

    2000-04-01

    In the developing world condom use among sex workers and their clients plays a dominant role in the transmission of HIV/STD. In Surabaya, Indonesia, data from the 1993 STD prevalence survey in female sex workers (brothels, street, massage parlours, barber shops, call-girl houses, and nightclubs) reveal that only 5% (33/692) of the brothel workers and 14% (25/177) of the street walkers had condoms in their possession at the time of the interview. During the last paid sexual intercourse, sex workers from the brothels, streets, and nightclubs used condoms infrequently (14%, 20%, and 25%, respectively). Sex workers from massage parlours, barber shops, and call girls were about 5 to 3 times more likely to use condoms than sex workers from nightclubs (adjusted odds ratio of 3.5, 4.9, and 4.2, respectively); thus condom promotion programmes should be targeted at sex workers at brothels, streets, and nightclubs. Programmes should include: (1) free distribution of condoms to sex establishments at the initial stage, and condom social marketing at later stages; (2) penalties, including legal sanctions, against any sex establishments that do not consistently use condoms; (3) participation of brothel owners and madams in encouraging sex workers to consistently have clients use condoms during sexual intercourse; and (4) establishment of sentinel surveillance to monitor STD/HIV and condom-use compliance. PMID:10772092

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

    PubMed

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

    2013-10-01

    Negotiation for condom use by female sex workers with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 female sex workers; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the 7 days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street-based female sex workers, respectively. Overall, 28.1% of female sex workers negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2-2.0) and self-perceived risk of human immunodeficiency virus infection (AOR, 1.8 95% CI, 1.6-2.1) were positive predictors for condom negotiation. Compared to the hotel-based female sex workers, street (AOR, 0.6; 95% CI, 0.4-0.9) and brothel-based female sex workers (AOR, 0.7; 95% CI, 0.5-0.9) were less likely to negotiate for condom use. Female sex workers in Bangladesh are at high risk for sexually transmitted infection / human immunodeficiency virus infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by female sex workers, and should be strengthened in commercial sex venues. PMID:23970599

  16. Rape, sex partnership, and substance use consequences in women veterans.

    PubMed

    Booth, Brenda M; Mengeling, Michelle; Torner, James; Sadler, Anne G

    2011-06-01

    The association of rape history and sexual partnership with alcohol and drug use consequences in women veterans is unknown. Midwestern women veterans (N = 1,004) completed a retrospective telephone interview assessing demographics, rape history, substance abuse and dependence, depression, and posttraumatic stress disorder (PTSD). One third met lifetime criteria for substance use disorder (SUD), half reported lifetime completed rape, a third childhood rape, one quarter in-military rape, 11% sex with women. Lifetime SUD was higher for women with rape history (64% vs. 44%). Women with women as sex partners had significantly higher rates of all measures of rape, and also lifetime substance use disorder. Postmilitary rape, sex partnership, and current depression were significantly associated with lifetime SUD in multivariate models (odds ratio = 2.3, 3.6, 2.1, respectively). Many women veterans have a high need for comprehensive mental health services. PMID:21567476

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

    PubMed

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

    2014-01-01

    A qualitative study was conducted to obtain a detailed understanding of two key determinants of condom breakage - 'rough sex' and poor condom fit - identified in a recent telephone survey of female sex workers, in Bangalore, India. Transcripts from six focus-group discussions involving 35 female sex workers who reported condom breakage during the telephone survey were analysed. Rough sex in different forms, from over-exuberance to violence, was often described by sex workers as a result of clients' inebriation and use of sexual stimulants, which, they report, cause tumescence, excessive thrusting and sex that lasts longer than usual, thereby increasing the risk of condom breakage. Condom breakage in this setting is the result of a complex set of social situations involving client behaviours and power dynamics that has the potential to put the health and personal lives of sex workers at risk. These findings and their implications for programme development are discussed. PMID:24588078

  18. A Venue Analysis of Predictors of Alcohol Use Prior to Sexual Intercourse among Female Sex Workers in Senggigi, Indonesia

    PubMed Central

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

    2010-01-01

    Background Female sex workers' (FSWs') use of alcohol, a known disinhibitor to risk behavior, has been largely understudied. Knowledge of how various sex work venues influence FSW's alcohol consumption before engaging in commercial sex is even rarer. Our analysis identifies those factors across three types of sex-work venues that predict alcohol use among FSWs prior to paid sexual intercourse with clients. Our data were collected through structured interviews with FSWs engaging in commercial sex in Senggigi Beach, Lombok Island in the eastern Indonesian province of West Nusa Tenggara. Methods Employing a cross sectional and multilevel design, three categories of venues where FSWs meet clients in Senggigi were sampled: (1) discotheques and bars (freelance), (2) brothels, and (3) recreational enterprises such as karaoke establishments and massage parlors. The sample consisted of 115 women “nested” within 16 sex work venues. The FSWs reported on 326 clients interactions. Results Results show that FSWs consumed alcohol before commercial sex with 157 (48%) of the 326 clients interactions. Alcohol use varied by differences in HIV policies and services offered at the sex work venue, the FSW's educational level and age, and client characteristics. Conclusion Alcohol use is common prior to sexual intercourse among FSWs and their clients in Senggigi, and the venue where FSWs meet their clients influences the women's alcohol use. Freelancers were likelier to use alcohol than those who work at brothels and recreational enterprises. Given the recognized links between alcohol use prior to sex and high risk behavior, HIV prevention programs that discourage alcohol use should be introduced to both women who engage in commercial sex and also sex-work venue managers, owners, and clients. PMID:20956075

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

    PubMed Central

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

    2010-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

    Griesel, Dorothee; Yuille, John C

    2012-01-01

    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

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

    PubMed

    Forbes, Anna

    2015-05-01

    Sex workers remain a vulnerable population at risk for HIV acquisition and transmission. Research suggests that interventions at the individual level, such as condom distribution, are less effective in preventing HIV among sex workers than structural changes such as allowing safer work settings and reducing the harassment and abuse of sex workers by clients and police. In the US, HIV incidence has not declined in the last decade. This may be due in part to its policy of wilful ignorance about sex work, but the data to resolve the question simply do not exist. Political actions such as PEPFAR's prostitution pledge and a congressional campaign against "waste, fraud and abuse" in research are products of an ideological environment that suppresses research on HIV prevention and treatment needs of sex workers. Even basic prevalence data are missing because there is no "sex worker" category in the US National HIV Behavior Surveillance System. However, international efforts are taking a public health approach and are calling for decriminalization of sex work, as the most effective public health strategy for reducing HIV incidence among sex workers. Although such an approach is not yet politically feasible in the US, some urgent practical policy changes can be implemented to improve data collection and generation of evidence to support HIV prevention and treatment programs targeting sex workers. PMID:26278830

  3. Women Workers: From Policy to Practice.

    ERIC Educational Resources Information Center

    Walsh, G.

    1987-01-01

    Discusses societal pressures, including the need for child care, that have resulted in the increased participation of women in the labor force. Outlines steps to increase women's participation in the labor movement and lists positive actions that some unions have already taken. (CH)

  4. Puerto Rican Women as Workers and Writers.

    ERIC Educational Resources Information Center

    Vazquez, Blanca, Ed.

    1989-01-01

    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…

  5. Women Workers: Trends & Issues, 1993 Handbook.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    This handbook offers a comprehensive view of the labor force activity of women in the United States and describes a range of legal and socioeconomic developments that have had an effect upon women's participation and progress in the work force. Through numerous statistical charts and tables, the book depicts change and reactions to change in the…

  6. An effective HIV risk-reduction protocol for drug-using female sex workers.

    PubMed

    Surratt, Hilary L; Inciardi, James A

    2010-01-01

    Female sex workers are especially vulnerable to HIV infection, particularly those who use drugs and engage in street-based sex exchange. This study examines the risk behaviors and HIV serostatus of 806 drug-using female sex workers in Miami and assesses the relative impact of two HIV and hepatitis prevention interventions on changes in risk behavior. Drug-using sex workers were recruited using targeted sampling strategies and were randomly assigned to the NIDA Standard Intervention or an innovative Sex Worker Focused (SWF) Intervention. Outcome analyses indicate that both groups benefited from participation in the intervention trial. However, the SWF Intervention was found to be more efficacious in regard to reductions in unprotected oral sex and sexual violence. PMID:20391059

  7. Genotypic characterization of Trichomonas vaginalis isolates among women who have sex with women in sexual partnerships.

    PubMed

    Muzny, Christina A; Rivers, Charles A; Mena, Leandro A; Schwebke, Jane R

    2012-07-01

    The random amplified polymorphic DNA technique was used to delineate the genetic relatedness of Trichomonas vaginalis isolates among 3 pairs of mutually infected women who have sex with women in sexual partnerships. One of the 3 pairs of women shared a T. vaginalis isolate with the same random amplified polymorphic DNA banding patterns. Shared use of washcloths to cleanse the vaginal area after receptive oral sex was the most likely method of T. vaginalis transmission among this pair of women. PMID:22706219

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

    PubMed

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

    2011-01-01

    Sex work research continues to be characterised by debates around decriminalization. Central to these debates are claims about the agency of those involved in the sex trade. Some researchers argue that individuals involved in the sex trade are victims of structural and interpersonal constraint, whilst others depict them as workers exercising choice. Drawing on structure-agency theory, a review of legal and media accounts of the sex trade and qualitative interviews with 21 indoor sex workers in Vancouver, Canada, we argue that both of these perspectives are insufficient. Rather than reducing the sex trade to part of a binary, we suggest that it is necessary to analyse sex work through the complex interplay of both structure and agency. Specifically, structural analyses undercover the numerous ways that sex workers are controlled, observed and influenced whilst agency perspectives elicit the means that sex workers continue to exercise control in spite of disadvantage. While we do not finalise decriminalisation debates, we do critique current Canadian laws for the lack of responsiveness to the lives of sex workers and their exploitative and contradictory stance on sex work. PMID:20967651

  9. Situating HIV risk in the lives of formerly trafficked female sex workers on the Mexico-US border.

    PubMed

    Collins, Shane P; Goldenberg, Shira M; Burke, Nancy J; Bojorquez-Chapela, Ietza; Silverman, Jay G; Strathdee, Steffanie A

    2013-01-01

    Due to stigma and the psychosocial repercussions of past trauma and abuse, survivors of sex trafficking may experience increased susceptibility to violence, revictimization, and various harmful health outcomes, including HIV infection. Given the paucity of research characterizing the experiences of formerly trafficked female sex workers (FSWs), we set out to describe and contextualize perceptions of HIV risk among women who have experienced past episodes of sex trafficking and who are currently engaged in sex work in Tijuana, Mexico. Based on semi-structured interviews and ethnographic fieldwork, we describe the following interrelated themes as influencing formerly trafficked FSWs' perceptions and experiences of HIV risk: economic vulnerability; susceptibility to violence; and psychological trauma. Our findings highlight the need for HIV prevention efforts to incorporate broader structural and social interventions aimed at reducing vulnerability to violence and human rights abuses among this population and improving their general economic, psychological, and social well-being. PMID:22963518

  10. Subjectivity, hygiene, and STI prevention: a normalization paradox in the cleanliness practices of female sex workers in post-socialist China.

    PubMed

    Yu, Yeon Jung

    2013-09-01

    This article illuminates the principal mechanisms that increase the risk of STIs for female sex workers in China. It draws primarily on my 26 months of ethnographic fieldwork (2006-2009) in red-light district neighborhoods in Haikou that have become centers of internal migration in post-reform southern China. Chinese sex workers here challenge dominant representations of them as illegal, immoral, and unclean subordinates and understand themselves also as sacrificing, capable, and modern women. I show how the women's conflicted subjectivity, continuously shaped through social networks, affects their personal health decisions and, significantly, leads them to adopt clinically risky practices. I conclude by arguing that public health interventions in southern China in and around certain red-light districts should take these conflicted subjectivities into account in working to improve sex workers' health. PMID:24123232

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    2013-01-01

    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

  15. Estimating the number of sex workers in South Africa: rapid population size estimation.

    PubMed

    Konstant, Tracey L; Rangasami, Jerushah; Stacey, Maria J; Stewart, Michelle L; Nogoduka, Coceka

    2015-02-01

    Although recognized as a vulnerable population, there is no national population size estimate for sex workers in South Africa. A rapid sex worker enumeration exercise was undertaken in twelve locations across the country based on principles of participatory mapping and Wisdom of the Crowd. Sites with a range of characteristics were selected, focusing on level of urbanisation, trucking, mining and borders. At each site, sex worker focus groups mapped local hotspots. Interviews with sex workers at identified hotspots were used to estimate the numbers and genders of sex workers working in each. Estimates provided in the literature were combined with enumeration exercise results to define assumptions that could be applied to a national extrapolation. A working estimate was reached of between 131,000 and 182,000 sex worker in South Africa, or between 0.76 and 1 % of the adult female population. The success of the exercise depended on integral involvement of sex worker peer educators and strong ethical considerations. PMID:25582921

  16. Building healthcare workers' confidence to work with same-sex parented families.

    PubMed

    von Doussa, Henry; Power, Jennifer; McNair, Ruth; Brown, Rhonda; Schofield, Margot; Perlesz, Amaryll; Pitts, Marian; Bickerdike, Andrew

    2016-06-01

    This article reports on a qualitative study of barriers and access to healthcare for same-sex attracted parents and their children. Focus groups were held with same-sex attracted parents to explore their experiences with healthcare providers and identify barriers and facilitators to access. Parents reported experiencing uncomfortable or anxiety-provoking encounters with healthcare workers who struggled to adopt inclusive or appropriate language to engage their family. Parents valued healthcare workers who were able to be open and honest and comfortably ask questions about their relationships and family. A separate set of focus groups were held with mainstream healthcare workers to identity their experiences and concerns about delivering equitable and quality care for same-sex parented families. Healthcare workers reported lacking confidence to actively engage with same-sex attracted parents and their children. This lack of confidence related to workers' unfamiliarity with same-sex parents, or lesbian, gay and bisexual culture, and limited opportunities to gain information or training in this area. Workers were seeking training and resources that offered information about appropriate language and terminology as well as concrete strategies for engaging with same-sex parented families. For instance, workers suggested they would find it useful to have a set of 'door opening' questions they could utilize to ask clients about their sexuality, relationship status or family make-up. This article outlines a set of guidelines for healthcare providers for working with same-sex parented families which was a key outcome of this study. PMID:25736035

  17. Pregnancy intentions among female sex workers: Recognising their rights and wants as mothers

    PubMed Central

    DUFF, Putu; SHOVELLER, Jeannie; FENG, Cindy; OGILVIE, Gina; MONTANER, Julio; SHANNON, Kate

    2016-01-01

    Objective To better understand the prevalence and correlates of pregnancy intentions among female sex workers (FSWs). Design Cross-sectional analysis using data from an open prospective cohort of street and off-street FSWs in Vancouver, Canada, in partnership with local sex work and community agencies. Methods FSWs were recruited through outreach to street and off-street locations (e.g., massage parlours, micro-brothels) and completed interviewer-administered questionnaires and HIV/STI testing. Bivariable and multivariable logistic regression was used to evaluate correlates of pregnancy intention, based on a “yes” versus “no” response to “are you planning on have any (any more) children in the future?”. Results Of the 510 women, 394 (77.3%) reported prior pregnancy, with 140 (27.5%) of the entire sample reporting positive pregnancy intentions. 35.3% were Caucasian, and 26.3% were Asian/visible minority, with no differences in pregnancy intention by ethnicity or HIV status. 38.4% reported Canadian Aboriginal ancestry. In our final multivariable model, servicing clients in formal indoor settings, inconsistent condom use by clients, younger age, and intimate partner violence (IPV) were associated with pregnancy intention. Conclusions FSWs may have pregnancy intention levels similar to that of women in other occupations. Policy changes are needed to improve FSWs’ access to integrated HIV and reproductive health services and harm reduction services, particularly for FSWs experiencing IPV. PMID:25056256

  18. Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners

    PubMed Central

    Bazzi, Angela Robertson; Martinez, Gustavo; Rangel, M. Gudelia; Ulibarri, Monica D.; Fergus, Kirkpatrick B.; Amaro, Hortensia; Strathdee, Steffanie A.

    2015-01-01

    Objectives. We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico–US border. Methods. From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. Results. Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. Conclusions. Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners’ HIV risk. HIV interventions should consider the emotional quality of sex workers’ intimate relationships. PMID:26066947

  19. Seeking Authenticity: Women and Learning in the Catholic Worker Movement

    ERIC Educational Resources Information Center

    Parrish, Marilyn McKinley; Taylor, Edward W.

    2007-01-01

    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,…

  20. Improving the Welfare of Women Factory Workers: Lessons from Indonesia.

    ERIC Educational Resources Information Center

    White, Mary C.

    1990-01-01

    Attention to the quality of the working environment for women factory workers can make a real contribution to productivity. The example of an Indonesian project that introduced low-cost workplace improvements and provided health instruction shows the feasibility and effectiveness of such efforts, provided there is a clear commitment from…

  1. Underage and underserved: reaching young women who sell sex in Zimbabwe

    PubMed Central

    Busza, Joanna; Mtetwa, Sibongile; Mapfumo, Rumbidzo; Hanisch, Dagmar; Wong-Gruenwald, Ramona; Cowan, Frances

    2016-01-01

    ABSTRACT Young women who sell sex (YWSS) in Southern Africa are highly vulnerable to HIV, as the risks of being young and female in a high prevalence setting coalesce with those of commercial sex. YWSS are less able to negotiate safe sex, more likely to have higher risk partners, and less likely to use available health services compared to older sex workers. In Zimbabwe’s national HIV programme for sex workers, fewer than 1% of clients were 15–29. We developed monthly interactive workshops for YWSS based on an Activity Pack consisting of 21 sessions organised into six modules. The aim was to encourage YWSS’ interaction with each other, build their trust, confidence and skills, and encourage uptake of clinical services. We conducted a process evaluation to assess programme strengths, identify challenges, and recommend changes. This paper presents findings synthesising programme records with qualitative data and discusses feasibility, acceptability, and outputs during the pilot phase. In total, 143 YWSS attended meetings and most were from the target 15–19-year-old age group. Participants enjoyed the sessions and reported improved cooperation, willingness to negotiate with clients, and self-reflection about their futures. Staff found facilitating sessions easy and activities clear and appropriate. Challenges included identifying appropriate referrals, initial recruitment of women in some sites, and managing participants’ requests for financial compensation. The number of clients aged 15–19 increased at sex worker clinics in all sites. This programme is the first to target YWSS in Zimbabwe to address their disproportionately low service use. It proved feasible to staff and acceptable to participants over a one-year period. Given enhanced vulnerability of YWSS, this programme provides one workable model for reaching this underserved group. PMID:27391994

  2. Underage and underserved: reaching young women who sell sex in Zimbabwe.

    PubMed

    Busza, Joanna; Mtetwa, Sibongile; Mapfumo, Rumbidzo; Hanisch, Dagmar; Wong-Gruenwald, Ramona; Cowan, Frances

    2016-03-01

    Young women who sell sex (YWSS) in Southern Africa are highly vulnerable to HIV, as the risks of being young and female in a high prevalence setting coalesce with those of commercial sex. YWSS are less able to negotiate safe sex, more likely to have higher risk partners, and less likely to use available health services compared to older sex workers. In Zimbabwe's national HIV programme for sex workers, fewer than 1% of clients were 15-29. We developed monthly interactive workshops for YWSS based on an Activity Pack consisting of 21 sessions organised into six modules. The aim was to encourage YWSS' interaction with each other, build their trust, confidence and skills, and encourage uptake of clinical services. We conducted a process evaluation to assess programme strengths, identify challenges, and recommend changes. This paper presents findings synthesising programme records with qualitative data and discusses feasibility, acceptability, and outputs during the pilot phase. In total, 143 YWSS attended meetings and most were from the target 15-19-year-old age group. Participants enjoyed the sessions and reported improved cooperation, willingness to negotiate with clients, and self-reflection about their futures. Staff found facilitating sessions easy and activities clear and appropriate. Challenges included identifying appropriate referrals, initial recruitment of women in some sites, and managing participants' requests for financial compensation. The number of clients aged 15-19 increased at sex worker clinics in all sites. This programme is the first to target YWSS in Zimbabwe to address their disproportionately low service use. It proved feasible to staff and acceptable to participants over a one-year period. Given enhanced vulnerability of YWSS, this programme provides one workable model for reaching this underserved group. PMID:27391994

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

    PubMed

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

    2015-01-01

    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

  4. Women's Sex-Role Attitudes: A Historical Perspective

    ERIC Educational Resources Information Center

    Rose, Clare

    1975-01-01

    Historical, sociological, and psychological factors have influenced women's self-concepts, and their sex-role attitudes, in turn, have influenced their productivity. An empirical study of 8,000 college women supports these contentions. Colleges and universities must create an atmosphere of sexual equality that makes constituents conscious of…

  5. HIV genotyping among female sex workers in the State of Santa Catarina.

    PubMed

    Schuelter-Trevisol, Fabiana; da Silva, Marcos Vinicius; Oliveira, Cristina M; Rodrigues, Rosângela

    2007-01-01

    The objective of this study was to investigate the frequency of HIV infection among female sex workers in the port area of Imbituba (State of Santa Catarina), and to identify the viral subtype and its susceptibility to antiretroviral medications. Ninety women were interviewed between December 2003 and February 2004. Six (6.7%) were HIV-positive. Genotyping for HIV, performed on four samples, detected subtype C in three of them, which is predominant in Africa and Asia, and subtype B in one of them, which is prevalent in Brazil, USA and Europe. The results suggest that the Port of Imbituba may be one of the gateways for HIV-1 subtype C to enter Brazil, and for its dissemination to the rest of the country and the Mercosul area, along the highway BR-101. This points towards the need for preventive work to reduce the introduction and dissemination of HIV subtype C in Brazil. PMID:17653456

  6. HIV prevalence, AIDS knowledge, and condom use among female sex workers in Santiago, Chile.

    PubMed

    Barrientos, Jaime E; Bozon, Michel; Ortiz, Edith; Arredondo, Anabella

    2007-08-01

    This paper describes HIV seroprevalence, knowledge of HIV transmission, and condom use among female sex workers (FSW) attending five specialized sexually transmitted disease (STD) clinics in Santiago, Chile. A short questionnaire with socio-demographic, AIDS knowledge, and condom-use variables was administered to 626 FSW. HIV seroprevalence was estimated with a blood test sent to the Chilean Public Health Institute. ELISA was used to confirm HIV in suspected cases. HIV prevalence was 0%. FSW showed adequate overall knowledge of HIV, even better than reported for the Chilean general population on some items. Condom use with clients was high ("always" = 93.4%), although regular use with steady partners was low ("always" = 9.9%). The zero HIV seroprevalence and consistent condom use with clients confirms the positive impact of intervention strategies for FSW, increasing both correct knowledge of AIDS and condom use with clients and helping decrease these women's HIV/AIDS vulnerability. PMID:17653395

  7. Prevalence and Correlates of Nonmedical Prescription Opioid Use Among a Cohort of Sex Workers in Vancouver, Canada

    PubMed Central

    Argento, Elena; Chettiar, Jill; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2014-01-01

    Background The nonmedical use of prescription opioids (POs) is a major public health concern, causing extensive morbidity and mortality in North America. Canada has the second highest consumption rate of POs globally and data indicate nonmedical PO use (NPOU) is growing among key populations and increasingly available in street-level drug markets. Despite accumulating evidence documenting the rise of NPOU, few studies have systematically examined NPOU in Canada among key vulnerable populations, such as sex workers. This study prospectively evaluated the prevalence and correlates of NPOU within a Vancouver cohort of sex workers over three-years follow-up. Methods Data were drawn from an open prospective cohort, AESHA (An Evaluation of Sex Workers Health Access) in Metro Vancouver, Canada (2010-2013). Women were recruited through outreach from outdoor street locations and indoor venues. Bivariate and multivariable logistic regression using Generalized Estimating Equations (GEE) were used to examine social and structural correlates of NPOU over 36 months. Results Of the 692 sex workers at baseline, close to one-fifth (n=130, 18.8%) reported NPOU (injection or non-injection) in the last six months. In multivariable GEE analyses, factors independently correlated with recent NPOU were: exchanging sex while high (AOR 3.26, 95%CI 2.29-4.64), police harassment/arrest (AOR 1.83, 95%CI 1.43-2.35), intimate partner injects drugs (AOR 1.66, 95%CI 1.11-2.49), and recent physical/sexual intimate partner violence (AOR 1.65, 95%CI 1.21-2.24). Conclusion Our results demonstrate that nearly one-fifth of sex workers in Metro Vancouver report NPOU. Factors independently statistically associated with NPOU included exchanging sex while high, police harassment/arrest, a drug injecting intimate partner and recent physical/sexual intimate partner violence. The high prevalence of NPOU use among sex workers underscores the need for further prevention and management strategies tailored to this

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Ng, Junice Y. S.; Wong, Mee-Lian

    2016-01-01

    Objectives We assessed the proportion of and socio-ecological factors associated with ever having had sex with female sex workers (FSWs) among heterosexual adolescents. We also described the characteristics of the adolescents who reported inconsistent condom use with FSWs. Methods This is a cross-sectional study (response rate: 73%) of 300 heterosexually active male adolescents of 16 to 19 years attending a national STI clinic in Singapore between 2009 and 2014. We assessed the ecological factors (individual, parental, peer, school and medial influences) and sexual risk behaviors using a self-reported questionnaire. Poisson regression was used to obtain the adjusted prevalence ratios (aPR) and confidence intervals (CI). Results The proportion of heterosexual male adolescents who had ever had sex with FSWs was 39%. Multivariate analysis showed that significant factors associated with ever having had sex with FSWs were sex initiation before 16 years old (aPR 1.79 CI: 1.30–2.46), never had a sexually active girlfriend (aPR 1.75 CI 1.28–2.38), reported lower self-esteem score (aPR 0.96 CI: 0.93–0.98), higher rebelliousness score (aPR 1.03 CI: 1.00–1.07) and more frequent viewing of pornography (aPR 1.47 CI: 1.04–2.09). Lifetime inconsistent condom use with FSWs was 30%. Conclusions A significant proportion of heterosexual male adolescents attending the public STI clinic had ever had sex with FSWs. A targeted intervention that addresses different levels of influence to this behavior is needed. This is even more so because a considerable proportion of adolescents reported inconsistent condom use with FSWs, who may serve as a bridge of STI transmission to the community. National surveys on adolescent health should include the assessment of frequency of commercial sex visits and condom use with FSWs for long-term monitoring and surveillance. PMID:26808561

  10. Prevalence and Behavioral Correlates of Depression and Anxiety Among Male Sex Workers in Vietnam

    PubMed Central

    Goldsamt, Lloyd A.; Clatts, Michael C.; Giang, Le Minh; Yu, Gary

    2015-01-01

    Objectives This study assessed depression and anxiety symptoms, and their association with high-risk sexual and drug behaviors, among male sex workers in three Vietnamese cities. Methods Male sex workers ages 16 to 35 completed an interview that included the CES-D to assess depressive symptoms and the BAI to assess anxiety symptoms, as well as questions assessing drug and sexual risk practices. Results A majority of participants reported depressive symptomatology although fewer report symptoms of anxiety. Risky sexual and drug use practices predicted both types of symptoms. Conclusions Mental distress is associated with drug and sexual risk among male sex workers. PMID:25984252

  11. Sex Equity for Rural American Women.

    ERIC Educational Resources Information Center

    Holder, Birdie H.

    1982-01-01

    Cites evidence showing traditional values are highly resistant to change regarding females in nontraditional skill/trade areas. Suggests a model for sex equity in vocational education in rural education systems, incorporating all components of rural education systems to interact in development of programs free from sex-role stereotyping. (NEC)

  12. Single-Sex Schooling and Women's Education.

    ERIC Educational Resources Information Center

    Bauch, Patricia A.

    Rarely when single-sex Catholic secondary schools convert to coed school organization is the potential loss of gender-specific benefits addressed. Since the movement to coeducation is seldom accompanied by the return of a "converted" school to single-sex status, the incalculable loss to the traditional gender diversity of school organization is…

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

    PubMed Central

    2013-01-01

    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

  14. Pragati: an empowerment programme for female sex workers in Bangalore, India

    PubMed Central

    Euser, Sjoerd M.; Souverein, Dennis; Rama Narayana Gowda, Pushpalatha; Shekhar Gowda, Chandra; Grootendorst, Diana; Ramaiah, Rajendra; Barot, Snehal; Kumar, Sunil; Jenniskens, Françoise; Kumar, Shiv; Den Boer, Jeroen W.

    2012-01-01

    Objectives To describe the effects of a broad empowerment programme among female sex workers (FSWs) in Bangalore, India, which seeks to develop the capacities of these women to address the issues that threaten their lives and livelihoods. Design This study is based on a comprehensive, on-going HIV-prevention and empowering programme, known as Pragati, which reaches out to approximately 10,000–12,000 FSWs in Bangalore each year. The programme has been designed in collaboration with the sex worker community and provides a personalised set of services, which include STI prevention and treatment services, crisis-response facilities, de-addiction services, and microfinance support all of which have been tailored to adequately fulfil each woman's needs. During the period examined by this study, the programme reached out to 20,330 individual FSWs [median (IQR) age 28 (24–35) years]. The programme's personal records of the participating FSWs were used for this descriptive study. Results Between 2005 and 2010, the number of participating FSWs increased from 2,307 to 13,392. These women intensified their contact with the programme over time: the number of programme contacts increased from 10,351 in 2005 to 167,709 in 2010. Furthermore, data on the effects of crisis-response facilities, de-addiction and microfinance services, condom distribution schemes, and STI diagnosis and treatment showed an accumulating involvement of the participating FSWs in these programme services. Conclusion This programme, which focuses on social and economic empowerment among FSWs, is successful in reaching and involving the target population. PMID:23195516

  15. Natural history of Mycoplasma genitalium Infection in a Cohort of Female Sex Workers in Kampala, Uganda

    PubMed Central

    Vandepitte, Judith; Weiss, Helen A.; Kyakuwa, Nassim; Nakubulwa, Susan; Muller, Etienne; Buvé, Anne; Van der Stuyft, Patrick; Hayes, Richard; Grosskurth, Heiner

    2014-01-01

    Background There have been few studies of the natural history of Mycoplasma genitalium in women. We investigated patterns of clearance and recurrence of untreated M. genitalium infection in a cohort of female sex workers in Uganda. Methods Women diagnosed as having M. genitalium infection at enrollment were retested for the infection at 3-month intervals. Clearance of infection was defined as testing negative after having a previous positive result: persistence was defined as testing positive after a preceding positive test result, and recurrence as testing positive after a preceding negative test result. Adjusted hazard ratios for M. genitalium clearance were estimated using Cox proportional hazards regression. Results Among 119 participants infected with M. genitalium at enrollment (prevalence, 14%), 55% had spontaneously cleared the infection within 3 months; 83%, within 6; and 93%, within 12 months. The overall clearance rate was 25.7/100 person-years (pyr; 95% confidence interval, 21.4–31.0). HIV-positive women cleared M. genitalium infection more slowly than did HIV-negative women (20.6/100 pyr vs. 31.3/100 pyr, P = 0.03). The clearance rate was slower among HIV-positive women with CD4 counts less than 350/mL3 than among those with higher CD4 counts (9.88/100 pyr vs. 29.5/100 pyr, P < 0.001). After clearing the infection, M. genitalium infection recurred in 39% women. Conclusions M. genitalium is likely to persist and recur in the female genital tract. Because of the urogenital tract morbidity caused by the infection and the observed association with HIV acquisition, further research is needed to define screening modalities, especially in populations at high risk for HIV, and to optimize effective and affordable treatment options. PMID:23588134

  16. The epidemiology of serum sex hormones in postmenopausal women

    SciTech Connect

    Cauley, J.A.; Kuller, L.H.; LeDonne, D. ); Gutai, J.P. ); Powell, J.G. )

    1989-06-01

    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.

  17. Alcohol Consumption Patterns and Sexual Risk Behavior among Female Sex Workers in two South Indian Communities

    PubMed Central

    Heravian, Anisa; Solomon, Raja; Krishnan, Gopal; Vasudevan, CK; Krishnan, AK; Osmand, Thomas; Ekstrand, Maria L.

    2012-01-01

    Background HIV transmission in India is primarily heterosexual and there is a concentrated HIV epidemic among female sex workers (FSWs). Earlier reports demonstrate that many FSWs consume alcohol regularly before sexual encounters. This qualitative study is part of a larger quantitative study designed to assess alcohol consumption patterns among female sex workers and their association with sexual risk taking. Here we investigate the environmental influence, reasons for and consequences of consuming alcohol in the FSW population. Methods Trained staff from two Non-Governmental Organizations in Andhra Pradesh and Kerala conducted semi-structured interviews with 63 FSWs in Chirala, Andhra Pradesh (n=35) and Calicut, Kerala (n=28) following extensive formative research, including social mapping and key informant interviews, to assess drinking patterns and sexual risk behaviors. Results FSWs reported consuming alcohol in multiple contexts: sexual, social, mental health and self-medication. Alcohol consumption during sexual encounters with clients was usually forced, but some women drank voluntarily. Social drinking took place in public locations such as bars and in private locations including deserted buildings, roads and inside autorickshaws (motorcycle taxis). Consequences of alcohol consumption included failure to use condoms and to collect payments from clients, violence, legal problems, gastrointestinal side effects, economic loss and interference with family responsibilities. Conclusion FSWs consume alcohol in multilevel contexts. Alcohol consumption during transactional sex is often forced and can lead to failure to use condoms. Social drinkers consume alcohol with other trusted FSWs for entertainment and to help cope with psychosocial stressors. There are multiple reasons for and consequences of alcohol consumption in this population and future interventions should target each specific aspect of alcohol use. PMID:22608567

  18. Sex trafficking and initiation-related violence, alcohol use, and HIV risk among HIV-infected female sex workers in Mumbai, India.

    PubMed

    Silverman, Jay G; Raj, Anita; Cheng, Debbie M; Decker, Michele R; Coleman, Sharon; Bridden, Carly; Pardeshi, Manoj; Saggurti, Niranjan; Samet, Jeffrey H

    2011-12-01

    Female sex workers (FSWs) are the group at greatest risk for human immunodeficiency virus (HIV) infection in India. Women and girls trafficked (ie, forced or coerced) into sex work are thought to be at even greater risk because of high exposure to violence and unprotected sex, particularly during the early months of sex work, that is, at initiation. Surveys were completed with HIV-infected FSWs (n = 211) recruited from an HIV-related service organization in Mumbai, India. Approximately 2 in 5 participants (41.7%) reported being forced or coerced into sex work. During the first month in sex work, such FSWs had higher odds of sexual violence (adjusted odds ratio [AOR], 3.1; 95% confidence interval [CI], 1.6-6.1), ≥ 7 clients per day (AOR, 3.3; 1.8-6.1), no use of condoms (AOR, 3.8, 2.1-7.1), and frequent alcohol use (AOR, 1.9; 1.0-3.4) than HIV-infected FSWs not entering involuntarily. Those trafficked into sex work were also at higher odds for alcohol use at first sex work episode (AOR, 2.2; 95% CI, 1.2-4.0). These results suggest that having been trafficked into sex work is prevalent among this population and that such FSWs may face high levels of sexual violence, alcohol use, and exposure to HIV infection in the first month of sex work. Findings call into question harm reduction approaches to HIV prevention that rely primarily on FSW autonomy. PMID:22043037

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

    PubMed Central

    Simić, Milena; Baroš, Sladjana; Platt, Lucy; Žikić, Bojan

    2008-01-01

    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

  20. Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases.

    PubMed

    Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

    2009-10-01

    The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women's empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n=110) compared to a control community (n=106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention's impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000-2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study

  1. Patterns of partnership and condom use in two communities of female sex workers in Tanzania.

    PubMed

    Outwater, A; Nkya, L; Lwihula, G; O'Connor, P; Leshabari, M; Nguma, J; Mwizarubi, B; Laukamm-Josten, U; Green, E C; Hassig, S E

    2000-01-01

    Two rapid ethnographic studies have found that commercial sex workers (CSWs) and other high-risk women in Tanzania have different categories of partners, ranging from single-time contacts to long and enduring relationships. Since the advent of HIV/AIDS prevention programs in Tanzania in the late 1980s, CSWs and their clients have been aware of the multiple benefits of condom use for the prevention of pregnancy and STDs including HIV. These women often use condoms for the single-time contact. However, since the HIV/AIDS epidemic, casual partners have decreased in number. These days, most of their sexual contacts occur within long-term partnerships, and within these relationships, condom use is rare. Although the message that condoms should be used during high-risk behavior has been largely accepted, the definition of a high-risk relationship needs to be extended from casual partnerships to include multiple long-term partnerships. In addition, men and women's empowerment through education, business, and equal rights needs to be addressed at all levels of society. PMID:10911593

  2. Health-seeking behaviour for sexually transmitted infections and HIV testing among female sex workers in Vietnam.

    PubMed

    Ngo, A D; Ratliff, E A; McCurdy, S A; Ross, M W; Markham, C; Pham, H T B

    2007-08-01

    This qualitative study was conducted to explore health-seeking behaviour for sexually transmitted infections (STIs) and HIV testing among female sex workers (FSWs) in the cities of Hanoi and Da Nang, Vietnam. Data were gathered from in-depth interviews, focus groups and participant observation. Results suggest that women's decision to seek STI treatment and HIV testing is influenced by the complex interplay of personal risk perceptions, social relationships and community discourse. The women exhibited adequate knowledge of HIV while their knowledge of STIs was limited. They demonstrated high-risk perceptions of HIV, but they showed little concern for STIs. Most women sought treatment at pharmacies when they noticed symptoms of the genital tract. Their decision to seek care in health facilities and HIV testing was hampered by the high costs of treatment, judgmental attitudes of service providers, and a lack of information on testing services. Future interventions need to focus on strengthening knowledge of STIs and the STI-HIV association, and increasing awareness of HIV counselling and testing services. Training for STI service providers including pharmacies and private practitioners on sex-worker friendly and non-judgmental services and counselling skills should be emphasized to provide timely diagnosis and treatment of STIs, and to refer women to HIV testing. PMID:17712691

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

    PubMed Central

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

    2006-01-01

    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

  4. Intravaginal Practices in Female Sex Workers in Cambodia: A Qualitative Study.

    PubMed

    Bui, Thanh Cong; Tran, Ly Thi-Hai; Hor, Leng Bun; Scheurer, Michael E; Vidrine, Damon J; Markham, Christine M

    2016-05-01

    Intravaginal practices (IVPs) are associated with several adverse health outcomes, including HIV infection. However, few studies have examined this topic in Asian cultures, particularly in female sex workers (FSWs). This theory-based qualitative study aimed to describe the IVPs and to identify salient determinants of these practices in FSWs in Phnom Penh, Cambodia. We conducted in-depth interviews using open-ended questions with 30 FSWs in July-August 2014. We analyzed data using thematic content analysis, with thematic codes based on the constructs of the theory of planned behavior. The results showed that the most common IVP was a combination of intravaginal washing and wiping, to which we refer as intravaginal cleansing. There was a clear and close connection between IVP and sex work. Perceived benefits of intravaginal cleansing were numerous, while the perceived risks were few. As a result, the attitude toward intravaginal cleansing was favorable. A common misperception of benefit was that intravaginal cleansing could prevent sexually transmitted infections. Local physicians considerably influenced the subjective norm related to IVP. Intention to quit IVPs was suboptimal. In conclusion, the psychological factors associated with IVPs in FSWs were somewhat different from those in the general population of Cambodian women and women in other countries. Behavioral beliefs, attitude, and subjective norms appeared salient and important factors in IVPs. Interventions aimed at reducing IVPs should target these constructs as well as the sex-work-associated economic motives. Local physicians may be an agent to change IVP and an effective channel to deliver interventions. PMID:26742508

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

    PubMed Central

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

    2015-01-01

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

  6. Structural barriers to receiving health care services for female sex workers in Russia.

    PubMed

    King, Elizabeth J; Maman, Suzanne

    2013-08-01

    Female sex workers in Russia have been particularly vulnerable to recent social, political, and economic changes. In this article, we describe the facilitators and barriers for sex workers receiving health care services in St. Petersburg, Russia. We conducted observations at medical institutions and nongovernmental organizations and in-depth interviews with 29 female sex workers. We identified the following barriers: poverty, not having documents, lack of anonymity in testing, and the official registration system. We identified the following facilitators: intervention by family members, social connections within the health care system, and referral services from a nongovernmental organization. Our findings indicate a need for reassessing policies and designing programs that better facilitate the use of health care services for the most vulnerable populations. This should include the expansion of support systems and outreach services designed to help female sex workers navigate the health care system. PMID:23774627

  7. The ‘Stolen Generations' of Mothers and Daughters: Child Apprehension and Enhanced HIV Vulnerabilities for Sex Workers of Aboriginal Ancestry

    PubMed Central

    Duff, Putu; Bingham, Brittany; Simo, Annick; Jury, Delores; Reading, Charlotte; Shannon, Kate

    2014-01-01

    Objectives The number of children in care of the state continues to grow in BC, Canada with a historical legacy of child apprehension among criminalized and marginalized populations, particularly women of Aboriginal ancestry and sex workers. However, there is a paucity of research investigating child apprehension experiences among marginalized mothers. The objective of the current analysis is to examine the prevalence and correlates of child apprehensions among female sex workers in Vancouver, Canada. Methods Analyses were drawn from the AESHA (An Evaluation of Sex Workers Health Access, 2010-present), a prospective cohort of street and off-street SWs, through outreach and semi-annual visits to the research office. Bivariate and multivariate logistic regression were used to examine correlates of child apprehension. Results Of a total of 510 SWs, 350 women who had given birth to at least one child were included in the analyses (median age = 37 yrs: IQR: 31–44 yrs). The prevalence of child apprehension among mothers was 38.3%, with 37.4% reporting having been apprehended themselves by child welfare services. In multivariable analysis, servicing clients in outdoor public spaces (versus formal sex work establishments or informal indoor settings) (adjusted odds ratio, (aOR) = 2.73; 95%CI 1.27–5.90), history of injecting drugs (aOR = 2.53; 95%CI 1.42–4.49), Aboriginal ancestry (aOR = 1.66; 95%CI 1.01–2.74) were associated with increased odds of child apprehension. Discussion/Conclusions Child apprehension rates are high, particularly among the most marginalized sex workers, including sex workers who use drugs and sex workers of Aboriginal ancestry. Structural reforms to child protection are urgently needed, that support family-based care address the historical legacy of colonization affecting Aboriginal peoples. PMID:24927324

  8. Examining negative effects of early life experiences on reproductive and sexual health among female sex workers in Tijuana, Mexico

    PubMed Central

    Oza, Karishma K.; Silverman, Jay G.; Bojorquez, Ietza; Strathdee, Steffanie A.; Goldenberg, Shira M.

    2014-01-01

    Objective To explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence. Methods A qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011. Results Four interrelated themes that shaped health experiences—early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care—were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections. Conclusion Programs and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico. PMID:25458416

  9. Sexual hazards, life experiences and social circumstances among male sex workers in Nigeria.

    PubMed

    Okanlawon, Kehinde; Adebowale, Ayo Stephen; Titilayo, Ayotunde

    2013-01-01

    The sexual health and rights needs of male sex workers in Nigeria remain poorly understood and served. Men who sell sex are at high risk of discrimination and violation because of laws criminalising same-sex activity and sex work. This paper examines the experiences, social circumstances, vulnerabilities and sexual hazards experienced by male sex workers in Nigeria. In-depth interviews were used to explore the experiences of six male sex workers who were selected by means of convenience sampling from among those who came for counselling. Findings reveal that economic disadvantage drives some men to engage in sex work and risky sexual behaviour. Subsequently, sex work may put their lives and health at risk as a result of violation by the police and clients, including ritual murder. Men's extreme vulnerability points to the need for appropriate interventions to improve well-being. Sexual health and rights programmes must identify ways of making male sex workers less vulnerable to abuse, and devise strategies for protecting their health and human rights, while empowering them economically to reduce their dependency on often risky sexual behaviour for livelihoods. PMID:23252939

  10. 'There is fear but there is no other work': a preliminary qualitative exploration of the experience of sex workers in eastern Democratic Republic of Congo.

    PubMed

    Kiernan, Brendan; Mishori, Ranit; Masoda, Maurice

    2016-01-01

    Two decades of conflict and insecurity have had a devastating impact on many in the Democratic Republic of Congo (DRC), including marginalised groups such as sex workers. In the province of North Kivu, many residents face desperate conditions that render them vulnerable to exploitation and abuse. As a result, many turn to the sex trade in what can often be described as 'survival sex'. This small-scale qualitative study explores the experience of urban sex workers in the eastern region of the DRC. Sex workers were recruited at their place of business and asked to participate in a semi-structured interview. Eight participants were recruited, including seven women and one man. Our analysis identified several themes: (1) economic hardship as a catalyst for joining the sex trade, (2) significant work-related violence and (3) a paucity of available resources or assistance. Responses to specific prompts indicated that sex workers do not trust law enforcement and there are significant barriers to both medical care and local resources. Further studies of this vulnerable population and its needs are encouraged in order to develop programmes that provide the means to manage the hazards of their work and obtain an alternative source of income. PMID:26414956

  11. The tide cannot be turned without us: sex workers and the global response to HIV.

    PubMed

    Overs, Cheryl; Loff, Bebe

    2013-01-01

    Improved knowledge, better programmes and policies, effective treatment and other scientific developments have reduced levels of new HIV infections globally. Evidence shows that programmes that prevent HIV among sex workers and their clients are most successful when all aspects of vulnerability are addressed and when they are underpinned by policy that advances human rights. This is particularly important in the context of the introduction of antiretroviral-based HIV prevention, which could have harmful consequences if not well planned. In this context, law and policy on sex work should not be limited to aiming to deliver medicine and services to sex workers in dangerous working conditions. A high-priority aim should be to ensure that the law enables commercial sex to take place in the safest possible conditions. To achieve this, the meaningful involvement of sex workers at all levels of the response is crucial. However, although that has been recognized in theory, it has not been achieved in practice. PMID:23993060

  12. A Prospective Cohort Study of Intimate Partner Violence and Unprotected Sex in HIV-Positive Female Sex Workers in Mombasa, Kenya.

    PubMed

    Wilson, Kate S; Deya, Ruth; Yuhas, Krista; Simoni, Jane; Vander Stoep, Ann; Shafi, Juma; Jaoko, Walter; Hughes, James P; Richardson, Barbra A; McClelland, R Scott

    2016-09-01

    We conducted a prospective cohort study to test the hypothesis that intimate partner violence (IPV) is associated with unprotected sex in HIV-positive female sex workers in Mombasa, Kenya. Women completed monthly visits and quarterly examinations. Any IPV in the past year was defined as ≥1 act of physical, sexual, or emotional violence by the current or most recent emotional partner ('index partner'). Unprotected sex with any partner was measured by self-report and prostate specific antigen (PSA) test. Recent IPV was associated with significantly higher risk of unprotected sex (adjusted relative risk [aRR] 1.91, 95 % CI 1.32, 2.78, p = 0.001) and PSA (aRR 1.54, 95 % CI 1.17, 2.04, p = 0.002) after adjusting for age, alcohol use, and sexual violence by someone besides the index partner. Addressing IPV in comprehensive HIV programs for HIV-positive women in this key population is important to improve wellbeing and reduce risk of sexual transmission of HIV. PMID:27094785

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

    PubMed Central

    Mishra, Shiva Raj; Neupane, Sanjeev Raj

    2015-01-01

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

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

    PubMed

    Muftic, Lisa R; Finn, Mary A

    2013-06-01

    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

  15. Evidence for adverse reproductive outcomes among women microelectronic assembly workers.

    PubMed Central

    Huel, G; Mergler, D; Bowler, R

    1990-01-01

    Microelectronics assembly entails complex processes where several potentially fetotoxic chemical compounds are used extensively. This study was undertaken to assess the potential adverse reproductive outcomes among former women workers in a microelectronics assembly plant in New Mexico with respect to a comparable population from the same geographical region and to examine the relation between these outcomes and employment history in this plant. After matching a pool of 143 former microelectronic female workers and 105 referents, 90 former microelectronic female worker-referent pairs were constituted (representing 302 and 324 pregnancies in former workers and referents respectively). The odds ratio (for pair matching design) of spontaneous abortion among women workers, before beginning to assemble microelectronic components, was 0.9 (chi 2 = 0.04; NS). After the beginning of employment this odds ratio became 5.6 (chi 2 = 9.8; p less than 1%). This estimated odds ratio decreased to 4.0, taking into account the increased risk for spontaneous abortion in previous pregnancies before employment (chi 2 = 5.4; p less than 5%). It was not possible to determine if this effect was reversible owing to the small number of pairs available after employment. The findings of this study corroborate the results of former studies that suggest a potential association between electronic manufacturing activity and risk of spontaneous abortion. Although the organic solvents were suspected of being the potential risk factor, this study was inconclusive from this point of view. Nevertheless, these investigations may provide some insight into reproductive outcomes among female workers exposed to solvents. PMID:2378817

  16. Young women selling sex online - narratives on regulating feelings.

    PubMed

    Jonsson, Linda S; Svedin, Carl Göran; Hydén, Margareta

    2015-01-01

    The current study concerns young women's life stories of their experiences selling sex online before the age of 18. The aim was to gain an understanding of young women's perceptions of the reasons they started, continued, and stopped selling sex. The study included interviews with 15 young women between the ages of 15 and 25 (M=18.9). Thematic analysis was used to identify similarities and differences in the narratives. Three themes and eight sub-themes were identified in relation to different stages in their lives in the sex trade. The themes were organized into three parts, each with its own storyline: "Entering - adverse life experiences"; traumatic events: feeling different and being excluded. "Immersion - using the body as a tool for regulating feelings"; being seen: being touched: being in control: affect regulation and self-harming. "Exiting - change or die"; living close to death: the process of quitting. The informants all had stable social lives in the sense that they had roofs over their heads, food to eat, and no substance-abuse issues. None had a third party who arranged the sexual contacts and none were currently trafficked. They described how their experiences of traumatic events and of feeling different and excluded had led them into the sex trade. Selling sex functioned as a way to be seen, to handle traumatic events, and to regulate feelings. Professionals working with young people who sell sex online need to understand the complex web of mixed feelings and emotional needs that can play a role in selling sex. Young people selling sex might need guidance in relationship building as well as help processing traumatic experiences and ending self-harming behavior. Further studies are needed on the functions of online sex selling and on the exit process for young people, in order to prevent entrance and facilitate exiting. PMID:25733944

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

    PubMed

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

    2014-08-01

    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

  18. Acceptability of Hypothetical Microbicides among Women in Sex Establishments in Rural Areas in Southern China

    PubMed Central

    Wang, Yu; Liao, Su-Su; Weeks, Margaret R.; Jiang, Jing-Mei; Abbott, Maryann; Zhou, Yue-Jiao; He, Bin; Liu, Wei; Mosack, Katie E.

    2010-01-01

    Objectives and Goal The objectives of this study were to measure the potential acceptability of a hypothetical microbicide among women in sex establishments in rural areas of Southern China, and demographic, behavioral and social context factors likely to affect microbicide acceptability. Study Design This was a cross-sectional survey, using a quota sampling, among 300 women from sex establishments in three rural towns. An interviewer-administered standardized questionnaire was used to measure the acceptability score of hypothetical microbicides’ characteristics, as well as sexual relationships and behaviors, and other contextual factors. Results Findings showed a generally positive response to microbicides, indicated by an acceptability index score of 2.89 (SD, 0.56, scale of 1–4) in the overall sample. Multivariate analysis shows the acceptability score varied significantly by study sites, type of sex-work establishments, marital status, sex partner type, vaginal product experience, locus of control by partners and locus of control by chance. Conclusions Microbicides may be acceptable among sex workers in rural settings in China; however, contextual factors should be carefully considered in education and promotion of microbicides in the future. PMID:17767093

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

    PubMed

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

    2010-01-01

    How governments should address sex work is a topic of current debate in Rwanda and other countries. Some constituencies propose harsher punishment of sex workers as the cornerstone of an improved policy. We argue that an adequate policy response to sex work in the Rwandan context must prioritize public health and reflect current knowledge of the social determinants of health. This does not imply intensified repression, but a comprehensive agenda of medical and social support to improve sex workers' access to health care, reduce their social isolation, and expand their economic options. Evidence from social epidemiology converges with rights-based arguments in this approach. Recent field interviews with current and former sex workers strengthen the case, while highlighting the need for further social scientific and epidemiological analysis of sex work in Rwanda. Rwanda has implemented some measures that reflect a rights-based perspective in addressing sex work. For example, recent policies seek to expand access to education for girls and support sex workers in the transition to alternative livelihoods. These policies reinforce the model of solidarity-based public health action for which Rwanda has been recognized. Whether such measures can maintain traction in the face of economic austerity and ideological resistance remains to be seen. PMID:21178192

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

    ERIC Educational Resources Information Center

    Hill, Robert J.

    2005-01-01

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

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

    PubMed

    Huang, Yingying; Pan, Suiming

    2014-01-01

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

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

    PubMed Central

    Huang, Yingying; Pan, Suiming

    2015-01-01

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

  3. Psychological health and HIV transmission among female sex workers: a systematic review and meta-analysis.

    PubMed

    Yuen, Winnie Wing-Yan; Tran, Lynn; Wong, Carlos King-Ho; Holroyd, Eleanor; Tang, Catherine So-Kum; Wong, William Chi-Wai

    2016-07-01

    Current HIV prevention interventions for female sex workers (FSWs) have tended to target the cognitive factors in changing their behaviors, yet little attention has been paid to the psychological factors that influence the behavior of women in sex work. This review aimed to explore the associations between the psychological health of FSWs and HIV risk. A total of eight studies published in English before July 2013 were identified and reviewed. FSWs had reported psychological issues, including depression, suicidal thoughts as well as lower quality of life, and the pooled prevalence of probable depression was as high as 62.4%. The majority of studies showed that higher scores in psychological health problems were associated with increased HIV risk behavior, in particular inconsistent condom use, or sexually transmitted infections. Among the five studies which measured symptoms of depression, four documented that higher depression scores were significantly associated with inconsistent condom use among FSWs with their clients and/or partners. Meta-analysis using a fixed-effects model was performed to examine the association between depression and inconsistent condom use and found that higher scores in depression were significantly associated with inconsistent condom use (odds ratio = 2.57, p < .001). This review contends that future HIV preventive interventions should take psychological health of FSWs into consideration. PMID:26837316

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2013-01-01

    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

  6. Sex Work and Motherhood: Social and Structural Barriers to Health and Social Services for Pregnant and Parenting Street and Off-Street Sex Workers.

    PubMed

    Duff, Putu; Shoveller, Jean; Chettiar, Jill; Feng, Cindy; Nicoletti, Rachel; Shannon, Kate

    2015-09-01

    Our study documents the correlates of barriers to pregnancy and mothering among sex workers in Vancouver, Canada. We used baseline data from An Evaluation of Sex Workers' Health Access (AESHA), a prospective cohort of sex workers. Among the 399 sex workers who had ever been pregnant or had a child, 35% reported having ever experienced a barrier, with lower education, homelessness, and history of injecting drugs significantly correlated with pregnancy and mothering barriers. Our findings highlight a critical need for tailored and nonjudgmental services and supports, including improved programs to address intersecting aspects of poverty, health literacy, stigma, and substance use. PMID:25513844

  7. Peer education reaches young women factory workers in Thailand.

    PubMed

    Cash, K

    1993-12-01

    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

  8. Trans Women Doing Sex in San Francisco.

    PubMed

    Williams, Colin J; Weinberg, Martin S; Rosenberger, Joshua G

    2016-10-01

    This research investigates the sexuality of trans women (individuals who were assigned male status at birth who currently identify as women), by focusing on the "bodily techniques" (Crossley, 2006) they use in "doing" sexuality. The "doing sexuality" framework not only is modeled after the "doing gender" approach of West and Zimmerman (1987), but also utilizes the idea of "sexual embodiment" to emphasize the agency of trans women as they conceptualize and organize their sexuality in a socially recognized way. This is often difficult as they confront discrimination from medical and legal professionals as well as intimate partners who may find it difficult to adapt to the trans woman's atypical body and conception of gender. However, with a study group of 25 trans women from San Francisco, we found the study participants to be adept at overcoming such hurdles and developing techniques to "do" their sexuality. At the same time, we found trans women's agency constrained by the erotic habitus (Green, 2008) of the wider society. The interplay between innovation and cultural tradition provides an opportunity to fashion a more general model of "doing" sexuality. PMID:27091188

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

    PubMed Central

    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

    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

  10. Consultations for women's health problems: factors influencing women's choice of sex of general practitioner.

    PubMed Central

    van den Brink-Muinen, A; de Bakker, D H; Bensing, J M

    1994-01-01

    AIM. This study set out to examine the degree to which women choose to visit a woman doctor for women's health problems and the determinants of this choice. The differences between women and men doctors with regard to treating women's health problems were also studied. METHOD. Data from the Dutch national survey of general practice were used. All group practices with both women and men general practitioners were selected. Analyses were restricted to consultations among women aged 15-65 years about menstruation, the menopause, vaginal discharge, breast examination and cervical smear tests. RESULts. Given the size of their female practice population, women doctors saw considerably more women with women's health problems than did their male colleagues. Women were more likely to consult a woman general practitioner if she was more available (that is, working longer hours), and younger women were more likely than older women to choose women general practitioners. Sex differences in the treatment of women's health problems were small and mainly related to the verbal part of the consultation: counselling and providing information. The doctors' availability and their certainty about the working diagnosis explained differences in the verbal aspects of consultations. Women general practitioners had longer consultations than their male colleagues mainly because more health problems were presented per consultation. CONCLUSION. In order to increase the possibility of patients choosing women general practitioners, policy should be directed towards the education of more women general practitioners and women general practitioners should be encouraged to work more days a week. PMID:8204333