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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. The need for family planning and safe abortion services among women sex workers seeking STI care in Cambodia.

    PubMed

    Delvaux, Thérèse; Crabbé, François; Seng, Sopheap; Laga, Marie

    2003-05-01

    In Cambodia, clinics established for the prevention and management of sexually transmitted infections (STIs) in women sex workers do not address other reproductive health services. The aim of this study was to assess the need for more comprehensive sexual and reproductive health services for women sex workers in Cambodia. In January 2000, relevant documents were reviewed, interviews with key informants carried out and group interviews with women sex workers conducted. Medical records from women sex workers were also reviewed and some data collected prospectively in one government STI clinic. Interviews with the women and data from the government clinic indicated that excluding condoms, a very low proportion of women sex workers were currently using a modern contraceptive method--5% of 38 women and 1.6% of 632 women, respectively. Induced abortion was widely used but was perceived to be risky and costly. Data from a mobile team intervention and the government clinic respectively showed that 25.5% (n = 1744) and 21.9% (n = 588) of women sex workers reported at least one previous induced abortion. These findings reveal the need for accessible contraception and safe abortion services among sex workers in Cambodia, and raise the issue of the reproductive rights and reproductive health needs of women sex workers in general. PMID:12800706

  6. Women sex workers and the HIV pandemic: stigma and blame in context.

    PubMed

    Maduna-butshe, A C

    1997-03-01

    In many African countries, the spread of HIV is aided by a complex knot of social, cultural, economic, and political factors. AIDS is becoming a disease of poverty, with the highest burden of prolonged economic crisis resting upon the shoulders of women. These same factors also result in women's enforced dependence on selling sex for survival and make sex workers highly vulnerable to HIV infection. However, concern for women in the context of the global pandemic has largely focused on their role in the transmission of the virus to others, primarily on their sexual partners and their children, rather than on their vulnerability. Blaming women for the spread of HIV and sexually transmitted diseases (STDs) has resulted in considerable discrimination against them. Recognizing that sex work makes women more vulnerable to HIV leads to the conclusion that developing alternative sources of income for women is an important strategy for promoting women's health. In addition, women should be informed about traditions and conditions that may predispose them to STDs and HIV infection. Finally, rather than being stigmatized as the cause of HIV/AIDS, sex workers may be regarded as an indicator of the status of women. PMID:12222371

  7. The effect of serostatus on HIV risk behaviour change among women sex workers in Miami, Florida.

    PubMed

    Inciardi, J A; Surratt, H L; Kurtz, S P; Weaver, J C

    2005-06-01

    HIV prevention and risk reduction are especially salient and timely issues for women, particularly among those who are drug-involved or who exchange sex for drugs or money. Studies suggest that HIV-prevention measures can be effective with highly vulnerable women, and have the potential to produce significant reductions in risk behaviours among both HIV-negative and HIV-positive women. Within this context, this paper examines risk behaviours and HIV serostatus among 407 drug-involved women sex workers in Miami, Florida, and investigates the effects of participation in HIV testing, counselling, and a risk-reduction intervention on subsequent behavioural change among this population. Overall, at follow-up, the HIV-positive women were 2.4 times more likely than the HIV-negative women to have entered residential treatment for drug abuse, 2.2 times more likely to have decreased the number of their sex partners, 1.9 times more likely to have decreased the frequency of unprotected sex, 1.9 times more likely to have reduced their levels of alcohol use, and 2.3 times more likely to have decreased their crack use. These data support the importance of HIV testing and risk-reduction programmes for drug-involved women sex workers. PMID:16096121

  8. 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

  9. Images of Place: Visuals from Migrant Women Sex Workers in South Africa.

    PubMed

    Oliveira, Elsa; Vearey, Jo

    2015-01-01

    Many migrants in inner-city Johannesburg survive through unconventional and sometimes criminalized livelihood activities. In this article, we draw on data from a study that applied a participatory visual methodology to work with migrant women who sell sex, and explored the suitability of this approach as a way to engage with a presumed 'hard to reach' urban population. The lived experiences of migrant women sex workers were documented by combining participatory visual methods with a more traditional ethnographic approach, and this approach led us to new ways of seeing their worlds. This methodological approach raises important considerations for working with marginalized and criminalized urban groups. PMID:25849062

  10. 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, alongside broader policy changes to fulfill sex workers’ health and human rights. PMID:27182736

  11. The role of housing in determining HIV risk among female sex workers in Andhra Pradesh, India: considering women's life contexts.

    PubMed

    Reed, Elizabeth; Gupta, Jhumka; Biradavolu, Monica; Devireddy, Vasavi; Blankenship, Kim M

    2011-03-01

    Recent research on HIV prevention, regardless of the population, has increasingly recognized the relevance of contextual factors in determining HIV risk. Investigating such factors among female sex workers (FSW) is especially relevant in the South Indian state of Andhra Pradesh, where HIV rates are among the highest across Indian states and where HIV has largely affected FSW. Stable housing is a particular contextual challenge experienced by female sex workers in this region (as well as elsewhere); however, local studies have not examined the impact of this issue on HIV risk. In this paper, we examine residential instability, defined as a high frequency of reported evictions, among FSW and relation to experiences of violence (as a factor increasing risk for HIV) and sexual risk factors for HIV. Women were recruited through respondent-driven sampling for a survey on HIV risk. Using logistic regression models, we assessed: (1) residential instability and association with HIV sexual risk variables (including unprotected sex, reported STIs, and recent physical and sexual victimization) and (2) whether the association between residential instability and reported STI (as an indicator of HIV risk) was attenuated by individual risk behaviors and violence. In adjusted logistic regression models, FSW who reported residential instability were more likely to report: sexual violence, physical violence, accepting more money for unprotected sex, and a recent STI symptom. Violence associated with residential instability contributed to reported STIs; however, residential instability remained significantly associated with STIs beyond the influence of both violence and unprotected sex with clients. Findings highlight the interrelation among residential instability, violence, and HIV risk. Residential instability appears to be associated with women's HIV risk, above and beyond its association with individual risky sexual behaviors. PMID:21306811

  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 health interventions and safer supportive housing to account for the daily lived experiences of women sex workers. PMID:22018526

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

    PubMed

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

    2015-06-01

    Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers' mandatory HIV screenings may be a cost-efficient disease-control strategy. PMID:25922331

  16. Governing sex workers in Timor Leste.

    PubMed

    Harrington, Carol

    2011-01-01

    This paper argues that international security forces in Timor Leste depend upon civilian partners in HIV/AIDs "knowledge networks" to monitor prostitutes' disease status. These networks produce mobile expertise, techniques of government and forms of personhood that facilitate international government of distant populations without overt coercion. HIV/AIDs experts promote techniques of peer education, empowerment and community mobilisation to construct women who sell sex as health conscious sex workers. Such techniques make impoverished women responsible for their disease status, obscuring the political and economic contexts that produced that status. In the militarised context of Timor Leste, knowledge of the sexual conduct of sub-populations labelled high risk circulates among global HIV/AIDs knowledge networks, confirming their expert status while obscuring the sexual harm produced by military intervention. HIV/AIDs knowledge networks have recently begun to build Timorese sex worker organisations by contracting an Australian sex worker NGO to train a Timorese NGO tasked with building sex worker identity and community. Such efforts fail to address the needs and priorities of the women supposedly empowered. The paper engages theories of global knowledge networks, mobile technologies of government, and governmentality to analyse policy documents, reports, programmes, official statements, speeches, and journalistic accounts regarding prostitution in Timor Leste. PMID:21847829

  17. 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

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

    PubMed Central

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

    2014-01-01

    Objective To longitudinally examine female sex workers’ (FSWs’) uptake of a women-only, sex-work-specific drop-in service and its impact on their access to sexual and reproductive health (SRH) services. Methods For the present longitudinal analysis, data were drawn from the AESHA (An Evaluation of Sex Workers’ Health Access) study, a community-based, open, prospective cohort of FSWs from Vancouver, BC, Canada. Data obtained between January 2010 and February 2013 were analyzed. Participants are followed up on a semi-annual basis. Multivariable logistic regression using generalized estimating equations was used to identify correlates of service uptake. Results Of 547 FSWs included in the present analysis, 330 (60.3%) utilized the services during the 3-year study period. Service use was independently associated with age (adjusted odds ratio [AOR] 1.04; 95% confidence interval [CI] 1.03–1.06), Aboriginal ancestry (AOR 2.18; 95% CI 1.61–2.95), injection drug use (AOR 1.67; 95% CI 1.29–2.17), exchange of sex for drugs (AOR 1.40; 95%CI 1.15–1.71), and accessing SRH services (AOR 1.65; 95% CI 1.35–2.02). Conclusion A sex-work-specific drop-in space for marginalized FSWs had high uptake. Women-centered and low-threshold drop-in services can effectively link marginalized women with SRH services. PMID:25627707

  1. The motivation and mental health of sex workers.

    PubMed

    Chudakov, Bella; Ilan, Keren; Belmaker, R H; Cwikel, Julie

    2002-01-01

    Commercial sex work presents specific mental health concerns. We aimed to study motivation for sex work and mental health issues in a sample of such women. We contacted 55 consenting women through organized brothels and interviewed them using the Farley questionnaire and screening items for posttraumatic stress disorder (PTSD) and depression. Eighty-two percent of the women had arrived illegally and had been "trafficked." All but 2 were engaged voluntarily in sex work. Seventeen percent met criteria for PTSD, and 19% were likely to be clinically depressed. We present representative case histories. Availability of mental health treatment for workers in the sex industry could improve compliance with HIV prevention programs and enlarge options for women to leave the sex industry. We observed that stereotypes of sex workers as either always having histories of childhood abuse or as being always "happy hookers" were incorrect. PMID:12082669

  2. 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

  3. 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…

  4. 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

  5. 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

  6. [Sex workers: from stigma to political consciousness].

    PubMed

    Lamas, M

    1996-01-01

    This work provides an overview of the different types of female sex workers in Mexico City, and discusses the recent trend toward politicizing of female sex workers. The sex industry, traditionally known as prostitution, encompasses a variety of activities that are economically and socially hierarchical, and that may be clandestine, public, or semiofficial. The penal code in Mexico does not outlaw prostitution as such, but specifies procuring as an infraction, while the police regulations contain a category of offenses against morals and good customs, which is used to control prostitution. The laws have lent themselves to exploitation and mistreatment of prostitutes, who are also systematically exploited by their "representatives." The stigma of prostitution has prevented political organization of sex industry workers. In Mexico, the AIDS epidemic directly affected prostitutes' lives and initiated their political awakening. In some AIDS-control campaigns, prostitution came to be spoken of as a means of earning a living rather than as a sin, vice, or destiny. AIDS control activities also gave some indication of preoccupation with the human rights of prostitutes. Efforts are underway to form a national organization of prostitutes that would seek to improve their working conditions and social status. To the extent that prostitutes reflect on their circumstances and organize to defend their basic rights, including recognition of their work, they redefine the symbolic terms of gender in which female sexuality is repressed and women are dichotomized as good women or prostitutes. Prostitution is a social institution reflecting the hierarchy of gender. Prostitution should be analyzed as a political problem and not just a personal or individual problem. It should also be studied as a problem of social relations, with attention to the demand side as well as the supply. PMID:12347780

  7. 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 intervention to attempt to simultaneously reduce injection and sexual risk behaviors among FSW-IDUs. The factorial design will permit analysis to determine whether the combination of the two interactive interventions and/or its respective components are effective in reducing injection and/or sexual risks, which will have direct, tangible policy implications for Mexico and potentially other resource-poor countries. Trial registration NCT00840658 PMID:22891807

  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. 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

  10. 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

  11. 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

  12. 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…

  13. 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

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

    PubMed

    Silverman, Jay G

    2011-05-01

    A large number of female sex workers are children. Multiple studies demonstrate that up to 40% of women in prostitution started this work prior to age 18. In studies across India, Nepal, Thailand and Canada, young age at entry to sex work has been found to heighten vulnerability to physical and sexual violence victimisation in the context of prostitution, and relates to a two to fourfold increase in HIV infection. Although HIV risk reduction among adult female sex workers has been a major focus of HIV prevention efforts across the globe, no public health interventions, to date, have addressed the increased hazards and HIV risk faced by adolescent female sex workers. Beyond the structural barriers that limit access to this vulnerable group, historical tensions between HIV prevention and child protection agencies must be overcome in order to develop effective strategies to address this large scale yet little recognised human rights and HIV-related crisis. PMID:21357241

  15. Improving the health of sex workers in NSW: maintaining success.

    PubMed

    Donovan, Basil; Harcourt, Christine; Egger, Sandra; Fairley, Christopher K

    2010-01-01

    NSW has a diverse sex industry that is limited in its size by modest demand. There is no evidence that decriminalisation in 1995 increased the frequency of commercial sex in NSW. Though the largest sector, female brothels, is now mainly staffed by Asian women, condom use for vaginal and anal sex exceeds 99% and sexually transmissible infection rates are at historic lows. These gains are attributable to the long-term support of the NSW Department of Health in collaboration with the community-based Sex Workers Outreach Project and sexual health services, facilitated by the removal of criminal sanctions without the expense and access barriers of licensing systems. PMID:20513305

  16. Automation and Women Workers.

    ERIC Educational Resources Information Center

    Wells, Jean A.

    To determine the repercussions of scientific and technological progress on the employment of women and their conditions of work, the Women's Bureau used available statistical data from 1958-68 to study: (1) Employment and Unemployment, (2) Vocational Guidance and Training, (3) Training and Retraining of Older Women, (4) Remuneration, (5) Hours of…

  17. UNDERUTILIZATION OF WOMEN WORKERS.

    ERIC Educational Resources Information Center

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

    INFORMATION ABOUT THE STATUS OF WORKING WOMEN AND THEIR UNDERUTILIZATION IN THE NATIONAL WORK FORCE IS PRESENTED IN SUMMARY AND GRAPH FORM. ALTHOUGH PROGRESS HAS BEEN MADE IN ASSURING WOMEN EQUALITY OF PAY AND NONDISCRIMINATION IN EMPLOYMENT, MUCH NEEDS TO BE DONE TO IMPROVE THE UTILIZATION OF THEIR ABILITIES. MOST WOMEN WORK TO SUPPORT THEMSELVES…

  18. 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

  19. Underutilization of Women Workers.

    ERIC Educational Resources Information Center

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

    Information about the status of working women and their underutilization in the national work force is presented in summary and graph form. Although progress has been made in assuring women equality of pay and nondiscrimination in employment, much work needs to be done to improve the utilization of their abilities. The barriers are still high…

  20. 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-government and international organizations as well as the UN agencies are working seriously to assist them and protect their rights. PMID:21218599

  1. 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

  2. Sex workers as safe sex advocates: Sex workers protect both themselves and the wider community from HIV.

    PubMed

    Bates, Julie; Berg, Rigmor

    2014-06-01

    Since the advent of HIV, significant changes have made the Australian sex industry one of the safest in the world. Creating this safety has been in large part due to the ability of sex workers to act as safe sex advocates through peer-based health promotion; to negotiate with sex business owners; and to inform and participate in the development of government policy. Empowerment of sex workers through legislative reform and government funding of sex worker organizations has been central to the prevention of HV transmission, as has been the development of genuine partnership between sex worker organizations, government departments and those working in public health. The paper describes these responses in some detail and explores some of the current issues facing sex workers in Australia. PMID:24846482

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

    PubMed

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

    2014-03-01

    The sex industry, where men sell sexual services to other men or women, has grown in recent years. These men who offer sexual services are particularly vulnerable to HIV infection due to such factors as: frequency of risky sexual practices, number of sex partners, drug-taking, prevalence of sexually-transmitted infections (STI) and their specific situation of social exclusion which may hinder access to health services. These multi-faceted realities faced by sex workers explain the burgeoning interest in new avenues of scientific research. There are too few preventive programs however aimed at this population group and the studies that evaluate their effectiveness are fewer still. In this article we survey more recent studies on the difficulties of implementing programs for HIV prevention in male sex workers (MSW), as well as the studies that have gauged the impact of preventive programs in this group. PMID:24366476

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

    PubMed Central

    2014-01-01

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

  5. 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

  6. 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

  7. 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

  8. 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

  9. Having Their Say: Sex Workers Discuss Their Needs and Resources.

    PubMed

    Mastin, Teresa; Murphy, Alexandra G; Riplinger, Andrew J; Ngugi, Elizabeth

    2016-03-01

    In many countries where HIV/AIDS is prevalent, social, cultural, and economic factors often mitigate the adoption of healthy reproductive behaviors and practices. One group that is particularly susceptible to mitigating influences is women who work in the sex trade. In this article, we utilize a culture-centered approach to determine how a population of sex workers in Nairobi, Kenya, perceives their individual, social, and structural needs and resources in relation to the public, their families, friends, and peers. We conclude the article with next steps regarding collaboration with media representatives and policymakers. PMID:25719732

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

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

    PubMed

    Damacena, Giseli Nogueira; Szwarcwald, Clia Landmann; Souza Jnior, 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

  20. 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

  1. 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…

  2. 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

  3. Unprotected sex with their clients among low-paying female sex workers in southwest China.

    PubMed

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

    2013-01-01

    China has been experiencing a rapid increase in the HIV epidemic for decades. Commercial sex plays a critical role in heterosexual transmission of HIV. Limited studies suggested that low-paying female sex workers (FSWs) faced a higher risk of HIV infection. Low-paying FSWs are women who usually encounter their clients on the street or small establishments in rural or less-developed areas, or who charge low fees for each sexual service. A total of 720 low-paying FSWs from 130 commercial sex venues/locations in southwest China were included in the data analysis. Multivariate regression models were employed to examine the associations of unprotected sex with a number of exploratory variables among the study sample. About 33.9 and 61.5% of low-paying FSWs reported unprotected sex with clients in the last sex act and in the last month, respectively. After controlling for confounders, women's HIV knowledge, risk perception, experience of police arrest, and venue types were significantly associated with unprotected sex among low-paying FSWs. Low-paying FSWs are at an alarmingly high risk of HIV infection. HIV prevention programs are urgently needed to address risk factors posit in both individual and contextual levels among this most-at-risk population in order to curb the HIV epidemic in China. PMID:23062062

  4. Sexually transmissible infections among illegal female sex workers in Israel.

    PubMed

    Cwikel, Julie G; Lazer, Tal; Press, Fernanda; Lazer, Simcha

    2006-12-01

    Due to the mobile and clandestine nature of those who enter a country illegally, female sex workers (FSWs) who are working without papers or work permits often have no access to sexual health care. This study reports on the sexually transmissible infection (STI) prevalence among a sample of 43 sex workers working illegally. Brothel workers from republics of the Former Soviet Union (FSU), working in two locales in Israel were tested for the presence of eight pathogens and the presence of pathology by Pap smear. Of these brothel workers, 48.8% had at least one positive STI result, 14% had two STIs and one woman had three STIs. There were no cases of HIV, gonorrhoea or malignancy detected; high rates of ureaplasma (26.8%) and chlamydia were found (16.7%). Four cases of hepatitis C (9%) and three cases of hepatitis B (7%) and mycoplasma (7%) were detected. There was no relationship between reported symptoms and the detection of STIs. The level of STIs is high among this population of FSWs and it is imperative to develop more accessible health services for these women. PMID:17112446

  5. 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

  6. 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

  7. 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…

  8. 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

  9. 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

  10. 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

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

    PubMed Central

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

    2011-01-01

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

  12. Measuring condom use among sex workers in the Dominican Republic.

    PubMed

    Weir, S S; Fox, L J; DeMoya, A; Gomez, B; Guerrero, E; Hassig, S E

    1998-04-01

    The purpose of this paper is to assess the internal consistency of self-reported condom use among sex workers in Puerto Plata and Santo Domingo, Dominican Republic. We examined the responses to questions about condom use among 4 cross-sectional samples of sex workers. We compared measures based on: (1) questions using always-to-never scales; (2) questions about use with the past 5 clients; and (3) questions about use in the past week obtained from a retrospective coital log. In each sample, more women reported 'always' using condoms with clients than with each of the past 5 clients. In 3 of the 4 samples, only about half of the women who reported 'always' using condoms used condoms with the most recent 5 clients and with all clients in the past week. Internal consistency was significantly higher when the comparison was limited to use with the most recent 5 clients and use in the past week. Self-reported measures of condom use can be difficult to interpret. Assessing the internal consistency of several measures of use provides insight into the strengths and weaknesses of each measure. PMID:9598750

  13. 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

  14. 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

  15. 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…

  16. 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

  17. Comparison of health behaviors among women brothel workers to those of the general population of women in Denmark.

    PubMed

    Pedersen, Pia Vivian; Arnfred, Anders; Algren, Maria Holst; Juel, Knud

    2016-01-01

    Previous research on behavioral risk factors for illness among sex workers has been limited and based on mixed, poorly defined groups of sex workers. The aim of the present study was to compare the health behaviors and weight of women brothel workers with women in the general population in Denmark. Logistic regression analyses were used to compare data from eighty-eight women working in brothels in 2010 with data from 3,225 women of similar age from the nationally representative Danish Health Survey 2010. Compared to Danish women, the prevalence of daily and heavy smoking was higher among brothel workers, but the prevalence of wanting to quit smoking was lower. The prevalence rates of exceeding the Danish high-risk level of alcohol consumption, binge drinking, and illicit drug use were higher among women brothel workers compared to Danish women. The prevalence of underweight was higher and overweight and obesity lower among brothel workers compared to Danish women. These differences were significant when adjusted for age and educational level. Few differences were noted regarding dietary habits and no differences regarding physical activity. Findings suggest the need for health-promotion initiatives, particularly for smoking, alcohol consumption, and drug use, targeted at women brothel workers. PMID:26479120

  18. 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

  19. 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

  20. 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

  1. 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

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

    PubMed

    Basnyat, Iccha

    2014-01-01

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

  3. HANDBOOK ON WOMEN WORKERS, 1965.

    ERIC Educational Resources Information Center

    HILTON, MARY N.; AND OTHERS

    FACTUAL INFORMATION COVERS THE PARTICIPATION AND CHARACTERISTICS OF WOMEN IN THE LABOR FORCE, THE PATTERNS OF THEIR EMPLOYMENT, THEIR OCCUPATIONS, THEIR INCOME AND EARNINGS, THEIR EDUCATION AND TRAINING, AND THE FEDERAL AND STATE LAWS AFFECTING THE EMPLOYMENT AND THE CIVIL AND POLITICAL STATUS OF WOMEN. IN 1965, ABOUT 26 MILLION WOMEN, 37 PERCENT…

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

    PubMed Central

    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.

    2016-01-01

    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 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 1 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

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

    PubMed

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

    2008-01-01

    In 1998, researchers in Burkina Faso enrolled 300 women more or less involved in commercial sex work in an open cohort to determine whether adequate management of their sexually transmitted infections and exposure to well-designed, well-delivered, and plentiful communication for behaviour change (CBC) might reduce their vulnerability to HIV. In 2000, they observed that the non-professional sex workers (occasional or clandestine sex workers) were more difficult to reach, to mobilize and to keep involved in the project's different activities. This group was also infected at the same or higher rates than professional sex workers because they did not use condoms routinely. To accomplish the project objectives, they therefore chose to recruit more non-professional sex workers in the new cohort of 700 women. This social-anthropological study was conducted to help them to enrol young clandestine sex workers. The overall objective of this study was to understand the life of this category of sex workers and to identify strategic actors to reach them. Using a qualitative method, social anthropologists reviewed literature, identified and geo-referenced all local places suitable to encountering these women, obtained life stories from some of them and interviewed key informants and participants in the field. The results showed that in Bobo-Dioulasso (Burkina Faso): - most young women who are clandestine sex workers are Burkinabe, and girls entering the sex trade are increasingly young and increasingly uneducated; - most of them come from families with low capital (financial, cultural, or social). The parents' socioeconomic status (contextual poverty) results in unmet financial needs, which in turn exposes them to starting work early, including commercial sex work; - of all the income-generating activities available to unskilled young girls, commercial sex work is one of the most profitable and easily accessible; - in the three-fold context of an HIV epidemic, poverty, and unemployment, clandestine commercial sex work is a rational action, insofar as condom use reduces the risk of HIV infection, "clandestinity" reduces the risk of social stigma, and earnings increase financial capital; - girls are coopted into sex work through an initiation process and the initiator explains to the initiate how sex workers think, act, and live, as well as the rules of the trade; - young clandestine commercial sex workers use various strategies to do their work in secret, unidentified, by changing the time, place, period, district, city or country of their work; - young clandestine commercial sex workers maintain friendly relations with men or boys in but have no or conflictual relationships with women and girls. Thus, only other participants in this trade, peer counsellors, and room renters can serve as strategic actors to reach, mobilize and keep these young girls in HIV programmes. Social anthropologists have concluded that one problem in the fight against official or professional commercial sex work is the development of clandestine commercial sex work, which is more dangerous, firstly for its practitioners, who are harder to reach by messages about HIV and thus do not change their behaviour, secondly, for their sexual partners who do not use condoms systematically, and finally for society as a whole, to the extent that social actors are embedded in an informal network, more or less extensive, of sexual partners. PMID:19359238

  6. 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…

  7. 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

  8. 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

  9. 1969 Handbook on Women Workers.

    ERIC Educational Resources Information Center

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

    Published periodically by the Women's Bureau of the United States Department of Labor, this handbook assembles factual information covering the participation and characteristics of women in the labor force, the patterns of their employment, occupations, income and earnings, education and training, and the federal and state laws affecting their…

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

    PubMed

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

    2013-01-01

    Violence experienced by female sex workers has been found to affect the HIV risk and quality of life of these women. Research on this topic has dealt with female sex workers and current experiences of violence with partners, clients, and in the workplace. In this study, we used feminist constructivist grounded theory to explore perceptions of violence among establishment-based female sex workers in Tijuana, Mexico. A key concept that emerged from 20 semi-structured in-depth interviews was "escaping violence with a romantic partner by becoming independent through sex work." The women also emphasized the negative impact of violence in the workplace but felt that achieving separation from a violent partner gave them strength to protect their lives and health. Interventions to help these women protect themselves from HIV infection and improve their quality of life should aim to build upon their strengths and the agency they have already achieved. PMID:23790279

  11. Dyspareunia: Painful Sex for Women

    MedlinePlus

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

  12. 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

  13. Sex and Women with Cancer -- Overview

    MedlinePlus

    ... Topic How a woman’s body works Sex and Women With Cancer: Overview This is a shorter, easier- ... of Use State Fundraising Notices Site Comments Better Business Bureau Health On The Net National Health Council © ...

  14. 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

  15. 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

  16. An untold story in labor health: Korean women workers.

    PubMed

    Kim, Myoung-Hee; Kim, Hyun-joo

    2007-01-01

    Very little is known about labor health among Korean women workers, who have been left behind by the occupational safety and health institutions. In this article, we examine, from a gender perspective, the occupational safety and health (OSH) statistics, institutions, and the struggles of women workers, and discuss how to make a society where women workers become and stay healthy. The problems Korean women workers face have both universal and unique aspects. On the one hand, they tend to be exposed to "invisible hazards" and to disproportionately suffer from neo-liberal policies, as do women workers in other countries. On the other hand, Korean women workers are still positioned under the strong patriarchy found in pre-modern societies. The examples of struggle presented here come out of this condition; those struggles by women workers and support from concerned specialists have played an important role in overcoming patriarchy and protecting health rights for women workers. PMID:18184625

  17. 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

  18. 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

  19. 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

  20. 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 to understand sex workers' unique health vulnerabilities and concerns. PMID:19362403

  1. 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

  2. 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 and incarceration in this study, our findings further add to growing calls to move away from criminalized and enforcement-based approaches to sex work in Canada and globally. PMID:26260991

  3. 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

  4. 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

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

    PubMed

    Homaifar, Nazaneen; Wasik, Suzan Zuljani

    2005-02-01

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

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

    PubMed

    Du, Y H; Wang, Z P; Fu, J H

    2016-01-10

    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

  7. 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

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

    PubMed

    Choi, Susanne Y P; Holroyd, Eleanor

    2007-01-01

    This paper analyses barriers to consistent condom use in the context of transactional sex among female sex workers in mainland China. It reveals how differences in socioeconomic profile and organisational hierarchies amongst different groups of sex workers create different barriers to condom use. Data was collected by means of field observation of entertainment venues and in-depth interviews. Findings suggest that, compared with other sex workers, street-walkers are less likely to use condoms with their clients, hold highly disadvantaged socioeconomic profiles and work in isolation. Major barriers to condom use link to economic deprivation and threats of violence from clients. For the women working in entertainment venues, drunkenness of clients, pricing mechanisms and familiarity with clients pose barriers to condom use. Yet within all these constraints women are not powerless and instead find ways to exercise agency and gain personal protection and economic advantage. In the newly emerging China, both structural hierarchies of work and individual agency inform condom use by female sex workers. Future HIV intervention programmes need to take these factors into account in order to meet the needs of different groups of women sex workers. PMID:17687674

  9. Reaching and identifying the STD/HIV risk of sex workers in Beijing.

    PubMed

    Rogers, Susan J; Ying, Liu; Xin, Yan Tao; Fung, Kee; Kaufman, Joan

    2002-06-01

    China's HIV cases are growing by more than 30% annually. Few researchers have been able to reach sex workers and examine their risk behavior patterns. Key informants in illegal prostitution connected with owners of establishments in Beijing to recruit the involvement of sex workers. A total of 69 were surveyed about their background and risk behaviors in spring, 2000 in four venues; hair salons, bathing centers, karaoke bars, and the street. The women were mostly young (in their 20s), of low socioeconomic status, and from small towns and villages. They worked about 3 to 4 days a week, averaged one to two clients per day, made the equivalent of about U.S. $135 a week, and averaged about 3 months at any one establishment. They lacked accurate knowledge of STDs/HIV, and although 61% reported consistent condom usage 93% associated usage with prevention of pregnancy and 72% perceived a low risk of HIV infection. Nearly all (98%) felt condoms were affordable, yet 37% reported they were not accessible; 74% had obtained a medical exam in the last year, but 29% were examined when sick; only 10% received prevention information during medical visits, and 55% did not know where to go for HIV testing. Based on venue, stratification among sex workers existed, impacting their risk. Sex workers are at high risk of HIV infection/transmission, especially as the virus becomes more established in Beijing. Although risk factors were consistent with those of sex workers in other countries, the variation by venue, the low perceived vulnerability to HIV, the highly illegal nature of prostitution, and high mobility of sex workers in Beijing calls for a tailored intervention approach. Prevention messages/strategies should be responsive to the differing background, knowledge, PMID:12092924

  10. 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

  11. 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

  12. HIV risk behaviors among three classes of female sex workers in Vietnam.

    PubMed

    Le, Mai-Nhung; D'Onofrio, Carol N; Rogers, John D

    2010-01-01

    Increases in the rate of HIV infection in Vietnam among female sex workers and their clients require more effective preventive interventions based on a better understanding of this population and important subgroups within it. Because little was known about women in the hospitality sex industry, this study compared demographic and work characteristics, history of sexually transmitted infections (STIs), and condom use among a sample of 310 female sex workers in low-, middle-, and high-class hospitality businesses in Ho Chi Minh City (mean age = 26.77 years, SD = 6.17). Data were collected through individual, face-to-face, semistructured interviews. Logistic regression models were used to identify demographic predictors of the incidence of STIs and reported condom use. Low occupational status was most strongly associated with a history of STIs, and use of condoms with new and regular clients also differed by occupational class. Implications are discussed. PMID:19499456

  13. 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

  14. Sex-related health risks and implications for interventions with hospitality women in Hainan, China.

    PubMed

    Liao, Su-Su; Schensul, Jean; Wolffers, Ivan

    2003-04-01

    This article describes the living situations of sex workers (hospitality girls) in a typical rural town in southern China; their personal, social, financial, and psychological needs and expectations; and the social and economic factors that place them at risk for STIs/HIV and unwanted pregnancy, based on the qualitative and quantitative data collected prior to and during a preventive intervention. Though some similarities to knowledge, attitudes, and behaviors of sex workers reported in other Asian countries were identified, this study identified some differences distinctive to the China context, such as how economic factors, kinship, and friendship networks function in the service industry, and how the culture of reproduction and birth control policy interact with and affect sex workers' health and decision-making options. Understanding these factors is critical for design of a culturally and contextually tailored intervention for the reduction of sex-related health risks of women in the sex service industry. PMID:12739788

  15. 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

  16. Looking beyond legality: understanding the context of female sex workers in greater Cairo, Egypt.

    PubMed

    Kabbash, I A; Abdul-Rahman, I; Shehata, Y A

    2013-01-01

    Data on demographic, social and behavioural characteristics of female sex workers in greater Cairo are very scarce. A cross-sectional study was conducted with 431 randomly selected sex workers after mapping of sites where they gather. Data collection was performed by direct interviewing using a questionnaire sheet covering sociodemographic data and sexual history with paying and non-paying partners. More than one half of participants (52.7%) were aged < 30 years. Only 39.3% were exclusively working as sex workers while the rest had other jobs beside sex work. Almost 70% were responsible for deperidants. The age of first selling sex was < 15 years for 4.7% of the women and 15-25 years for 58.7%. Unwanted pregnancies were experienced by 36.2% and 34.8% had had an abortion. Many participants had ever been arrested by the police (71.2%). The study has provided some useful background data for further studies in this very sensitive area of research. PMID:23520902

  17. `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

  18. 20 Facts on Women Workers. Facts on Working Women No. 90-2.

    ERIC Educational Resources Information Center

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

    This information sheet presents 20 facts on women workers in 1989: (1) 56 million women 16 years of age and over are working or looking for work; (2) 69 percent of all women 18 to 64 years of age are in the civilian labor force; (3) most women workers are employed full time; (4) the average women worker spends 29.3 years of her life in the labor…

  19. 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

  20. 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

  1. Police-Related Experiences and HIV Risk Among Female Sex Workers in Andhra Pradesh, India

    PubMed Central

    Reed, Elizabeth; Blankenship, Kim M.

    2011-01-01

    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

  2. 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

  3. 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

  4. 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…

  5. 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

  6. Occupational Stigma as a Primary Barrier To Health Care For Street-Based Sex Workers in Canada

    PubMed Central

    Lazarus, Lisa; Deering, Kathleen N; Nabess, Rose; Gibson, Kate; Tyndall, Mark W; Shannon, Kate

    2011-01-01

    Individuals working in the sex industry continue to experience many negative health outcomes. As such, disentangling the factors shaping poor health access remains a critical public health priority. Within a quasi-criminalised prostitution environment, this study aimed to evaluate the prevalence of occupational stigma associated with sex work and its relationship to barriers to accessing health services. Analyses draw on baseline questionnaire data from a community-based cohort of women in street-based sex work in Vancouver, Canada (2006–8). Of a total of 252 women, 141 (58.5%) reported occupational sex work stigma (defined as hiding occupational sex work status from family, friends and/or home community), while 125 (49.6%) reported barriers to accessing health services in the previous six months. In multivariable analysis, adjusting for socio-demographic, interpersonal and work environment risks, occupational sex work stigma remained independently associated with an elevated likelihood of experiencing barriers to health access. Study findings indicate the critical need for policy and societal shifts in views of sex work as a legitimate occupation, combined with improved access to innovative, accessible and non-judgmental health care delivery models for street-based sex workers that include the direct involvement of sex workers in development and implementation. PMID:22084992

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

    PubMed

    Abdolsalehi-Najafi, Emon; Beckman, Linda J

    2013-08-01

    Although the experience of sex guilt has been considered among a variety of ethnic groups, the area has not yet been empirically explored among Iranian American women. The present study investigated the relationship between sexual self-schema (i.e., beliefs about the sexual aspects of oneself), acculturation, and sex guilt, and it further examined the association between sex guilt and life satisfaction in Iranian American women. A total of 65 Iranian American women, with a mean age of 31.3 years (SD = 11.7), completed five self-administered questionnaires. Findings indicated a significant inverse correlation between sexual self-schema and sex guilt. More specifically, women who endorsed negative self-views regarding their sexual self reported higher levels sex guilt. Results revealed that acculturation was unrelated to sex guilt, when the effect of being Muslim or non-Muslim was controlled. Women with high sex guilt reported significantly lower levels of life satisfaction. Moreover, analyses for mediation effects supported sex guilt as a partially mediating variable between sexual self-schema and life satisfaction. Levels of sex guilt were higher among Muslim women when compared to women of other religious affiliations. Additionally, Muslim women appeared to be significantly less acculturated to Western ideals than other religious groups. The present findings suggest that mental health professionals who provide services to Iranian American women need to consider the negative effects of sex guilt, particularly among Muslim women. PMID:23546891

  8. 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

  9. 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…

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

    PubMed

    Smith, Michael D; Seal, David W

    2008-10-01

    Although indoor male sex workers (MSWs) have been found to engage in lower rates of HIV risk behavior with clients than street-based MSWs, few studies have examined the motivations behind such practices. We interviewed 30 MSWs working for the same escort agency regarding their safer sex practices with clients and their reasons for these. As in other research, MSWs reported little risk behavior with clients. Five motivational themes related to safer sex on the job emerged: health concerns, emotional intimacy, client attractiveness, relationships, and structural work factors. Results suggest that participants engaged in rational decision-making relative to sex with clients, facilitated by reduced economic incentive for riskier behavior and a supportive social context. MSWs desired a safe sexual work place, personal integrity, and minimal negative consequences to personal relationships. Collaborating with sex work employers to study their role in encouraging a safer workplace may be important to future research. PMID:18288599

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

    PubMed Central

    2011-01-01

    Background Condoms are effective in preventing the transmission of HIV and other sexually transmitted infections, when properly used. However, recent data from surveys of female sex workers (FSWs) in Karnataka in south India, suggest that condom breakage rates may be quite high. It is important therefore to quantify condom breakage rates, and examine what factors might precipitate condom breakage, so that programmers can identify those at risk, and develop appropriate interventions. Methods We explored determinants of reported condom breakage in the previous month among 1,928 female sex workers in four districts of Karnataka using data from cross-sectional surveys undertaken from July 2008 to February 2009. Using stepwise multivariate logistic regression, we examined the possible determinants of condom breakage, controlling for several independent variables including the district and client load. Results Overall, 11.4% of FSWs reported at least one condom break in the previous month. FSWs were much more likely to report breakage if under 20 years of age (AOR 3.43, p = 0.005); if divorced/ separated/widowed (AOR 1.52, p = 0.012); if they were regular alcohol users (AOR 1.63, p = 0.005); if they mostly entertained clients in lodges/rented rooms (AOR 2.99, p = 0.029) or brothels (AOR 4.77, p = 0.003), compared to street based sex workers; if they had ever had anal sex (AOR 2.03, p = 0.006); if the sex worker herself (as opposed to the client) applied the condom at last use (AOR 1.90, p < 0.001); if they were inconsistent condom users (AOR 2.77, p < 0.001); and if they had never seen a condom demonstration (AOR 2.37, p < 0.001). Conclusions The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct condom use. More research is also needed on what specific situational parameters might be important in predisposing women to condom breakage. PMID:22376237

  12. Understanding socio economic contexts of female sex workers in eastern Nepal.

    PubMed

    Sagtani, R A; Bhattarai, S; Adhikari, B R; Baral, D D; Yadav, D K; Pokharel, P K

    2014-12-01

    The present focus is mostly laid on high risk behavior of commercial sex workers without any consideration of their location, educational status and other socio-cultural norms. Thus, we designed a study to understand socio demographic characteristics, lifestyle of female sex workers and search for driving factors for prostitution in eastern Nepal. A descriptive study was conducted in three districts of Eastern Nepal in 2012 over the period of six months. The data regarding their socio demographic characteristics, income, reason for joining sex trade and future choice regarding the profession were recorded from 210 female sex workers through face-to-face interviews. Majority (53.3%) of respondents belonged to the productive age group of 20-29 years, more than one thirds (43.3%) had not received any form of formal education and were unmarried. More than half (53.80%) were presently living alone and about one thirds of the women (31.90%) were minors when they joined this profession. Major portion of the sample (94.80%) worked more than three days a week with median income of 15 thousand per month and 41 percent had sex with more than or equal to ten clients per week. Poor economic condition was the most frequent (47.6%) factor leading to joining of sex trade however, more than two thirds, (72.80%) wanted to quit the profession. Given low level of education, relatively low income, and young age among this population, empowerment and alternative employment/education opportunities should be created to develop this part of Nepalese society. PMID:26930727

  13. 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

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

  15. 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

  16. 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

  17. 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

  18. 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; Garca, 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

  19. 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

  20. Can a targeted GP-led clinic improve outcomes for street sex workers who use heroin?

    PubMed

    Litchfield, Jane; Maronge, Andrew; Rigg, Tim; Rees, Benjamin; Harshey, Ravi; Keen, Jenny

    2010-07-01

    Female street sex workers in the UK are often addicted to heroin, and sex work may be a result of the economic drive to fund this addiction. This study looks at outcomes of a primary care drugs treatment intervention for street sex workers who use heroin, using prescribed maintenance treatment with intensive health and psychosocial support. Thirty-four sex workers entered the study and 100% were retained in the study at 1 year. After 1 year, only 33% of participants were still sex workers. Quality of life had improved significantly and heroin use had reduced. PMID:20594441

  1. Trends in sexually transmitted diseases and condom use patterns among commercial sex workers in Fukuoka City, Japan 1990-93.

    PubMed Central

    Tanaka, M; Nakayama, H; Sakumoto, M; Matsumoto, T; Akazawa, K; Kumazawa, J

    1996-01-01

    OBJECTIVE: To investigate trends in sexually transmitted diseases (STDs) among female commercial sex workers and in their condom use patterns during the period from 1990 to 1993 in Fukuoka, Japan. METHODS: The study group consisted of a total of 824 commercial sex workers who attended an STD clinic to undergo screening for STDs including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV-1 infection during the period from 1990 to 1993. For detection of Chlamydia trachomatis and Neisseria gonorrhoeae, endocervical smear specimens were taken from the women. Blood samples were obtained for serological diagnosis of syphilis, hepatitis B and HIV-1. Commercial sex workers who visited the clinic during the period from November to December of 1993 were interviewed concerning past (1990 and 1991) and recent (1992 and 1993) condom use patterns. RESULTS: The annual detection rates of C trachomatis and N gonorrhoeae declined significantly from 16.3% in 1990 to 12.2% in 1993 (P < 0.0001) and from 1.5% in 1990 to 0.8% in 1993 (P = 0.0096), respectively. There was a remarkable reduction in the annual syphilis infection rate, from 7.5% in 1990 to 0.5% in 1993 (P = 0.0011). The positive rate for the hepatitis B surface antigen in the women ranged from only 0.6% to 1.9% and none were found to be positive for HIV-1 during the 4-year period. During the same period, there was a significant increase in the proportion of commercial sex workers always using condoms from 6.3% in 1990-91 to 25.3% in 1992-93 (P = 0.0023). CONCLUSION: The prevalences of chlamydia, gonorrhoea, and syphilis infections decreased significantly among commercial sex workers in Fukuoka from 1990 through 1993, and no commercial sex workers were HIV-1 seropositive. The reductions in the prevalence of major STDs may be related to the increased use of condoms. PMID:8976854

  2. 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

  3. 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

  4. 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

  5. Status report on the forcibly rescued and detained sex workers in Mumbai.

    PubMed

    1996-01-01

    On January 17, 1996, the Chief Justice and Justice of India's High Court issued a suo moto petition ordering the police to rescue all underage sex workers from Mumbai brothels. Approximately 50 simultaneous police raids were conducted in a 1-hour period on February 5th during which 437 female alleged child sex workers were detained for rescue. None were produced in court within 24 hours of their detention, against Indian law. While a police surgeon determined the majority to be under age 18 years, the women's backgrounds and histories make it likely that many are actually age 18 years and older. The justices have argued that even the women of majority age should be detained for rehabilitation. These detainees have since been discriminated against and subjected to mandatory HIV testing without their informed consent, inhumane living conditions, and violations of their fundamental rights. The de facto imprisonment of these women violates their rights of freedom of movement, freedom of association, and freedom of residence. The Indian Health Organization and Counseling and Allied Services for AIDS have been making regular weekly visits to provide medical and counseling services to the women. There is strong clinical suspicion that 65-70% of the detainees are HIV-positive, 62% are undergoing treatment for other sexually transmitted diseases, and 85% have nonsexually transmitted diseases such as tuberculosis. All require immediate medical attention. Some women have been sent under police escort to institutions or their families in their countries of origin. 236 mainly Nepalese women remain in six remand homes in and around Bombay awaiting court decisions on their futures. PMID:12347629

  6. 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

  7. Psychological stressors in the context of commercial sex among female sex workers in China.

    PubMed

    Zhang, Chen; Hong, Yan; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao; Su, Shaobing

    2015-01-01

    Because of the illegality and stigma associated with female sex workers (FSWs) in China, data were limited regarding their psychological stressors examined through the lens of occupational health. Analyzing qualitative data from 16 gatekeepers and 38 FSWs, we explored these stressors in the context of commercial sex in China. We found that FSWs faced a continuum of stressors that resulted from poverty, limited employment, lack of social protection, violence perpetrated by clients, and limited social support from peers and stable partners. We call for empowerment and a structural approach to address the needs of FSWs to improve their psychological well-being. PMID:24180467

  8. Women Workers and Maternity: Some Examples from Western Europe.

    ERIC Educational Resources Information Center

    Paoli, Chantal

    1982-01-01

    The author studies measures adopted in some European market economy countries with a view to improving maternity protection and enabling women workers to reconcile the dual function of maternity and economic activity without undermining equality. (Editor)

  9. 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

  10. 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

  11. Occupational Sex Segregation and Job Satisfaction of Women.

    ERIC Educational Resources Information Center

    Smart, John C.; Ethington, Corinna A.

    1987-01-01

    Women employed in sex-balanced and male- and female-dominated occupations in the public sector have comparable levels of job satisfaction. In private firms, women in sex-balanced careers are more satisfied with the intrinsic nature of their jobs than those employed in female-dominated occupations. (Author/MLW)

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

    PubMed

    Cunningham, Scott; Kendall, Todd D

    2010-12-01

    Sex workers have historically played a central role in STI outbreaks by forming a core group for transmission and due to their higher rates of concurrency and inconsistent condom usage. Over the past 15 years, North American commercial sex markets have been radically reorganised by internet technologies that channelled a sizeable share of the marketplace online. These changes may have had a meaningful impact on the role that sex workers play in STI epidemics. In this study, two new datasets documenting the characteristics and practices of internet-facilitated sex workers are presented and analysed. The first dataset comes from a ratings website where clients share detailed information on over 94,000 sex workers in over 40 cities between 1999 and 2008. The second dataset reflects a year-long field survey of 685 sex workers who advertise online. Evidence from these datasets suggests that internet-facilitated sex workers are dissimilar from the street-based workers who largely populated the marketplace in earlier eras. Differences in characteristics and practices were found which suggest a lower potential for the spread of STIs among internet-facilitated sex workers. The internet-facilitated population appears to include a high proportion of sex workers who are well-educated, hold health insurance and operate only part time. They also engage in relatively low levels of risky sexual practices. PMID:20852309

  13. Male sex workers in Antwerp, Belgium: a descriptive study.

    PubMed

    Leuridan, E; Wouters, K; Stalpaert, M; Van Damme, P

    2005-11-01

    The objective of this study was to describe the prevalence of sexually transmitted infections (STI), sociodemographic and behavioural characteristics in a population of male sex workers (MSW) in Antwerp, Belgium. Between September 1999 and March 2004, 129 MSW were reached by Gh@pro, an outreach programme providing preventive health care, free STI check-up and hepatitis B vaccination, to sex workers (SW). Sera were collected from 121 men, urine samples from 115 men and a questionnaire was filled in by 43 MSW. In 45.5% of MSW one or more STI were diagnosed (including hepatitis B), 76% on laboratory testing at first screening, 9% through symptomatology at first visit. The prevalence of HIV was 10.8%, hepatitis B virus (HBV) infection 28.9%, syphilis 12.5%, gonorrhoea 1.7% and Chlamydia trachomatis 9.7%. More than 50% of non-immune MSW completed their three-dose hepatitis B vaccination course. Prevalence of STI is concordant with published data on MSW; this population clearly requests and deserves particular attention and approach. There is an important difference in sociodemographic and behavioural characteristics between MSW working in the red light district and those working on the street. Health promotion should be tailored to the different subpopulations and outreach appears to be a successful tool. PMID:16303070

  14. 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…

  15. 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…

  16. 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

  17. 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

  18. "What makes you think you have special privileges because you are a police officer?" A qualitative exploration of police's role in the risk environment of female sex workers.

    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

  19. 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 then makes the selling of sex unnecessary. This has implications for interventions, and part of the longer-term solution should lie in improving the economic position of women vis-à-vis men. PMID:11824924

  20. 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

  1. "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

  2. 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

  3. Heterosexual Anal Sex among Female Sex Workers in High HIV Prevalence States of India: Need for Comprehensive Intervention

    PubMed Central

    Alexander, Mallika; Mainkar, Mandar; Deshpande, Sucheta; Chidrawar, Shweta; Sane, Suvarna; Mehendale, Sanjay

    2014-01-01

    Introduction Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS) is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs) and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. Methods Data for this paper are drawn from Round I survey of 9667 FSWs in the Integrated Biological and Behavioral Assessment (IBBA) from 23 districts of 4 high HIV prevalent states of India. Bivariate and multivariate analysis identified factors associated with HAS. Results Ever having anal sex was reported by 11.9% FSWs (95% CI: 11.3%–12.6%). Typology (AOR 2.20, 95% CI 1.64–2.95) and literacy (AOR 1.28, 95% CI 1.10–1.49) were positively associated with practice of HAS. Longer duration in sex trade (AOR 1.69, 95% CI 1.44–1.99), entertaining larger number of clients the previous week (AOR 1.78, 95% CI 1.47–2.15), alcohol consumption (AOR 1.21, 95% CI 1.03–1.42) and inability to negotiate condom use (AOR 1.53, 95% CI 1.28–1.83) were also correlated with HAS. Self-risk perception for HIV (AOR 1.46, 95% CI 1.25–1.71) did not impede HAS. Although symptoms of sexually transmitted infections (STIs) in the last 12 months were associated with anal sex (AOR 1.39, 95% CI 1.13–1.72) there was no significant association between laboratory confirmed HIV and other STIs with HAS. Conclusion Practice of HAS by FSWs might significantly contribute to HIV transmission in India. This study also shows that despite self-risk perception for HIV, even literate FSWs with longer duration in sex work report HAS. General messages on condom use may not influence safe HAS. FSWs need to be targeted with specific messages on HIV transmission during anal sex. Women controlled prevention methods, such as rectal microbicides and vaginal microbicides are needed. PMID:24586416

  4. Women and the Future: Changing Sex Roles in Modern America.

    ERIC Educational Resources Information Center

    Giele, Janet Zollinger

    This book identifies, analyzes, and evaluates the changes in the status of women in government, work, the family, and the cultural system. It is intended for persons interested in any aspect of women's studies or sex roles. American women today have a greater voice in politics than at any earlier point in history. But signs of inequality in actual…

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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…

  10. 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

  11. 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

  12. 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

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

    PubMed Central

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

    2012-01-01

    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

  14. 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

  15. 20 Facts on Women Workers. Facts on Working Women.

    ERIC Educational Resources Information Center

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

    Of the 108 million women age 16 or over who were part of the 1999 civilian noninstitutional U.S. population, 65 million (about 60%) were either employed or actively looking for work. In 1999, black, white, and Hispanic women participated in the labor force at rates of 63.5%, 59.6%, and 55.9%, respectively. According to projections, women will…

  16. Exploring barriers to 'respondent driven sampling' in sex worker and drug-injecting sex worker populations in Eastern Europe.

    PubMed

    Simic, Milena; Johnston, Lisa Grazina; Platt, Lucy; Baros, Sladjana; Andjelkovic, Violeta; Novotny, Tom; Rhodes, Tim

    2006-11-01

    Respondent driven sampling (RDS) has been used in several counties to sample injecting drug users, sex workers (SWs) and men who have sex with men and as a means of collecting behavioural and biological health data. We report on the use of RDS in three separate studies conducted among SWs between 2004 and 2005 in the Russian Federation, Serbia, and Montenegro. Findings suggest that there are limitations associated with the use of RDS in SW populations in these regions. Findings highlight three main factors that merit further investigation as a means of assessing the feasibility and appropriateness of RDS in this high risk population: the network characteristics of SWs; the appropriate level of participant incentives; and lack of service contact. The highly controlled and hidden nature of SW organizations and weak SW social networks in the region can combine to undermine assumptions underpinning the feasibility of RDS approaches and potentially severely limit recruitment. We discuss the implications of these findings for recruitment and the use of monetary and non-monetary incentives in future RDS studies of SW populations in Eastern Europe. PMID:17109206

  17. 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…

  18. 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

  19. 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

  20. Identification of differentially expressed proteins in the cervical mucosa of HIV-1-resistant sex workers.

    PubMed

    Burgener, Adam; Boutilier, Julie; Wachihi, Charles; Kimani, Joshua; Carpenter, Michael; Westmacott, Garrett; Cheng, Keding; Ball, Terry B; Plummer, Francis

    2008-10-01

    Novel tools are necessary to understand mechanisms of altered susceptibility to HIV-1 infection in women of the Pumwani Sex Worker cohort, Kenya. In this cohort, more than 140 of the 2000 participants have been characterized to be relatively resistant to HIV-1 infection. Given that sexual transmission of HIV-1 occurs through mucosal surfaces such as that in the cervicovaginal environment, our hypothesis is that innate immune factors in the genital tract may play a role in HIV-1 infection resistance. Understanding this mechanism may help develop microbicides and/or vaccines against HIV-1. A quantitative proteomics technique (2D-DIGE: two-dimensional difference in-gel electrophoresis) was used to examine cervical mucosa of HIV-1 resistant women ( n = 10) for biomarkers of HIV-1 resistance. Over 15 proteins were found to be differentially expressed between HIV-1-resistant women and control groups ( n = 29), some which show a greater than 8-fold change. HIV-1-resistant women overexpressed several antiproteases, including those from the serpin B family, and also cystatin A, a known anti-HIV-1 factor. Immunoblotting for a selection of the identified proteins confirmed the DIGE volume differences. Validation of these results on a larger sample of individuals will provide further evidence these biomarkers are associated with HIV-1 resistance and could help aid in the development of effective microbicides against HIV-1. PMID:18707157

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

    PubMed

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

    2008-02-01

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

  2. Pilot study assessing HIV vaccine trial readiness among female sex workers, injection and non-injection drug users, and men who have sex with men in Spain.

    PubMed

    Etcheverry, María Florencia; de Lazzari, Elisa; Fuchs, Jonathan D; Meroño, Mercé; Sierra, Ernesto; Del Romero, Jorge; Evans, Jennifer L; Mendez-Arancibia, Eva; Jacques, Constanza; Rojas, Daniela; Segú, Marta; Gatell, José María; Joseph, Joan

    2010-06-01

    The purpose of this study was to assess HIV risk and willingness to participate in HIV vaccine trials in three high risk populations in Spain. Eight hundred and forty-four participants, comprising female sex workers, injection and non-injection drug users (IDUs and NIDUs, respectively), and men who have sex with men were tested for HIV and surveyed for risk and willingness to participate in future preventive HIV vaccine trials. HIV seroprevalence was 3.8% (95% CI: 2-11). HIV infection was associated with transgender identification, IDU in the past year, and sex with an IDU or other drug-using partner. The majority (82%) expressed their willingness to participate in HIV vaccine trials. Substantial sexual and parenteral risk in all groups and concomitant willingness to participate in vaccine trials was found, particularly among women and IDUs. Additional longitudinal cohort studies in Spain are needed to plan future vaccine efficacy trials. PMID:19037720

  3. 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

  4. 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

  5. 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

  6. 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

  7. Condom use among female sex workers in Uganda.

    PubMed

    Bukenya, Justine; Vandepitte, Judith; Kwikiriza, Maureen; Weiss, Helen A; Hayes, Richard; Grosskurth, Heiner

    2013-01-01

    Consistent condom use can prevent HIV infection, yet levels of condom use are low in many settings. This paper examines determinants of inconsistent condom use among 905 women enrolled in a high-risk cohort in Kampala, Uganda, who reported sexual intercourse with paying clients in the last month. Among these, 40% participants reported using condoms inconsistently with paying clients in the past month. The most common reason for inconsistent condom use was client preference. Factors independently associated with inconsistent condom use included: sex work not being the sole source of income [adjusted odds ratio (aOR) = 1.54; 95% confidence interval (CI): 1.13-2.09], sexual debut before 14 years (aOR = 1.46; 95% CI: 1.09-1.96), daily consumption of alcohol (aOR = 1.90; 95% CI: 1.26-2.88) and being currently pregnant (aOR = 2.11; 95% CI: 1.25-3.57). Being currently married (aOR = 0.36; 95% CI: 0.18-0.73) and a higher number of sexual partners per month (p-trend = 0.001) were associated with a lower risk of inconsistent condom use. Targeted programmes should be developed to promote consistent condom use in high-risk women, alongside interventions to reduce alcohol use. PMID:23216336

  8. 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

  9. 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 key population. The correlates of NPOU uncovered here suggest that structural interventions may be further implemented to ameliorate this growing concern. PMID:25148695

  10. 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

  11. 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 further exploration into their mode of action. PMID:26090884

  12. 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…

  13. 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,…

  14. 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

  15. 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 health outcomes in these communities. If developed at sufficient scale and intensity, sex work organisations could play a critical role in reducing the present harms caused by criminalisation and stigma. PMID:23889941

  16. 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

  17. 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…

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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's results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs. PMID:19716639

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

    PubMed Central

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

    2011-01-01

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

  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. 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

  6. Youth, violence and non-injection drug use: Nexus of vulnerabilities among lesbian and bisexual sex workers

    PubMed Central

    Lyons, Tara; Kerr, Thomas; Duff, Putu; Feng, Cindy; Shannon, Kate

    2014-01-01

    Despite increasing evidence of enhanced HIV risk among sexual minority populations, and sex workers in particular, there remains a paucity of epidemiological data on the risk environments of sex workers who identify as lesbian or bisexual. Therefore, this short report describes a study that examined the individual, interpersonal and structural associations with lesbian or bisexual identity among sex workers in Vancouver, Canada. Analysis drew on data from an open prospective cohort of street and hidden off-street sex workers in Vancouver. Bivariate and multivariable logistic regression were used to examine the independent relationships between individual-, interpersonal, work environment- and structural-factors and lesbian or bisexual identity. Of the 510 individuals in our sample, 95 [18.6%] identified as lesbian or bisexual. In multivariable analysis, reporting non-injection drug use in the last 6 months (adjusted odds ratio [AOR]= 2.89; 95% confidence intervals [CI]= 1.42, 5.75), youth ≤ 24 years of age (AOR= 2.43; 95% CI = 1.24, 4.73) and experiencing client-perpetrated verbal, physical and/or sexual violence in the last 6 months (AOR= 1.85; 95% CI= 1.15, 2.98) remained independently associated with lesbian/bisexual identity, after adjusting for potential confounders. The findings demonstrate an urgent need for evidence-based social and structural HIV prevention interventions. In particular, policies and programs tailored to lesbian and bisexual youth and women working in sex work, including those that prevent violence and address issues of non-injection stimulant use are required. PMID:24382155

  7. 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

  8. Primary care of women who have sex with women. Recommendations from the research.

    PubMed

    Roberts, Susan J

    2015-12-12

    Research on women who have sex with women has increased in the last decade. Attention has been brought to this group of women through the IOM report, which noted a lack of research related to their care. Most of the research has not been published in nursing literature. This article reviews this literature with recommendations for primary care practice. PMID:25757088

  9. 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

  10. 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

  11. 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

  12. '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

    2016-03-01

    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

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

    PubMed Central

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

    2011-01-01

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

  14. Suicidal Behavior Among Female Sex Workers in Goa, India: The Silent Epidemic

    PubMed Central

    Wayal, Sonali; Cowan, Frances; Mabey, David; Copas, Andrew; Patel, Vikram

    2009-01-01

    Objectives. We sought to study suicidal behavior prevalence and its association with social and gender disadvantage, sex work, and health factors among female sex workers in Goa, India. Methods. Using respondent-driven sampling, we recruited 326 sex workers in Goa for an interviewer-administered questionnaire regarding self-harming behaviors, sociodemographics, sex work, gender disadvantage, and health. Participants were tested for sexually transmitted infections. We used multivariate analysis to define suicide attempt determinants. Results. Nineteen percent of sex workers in the sample reported attempted suicide in the past 3 months. Attempts were independently associated with intimate partner violence (adjusted odds ratio [AOR] = 2.70; 95% confidence interval [CI] = 1.38, 5.28), violence from others (AOR = 2.26; 95% CI = 1.15, 4.45), entrapment (AOR = 2.76; 95% CI = 1.11, 6.83), regular customers (AOR = 3.20; 95% CI = 1.61, 6.35), and worsening mental health (AOR = 1.05; 95% CI = 1.01, 1.11). Lower suicide attempt likelihood was associated with Kannad ethnicity, HIV prevention services, and having a child. Conclusions. Suicidal behaviors among sex workers were common and associated with gender disadvantage and poor mental health. India's widespread HIV-prevention programs for sex workers provide an opportunity for community-based interventions against gender-based violence and for mental health services delivery. PMID:19443819

  15. 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

  16. Stigma, sexual health, and human rights among women who have sex with women in Lesotho.

    PubMed

    Poteat, Tonia C; Logie, Carmen H; Adams, Darrin; Mothopeng, Tampose; Lebona, Judith; Letsie, Puleng; Baral, Stefan

    2015-11-01

    In recent years, gender and sexual minorities have become increasingly visible across sub-Saharan Africa, marking both the progression and violation of their human rights. Using data from a study with sexual minorities in Lesotho, this analysis leveraged the social ecological model to examine relationships between stigma, human rights, and sexual health among women who have sex with women in Lesotho. A community-based participatory approach was used for the mixed-method, cross-sectional study. A total of 250 women who have sex with women completed a structured questionnaire, of which 21 participated in a total of three focus group discussions. Stigma was common within and outside the health sector. Stigma and human rights abuses were associated with increased risk for HIV and STIs. Interventions to address stigma at the structural, community, and interpersonal levels are essential to ensuring sexual health and rights for women who have sex with women in Lesotho. PMID:26719002

  17. 20 Facts on Women Workers. Fact Sheet No. 88-2.

    ERIC Educational Resources Information Center

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

    This fact sheet lists 20 interpreted statistics on women workers. The facts cover the following data: number of women workers and their percentage in the labor force; length of time women are expected to stay in the labor force; racial and ethnic groups in the labor force; part-time and full-time employment; types of occupations in which women are…

  18. 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

  19. 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

  20. 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

  1. 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…

  2. Human papillomavirus prevalence, cervical abnormalities and risk factors among female sex workers in Lima, Peru

    PubMed Central

    Brown, B; Blas, M M; Cabral, A; Byraiah, G; Guerra-Giraldez, C; Sarabia-Vega, V; Carcamo, C; Gravitt, P E; Halsey, N A

    2015-01-01

    Summary Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infection. Questionnaires were administered to 200 FSWs aged 1826 years in Lima, Peru, to gather risk behaviours, and cervical swab samples were collected for Pap smears and HPV DNA testing as part of a longitudinal study. Participants reported a median of 120 clients in the past month, and 99.2% reported using condoms with clients. The prevalence of any HPV in cervical samples was 66.8%; 34 (17.1%) participants had prevalent HPV 16 or 18, and 92 (46.2%) had one or more oncogenic types. Fifteen women had abnormal Pap smears, 13 of which were HPV DNA positive. Fewer years since first sex was associated with oncogenic HPV prevalence in a model adjusted for previous sexually transmitted infection (STI) status and condom use with partners (prevalence ratio = 0.77, 95% confidence interval [CI] = 0.600.97). Our data confirm the high rates of HPV transmission among FSWs in Peru, highlighting the need for early and effective strategies to prevent cervical cancer. PMID:22581946

  3. Partner Violence and Psychosocial Distress among Female Sex Workers in China

    PubMed Central

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

    2013-01-01

    Background Despite recognized vulnerability of female sex workers (FSW), most data on this population are focused on their HIV and STI prevalence; studies on their experience of partner violence and psychosocial distress are limited, especially FSW in China. Methods and Findings A cross-sectional survey was administered among 1,022 FSW recruited from 9 different types of commercial sex venues in Southwest China. Partner violence scales were adapted from WHO's Women's Health and Domestic Violence scale and psychosocial distress was measured by five indicators, including alcohol intoxication, drug use, suicidal behavior, depression, and loneliness. Random effects modeling was used to control for cluster effects. Findings: About 58% of FSW ever experienced violence from their stable partners, and 45% suffered it from their clients. Partner violence was strongly associated with each of the five measures of psychosocial distress, even after controlling for potential confounders. Conclusion This study is one of the first to examine the association between partner violence and psychosocial distress among FSW in China. The high prevalence of violence experience and distress in this population suggests urgency for intervention. The public health programs targeting FSW should go beyond the focus on HIV/STI prevention and care for the fundamental health and human rights of millions of FSW in China. PMID:23626798

  4. 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

  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. 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 only sparse specific and competent programming. FSW are an important population for further investigation and rapid scale-up of combination HIV prevention including biomedical, behavioral, and structural interventions. PMID:25531771

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

    PubMed Central

    2012-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  9. 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

  10. Female Migrant Sex Workers in Moscow: Gender and Power Factors and HIV Risk

    PubMed Central

    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 we 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

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

    PubMed

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

    2007-05-01

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

  12. 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

  13. A Systematic Review of the Correlates of Violence Against Sex Workers

    PubMed Central

    Deering, Kathleen N.; Amin, Avni; Shoveller, Jean; Nesbitt, Ariel; Garcia-Moreno, Claudia; Duff, Putu; Argento, Elena; Shannon, Kate

    2014-01-01

    We conducted a systematic review in June 2012 (updated September 2013) to examine the prevalence and factors shaping sexual or physical violence against sex workers globally. We identified 1536 (update = 340) unique articles. We included 28 studies, with 14 more contributing to violence prevalence estimates. Lifetime prevalence of any or combined workplace violence ranged from 45% to 75% and over the past year, 32% to 55%. Growing research links contextual factors with violence against sex workers, alongside known interpersonal and individual risks. This high burden of violence against sex workers globally and large gaps in epidemiological data support the need for research and structural interventions to better document and respond to the contextual factors shaping this violence. Measurement and methodological innovation, in partnership with sex work communities, are critical. PMID:24625169

  14. Injecting Drug Use Among Mexican Female Sex Workers on the US-Mexico Border.

    PubMed

    Cepeda, Alice; Nowotny, Kathryn M; Valdez, Avelardo

    2015-01-01

    Both injecting drug users (IDU) and sex workers are at great risk of contracting and transmitting HIV. Therefore, IDU sex workers could be at especially high risk. The recent increase of HIV infection in Mexico has caused increased attention to sex work. We identify the correlates of injecting drug use including socio-demographic, work history, and sexual and non-injecting drug use risk behaviors among Mexican female sex workers. There is a high risk profile for IDUs compared to never injectors including a high prevalence of lifetime STI infection (54.2%). Revealed is an environment composed of high-risk networks that may have serious binational public health implications. PMID:26211392

  15. A systematic review of the correlates of violence against sex workers.

    PubMed

    Deering, Kathleen N; Amin, Avni; Shoveller, Jean; Nesbitt, Ariel; Garcia-Moreno, Claudia; Duff, Putu; Argento, Elena; Shannon, Kate

    2014-05-01

    We conducted a systematic review in June 2012 (updated September 2013) to examine the prevalence and factors shaping sexual or physical violence against sex workers globally. We identified 1536 (update = 340) unique articles. We included 28 studies, with 14 more contributing to violence prevalence estimates. Lifetime prevalence of any or combined workplace violence ranged from 45% to 75% and over the past year, 32% to 55%. Growing research links contextual factors with violence against sex workers, alongside known interpersonal and individual risks. This high burden of violence against sex workers globally and large gaps in epidemiological data support the need for research and structural interventions to better document and respond to the contextual factors shaping this violence. Measurement and methodological innovation, in partnership with sex work communities, are critical. PMID:24625169

  16. A systematic review of the correlates of violence against sex workers.

    TOXLINE Toxicology Bibliographic Information

    Deering KN; Amin A; Shoveller J; Nesbitt A; Garcia-Moreno C; Duff P; Argento E; Shannon K

    2014-05-01

    We conducted a systematic review in June 2012 (updated September 2013) to examine the prevalence and factors shaping sexual or physical violence against sex workers globally. We identified 1536 (update = 340) unique articles. We included 28 studies, with 14 more contributing to violence prevalence estimates. Lifetime prevalence of any or combined workplace violence ranged from 45% to 75% and over the past year, 32% to 55%. Growing research links contextual factors with violence against sex workers, alongside known interpersonal and individual risks. This high burden of violence against sex workers globally and large gaps in epidemiological data support the need for research and structural interventions to better document and respond to the contextual factors shaping this violence. Measurement and methodological innovation, in partnership with sex work communities, are critical.

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

    PubMed

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

    2015-01-10

    We reviewed evidence from more than 800 studies and reports on the burden and HIV implications of human rights violations against sex workers. Published research documents widespread abuses of human rights perpetrated by both state and non-state actors. Such violations directly and indirectly increase HIV susceptibility, and undermine effective HIV-prevention and intervention efforts. Violations include homicide; physical and sexual violence, from law enforcement, clients, and intimate partners; unlawful arrest and detention; discrimination in accessing health services; and forced HIV testing. Abuses occur across all policy regimes, although most profoundly where sex work is criminalised through punitive law. Protection of sex workers is essential to respect, protect, and meet their human rights, and to improve their health and wellbeing. Research findings affirm the value of rights-based HIV responses for sex workers, and underscore the obligation of states to uphold the rights of this marginalised population. PMID:25059943

  18. Excess Metabolic Syndrome Risks Among Women Health Workers Compared With Men.

    PubMed

    Adeoye, Abiodun M; Adewoye, Ifeoluwa A; Dairo, David M; Adebiyi, Adewole; Lackland, Daniel T; Ogedegbe, Gbenga; Tayo, Bamidele O

    2015-11-01

    Metabolic syndrome is associated with higher rates of cardiovascular morbidity and mortality. Although significant disparities in the risks of metabolic syndrome by occupation type and sex are well documented, the factors associated with metabolic syndrome in low- to middle-income countries remain unclear. These gaps in evidence identify the need for patterns of metabolic syndrome among hospital personnel of both sexes in Nigeria. A total of 256 hospital workers comprising 32.8% men were studied. The mean age of the participants was 42.03 9.4 years. Using International Diabetic Federation criteria, the prevalence of metabolic syndrome was 24.2%. Women were substantially and significantly more likely to be identified with metabolic syndrome compared with men (34.9% vs 2.4%, respectively; P=.0001). This study identified metabolic syndrome among health workers with over one third of women with metabolic syndrome compared with <10% of men. These results support the implementation of lifestyle modification programs for management of metabolic syndrome in the health care workplace. PMID:26053898

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

    PubMed

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

    2011-05-01

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

  20. [Sex education of pregnant women and its relationship with their knowledge and attitude to sex].

    PubMed

    Ishimatsu, N; Fujita, Y

    1982-06-01

    Pregnant women's knowledge and awareness of sex in connection with their sex education were examined. There were 403 pregnant women of ages 19-40, who were obstetric outpatients at 2 general hospitals in Fukuoka and Yokohama. A questionnaire was administered between November 20 and December 19 in 1979. Main findings were as follows. 69% received their sex education in elementary school; 47.5%, in hospital; less than 5%, at local health clinic. They received sex education an average of 2.4 times. 46.6% obtained sex information via mass media; 34.1%, via relatives; 19.3%, via sex specialists. In the area of reproduction, 34% had accurate knowledge of menstruation; 32.8%, of basal body temperature; 14%, of family planning. Those who received formal sex education had much better understanding of reproduction. In the area of morals, 48.3% recognized a great decline in moral standards; 19.3% strongly objected to premarital sex; 29.5% regarded sex between engaged couples as exception. Women in their 20's tended to support sex between 2 people in love regardless of marital status. 19% unconditionally disapproved of abortion, while 75% approved of it with some conditions. Sources of information on morals, premarital sex, and abortion were mass media (23.8%) and sex education (10.3%). In the area of marriage, 62.3% got married for love; 51.8% listed love between husband and wife as the most important element in marriage; 56.5% thought child care belonged to both parents. 91.5% were thrilled about pregnancy; 88.5% thought expectant mothers' class very important; 57% were determined to nurse their babies. The majority learned about marriage from friends, marital life from husbands, infant care from parents and sisters. Only 5% learned about the same in sex education. 84.8% recognized the great necessity of sex education which would include social and psychological aspects as well as the physical aspects. PMID:6921276

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

    PubMed Central

    Tang, Weiming; Mahapatra, Tanmay; Liu, Fengying; Fu, Gengfeng; Yang, Bin; Tucker, Joseph D.; Zhao, Jinkou; Detels, Roger

    2015-01-01

    Background The increasing burden of sexually transmitted infections (STIs) including HIV and syphilis among male sex workers (MSWs) is a major global concern. The aim of our study was to evaluate the difference between MSWs and non-commercial MSMs in China. Methods During 2008-09, in a cross-sectional study, 2618 adult MSM were recruited through respondent-driven and snowball sampling from seven cities of China. Information regarding socio-demographics, risk behaviors, HIV-related knowledge and STI-related symptoms were collected and participants were tested for HIV and syphilis. Results Among 2618 participating MSM, 9.97% sold sex to males. HIV prevalence was 7.45% (6.13% among MSWs and 7.59% among non-MSW MSM) and syphilis prevalence was 14.32% (10.73% for MSWs and 14.72% for non-MSW MSM). Compared to non-MSW MSM, MSWs were more likely to be younger (adjusted odds ratio: aOR = 0.91, 95% confidence interval: 95%CI=0.88-0.93), never married (aOR = 4.38, 95% CI = 2.38-6.80), less educated, heterosexual (aOR = 13.04, 95% CI = 6.08-27.95), less knowledgeable regarding HIV (aOR = 0.70, 95% CI=0.51-0.96), experiencing symptoms of STI (aOR = 2.16, 95% CI = 1.47-3.19), engaging in condomless vaginal intercourse (aOR = 2.16, 95% CI = 1.47-3.19) and less likely to engage in condomless anal intercourse (aOR = 0.62, 95% CI = 0.46-0.85). Conclusions High HIV and syphilis prevalence warranted urgent intervention targeting MSWs as a separate sentinel group for efficient surveillance owing to their different distribution from non-MSW MSM. Although male sex workers and non-commercial homosexuals have similar rates of HIV and syphilis, MSWs have different characteristics which should be considered in designing intervention programs targeting them. PMID:25961721

  2. Group Work Practice with Transgendered Male to Female Sex Workers.

    ERIC Educational Resources Information Center

    Klein, Rebecca

    1999-01-01

    Examines group work with transgendered male-to-female adolescents who engage in sex work. Provides an overview of the role that sex work plays in the lives of some transgendered youth, using case examples, and offers guidance for those utilizing group work approaches with transgendered adolescents. Discusses homelessness and institutionalization,…

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

    PubMed Central

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

    2015-01-01

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

  4. A primary health care service for Glasgow street sex workers--6 years experience of the "drop-in centre', 1989-1994.

    PubMed

    Carr, S; Goldberg, D J; Elliott, L; Green, S; Mackie, C; Gruer, L

    1996-08-01

    In Glasgow, a health and social care centre opened in 1988 principally to facilitate HIV prevention among street prostitutes, most of whom are injecting drug users. During 1992 to 1994, 551 women made 17,554 visits to the medical room which is functional 5 nights per week. The mean age of the sex workers was 26 years (range 15 to 62) and 89% injected drugs. Fifty-five per cent of the attendances were for needle/syringe exchange only whilst the remainder involved other health care provision. Common presenting problems included abscesses, burns and venous thromboses, reflecting the high proportion of sex workers who injected drugs. Most women always used condoms for penetrative commercial sex and symptomatic sexually transmitted disease was seen infrequently. In addition to the provision of injecting equipment and condoms, other key prevention activities included Hepatitis B vaccination and cervical screening. The prevalence of HIV infection amongst the women remains under 5% and most seropositives were known to be infected before the Centre opened. This initiative shows that if multidisciplinary health and social services are provided to street sex workers at a time and place convenient to their work, the benefits are considerable. PMID:8863919

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

    PubMed

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

    2015-01-01

    The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China. PMID:25950448

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

    PubMed Central

    Bar-Johnson, Michael; Weiss, Petr

    2014-01-01

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

  7. Alcohol use and client-perpetrated sexual violence against female sex workers in China

    PubMed Central

    Zhang, Chen; Li, Xiaoming; Stanton, Bonita; Hong, Yan; Chen, Yiyun; Shan, Qiao; Liu, Wei; Zhou, Yuejiao

    2012-01-01

    Background The global literature suggests that female sex workers (FSWs) experience high rates of sexual violence perpetrated by their clients, especially when FSWs are under the influence of alcohol. However, such data are limited in China. The current study is aimed to fill in the literature gap by examining the association between alcohol use by FSWs and client-perpetrated sexual violence against FSWs in China. Methods A total of 1,022 FSWs were recruited through community outreach in Guangxi, China. FSWs completed a self-administered survey on their demographic information, alcohol use, and sexual violence perpetrated by clients. Multivariable regression was employed to assess the relationship between alcohol use and client-perpetrated sexual violence among FSWs while controlling for possible confounders. Results Alcohol use was positively associated with the experience of sexual violence in both bivariate and multivariable analyses. Women who were at a higher risk level of alcohol use were more likely to experience sexual violence perpetrated by clients even after controlling confounders (e.g., demographics and alcohol-serving practice). Conclusion Given the association between alcohol use and client-perpetrated sexual violence, preventing or reducing alcohol use among FSWs could be an effective strategy to protect these women from sexual violence perpetrated by their clients. Alternatively, psychological counseling and other support should be available to these women so they can reduce their alcohol use as a maladaptive coping strategy. We call for culturally appropriate alcohol use reduction components, incorporated with sexual violence reduction strategies including adaptive coping skills training as well as empowerment, and targeting both FSWs and their clients. PMID:22882121

  8. Women and Lung Disease. Sex Differences and Global Health Disparities.

    PubMed

    Pinkerton, Kent E; Harbaugh, Mary; Han, MeiLan K; Jourdan Le Saux, Claude; Van Winkle, Laura S; Martin, William J; Kosgei, Rose J; Carter, E Jane; Sitkin, Nicole; Smiley-Jewell, Suzette M; George, Maureen

    2015-07-01

    There is growing evidence that a number of pulmonary diseases affect women differently and with a greater degree of severity than men. The causes for such sex disparity is the focus of this Blue Conference Perspective review, which explores basic cellular and molecular mechanisms, life stages, and clinical outcomes based on environmental, sociocultural, occupational, and infectious scenarios, as well as medical health beliefs. Owing to the breadth of issues related to women and lung disease, we present examples of both basic and clinical concepts that may be the cause for pulmonary disease disparity in women. These examples include those diseases that predominantly affect women, as well as the rising incidence among women for diseases traditionally occurring in men, such as chronic obstructive pulmonary disease. Sociocultural implications of pulmonary disease attributable to biomass burning and infectious diseases among women in low- to middle-income countries are reviewed, as are disparities in respiratory health among sexual minority women in high-income countries. The implications of the use of complementary and alternative medicine by women to influence respiratory disease are examined, and future directions for research on women and respiratory health are provided. PMID:25945507

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

    PubMed Central

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

    2013-01-01

    Abstract Men who have sex with men and women (MSMW) are a potential bridge population for transmitting HIV to heterosexual women. This study assessed key characteristics of this subgroup of men who have sex with men (MSM) in China. Of 1141 eligible MSM, 45.6% reported bisexual behaviors. Besides marriage as a strong predictor (odds ratio: 23.90, 95% confidence interval: 14.2939.98), older age (1.12, 1.101.15) and lower education (or no college education) (1.98, 1.522.59) were also independently associated with having ever had sex with women. MSMW reported higher proportions of alcohol drinking, heterosexual/bisexual orientation, and preference for an insertive role in anal sex than men who had sex with men only; but there was no statistically significant difference between two groups in prevalence of HIV and syphilis infections and in history of sexually transmitted infections. HIV prevention intervention programs should break the bridging role of HIV transmission in MSMW population. PMID:23931683

  10. Sex Discrimination and Sex Equity for Faculty Women in the 1980s.

    ERIC Educational Resources Information Center

    Robbins, Lillian; Kahn, Ethel D.

    1985-01-01

    Discusses overt and subtle ways that women are discriminated against in higher education--both at faculty and administrative levels--and highlights the personal, institutional, and financial costs of such discrimination. Briefly reviews the articles that follow in this special journal issue on sex discrimination in academe. (GC)

  11. AIDS: risk behaviors among rural Mexican women married to migrant workers in the United States.

    PubMed

    Salgado de Snyder, V N; Díaz Pérez, M; Maldonado, M

    1996-04-01

    International migration between Mexico and the United States has been acknowledged as a phenomenon that may contribute to the spread of AIDS in rural Mexico. The purpose of this study is to identify the information held by the participants regarding AIDS and to describe selected high-risk behaviors for AIDS transmission among a representative sample of rural women living in Mexico who are married to immigrant temporary workers to the United States. The women who participated in the study were married, of reproductive age, and had active sex lives with their spouses. Results revealed that most of the women interviewed had at least some knowledge about AIDS. Although some misconceptions were evident, most of the information they had was accurate. About one-third of the women felt at risk for AIDS, mostly because they doubted their husbands' fidelity, or because in the last five years they had donated blood, received a blood transfusion, or received an intramuscular or intravenous injection. The results of the study are discussed within the sociocultural context that surrounds the lives of the women interviewed. PMID:8727653

  12. Assessing reported condom use among female sex workers in southern India through examination of condom availability

    PubMed Central

    Moses, Stephen; Blanchard, James F; Rajaram, S; Ramesh, B M; Verma, Supriya; Alary, Michel

    2010-01-01

    Objectives A key indicator of success of HIV prevention programmes is the number of female sex worker (FSW) sex acts protected by condoms. This measure usually relies on FSW reports, which may be biased. We examined condom availability data in five Karnataka districts to estimate the proportion of FSW sex acts potentially protected by condoms. Methods Financial, programme, population, condom and contraceptive data were obtained from governmental and non-governmental sources, surveys and HIV prevention programmes. Sexual behaviour data were obtained from general population and FSW surveys. We examined four scenarios in a sensitivity analysis, each one assuming different proportions of available condoms that might have been used by sex workers. Results Possible condom use rates for all FSW sex acts ranged from 3%–36% in 2004 to 56%–96% in 2008. The two most realistic scenarios that discounted the number of private sector condoms that might have been bought for sex acts other than with FSWs showed that 16–24% of FSW sex acts could have been protected by condoms in 2004 rising to 77–85% in 2008. Conclusions These data suggest that condom availability in these Karnataka districts in 2004 was low in relation to the number of FSW sex acts, but rose substantially over the ensuing 4 years. Condom availability data can be useful for triangulation with other available data, such as self-reported condom use, to provide a range of possibilities regarding the number of FSW sex acts protected by condoms. PMID:20167730

  13. Sexual Health Knowledge and Health Practices of Female Sex Workers in Liuzhou, China, Differ by Size of Venue

    PubMed Central

    Brown, Jane D.; Muessig, Kathryn E.; Xianxiang, Feng; Wenzhen, He

    2013-01-01

    We conducted qualitative interviews with 48 female sex workers (FSW) recruited from entertainment venues in Liuzhou, China. Analyses found that HIV knowledge and sexual health seeking strategies differed by size of venue: (1) Women in smaller venues said they douched before/after sex and used condoms with all but their regular partners and clients. Most found the brochures distributed by Chinese CDC workers “irrelevant” or “boring” and relied on friends for health advice. (2) FSW in middle and large venues were less concerned about prevention, claiming their clients were “healthy.” They relied more on the Internet for health information and were less concerned about the cost of seeing a doctor. (3) Pregnancies and abortions were frequent, especially among the younger women in large venues. This research documents the need to develop tailored HIV-related messages and prevention strategies with the help of FSW to address differences among FSW working in venues of different sizes. PMID:23612941

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

    PubMed

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

    2014-09-01

    The literature on positive psychology and resilience demonstrates that individuals utilize their personal strengths and environmental resources to facilitate positive adaptation. Using a qualitative approach, we investigated how these frameworks operated as self-protective strategies for female sex workers to maintain their psychological and physical well-being under stressful socioeconomic and work-related conditions. Twenty-three female sex workers in Hong Kong participated in in-depth interviews. We used the grounded theory approach for data analysis. The informants reported negative feelings in response to financial burden, clients' demands, threats to physical health, and stigma. Some female sex workers showed their resilience by being able to rationalize their role, believe their ability to make a change in life, and stay optimistic. They adopted strategies including emotional regulation and acceptance of their responsibility and limits to cope with stressful life events. The results help us understand the role of positive psychology and resilience in this vulnerable population. PMID:25082156

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

    PubMed Central

    Brouwer, Kimberly C.; Jimenez, Teresita Rocha; Miranda, Sonia Morales; Mindt, Monica Rivera

    2016-01-01

    Background Migrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers. Methods Focus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013–February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops. Results Key themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma) represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers. Conclusions Results highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization and supports for migrant sex workers are recommended, as are broader policy shifts that move away from punitive legal approaches towards approaches that safeguard and prioritize the human rights of migrant sex workers. PMID:27159157

  16. The deregulated global economy: women workers and strategies of resistance.

    PubMed

    Hale, A

    1996-10-01

    This article discusses the lack of input from women in international debates about the global economy. Women in the South are the most vulnerable to exploitation and most ignored in international discussions of how to protect fair labor standards. Restructuring has led to loss of secure jobs in the public sector and the expansion of female employment in low-paid, insecure, unskilled jobs. Businesses desire a cheap and flexible workforce. Declines in social services, the elimination of subsidies on basic goods, and the introduction of user fees puts pressure on women to supplement family income. A parallel outcome is reduced employment rights, neglect of health and safety standards, and increased disregard among women for their domestic responsibilities. There is a need for alternative models of development. The Self-Employed Women's Organization in India serves as a model for resisting exploitation among self-employed and home-based employees. Female industrial strikers are demanding attention to excessive hours of work, enforced overtime, bullying, and lack of sanitary and medical facilities. There is always fear that organized resistance will lead to industrial relocation or loss of jobs. The International Labor Organization has had a code for 20 years, but the threat of exposure to the press is sometimes more effective. There must be regulation throughout subcontracting chains of transnational companies. International alliances should revolve around issues/strategies identified by workers. International alliances are needed for influencing multinational companies and national governments and lobbying global economic and financial institutions. Standards that are included in social clause discussions are minimum requirements that do not address gender-specific issues. Women Working Worldwide is developing a position statement of social clauses that incorporates a women's perspective. PMID:12347718

  17. Young women selling sex online – narratives on regulating feelings

    PubMed Central

    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

  18. Negotiation for safer sex among married women in Cambodia: the role of women's autonomy.

    PubMed

    Ung, Mengieng; Boateng, Godfred O; Armah, Frederick A; Amoyaw, Jonathan A; Luginaah, Isaac; Kuuire, Vincent

    2014-01-01

    Negotiating safer sex among married women has been identified as an important determinant of vulnerability or resilience to new HIV infections. Using the Cambodia Demographic and Health Survey data of 2010, this paper examined negotiation for safer sex among 11,218 married women in the context of Cambodia's highly touted reduction in HIV/AIDS prevalence. The results from a complementary log-log regression model indicate that wealthier and highly educated married women were more likely to report that they can refuse sexual intercourse and ask their husbands to use a condom. Interestingly, while women who were fully involved in decision-making on their own health care were 19% more likely to refuse sex, they were 14% less likely to be able to ask their husbands to use a condom, compared with their counterparts who were not involved in this decision-making. Women who were partially involved in decision-making on family visits were 17% less likely to be able to ask their husbands to use a condom compared with those who were not involved. In this context, involvement in decision-making may have translated into trust and risk compensation. Those who believed in HIV transmission myths were less likely to negotiate safer sex relative to their counterparts who did not hold such myths to be true. Women's ability to negotiate for safer sex is, therefore, a function of their autonomy in terms of their full participation in decision-making in health care, household expenditure and mobility. Policy implications of the capacity of women to negotiate for safer sex are delineated. PMID:23517629

  19. Do Androgynous Women Reject Femininity? An Investigation of Sex Role and Magazine Choice.

    ERIC Educational Resources Information Center

    Sheppard, Alice; Gange, Julie

    The mass magazine industry offers new role images for women in contemporary magazines, assuming that they reflect the psychological needs of women's changing sex-role identities. To determine whether women classified as androgynous by the Bem Sex Role Inventory (BSRI) would prefer nontraditional models of femininity, 101 college women were asked…

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

    PubMed

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

    2015-05-01

    Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members. PMID:25795530

  1. Sexual Safety and Sexual Security among Young Black Women Who Have Sex with Women and Men

    PubMed Central

    Alexander, Kamila Anise; Fannin, Ehriel F.

    2014-01-01

    Objective To examine sexuality narratives of Black women who have sex with women and men and explore factors that influence their sexual safety and sexual security. Design Secondary qualitative content analysis. Setting We recruited young self-identified Black women from beauty salons and community-based organizations. Participants Our sample included a subset of five sexually active, Black women age 19 to 25 who reported engaging in sexual relationships with women and men. Participants were selected from a larger parent study that included sexuality narratives from 25 women. Methods We analyzed interview transcripts in which participants described sexual relationships. We used constant comparative techniques and conventional content analysis methodology. Results We uncovered three themes illustrating influences on sexual safety and sexual security: institutional expectations, emotional connectedness, and sexual behaviors. Conclusions From this analysis, we derive valuable insights into decision-making processes within sexual relationships from the perspectives of young Black women who have sex with women and men. Clinicians and investigators can use these findings to inform programs designed to improve the sexual health of this often invisible group of women. Nurses are uniquely positioned to support young women as they navigate societal institutions and emotional experiences that inform future sexual decisions and behaviors. PMID:24942676

  2. Predictors of HIV Sexual Risk Behavior among Men Who Have Sex with Men, Men Who Have Sex with Men and Women, and Transgender Women

    PubMed Central

    Bowers, Jane Rohde; Branson, Catherine M.; Fletcher, Jesse B.; Reback, Cathy J.

    2014-01-01

    Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations. PMID:24660042

  3. Predictors of HIV Sexual Risk Behavior among Men Who Have Sex with Men, Men Who Have Sex with Men and Women, and Transgender Women.

    PubMed

    Bowers, Jane Rohde; Branson, Catherine M; Fletcher, Jesse B; Reback, Cathy J

    2012-01-01

    Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations. PMID:24660042

  4. Intimate Partner Violence among Female Sex Workers in Two Mexico-U.S. Border Cities: Partner Characteristics and HIV Risk-behaviors as Correlates of Abuse

    PubMed Central

    Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O’Campo, Patricia; Patterson, Thomas L.

    2009-01-01

    Intimate partner violence (IPV) has been associated with greater vulnerability to HIV infection among women. We examined prevalence and correlates of IPV among female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-U.S. border cities where HIV prevalence is rising. Participants were 300 FSWs with a current spouse or a steady partner. Participants’ mean age was 33 years, and mean number of years as a sex worker was 6 years. The prevalence of IPV in the past 6 months among participants was 35%. Using multivariate logistic regression, factors independently associated with IPV included having experienced abuse as a child, a partner who had sex with someone else, and lower sexual relationship power. Our findings suggest the need for previous abuse screening and violence prevention services for FSWs in the Mexico-U.S. border region. Careful consideration of relationship dynamics such as infidelity and relationship power is warranted when assessing for IPV risk. PMID:21532933

  5. Estimation of the number of female sex workers in Yangon and Mandalay, Myanmar.

    PubMed

    Thein, Si Thu; Aung, Tin; McFarland, Willi

    2015-10-01

    While it is known that HIV prevalence is higher among key affected populations, such as female sex workers (FSW), the sizes of these populations are difficult to estimate. This study aimed to estimate the numbers of FSW in the two largest cities of Myanmar using multiple data-driven methods. A total of 778 FSW (450 in Yangon, 328 in Mandalay) were recruited though time-location sampling during November and December 2013. Five multiplier methods and a modified wisdom of the crowds method were applied within the surveys to calculate the number of FSW in each city. The median of the methods estimated a population size of FSW in Yangon at 4992 (acceptable upper and lower bounds: 4482-5753) and 3315 (2992-3368) in Mandalay. These estimates translate to a population prevalence of FSW among adult women (age 18-49 years) of 0.35 % (0.32-0.40 %) in Yangon and 0.77 % (0.69-0.84 %) in Mandalay. PMID:26267254

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

    PubMed Central

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

    2012-01-01

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

  7. Safer Conception Needs for HIV Prevention among Female Sex Workers in Burkina Faso and Togo

    PubMed Central

    Schwartz, Sheree R.; Papworth, Erin; Ky-Zerbo, Odette; Anato, Simplice; Ouedraogo, Henri Gautier; Ketende, Sosthenes; Pitche, Vincent Palokinam

    2014-01-01

    Background. Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning. Methods. Adult FSW were enrolled into a cross-sectional study across four sites in Burkina Faso and Togo using respondent-driven sampling. Sociobehavioral questionnaires and HIV counseling and testing were administered. Sample statistics and engagement in HIV treatment were described and compared using Chi-squared statistics. Results. 1,349 reproductive-aged FSW were enrolled from January to July 2013. Overall, 267 FSW (19.8%) were currently trying to conceive. FSW trying to conceive were more likely to test positive for HIV at enrollment as compared to women not trying to become pregnant (24.5% versus 17.7%, P < 0.01); however awareness of HIV status was similar across groups. Among FSW trying to conceive, 79.0% (211/267) had previously received HIV testing, yet only 33.8% (23/68) of HIV-infected FSW reported a previous HIV diagnosis. Overall 25.0% (17/68) of HIV-infected FSW trying to conceive were on antiretroviral therapy. Conclusion. FSW frequently desire children. However engagement in the HIV prevention and treatment cascade among FSW trying to conceive is poor potentiating periconception transmission risks to partners and infants. Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services. PMID:25404849

  8. Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, 2011–2012

    PubMed Central

    Elhadi, Magda; Elbadawi, Abdulateef; Abdelrahman, Samira; Mohammed, Ibtisam; Bozicevic, Ivana; Hassan, Ehab A; Elmukhtar, Mohammed; Ahmed, Sally; Abdelraheem, Mohammed Sidahmed; Mubarak, Nazik; Elsanousi, Salwa; Setayesh, Hamidreza

    2013-01-01

    Objectives To assess HIV and syphilis prevalence, HIV-related behaviours and testing for HIV in female sex workers (FSW) in Sudan. Design Bio-behavioural surveys using respondent-driven sampling were carried out among FSW in the capital cities of 14 states in Sudan in 2011–2012. HIV and syphilis testing was done by rapid tests. Results 4220 FSW aged 15–49 years were recruited. The median age of recruited women varied from 21 to 28 years per site. The highest HIV prevalence was measured at two sites in the eastern zone (5.0% and 7.7%), while in the other zones it ranged from 0% to 1.5%. Syphilis prevalence ranged from 1.5% in the northern zone to 8.9% in the eastern zone. Ever having been tested for HIV was reported by 4.4%–23.9% of FSW across all sites. Condom use at last sex with a client varied from 4.7% to 55.1%, while consistent condom use with clients in the month preceding the surveys was reported by 0.7%–24.5% of FSW. The highest reporting of ever injecting drugs was measured at a site in the western zone (5.0%). Conclusions The surveys’ findings indicate that the highest burden of HIV in FSW is in the eastern states of the country. Condom use and HIV testing data demonstrate the need for HIV interventions that should focus on HIV testing and risk reduction strategies that include stronger condom promotion programmes in FSW and their clients. PMID:23996450

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

    PubMed Central

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

    2013-01-01

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

  10. HIV risk and social networks among male-to-female transgender sex workers in Boston, Massachusetts.

    PubMed

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

    2009-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  13. Endogenous sex hormones and breast density in young women

    PubMed Central

    Jung, Seungyoun; Stanczyk, Frank Z.; Egleston, Brian L.; Snetselaar, Linda G.; Stevens, Victor J.; Shepherd, John A.; Van Horn, Linda; LeBlanc, Erin S.; Paris, Kenneth; Klifa, Catherine; Dorgan, Joanne F.

    2014-01-01

    Background Breast density is a strong risk factor for breast cancer and reflects epithelial and stromal content. Breast tissue is particularly sensitive to hormonal stimuli before it fully differentiates following the first full-term pregnancy. Few studies have examined associations between sex hormones and breast density among young women. Methods We conducted cross-sectional study among 180 women aged 25-29 years old who participated in the Dietary Intervention Study in Children 2006 Follow-up Study. Eighty-five percent of participants attended a clinic visit during their luteal phase of menstrual cycle. Magnetic resonance imaging measured the percentage of dense breast volume (%DBV), absolute dense breast volume (ADBV), and absolute nondense breast volume (ANDBV). Multiple-linear mixed-effect regression models were used to evaluate the association of sex hormones and sex hormone-binding globulin (SHBG) with %DBV, ADBV, and ANDBV. Results Testosterone was significantly positively associated with %DBV and ADBV. The multivariable geometric mean of %DBV and ADBV across testosterone quartiles increased from 16.5% to 20.3% and from 68.6cm3 to 82.3cm3, respectively (Ptrend ≤ 0.03). There was no association of %DBV or ADBV with estrogens, progesterone, non-SHBG bound testosterone or SHBG (Ptrend ≥ 0.27). Neither sex hormones nor SHBG was associated with ANDBV except progesterone; however, the progesterone result was nonsignificant in analysis restricted to women in the luteal phase. Conclusions These findings suggest a modest positive association between testosterone and breast density in young women. Impact Hormonal influences at critical periods may contribute to morphological differences in the breast associated with breast cancer risk later in life. PMID:25371447

  14. “What makes you think you have special privileges because you're a police officer?” A qualitative exploration of police's role in the risk environment of female sex workers

    PubMed Central

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

    2014-01-01

    Worldwide, female sex workers have high rates of HIV. Many factors that escalate their risk lay outside of their control, name 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 female sex workers 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

  15. Vaginal douching and association with sexually transmitted infections among female sex workers in a prefecture of Yunnan Province, China.

    PubMed

    Luo, Li; Xu, Jun-Jie; Wang, Gui-Xiang; Ding, Guo-Wei; Wang, Ning; Wang, Hai-Bo

    2016-06-01

    SummaryVaginal douching is a common practice and has been hypothesised to increase a woman's risk for human of contracting HIV and sexually transmitted infections (STIs). Our objective was to assess the prevalence of douching and its association with STIs, genital symptoms and HIV/STI knowledge among female sex workers (FSWs). We conducted a cross-sectional study of 837 FSWs with interviews and laboratory tests for HIV/STIs in a prefecture of Yunnan Province in southern China. Vaginal douching was reported by 84% of the women. We found a higher prevalence of vaginal douching practice among FSWs of Han ethnicity, and who were single or cohabitating. Douching was also significantly more common among more educated FSWs and those with greater knowledge of HIV/STIs, and as well as in FSWs who had experienced clinical symptoms in the previous 12 months. Douching was linked to higher risks of HIV (adjusted odds ratio = 2.29; 95% confidence interval 1.01-5.23) and herpes simplex virus type 2 infections (adjusted odds ratio = 2.18; 95% confidence interval 1.46-3.24) after adjusting for confounding factors. Medical professionals and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities. More prospective studies among FSWs are urgently required to identify the relationship between vaginal douching and HIV/STIs. PMID:26016725

  16. Sexy ladies sexing ladies: women as consumers in strip clubs.

    PubMed

    Wosick-Correa, Kassia R; Joseph, Lauren J

    2008-01-01

    Recent shifts in the consumer base of the sex industry have involved greater female attendance in strip clubs. This article examines how strip clubs and dancers incorporate female patrons into a sexualized space traditionally designed for men by identifying three interactional processes: passing over, sidestaging, and tailoring. We suggest dancers pass over women because they perceive female patron behavior to include resistance to "buying the game" and spending patterns that diverge from male customers. Drawing on Goffman's dramaturgical analysis, we suggest the dynamic relationship between dancer and female patron involves what we term sidestaging, which refers to both dancers' disclosure and how the club's spatial organization inhibits the construction of women as customers through sharing gendered spaces, such as the bathroom. We argue that when a dancer tailors her lap dance for a female patron, she succeeds in acknowledging the female customer's sexual subjectivity and potential same-sex desires by providing an individualized avenue for exploring an erotic experience. Finally, we discuss data implications for understanding how same-sex desire and sexual identity operate in an environment that eroticizes the female form, and how the strip club becomes a potential space for engaging in same-sex eroticism that includes elements of play. PMID:18686149

  17. Violence against women in war: rape, AIDS, sex slavery. International.

    PubMed

    At an international conference attended by 2000 delegates, violence against women in Rwanda, former Yugoslavia, and Kurdistan was discussed. Kalliope Migirou, of the United Nations Human Rights Field Operation in Rwanda, described the slaughter of between 500,000 and 1.5 million Tutsis and moderate Hutus in 1994; estimates of the number of rapes ranged from 15,700 (Rwandan government) to 250,000-500,000 (UN special representative). Women were gang-raped and sexually mutilated; fathers were forced to rape their daughters, and sons, their mothers. The transmission of HIV was used as a weapon to murder women and their communities. Women were taken to refugee camps as sex slaves and have written their families about their "new marriages" to Hutu militia men. No rape charge is found among the more than 4000 cases prepared for the Rwandan war crimes trial. 80,000 Rwandans are in prison on suspicion of participating in the genocide; 8% are women. Violete Krasnic, of the Autonomous Women's Center Against Sexual Violence in Belgrade, spoke about the war in former Yugoslavia, which increased all forms of violence against women: 1) domestic violence, particularly in inter-ethnic marriages; 2) death threats against women (up 30-50%); 3) rape (up 30%); and 4) threats with weapons (40%). Men, upon exposure to nationalistic propaganda, used violence against their wives. Nazaneen Rasheed, a London-based representative of the Women's Union of Kurdistan, stated that women in northern Iraq had no power or land. While some turned to prostitution to survive, hundreds were killed by male relatives because of shame to the family. PMID:12347566

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

    PubMed

    Thuy, Bui Thi Thanh; Kretchmar, Joshua

    2008-06-01

    This study examines the influence of social networks on the sexual relations of migrant construction workers in Ha Noi, Viet Nam. Research included observation and interviews with members of two different groups of workers. The first group, together with their employer (cai), came from the same village; the second group came from different villages. Of interest in the present study was how social relationships among workers and their employers influence extra-marital sexual activity. In the group where workers and their cai came from the same village of origin, fear of acquiring a bad reputation made these workers reluctant to seek sex services, since accounts of their behaviour were transmitted quickly home. In contrast, workers from the group who came from different villages often went out together to purchase sex. The absence of direct links to their villages of origin made it easier for these latter workers to conceal their activity. The implication of these findings for sexual safety and risk are discussed. PMID:18446563

  19. Gaps in the hepatitis C continuum of care among sex workers in Vancouver, British Columbia: Implications for voluntary hepatitis C virus testing, treatment and care

    PubMed Central

    Socías, M Eugenia; Shannon, Kate; Montaner, Julio S; Guillemi, Silvia; Dobrer, Sabina; Nguyen, Paul; Goldenberg, Shira; Deering, Kathleen

    2015-01-01

    BACKGROUND: Hepatitis C virus (HCV) eradication leads to reduced morbidity, mortality and transmission. Despite the disproportionate burden of HCV among sex workers, data regarding the HCV care continuum in this population remain negligible. METHODS: Using baseline data from an ongoing cohort of women sex workers in Vancouver (An Evaluation of Sex Workers’ Health Access, January 2010 to August 2013), the authors assessed HCV prevalence and engagement in the HCV care continuum within the past year. Multivariable logistic regression analyses were used to evaluate associations with recent (ie, in the past year) HCV testing. RESULTS: Among 705 sex workers, 302 (42.8%) were HCV seropositive. Of these, 22.5% were previously unaware of their HCV status, 41.7% had accessed HCV-related care, 13.9% were offered treatment and only 1.0% received treatment. Among 552 HCV-seronegative sex workers, only one-half (52.9%) reported a recent HCV test. In multivariable analysis, women who self-identified as a sexual/gender minority (adjusted OR [aOR] 1.89 [95% CI 1.11 to 3.24]), resided in the inner city drug use epicentre (aOR 3.19 [95%CI 1.78 to 5.73]) and used injection (aOR 2.00 [95% CI 1.19 to 3.34]) or noninjection drugs (aOR 1.95 [95% CI 1.00 to 3.78]) had increased odds of undergoing a recent HCV test, while immigrant participants (aOR 0.24 [95% CI 0.12 to 0.48]) had decreased odds. CONCLUSIONS: Despite a high burden of HCV among sex workers, large gaps in the HCV care continuum remain. Particularly concerning are the low access to HCV testing, with one-fifth of women living with HCV being previously unaware of their status, and the exceptionally low prevalence of HCV treatment. There is a critical need for further research to better understand and address barriers to engage in the HCV continuum for sex workers. PMID:26492129

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

    PubMed

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

    2014-01-01

    Commercial sex work is frequent among male-to-female transvestites, transsexuals and transgenders in Argentina, leading to high susceptibility to HIV, HBV, and HCV among other sexually transmitted infections. In a global context of scarce data on the trans sex workers population, this study was aimed to study the genomic characterization of these viruses. Plasma presence of HIV, HBV, and HCV genomic material was evaluated in samples from 273 trans sex workers. Genomic sequences of HIV-gag, pol, and vif-vpu genes, HBV-S gene, and HCV-5'UT and NS5B genes were obtained. Molecular characterization involved phylogenetic analysis and several in silico tools. Resistance-associated mutations in HIV and HBV pol genes were also analyzed. The HIV genomic characterization in 62 trans sex workers samples showed that 54.8% of the isolates corresponded to BF intersubtype recombinants, and 38.7% to subtype B. The remaining were classified as subtypes C (4.8%) and A (1.6%). HBV and HCV co-infection prevalence among HIV positive trans sex workers yielded rates of 3.2% and 6.5% respectively. Drug resistance-associated mutations were found in 12/62 (19%) HIV pol sequences, but none among HBV. Based on phylogenetic relationships, HIV isolates characterized as subtypes BF and B appeared intermingled with those from other high-risk groups. Despite trans sex workers declared not to have received antiviral treatment, complex drug resistance-associated mutation patterns were found in several HIV isolates. Planned prevention, screening, and treatment are needed to reduce further transmission and morbidity. PMID:24123155

  1. Treatment with Antiretroviral Therapy is Not Associated with Increased Sexual Risk Behaviour in Kenyan Female Sex Workers

    PubMed Central

    McClelland, R. Scott; Graham, Susan M.; Richardson, Barbra A.; Peshu, Norbert; Masese, Linnet N.; Wanje, George H.; Mandaliya, Kishorchandra N.; Kurth, Ann E.; Jaoko, Walter; Ndinya-Achola, J. O.

    2010-01-01

    Objective The objective of this study was to test the hypothesis that sexual risk behaviour would increase following initiation of antiretroviral therapy (ART) in Kenyan female sex workers (FSWs). Design Prospective cohort study. Setting FSW cohort in Mombasa, Kenya, 1993-2008. Subjects 898 women contributed HIV-1-seropositive follow-up visits, of whom 129 initiated ART. Intervention Beginning in March 2004, ART was provided to women qualifying for treatment according to Kenyan National Guidelines. Participants received sexual risk reduction education and free condoms at every visit. Main Outcome Measures Main outcome measures included unprotected intercourse, abstinence, 100% condom use, number of sexual partners, and frequency of sex. Outcomes were evaluated at monthly follow-up visits using a one week recall interval. Results Compared to non-ART-exposed follow-up, visits following ART initiation were not associated with an increase in unprotected sex (adjusted odds ratio [AOR] 0.86, 95% confidence interval [CI] 0.62-1.19, P=0.4). There was a non-significant decrease in abstinence (AOR 0.81, 95% CI 0.65-1.01, P=0.07), which was offset by a substantial increase in 100% condom use (AOR 1.54, 95% CI 1.07-2.20, P=0.02). Numbers of sex partners and frequency of sex were similar before versus after starting ART. A trend for decreased sexually transmitted infections following ART initiation provides additional support for the validity of the self-reported behavioural outcomes (AOR 0.67, 95% CI 0.44-1.02, P=0.06). Conclusions In the setting of ongoing risk reduction education and provision of free condoms, initiation of ART was not associated with increased sexual risk behaviour in this cohort of Kenyan FSWs. PMID:20179576

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

    PubMed

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

    2015-02-01

    HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino versus non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed. PMID:23979714

  3. Transactional Sex Risk across a Typology of Rural and Urban Female Sex Workers in Indonesia: A Mixed Methods Study

    PubMed Central

    Puradiredja, Dewi Ismajani; Coast, Ernestina

    2012-01-01

    Context-specific typologies of female sex workers (FSWs) are essential for the design of HIV intervention programming. This study develops a novel FSW typology for the analysis of transactional sex risk in rural and urban settings in Indonesia. Mixed methods include a survey of rural and urban FSWs (n = 310), in-depth interviews (n = 11), key informant interviews (n = 5) and ethnographic assessments. Thematic analysis categorises FSWs into 5 distinct groups based on geographical location of their sex work settings, place of solicitation, and whether sex work is their primary occupation. Multiple regression analysis shows that the likelihood of consistent condom use was higher among urban venue-based FSWs for whom sex work is not the only source of income than for any of the other rural and urban FSW groups. This effect was explained by the significantly lower likelihood of consistent condom use by rural venue-based FSWs (adjusted OR: 0.34 95% CI 0.13–0.90, p = 0.029). The FSW typology and differences in organisational features and social dynamics are more closely related to the risk of unprotected transactional sex, than levels of condom awareness and availability. Interventions need context-specific strategies to reach the different FSWs identified by this study's typology. PMID:23285205

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

    PubMed Central

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

    2013-01-01

    HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino vs. non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed. PMID:23979714

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Ditmore, Melissa Hope; Allman, Dan

    2011-01-01

    After premature closures in 2004 of biomedical human immunodeficiency virus (HIV) prevention trials involving sex workers in Africa and Asia, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Global Advocacy for HIV Prevention (AVAC) undertook consultations to establish better participatory guidelines for such trials in order to address…

  8. 'She's a professional like anyone else': social identity among Brazilian sex workers.

    PubMed

    Murray, Laura R; Lippman, Sheri A; Donini, Angela A; Kerrigan, Deanna

    2010-04-01

    Community mobilisation among sex workers is recognised as an important HIV/STI prevention strategy. However, factors such as poverty and stigma often negatively influence participation in activities that attempt to mobilise around a common identity of 'sex workers'. A qualitative study was conducted to explore the relationship between social identity and participation among 24 sex workers enrolled in an HIV/STI prevention intervention research project with a community mobilisation component. The relationship between social identity and participation was found to be a dynamic process in which participation in project clinic and community-based activities was motivated by three overlapping strategies: participation for psycho-social and health benefits; participation to improve individual status; and participation to change group status. Rather than mobilising around a 'sex worker identity', we conclude that projects with a community mobilisation approach may be more effective if they facilitate space for critical self-reflection and opportunities for collective action with an emphasis on acceptance and solidarity. PMID:20390588

  9. Heterogeneous and vulnerable: the health risks facing transnational female sex workers.

    PubMed

    Choi, Susanne Y P

    2011-01-01

    Representations of transnational sex workers have been dominated by the trafficked victim discourse that often overlooks the heterogeneity of this population and variations in the health risks that different sub-groups face. This paper addresses this deficiency by examining differences in the socio-economic backgrounds, working conditions, HIV/AIDS knowledge, and vulnerability to health risks of female sex workers from Russia, Vietnam, Thailand, and Mainland China currently working in the Chinese city of Macau. It also examines the correlates of three health risks: client-perpetrated violence, non-condom use and condom failure. The results show major differences in the socio-economic profiles, working conditions and exposure to health risks of the four groups of workers studied. They also suggest that age, ethnicity, education, economic pressure, AIDS and STI knowledge, and workplace condom-use norm are significant correlates of the three health risks examined. The findings shed light on the importance of locating the social and cultural contexts that constrain the response of different groups of transnational sex workers to health risks, and the need to tailor intervention measures to meet the specific conditions of individual groups. They also point out the urgency of tackling the interpersonal and structural obstacles to safe sex practices among marginalised populations. PMID:20942821

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Ditmore, Melissa Hope; Allman, Dan

    2011-01-01

    After premature closures in 2004 of biomedical human immunodeficiency virus (HIV) prevention trials involving sex workers in Africa and Asia, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Global Advocacy for HIV Prevention (AVAC) undertook consultations to establish better participatory guidelines for such trials in order to address

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  14. Sexual assault in the lives of urban sex workers: a descriptive and comparative analysis.

    PubMed

    Du Mont, Janice; McGregor, Margaret J

    2004-01-01

    This exploratory study contributes to the sparse literature on sexually assaulted sex workers. We examined 462 sexual assault cases seen at an emergency department-based sexual assault service and reported to the police between 1993 and 1997. More than one fifth of victims were sex workers. We compared them to other victims on victim characteristics, assault characteristics, and medical-legal findings. Relative to other victims, sex workers were younger, had lower incomes, and were more likely to be heroin and/or cocaine users. They suffered a greater number of injuries and forensic samples collected from their bodies were more likely to test positive for sperm and/or semen. These victims were also less likely to have been using alcohol and/or marijuana prior to the assault and to be emotionally expressed during the medical- legal examination. The substantial proportion of sex workers in the study population suggests that attention to their particular needs should be an important part of hospital-based sexual assault services. Clinical implications and directions for future research are discussed. PMID:15256357

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

    PubMed Central

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

    2016-01-01

    Background Violence toward MSM and female sex workers (FSW) is associated with HIV risk, and its prevention is prioritized in international HIV/AIDS policy. Methods Sociodemographic and behavioural data derived from HIV risk and follow-up cohorts including MSM and FSW in coastal Kenya between 2005 and 2014 was used to estimate the risk of rape, physical assault and verbal abuse, and to assess associations between first occurrence of assault with individual and recent behavioural factors. Results Incidence of first reported rape was similar for MSM [3.9, confidence interval (CI) 3.1–5.0 per 100 person-years (pyrs)] and FSW (4.8 CI 3.5–6.4 per 100 pyrs), P =0.22. Incidence of first reported physical and verbal assault was higher for FSW than MSM (21.1 versus 12.9 per 100 pyrs, P =0.14 and 51.3 versus 30.9 per 100 pyrs, P =0.03 respectively). Recent alcohol use was associated with reporting of all forms of assault by MSM [adjusted odds ratio (AOR) 1.8, CI 0.9–3.5] and FSW (AOR 4.4, CI 1.41–14.0), as was recent sale of sex for MSM (AOR 2.0, CI 1.1–3.8). Exclusive sex with men, active sex work, and group sex were also specifically associated with reporting rape for MSM. Perpetrators of sexual and verbal assault were usually unknown, whilst perpetrators of physical violence toward FSW were usually regular sexual partners. Conclusion MSM and FSW experienced a similarly high incidence of sexual assault in coastal Kenya, in addition to physical and verbal assault. Current national policies focus heavily on gender-based violence against women and young girls, but need to be inclusive of MSM and FSW. PMID:26562812

  16. The Struggles of Women Industrial Workers To Improve Work Conditions in the Progressive Era.

    ERIC Educational Resources Information Center

    Barrett, Nancy J.

    1999-01-01

    Offers a lesson plan that addresses the working conditions endured by women in the Progressive Era and their struggles for womens rights in the workplace. Strives to demonstrate the similarities between the plights of the Progressive Era women to those of women workers in the 1990s. (CMK)

  17. Survival times of pre-1950 US women radium dial workers

    SciTech Connect

    Stehney, A.F.

    1994-05-01

    Survival times of US women radium dial workers to the end of 1989 were examined by life table methods. Included were 1301 women rust employed before 1930 and 1242 first employed in 1930-1949. Expected numbers of deaths were estimated from age- and time-specific death rates for US white females. In the early group, 85 deaths from the well-known radium-induced cancers - bone sarcomas and head carcinomas - were observed, but only 724 deaths from aH other causes were observed vs 755 expected. Life shortening ({plus_minus}S.E.) of 1.8 {plus_minus}0.5 y compared to the general population of US white females was calculated from the time distribution of all deaths in the pre-1930 group. In the 1930--1949 group, 350 deaths were observed vs 343 expected and no bone sarcomas or head carcinomas occurred. Among women who survived at least 2 y after rust measurement of body radium, a significant excess of observed vs expected deaths was found only for radium intakes greater than 1.85 MBq of {sup 226}Ra + {sup 228}Ra, and no trend of deaths or reduction of life expectancy was found with length of employment.

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

    PubMed

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

    2015-01-01

    Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing practices and licensing requirements increase sex workers' risk of violence and conflict with clients and result in heightened stress, an inability to rely on police support, lost income and the displacement of sex workers to more hidden informal work venues. Prohibitive licensing and policing practices prevent sex workers, managers and owners from adopting safer workplace measures and exacerbate health and safety risks for sex workers. This study provides critical evidence of the negative public health implications of prohibitive municipal licensing in the context of a criminalised and enforcement-based approach to sex work. Workplace safety recommendations include the decriminalisation of sex work and the elimination of disproportionately high fees for licences, criminal record restrictions, door lock restrictions, employee registration requirements and the use of police as licensing inspectors. PMID:25686777

  19. Circulating sex hormones and mammographic breast density among postmenopausal women

    PubMed Central

    Sprague, Brian L.; Trentham-Dietz, Amy; Gangnon, Ronald E.; Buist, Diana S. M.; Burnside, Elizabeth S.; Aiello Bowles, Erin J.; Stanczyk, Frank Z.; Sisney, Gale S.

    2011-01-01

    The use of breast density as an intermediate or predictive marker of breast cancer risk is limited by an incomplete understanding of the etiology of breast density. High blood levels of endogenous estrogens and androgens are associated with increased risk of breast cancer among postmenopausal women. We sought to examine whether these hormones are also associated with breast density. The Wisconsin Breast Density Study enrolled 257 postmenopausal women, ages 55–70 years, with no history of postmenopausal hormone use, from mammography clinics in Madison, Wisconsin. Subjects provided a blood sample for sex hormone analysis, and breast density was measured from subjects’ screening mammograms using a computer-assisted thresholding method. Numerous sex hormones were associated with breast density in age-adjusted analyses. However, further adjustment for body mass index and other potentially confounding factors substantially attenuated or eliminated these associations. In the fully adjusted model, there remained a positive association between percent breast density and serum progesterone (P=0.03), with percent density rising from 11.9% (95% CI: 9.8, 14.1%) among women in the lowest quartile of serum progesterone to 15.4% (12.9, 18.2%) among women in the highest quartile. There was also a positive association between sex hormone binding globulin and percent breast density (P=0.06). In contrast, there were no associations between percent breast density and estradiol (total, free, or bioavailable), estrone, estrone sulfate, or testosterone (total, free, or bioavailable). These results suggest that breast density has a hormonal etiology, however, it may differ in important ways from that of breast cancer risk. PMID:21318123

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

    PubMed

    Poll, Ray

    2011-10-01

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

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

    PubMed Central

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

    2015-01-01

    Introduction: Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. Materials and Methods: A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. Results: The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Conclusions: Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI. PMID:25861174

  2. Sexual Debut of Young Black Women Who Have Sex with Women: Implications for STI/HIV Risk

    ERIC Educational Resources Information Center

    Timm, Tina M.; Reed, Sarah J.; Miller, Robin Lin; Valenti, Maria T.

    2013-01-01

    Young Black women continue to be at high risk for HIV and sexually transmitted infections (STIs). However, little is known about the risks specifically to young Black women who primarily have sex with women (YWSW). As part of a larger sexual health project, in-depth qualitative interviews were completed with 14 Black women ages 16-24, who…

  3. Anorectal Chlamydia trachomatis Load Is Similar in Men Who Have Sex with Men and Women Reporting Anal Sex

    PubMed Central

    van Liere, Geneviève A. F. S.; Dirks, Jeanne A. M. C.; Hoebe, Christian J. P. A.; Wolffs, Petra F.; Dukers-Muijrers, Nicole H. T. M.

    2015-01-01

    Background Anorectal Chlamydia trachomatis (chlamydia) is frequently diagnosed in men who have sex with men (MSM) and in women, but it is unknown whether these infections are comparable in clinical impact and transmission potential. Quantifying bacterial load and identifying determinants associated with high bacterial load could provide more insight. Methods We selected a convenience sample of MSM who reported anal sex (n = 90) and women with concurrent urogenital/anorectal chlamydia who reported anal sex (n = 51) or did not report anal sex (n = 61) from the South Limburg Public Health Service’s STI unit. Bacterial load (Chlamydia/ml) was quantified for all samples and log transformed for analyses. Samples with an unquantifiable human leukocyte antigen (n = 9) were excluded from analyses, as they were deemed inadequately sampled. Results The mean log anorectal chlamydia load (3.50) was similar for MSM and women who reported having anal sex (3.80, P = 0.21). The anorectal chlamydia load was significantly higher in these groups than in women who did not report having anal sex (2.76, P = 0.001). Detectable load values ranged from 1.81–6.32 chlamydia/ml for MSM, 1.74–7.33 chlamydia/ml for women who reported having anal sex and 1.84–6.31 chlamydia/ml for women who did not report having anal sex. Symptoms and several other determinants were not associated with anorectal chlamydia load. Conclusions Women who did not report anal sex had lower anorectal loads, but they were within a similar range to the other two groups. Anorectal chlamydia load was comparable between MSM and women who reported anal sex, suggesting similar transmission potential. PMID:26262680

  4. Sex Hormone Binding Globulin and Sex Steroids Among Premenopausal Women in the Diabetes Prevention Program

    PubMed Central

    Pi-Sunyer, Xavier; Barrett-Connor, Elizabeth; Stentz, Frankie B.; Murphy, Mary Beth; Kong, Shengchun; Nan, Bin; Kitabchi, Abbas E.

    2013-01-01

    Context: It is unknown whether intensive lifestyle modification (ILS) or metformin changes sex steroids among premenopausal women without a history of polycystic ovarian syndrome (PCOS). Objectives: We examined 1-year intervention impact on sex steroids (estradiol, testosterone, dehydroepiandrosterone, and androstenedione [A4]) and SHBG and differences by race/ethnicity. Participants: A subgroup of Diabetes Prevention Program participants who were premenopausal, not using estrogen, without a history of PCOS or irregular menses, and who reported non-Hispanic white (NHW), Hispanic, or African-American race/ethnicity (n = 301). Interventions: Randomization arms were 1) ILS with the goals of weight reduction of 7% of initial weight and 150 minutes per week of moderate intensity exercise, 2) metformin 850 mg twice a day, or 3) placebo. Results: Neither intervention changed sex steroids compared to placebo. ILS, but not metformin, increased median SHBG by 3.1 nmol/L (∼11%) compared to decreases of 1.1 nmol/L in the placebo arm (P < .05). This comparison remained significant after adjustment for changes in covariates including waist circumference. However, associations with glucose were not significant. Median baseline A4 was lower in Hispanics compared to NHWs (5.7 nmol/L vs 6.5 nmol/L, P < .05) and increases in A4 were greater in Hispanics compared to NHWs (3.0 nmol/ vs 1.2 nmol/L, P < .05), and these differences did not differ significantly by intervention arm. No other racial/ethnic differences were significant. Conclusions: Among premenopausal glucose-intolerant women, no intervention changed sex steroids. ILS increased SHBG, although associations with glucose were not significant. SHBG and sex steroids were similar by race/ethnicity, with the possible exception of lower baseline A4 levels in Hispanics compared to NHWs. PMID:23709655

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

    PubMed

    Ford, N; Koetsawang, S

    1999-01-01

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

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

    PubMed

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

    2015-09-01

    Mexico has a concentrated HIV epidemic, with male sex workers constituting a key affected population. We estimated annual HIV cumulative incidence among male sex workers' partners, and then compared incidence under three hypothetical intervention scenarios: improving condom use; and scaling up HIV treatment as prevention, considering current viral suppression rates (CVS, 60.7 %) or full viral suppression among those treated (FVS, 100 %). Clinical and behavioral data to inform model parameterization were derived from a sample (n = 79) of male sex workers recruited from street locations and Clínica Condesa, an HIV clinic in Mexico City. We estimated annual HIV incidence among male sex workers' partners to be 8.0 % (95 % CI: 7.3-8.7). Simulation models demonstrated that increasing condom use by 10 %, and scaling up HIV treatment initiation by 50 % (from baseline values) would decrease the male sex workers-attributable annual incidence to 5.2, 4.4 % (CVS) and 3.2 % (FVS), respectively. Scaling up the number of male sex workers on ART and implementing interventions to ensure adherence is urgently required to decrease HIV incidence among male sex workers' partners in Mexico City. PMID:25307025

  7. Correlates of condom use among female sex workers in The Gambia: results of a cross-sectional survey.

    PubMed

    Grosso, Ashley L; Lei, Esther L; Ketende, Sosthenes C; Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou Maria; Loum, Jaegan; Papworth, Erin; Baral, Stefan

    2015-01-01

    Objectives. This study examined correlates of condom use among 248 female sex workers (FSW) in The Gambia. Methods. Between July and August 2011, FSW in The Gambia who were older than 16 years of age, the age of consent in The Gambia, were recruited for the study using venue-based sampling and snowball sampling, beginning with seeds who were established clients with the Network of AIDS Services Organizations. To be eligible, FSW must have reported selling sex for money, favors, or goods in the past 12 months. Bivariate and multivariate logistic regressions were used to determine associations and the relative odds of the independent variables with condom use. Four different condom use dependent variables were used: consistent condom use in the past six months during vaginal or anal sex with all clients and partners; consistent condom use in the past month during vaginal sex with new clients; consistent condom use in the past month during vaginal sex with nonpaying partners (including boyfriends, husbands, or casual sexual partners); and condom use at last vaginal or anal sex with a nonpaying partner. Results. Many FSW (67.34%, n = 167) reported it was not at all difficult to negotiate condom use with clients in all applicable situations, and these FSW were more likely to report consistent condom use with all clients and partners in the past 6 months (aOR 3.47, 95% CI [1.70-7.07]) compared to those perceiving any difficulty in condom negotiation. In addition, FSW were more likely to report using condoms in the past month with new clients (aOR 8.04, 95% CI [2.11-30.65]) and in the past month with nonpaying partners (aOR 2.93, 95% CI [1.09-7.89]) if they had been tested for HIV in the past year. Women who bought all their condoms were less likely than those who received all of their condoms for free (aOR 0.38, 95% CI [0.15-0.97]) to have used a condom at last vaginal or anal sex with a nonpaying partner. Conclusions. HIV and sexually transmitted infection (STI) prevention interventions for FSW should aim to improve condom negotiation self-efficacy since women who report less difficulty negotiating condom use are more likely to use condoms with clients. Interventions should also be aimed at structural issues such as increasing access to free condoms and HIV testing since these were positively associated with condom use among FSW. PMID:26290781

  8. Women's Sex Lives Get a Boost After Non-Surgical Fibroid Treatment

    MedlinePlus

    ... nih.gov/medlineplus/news/fullstory_158124.html Women's Sex Lives Get a Boost After Non-Surgical Fibroid ... with bothersome uterine fibroids saw improvements in their sex lives and significant symptom relief a year after ...

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

    PubMed

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

    2015-01-01

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

  10. Psychotherapy with women who have worked in the "sex industry".

    PubMed

    Anklesaria, Ariz; Gentile, Julie P

    2012-10-01

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

  11. Psychotherapy with Women Who Have Worked in the Sex Industry

    PubMed Central

    Anklesaria, Ariz

    2012-01-01

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

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

    PubMed

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

    2016-05-01

    Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8 % reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions. PMID:25905909

  13. Violence, condom breakage and HIV infection among female sex workers in Benin, West Africa

    PubMed Central

    Tounkara, Fatoumata K.; Diabaté, Souleymane; Guédou, Fernand A.; Ahoussinou, Clément; Kintin, Frédéric; Zannou, Djimon M.; Kpatchavi, Adolphe; Bédard, Emmanuelle; Bietra, Raphaël; Alary, Michel

    2014-01-01

    Objective To examine the relationship between violence, condom breakage and HIV prevalence among female sex workers (FSWs). Methods Data were obtained from the 2012 cross-sectional integrated biological and behavioural survey conducted in Benin. Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios (APRs) of HIV infection and condom breakage in relation to violence towards FSWs. A score was created to examine the relationship between the number of violence types reported and HIV infection. Results Among the 981 women who provided a blood sample, HIV prevalence was 20.4%. During the last month, 17.2%, 13.5% and 33.5% of them had experienced physical, sexual and psychological violence, respectively. In addition, 15.9% reported at least one condom breakage during the previous week. There was a significant association between all types of violence and HIV prevalence. The APRs of HIV were 1.45 (95% confidence interval [95%CI]: 1.05 – 2.00), 1.42 (95%CI: 1.02 – 1.98), and 1.41 (95%CI: 1.08 – 1.41) among those who had ever experienced physical, sexual and psychological violence, respectively. HIV prevalence increased with the violence score (p=0.002, test for trend), and physical and sexual violence were independently associated with condom breakage (p values 0.010 and 0.003, respectively). Conclusion The results show that violence is associated with a higher HIV prevalence among FSWs and that condom breakage is a potential mediator for this association. Longitudinal studies designed to analyse this relationship and specific interventions integrated to current HIV prevention strategies are needed to reduce the burden of violence among FSWs. PMID:24722385

  14. Who are the Preferential Targets for Intervention Programs Related to the Female Condom among Sex Workers in Southern China?

    PubMed Central

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

    2015-01-01

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

  15. STI Screening Uptake and Knowledge of STI Symptoms among Female Sex Workers Participating in a Community Randomized Trial in Peru

    PubMed Central

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

    2016-01-01

    This study aims to evaluate condom use, STI screening, and knowledge of STI symptoms among female sex workers (FSW) in Peru associated with sex work venue and a community randomized trial of STI control. One component of the Peru PREVEN intervention conducted mobile-team outreach to FSW 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. FSW reporting exposure to the intervention had 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 FSW, brothel-based FSW reported significantly higher rates of condom use with last client, recent screening exams for STIs and HIV testing. Brothel-based FSW 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 FSW in Peru should consider structural or regulatory factors related to sex work venue. PMID:25941053

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

    PubMed

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

    2013-08-01

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

  17. PREVALENCE AND CORRELATES OF CLIENT-PERPETRATED ABUSE AMONG FEMALE SEX WORKERS IN TWO MEXICO-U.S. BORDER CITIES

    PubMed Central

    Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L.

    2011-01-01

    History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence, psychological distress and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125

  18. HPV and cervical cancer related knowledge, awareness and testing behaviors in a community sample of female sex workers in China

    PubMed Central

    2013-01-01

    Background Limited data suggested that the prevalence of Human Papillomavirus (HPV) among female sex workers (FSW) is much higher than in the general female population. The current study aimed to examine the HPV and cervical cancer related awareness, knowledge, and behaviors among FSW in China. Methods A total of 360 FSW recruited from entertainment establishments in Beijing completed a self-administered survey including demographics, HPV related knowledge, and health-seeking and cervical cancer preventive behaviors. Results Approximately 70.8% of the participants ever heard of cervical cancer, and as few as 22.1% and 13.3% ever heard of HPV and HPV vaccine, respectively. The mean score on a 7-item knowledge scale was 2.2 (SD = 2.4). Less than 10% of FSW perceived any risk of cervical cancer, and only 15.3% ever had a Pap smear. About 40.8% of FSW would accept HPV vaccine if it is free, and 21.8% would accept it even with a charge. Multivariate regression suggested that women with better knowledge of cervical cancer were more likely to have a Pap smear (aOR = 1.35); women who had tested for HIV were 11 times more likely to have a Pap smear, and women who had worked longer in commercial sex (aOR = 1.01) and had regular health check-ups (aOR = 1.95) were more likely to accept HPV vaccine. Conclusions Our study underscores the needs for effective cervical cancer prevention programs for FSW in China and other resource-limited countries. We specifically call for cervical cancer and HPV knowledge and awareness programs and regular screening as well as HPV risk-reduction programs for these vulnerable women. PMID:23898889

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

    PubMed Central

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

    2011-01-01

    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 health interventions and safer supportive housing to account for the daily lived experiences of women sex workers. PMID:22018526

  20. The influence of gender on sex: a study of men's and women's self-reported high-risk sex behavior.

    PubMed

    Cubbins, L A; Tanfer, K

    2000-06-01

    An investigation is presented of the relationship between gender and five self-reported high-risk sex behaviors: ever having had casual sex, the lifetime number of vaginal sex partners, the lifetime number of anal sex partners, having had multiple vaginal sex partners over the short term, and having had multiple anal sex partners over the short term. The analysis was guided by a conceptual model that emphasized the constraints and opportunities for high-risk sex behavior that arise from an individual's structural position and cultural context. Gender differences in high-risk sex behaviors were predicted to be due to differences in men's and women's family roles, work roles, religious behaviors, and past sex experience. In addition, the effects of certain sociocultural factors on the high-risk sex behaviors were expected to be dependent on an individual's gender. The hypotheses were evaluated using national data from the United States on self-reported sex behaviors for men ages 20 to 39 years old and women ages 20 to 37 years old. Data analyses were conducted using ordinary least-squares regression and logistic regression. Findings provided mixed support for the predictions. Gender was not significantly related to short-term, self-reported high-risk sex behaviors once social and cultural factors were included in the statistical models. But it continued to predict lifetime behaviors. Several variables, including race, age, age at first sex, and marital status, had gender-specific effects on the self-reported high-risk sex behaviors. The study demonstrates how the effects of structural and cultural factors on sex behavior differ for men and women. PMID:10992980

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

    PubMed

    Bar-Johnson, Michael David; Weiss, Petr

    2015-01-01

    Prague, the Czech Republic, is a popular sex tourism destination where sex work is decriminalized and young men offer sexual services at low prices relative to countries in Western Europe. This quantitative survey aimed to identify some of the demographic characteristics of these young men and their experiences in the sex industry. Internet escorts (N = 20) and sex workers in bars and clubs (N = 20) completed the survey anonymously in spring 2011. The results showed that sex workers in clubs often had troubled pasts and were forced into sex work to survive. They also reported incidents of violence, serious alcohol and drug use, as well as frequent gambling. The larger group of sex workers in Prague is made up of Internet escorts who have backgrounds that are not atypical for the average Czech youth. They had fewer problems with drugs and alcohol but were twice as likely as sex workers in bars and clubs to be victims of violent crime. Plans for interventions to help those who would change their line of work, as well as the importance of sociocultural context in understanding sex workers, are discussed. PMID:24423089

  2. When Sex Work Becomes Your Everything: The Complex Linkages Between Economy and Affection Among Male Sex Workers in Peru.

    PubMed

    Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J

    2014-09-01

    In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs' perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs' perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. PMID:24368712

  3. When sex work becomes your everything: The complex linkages between economy and affection among male sex workers in Peru

    PubMed Central

    Bayer, Angela M.; Garvich, Mijail; Díaz, David A.; Sánchez, Hugo; García, Patricia J.; Coates, Thomas J.

    2014-01-01

    In Peru, there are few studies on male sex workers (MSWs) and existing studies explore limited sub-groups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives and HIV/STI risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health and well-being. PMID:24368712

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

    PubMed Central

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

    2005-01-01

    Background Heterosexual contact is the most common mode of HIV transmission in India that is largely linked to sex work. We assessed the non-use of condoms in sex work and with regular sex partners by female sex workers (FSWs), and identified its associations that could assist in planning HIV prevention programmes. Methods Detailed documentation of various aspects of sex work, and sexual behaviour with regular sex partners, was done through confidential interviews for 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. Multivariate analysis was done to understand condom non-use with clients. Results 5010 (75.4%), 1499 (22.5%), and 139 (2.1%) FSWs were street-, home-, and brothel-based, respectively. Of the total 6648 FSWs, 6165 (92.7%) had penetrative vaginal/anal sex with at least one client in the last 15 days, and of these 2907 (47.2%; 95% CI 41.2–53.2%) reported non-use of condom with at least one of her last three clients. Lack of knowledge that HIV could be prevented (odds ratio 5.01; 95% CI 4.38–5.73), no access to free condoms (odds ratio 3.45; 95% CI 2.99–3.98), being street-based as compared with brothel-based (odds ratio 3.36; 95% CI 1.87–6.04), and no participation in FSW support groups (odds ratio 2.02; 95% CI 1.50–2.70) were the most significant predictors of condom non-use with clients. Other associations included lower social support, lower income, age >24 years, illiteracy, and living in medium-size urban or rural areas. Of the 2582 who had penetrative sex with regular sex partner within the last 7 days, 2428 (94%; 95% CI 92.1–95.9%) had not used condom at last sex, and 1032 (41.8%) had neither used condom consistently with clients nor with regular sex partner. Conclusion About half the FSWs do not use condom consistently with their clients in this Indian state putting them at high risk of HIV infection. Non-brothel-based FSWs, who form the majority of sex workers in India, were at a significantly higher risk of HIV infection as compared with brothel-based FSWs. With their high vulnerability, the success of expansion of HIV prevention efforts will depend on achieving and sustaining an environment that enables HIV prevention with the non-brothel based FSWs. PMID:16111497

  5. Use of barrier protection for sexual activity among women who have sex with women

    PubMed Central

    Rowen, Tami S.; Breyer, Benjamin N.; Lin, Tzu-Chin; Li, Chin-Shang; Robertson, Patricia A.; Shindel, Alan W.

    2013-01-01

    Objective To assess the frequency and associations of barrier protection use during sexual activity in a population of women who have sex with women (WSW). Methods WSW were invited to participate in an international internet-based survey. Information regarding ethnodemographics, sexual health, and barrier use during sexual activities was collected. Results The study cohort comprised 1557 participants. Barrier use was least prevalent during digital genital stimulation (11.3% ever used barriers) and most prevalent during stimulation with a sex toy (34.4% ever used barriers). Univariate analysis revealed that women in non-monogamous relationships were more likely than monogamous women to always use barrier protection for sexual activity (14.3% vs 3.5%). On multivariate analysis, there was no association between barrier use and frequency of casual sexual activity or history of sexually transmitted infection. Small associations were noted between barrier use and certain sexual activities, age, race, and number of partners. Conclusion Many WSW do not use barrier protection during sexual activity, even in the context of potentially risky sexual behaviors. Safer-sex practices among WSW merit increased attention from healthcare providers and public health researchers. PMID:23106842

  6. Sexual desire, communication, satisfaction, and preferences of men and women in same-sex versus mixed-sex relationships.

    PubMed

    Holmberg, Diane; Blair, Karen L

    2009-01-01

    In an online study, measures of subjective sexual experiences in one's current relationship were compared across four groups: Men and women in mixed-sex (i.e., heterosexual) and same-sex (i.e., homosexual) relationships. Results indicated far more similarities than differences across the four groups, with groups reporting almost identical sexual repertoires, and levels of sexual communcation with partner. Men reported experiencing somewhat more sexual desire than women, while women reported slightly higher levels of general sexual satisfaction than men. Those in same-sex relationships reported slightly higher levels of sexual desire than those in mixed-sex relationships. Compared to the other three groups, heterosexual men reported deriving somewhat less satisfaction from the more tender, sensual, or erotic sexual activities. Implications of these findings for sex therapists are discussed. PMID:19116863

  7. Factors associated with drinking alcohol before visiting female sex workers among men in Sichuan Province, China.

    PubMed

    Yang, Cui; Latkin, Carl; Luan, Rongsheng; Nelson, Kenrad

    2013-02-01

    Alcohol use in commercial sex is highly prevalent globally and alcohol use in conjunction with sexual activity might increase the probability of risky behaviors. In the current study, we explored individual and contextual factors associated with drinking alcohol before visiting female sex workers (FSWs) among 560 male clients in Sichuan province, China. A cross-sectional survey was conducted in Sichuan province, China. Over one-fifth (21.1 %) of the participants reported always using alcohol before having sex with FSWs. As compared to those who reported not always drinking alcohol before having sex with FSWs, male clients who reported always drinking alcohol before having sex with FSWs had higher income, were more likely to have main sex partners, to drink alcohol daily, to report minor depressive symptoms and were more likely to visit FSWs with friends rather than by themselves. Results from this study highlight the importance of addressing alcohol use among men who pay for sex in China. Future interventions should promote alcohol-related norms in reducing the harms associated with consuming alcohol. PMID:22806054

  8. Induced abortion among Brazilian female sex workers: a qualitative study.

    PubMed

    Madeiro, Alberto Pereira; Diniz, Debora

    2015-02-01

    Prostitutes are vulnerable to unplanned pregnancies and abortions. In Brazil, abortion is a crime and there is no data about unsafe abortions for this population. The study describes how prostitutes perform illegal abortions and the health consequences thereof. Semi-structured interviews with 39 prostitutes from three cities in Brazil with previous induced abortion experience were conducted. Sixty-six abortions, with between one and eight occurrences per woman, were recorded. The majority of the cases resulted from sexual activity with clients. The inconsistent use of condoms with regular clients and the consumption of alcohol during work were indicated as the main causes of unplanned pregnancies. The main method to perform abortion was the intravaginal and oral use of misoprostol, acquired in pharmacies or on the black market. Invasive measures were less frequently reported, however with more serious health complications. The fear of complaint to the police meant that most women do not inform the health team regarding induced abortion. The majority of prostitutes aborted with the use of illegally-acquired misoprostol, ending abortion in a public hospital with infection and hemorrhagic complications. The data indicate the need for a public policy focusing on the reproductive health of prostitutes. PMID:25715152

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

    PubMed

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

    1994-01-01

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

  10. "I do what I have to do to survive": An investigation into the perceptions, experiences and economic considerations of women engaged in sex work in Northern Namibia

    PubMed Central

    2011-01-01

    Background There is little published research investigating sex work in Namibia, particularly in rural areas. Therefore, the aim of this paper was to determine the views of women engaged in sex work in the Oshakati area of Namibia concerning the main factors influencing their use, or non-use, of male condoms during transactional sexual exchanges. Methods Qualitative interviews were used to better understand the perceptions, experiences and economic considerations of female sex workers in Namibia who were involved in a Behavior Change Communication Program encouraging safer sex practices among high-risk populations in 2006 and 2007. Results While the Behavior Change Communication Program has made significant strides in educating and empowering young women to negotiate more consistent condom use with sexual partners, the gendered economic inequalities and power imbalances within rural and semi-urban Namibian society that favor men hinder further advancement towards positive behavioral change for HIV prevention and also hinder the development of the loving relationships sought by some sex workers. Conclusion This study found that sex workers and transactional sex encounters are heterogeneous entities dependent upon the characteristics of the man (known, stranger, wealthy, attractive to the woman) and the woman (in financial need, desiring love). These features all influence condom use. The 3 E's 'education, empowerment and economic independence' are critical factors needed to encourage and facilitate consistent condom use to prevent HIV transmission. Without financial independence and occupational alternatives building on their health education and empowerment, women who engage in sex work-and transactional sex more generally-will remain largely marginalized from Namibian society, and will continue engaging in risky sexual practices that facilitate HIV acquisition and transmission throughout the community. PMID:21813006

  11. Sex work and risky sexual behaviors among foreign entertainment workers in urban Singapore: findings from Mystery Client Survey.

    PubMed

    Wong, Mee-Lian; Chan, Roy; Tan, Hiok Hee; Yong, Eunice; Lee, Lionel; Cutter, Jeffrey; Tay, Joanne; Koh, David

    2012-12-01

    Globalization has led to a rapid influx of female workers from Asian countries with high prevalence of HIV to Singapore, with many entering the entertainment industry. We assessed the prevalence of sexual services, condom use, and self-initiated screening for sexually transmitted infections (STIs) and associated variables among foreign female entertainment workers in Singapore. A cross-sectional survey of 317 female entertainment workers, using mystery clients, was conducted on a two-stage proportional cluster sample of 93 entertainment establishments stratified by geographical zone in Singapore. We found a high prevalence (71 %) of sexual services in entertainment establishments with 53 % of the female entertainment workers reporting selling sex. Consistent condom use for sex with paying clients in a usual week in the past 3 months was low, ranging from 37.9 % for oral sex, 46.9 % for anal sex, to 51.9 % for vaginal sex. On multivariate logistic regression, consistent condom use for vaginal sex with clients showed a significant independent association with the entertainment worker's behavior of asking clients to use condoms and a borderline association with entertainment worker being a Chinese national. Less than half (48.9 %) of the sex workers had ever been screened for STIs either locally or in their home country. The only independent factor significantly associated with STI screening was having to support one's family. In summary, a high percentage of foreign female entertainment workers in Singapore reported selling sex. Condom use and STI screening were low among them. Access to STI screening, treatment, and education services should be enhanced for foreign female entertainment workers in Singapore. PMID:22707309

  12. Lipoprotein subclasses and endogenous sex hormones in women at midlife

    PubMed Central

    El Khoudary, Samar R.; Brooks, Maria M.; Thurston, Rebecca C.; Matthews, Karen A.

    2014-01-01

    The objective of this work was to evaluate the associations between levels of endogenous sex hormones in women at midlife and lipoprotein subclasses. One hundred and twenty women (68 late peri-/postmenopausal and 52 pre-/early perimenopausal) from the Study of Women’s Health Across the Nation (Pittsburgh site) were included. Lipoprotein subclasses were quantified using NMR spectroscopy. Participants (57.5% White and 42.5% Black) were 50.4 ± 1.9 years old. Adjusting for age, race, cycle day of blood draw, BMI, physical activity, and alcohol consumption, a negative correlation was found between estradiol (E2) and medium-small LDL particle (LDL-P) concentration (ρ = −0.19, P = 0.04). Further, E2 was positively correlated with HDL particle (HDL-P) size (ρ = 0.22, P = 0.02). For sex hormone binding globulin (SHBG), independent negative correlation was found with total small LDL-P concentration. SHBG was also positively correlated with LDL-P and HDL-P sizes (P < 0.05 for all). For free androgen index (FAI), positive correlations were found with concentrations of total VLDL particles, total LDL-Ps, and total small LDL-Ps. Additionally, FAI was negatively correlated with large HDL-P concentration, and HDL-P and LDL-P sizes (P < 0.05 for all). Lower levels of E2 and SHBG, and higher levels of FAI were associated with a more atherogenic profile of lipoprotein subclasses. Sex hormone levels at midlife may increase women’s risk of coronary heart disease. PMID:24852168

  13. High Seroprevalence of Toxoplasma Gondii Infection in Female Sex Workers: A Case-Control Study

    PubMed Central

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Hernández-Tinoco, Jesús; Arreola-Cháidez, Emilio; López, Juan; Salcido-Meraz, Karla Itzel; Estrada-Martínez, Sergio; Navarrete-Flores, José Antonio; Pérez-Álamos, Alma Rosa; Hernández-Ochoa, Marcia; Rábago-Sánchez, Elizabeth; Liesenfeld, Oliver

    2015-01-01

    Through an age- and sex-matched case-control study, we sought to determine whether female sex workers have an increased risk of Toxoplasma gondii exposure and to determine the sociodemographic, work, clinical, and behavioral characteristics of these workers associated with T. gondii exposure. Female workers (n = 136) and controls (n = 272) were examined with enzyme-linked immunoassays (EIA) for the presence of anti-Toxoplasma IgG and IgM antibodies. IgM positive sera were additionally tested with enzyme linked-fluorescence immunoassay (ELFA). Anti-T. gondii IgG antibodies were found in 21 (15.44%) of 136 cases and in 10 (3.67%) of 272 controls (OR = 4.05; 95% CI: 1.84–8.89; P = 0.0001). Anti-T. gondii IgG levels higher than 150 IU/ml were found in 13 (9.6%) of 136 cases and in 8 (2.9%) of 272 controls (P = 0.007). Anti-T. gondii IgM antibodies were found in two cases and in six controls by EIA, but all were negative by ELFA. T. gondii seropositivity was associated with being born out of Durango State (OR = 10.47; 95% CI: 2.9–36.8; P < 0.01), injuries during sex work (OR = 6.30; 95% CI: 1.1–33.7; P = 0.03), and soil contact (OR = 4.11; 95% CI: 1.2–14.0; P = 0.02). This is the first report of an association of T. gondii infection and female sex workers. PMID:26716017

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed

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

    2015-02-01

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

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

    Hail-Jares, Katie; Chang, Ruth C. F.; Choi, Sugy; Zheng, Huang; He, Na; Huang, Z. Jennifer

    2015-01-01

    Background Globally, female street-based sex workers are vulnerable to gender-based violence. Previous research has shown having a peer social network can reduce sex workers’ risks of victimization. However, mechanisms of how social network impacts violence among female street-based sex workers are still far from clear. Methods Our study was based on data abstracted from a paper-and-pencil survey administered among 218 female street-based sex workers in Shanghai, China. We focused on self-reported client-initiated violence and intimate-partner violence in emotional, physical, and sexual forms. Social networks were characterized by the size and sources of financial and psychosocial support (e.g. family, friends, and peers). Multi-variable logistic regression was used to estimate adjusted odds ratios (AOR) of each type of violence exposure by social network structure after the adjustment of age, education, and years in Shanghai. Results The street-based female sex workers in our study were primarily rural-to-urban migrants (95.7%) with an average age of 41 years old. 24.3% and 62.8% of the sex workers reported intimate-partner violence and client-initiated violence respectively. Lack of financial support, as defined by having only one individual or none in her peer support system to help financially, was significantly associated with self-reported intimate-partner violence (AOR: 2.5; 95% CI: 1.1–5.9). Respondents who reported client-initiated violence, by contrast, were more likely to report lacked psychosocial support from family (AOR: 2.2, 95% CI: 1.0–4.6) and peers (AOR: 5.1, 95% CI: 2.2–11). Conclusion This study is one of the first to systematically analyze the associations between social network and gender-based violence among street-based female sex worker. We reported a high prevalence of both types of gender-based violence and their complex associations with family, friends, and peer support network. Policies with goals to reduce violence against women may apply these findings to leverage social network in the interventions against gender-based violence. PMID:26413776

  18. Peer outreach work as economic activity: implications for HIV prevention interventions among female sex workers.

    PubMed

    George, Annie; Blankenship, Kim M

    2015-01-01

    Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers' economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers' relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers. PMID:25775122

  19. Factors Associated with Risky Sexual Practices among Female Sex Workers in Karnataka, India

    PubMed Central

    Mahapatra, Bidhubhusan; Lowndes, Catherine M.; Mohanty, Sanjay Kumar; Gurav, Kaveri; Ramesh, Banadakoppa M.; Moses, Stephen; Washington, Reynold; Alary, Michel

    2013-01-01

    Introduction The objectives of this study are to develop a summary measure of risky sexual practice and examine the factors associated with this among female sex workers (FSWs) in Karnataka, India. Materials and Methods Data were drawn from special behavioral surveys (SBS) conducted in 2007 among 577 FSWs in two districts of Karnataka, India: Belgaum and Bangalore. FSWs were recruited using the two-stage probability sampling design. FSWs' sexual practice was considered risky if they reported inconsistent condom use with any sexual partner and reported experience of one of the following vulnerabilities to HIV risk: anal sex, alcohol consumption prior to sex and concurrent sexual relationships. Results About 51% of FSWs had engaged in risky sexual practice. The odds of engaging in risky sex were higher among FSWs who were older (35+ years) than younger (18–25 years) (58% vs. 45%, Adjusted Odds Ratio (AOR): 2.0, 95% confidence interval (CI): 1.2–3.4), who were currently married than never married (61% vs. 51%, AOR: 4.8, 95% CI: 2.5–9.3), who were in sex work for 10+ years than those who were in sex work for less than five years (66% vs. 39%, AOR: 2.6, 95% CI: 1.6–4.2), and who had sex with 3+ clients/day than those who had sex with fewer clients (67% vs. 38%, AOR: 3.7, 95% CI:2.5–5.5). Conclusion FSWs who are older, currently married, practicing sex work for longer duration and with higher clientele were more likely to engage in risky sexual practices. HIV prevention programs should develop strategies to reach these most-at risk group of FSWs to optimize the effectiveness of such programs. PMID:23637991

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

    PubMed

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

    2015-07-01

    French Guiana is the French territory that is most affected by HIV. AIDS incidence is much higher than in mainland France and sex work seems to be an important driver of the epidemic. The objective of this study was to describe consistent condom use among female sex workers with their clients and their intimate partners and to identify determinants of non-use of condoms. An HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey was conducted in 2009-2010 among sex workers in French Guiana. A total of 477 sex workers were interviewed. Female sex workers were more likely to use condoms with their clients (97%) than with their intimate partners (45%). The factors associated with non-consistent condom use with the intimate partner were having had an abortion, feeling at risk for HIV, not evaluating one's own risk for HIV, living as a couple, being Dominican, and not feeling comfortable asking intimate partners to use condoms. Although a high proportion of female sex workers declared using condoms with commercial partners, there is still room for improvement in the prevention of transmission with both commercial and intimate partners. PMID:25080287

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

    ERIC Educational Resources Information Center

    Korabik, Karen

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

  2. Is Audio Computer-Assisted Self-Interview (ACASI) Useful in Risk Behaviour Assessment of Female and Male Sex Workers, Mombasa, Kenya?

    PubMed Central

    van der Elst, Elisabeth M.; Okuku, Haile Selassie; Nakamya, Phellister; Muhaari, Allan; Davies, Alun; McClelland, R. Scott; Price, Matthew A.; Smith, Adrian D.; Graham, Susan M.; Sanders, Eduard J.

    2009-01-01

    Background Audio computer-assisted self-interview (ACASI) may elicit more frequent reporting of socially sensitive behaviours than face-to-face (FtF)-interview. However, no study compared responses to both methods in female and male sex workers (FSW; MSW) in Africa. Methodology/Principal Findings We sequentially enrolled adults recruited for an HIV-1 intervention trial into a comparative study of ACASI and FtF-interview, in a clinic near Mombasa, Kenya. Feasibility and acceptability of ACASI, and a comparative analysis of enrolment responses between ACASI and FtF on an identical risk assessment questionnaire were evaluated. In total, 139 women and 259 men, 81% of eligible cohort participants, completed both interviews. ACASI captured a higher median number of regular (2 vs. 1, p<0.001, both genders) and casual partners in the last week (3 vs. 2, p = 0.04 in women; 2 vs. 1, p<0.001 in men). Group sex (21.6 vs. 13.5%, p<0.001, in men), intravenous drug use (IDU; 10.8 vs. 2.3%, p<0.001 in men; 4.4 vs. 0%, p = 0.03 in women), and rape (8.9 vs. 3.9%, p = 0.002, in men) were reported more frequently in ACASI. A surprisingly high number of women reported in ACASI that they had paid for sex (49.3 vs. 5.8%, p<0.001). Behaviours for recruitment (i.e. anal sex, sex work, sex between males) were reported less frequently in ACASI. The majority of women (79.2%) and men (69.7%) felt that answers given in ACASI were more honest. Volunteers who were not able to take ACASI (84 men, and 37 women) mostly lacked reading skills. Conclusions/Significance About 1 in 5 cohort participants was not able to complete ACASI, mostly for lack of reading skills. Participants who completed ACASI were more likely to report IDU, rape, group sex, and payment for sex by women than when asked in FtF interview. ACASI appears to be a useful tool for high risk behaviour assessments in the African context. PMID:19412535

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

    PubMed Central

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

    2012-01-01

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

  4. Diversity among Clients of Female Sex Workers in India: Comparing Risk Profiles and Intervention Impact by Site of Solicitation. Implications for the Vulnerability of Less Visible Female Sex Workers

    PubMed Central

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

    2013-01-01

    Background It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. Methods The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients’ consistent condom use with FSW. Results Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. Conclusion Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks. PMID:24023877

  5. An exploratory study of HIV risk behaviours and testing among male sex workers in Beirut, Lebanon

    PubMed Central

    Aunon, Frances M.; Wagner, Glenn J.; Maher, Rabih; Khouri, Danielle; Kaplan, Rachel L.; Mokhbat, Jacques

    2015-01-01

    Male sex workers (MSW) are a particularly high-risk subset of men who have sex with men in Lebanon and report higher numbers of sex partners and lower rates of condom use. The purpose was to explore the factors influencing sexual risk behaviors and HIV testing among MSW. Qualitative interviews were conducted with 16 MSW living in Beirut and working in bathhouses (hammam) or as escorts; content analysis identified emergent themes. Escorts reported more consistent condom use with clients and HIV testing than hammam MSW, with influential factors including HIV risk knowledge and perceived risk susceptibility, job security, and internalized stigma and related feelings of self-worth and fatalism regarding health and HIV risk. In contrast, both groups of MSW typically opted not to condoms with nonclient sex partners, in an effort to differentiate sex for work versus pleasure. The uptake of HIV testing was limited by concerns about the confidentiality of the test results and fear of repercussions of a positive test result for their health and employment. The respondents described an insular existence within the sex work culture, in part to limit exposure to stigma, which has implications for access to support as well as the influence of peer norms regarding sexual risk behavior and health seeking behaviors such as HIV testing. Further research is needed to tailor prevention and HIV testing efforts to reflect the distinct sexual health “cultures” that distinguish these two populations of MSW in Lebanon. PMID:25950906

  6. An Exploratory Study of HIV Risk Behaviors and Testing among Male Sex Workers in Beirut, Lebanon.

    PubMed

    Aunon, Frances M; Wagner, Glenn J; Maher, Rabih; Khouri, Danielle; Kaplan, Rachel L; Mokhbat, Jacques

    2015-01-01

    Male sex workers (MSW) are a particularly high-risk subset of men who have sex with men in Lebanon and report higher numbers of sex partners and lower rates of condom use. The purpose was to explore the factors influencing sexual risk behaviors and HIV testing among MSW. Qualitative interviews were conducted with 16 MSW living in Beirut and working in bathhouses (hammam) or as escorts; content analysis identified emergent themes. Escorts reported more consistent condom use with clients and HIV testing than hammam MSW, with influential factors including HIV risk knowledge and perceived risk susceptibility, job security, and internalized stigma and related feelings of self-worth and fatalism regarding health and HIV risk. In contrast, both groups of MSW typically opted not to condoms with nonclient sex partners, in an effort to differentiate sex for work versus pleasure. The uptake of HIV testing was limited by concerns about the confidentiality of the test results and fear of repercussions of a positive test result for their health and employment. The respondents described an insular existence within the sex work culture, in part to limit exposure to stigma, which has implications for access to support as well as the influence of peer norms regarding sexual risk behavior and health seeking behaviors such as HIV testing. Further research is needed to tailor prevention and HIV testing efforts to reflect the distinct sexual health "cultures" that distinguish these two populations of MSW in Lebanon. PMID:25950906

  7. Alcohol Use Among Female Sex Workers and Male Clients: An Integrative Review of Global Literature

    PubMed Central

    Li, Qing; Li, Xiaoming; Stanton, Bonita

    2010-01-01

    Aims: To review the patterns, contexts and impacts of alcohol use associated with commercial sex reported in the global literature. Methods: We identified peer-reviewed English-language articles from 1980 to 2008 reporting alcohol consumption among female sex workers (FSWs) or male clients. We retrieved 70 articles describing 76 studies, in which 64 were quantitative (52 for FSWs, 12 for male clients) and 12 qualitative. Results: Studies increased over the past three decades, with geographic concentration of the research in Asia and North America. Alcohol use was prevalent among FSWs and clients. Integrating quantitative and qualitative studies, multilevel contexts of alcohol use in the sex work environment were identified, including workplace and occupation-related use, the use of alcohol to facilitate the transition into and practice of commercial sex among both FSWs and male clients, and self-medication among FSWs. Alcohol use was associated with adverse physical health, illicit drug use, mental health problems, and victimization of sexual violence, although its associations with HIV/sexually transmitted infections and unprotected sex among FSWs were inconclusive. Conclusions: Alcohol use in the context of commercial sex is prevalent, harmful among FSWs and male clients, but under-researched. Research in this area in more diverse settings and with standardized measures is required. The review underscores the importance of integrated intervention for alcohol use and related problems in multilevel contexts and with multiple components in order to effectively reduce alcohol use and its harmful effects among FSWs and their clients. PMID:20089544

  8. High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need

    PubMed Central

    2011-01-01

    Background The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs) in Vancouver. Methods The study sample was obtained from a community-based prospective cohort study (2006-2008) of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody), and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4) were examined. Results Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5). The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR): 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1;IQR:1-3), apprehension (median = 2; IQR:1-4) and adoption (median = 1; IQR:1-2) among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95%CI = 1.14-5.45]), and permanent contraceptives (e.g., tubal ligation and hysterectomy) (OR = 2.76; [95%CI = 1.36-5.59]) were both significantly associated with having five or more pregnancies. Conclusion These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver. PMID:21851622

  9. Safer sex negotiation and its association with condom use among clients of female sex workers in Bangladesh.

    PubMed

    Kamal, S M Mostafa; Hassan, Che Hashim; Salikon, Roslan Hj

    2015-03-01

    This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients. PMID:24345848

  10. Sexual HIV risk among substance-using female commercial sex workers in Durban, South Africa.

    PubMed

    Carney, Tara; Petersen Williams, Petal M; Plüddemann, Andreas; Parry, Charles D H

    2015-01-01

    This study examined data collected from a sample of female sex workers (FSWs) during the first two years of a brief risk-reduction intervention for vulnerable populations that focused on substance use and HIV risk-related behaviours (2007-2009) as part of a rapid assessment and response evaluation study. In 2007, in collaboration with a local non-governmental organisation (NGO), an initiative was begun to roll out targeted harm reduction strategies for drug-using street based FSWs in Durban, South Africa. Data were collected on demographic characteristics, substance use and HIV risk behaviours to tailor these harm reduction strategies with participants. Over the first two years of the intervention, data were collected from 646 FSWs: 428 who reported being at low risk for HIV and 218 who reported being at high risk for HIV (defined as engaging in unprotected sex with sexual partners in the past 90 days). FSWs who had previously been diagnosed with HIV or a sexually transmitted disease (STD) were significantly less likely to report engaging in unprotected sex. Those who used over-the-counter or prescription (OTC/PRE) drugs reported engaging in unprotected sex significantly more often than FSWs who did not use these substances, while those who used heroin were less likely to report unprotected sex. The findings are encouraging in that those who are aware of their HIV status are less likely to engage in risky sexual behaviour, and therefore HIV testing and counselling is recommended. It indicates the need to identify strategies to encourage the likelihood of all FSWs, particularly those who are HIV-positive, to use condoms. It also encourages further research to investigate specific substances as possible predictors of high risk behaviours in high-risk populations of sex workers. PMID:26223332

  11. Vulnerabilities faced by the children of sex workers in two Mexico - U.S. border cities: a retrospective study on sexual violence, substance use and HIV risk

    PubMed Central

    Servin, Argentina E.; Strathdee, Steffanie; Muñoz, Fatima A.; Vera, Alicia; Rangel, Gudelia; Silverman, Jay G.

    2014-01-01

    Most studies of female sex workers (FSWs) conducted in the Mexico-US border region have focused on individual HIV risk, centered on sexual behaviors and substance abuse patterns. Little attention has been drawn to the reality that sex workers are often parents whose children potentially face vulnerabilities unique to their family situation. The objective of the present study was to identify the vulnerabilities faced by the children of FSWs in two Mexican-U.S. border cities. From 2008-2010, 628 FSW-IDUs underwent interviewer-administered surveys and HIV/STI testing. Approximately 1 in 5 participants (20%) reported having a parent involved in sex work and majority referred it was their mother (88%). Close to one third of participants (31%) reported first injecting drugs <18 years of age and 33% reported they began working regularly as a prostitute <18 years of age. First drinking alcohol <18 years old (AdjOR=1.87, 95%CI: 1.13–3.08), lifetime cocaine use (AOR=1.76, 95%CI: 1.09–2.84), ever being forced or coerced into non–consensual sex as a minor (<18 years of age) (AdjOR =1.54, 95%CI: 1.01-2.35) and injecting drugs with used syringes in the prior month (AOR=1.63, 95%CI:1.07 -2.49) were factors associated with having had a parent involved in sex work. These findings begin to lay the groundwork for understanding the potential vulnerabilities faced by the children of sex workers. Understanding these potential needs are necessary for creating relevant, evidence based interventions focused on supporting these women. PMID:25117749

  12. Is Scale-Up of Community Mobilisation among Sex Workers Really Possible in Complex Urban Environments? The Case of Mumbai, India

    PubMed Central

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

    2015-01-01

    Background In the last decade, community mobilisation (CM) interventions targeting female sex workers (FSWs) have been scaled-up in India’s national response to the HIV epidemic. This included the Bill and Melinda Gates Foundation’s Avahan programme which adopted a business approach to plan and manage implementation at scale. With the focus of evaluation efforts on measuring effectiveness and health impacts there has been little analysis thus far of the interaction of the CM interventions with the sex work industry in complex urban environments. Methods and Findings Between March and July 2012 semi-structured, in-depth interviews and focus group discussions were conducted with 63 HIV intervention implementers, to explore challenges of HIV prevention among FSWs in Mumbai. A thematic analysis identified contextual factors that impact CM implementation. Large-scale interventions are not only impacted by, but were shown to shape the dynamic social context. Registration practices and programme monitoring were experienced as stigmatising, reflected in shifting client preferences towards women not disclosing as ‘sex workers’. This combined with urban redevelopment and gentrification of traditional red light areas, forcing dispersal and more ‘hidden’ ways of solicitation, further challenging outreach and collectivisation. Participants reported that brothel owners and ‘pimps’ continued to restrict access to sex workers and the heterogeneous ‘community’ of FSWs remains fragmented with high levels of mobility. Stakeholder engagement was poor and mobilising around HIV prevention not compelling. Interventions largely failed to respond to community needs as strong target-orientation skewed activities towards those most easily measured and reported. Conclusion Large-scale interventions have been impacted by and contributed to an increasingly complex sex work environment in Mumbai, challenging outreach and mobilisation efforts. Sex workers remain a vulnerable and disempowered group needing continued support and more comprehensive services. PMID:25811484

  13. Vulnerabilities faced by the children of sex workers in two Mexico-US border cities: a retrospective study on sexual violence, substance use and HIV risk.

    PubMed

    Servin, Argentina E; Strathdee, Steffanie; Muñoz, Fatima A; Vera, Alicia; Rangel, Gudelia; Silverman, Jay G

    2015-01-01

    Most studies of female sex workers (FSWs) conducted in the Mexico-US border region have focused on individual HIV risk, centered on sexual behaviors and substance abuse patterns. Little attention has been drawn to the reality that sex workers are often parents whose children potentially face vulnerabilities unique to their family situation. The objective of the present study was to identify the vulnerabilities faced by the children of FSWs in two Mexican-US border cities. From 2008 to 2010, 628 FSW-injection drug users underwent interviewer-administered surveys and HIV/STI testing. Approximately one in five participants (20%) reported having a parent involved in sex work and majority referred it was their mother (88%). Close to one-third of participants (31%) reported first injecting drugs <18 years of age, and 33% reported they began working regularly as a prostitute <18 years of age. First drinking alcohol <18 years old (AOR = 1.87, 95%CI: 1.13-3.08), lifetime cocaine use (AOR = 1.76, 95%CI: 1.09-2.84), ever being forced or coerced into non-consensual sex as a minor (<18 years of age; AOR = 1.54, 95%CI: 1.01-2.35), and injecting drugs with used syringes in the prior month (AOR = 1.63, 95%CI: 1.07-2.49) were the factors associated with having had a parent involved in sex work. These findings begin to lay the groundwork for understanding the potential vulnerabilities faced by the children of sex workers. Understanding these potential needs is necessary for creating relevant, evidence-based interventions focused on supporting these women. PMID:25117749

  14. Rape against Brazilian Women: Characteristics of Victims and Sex Offenders

    PubMed Central

    SOUTO, Rafaella Q.; ARAÚJO, Francisco K. C. D.; XAVIER, Alidianne F. C.; CAVALCANTI, Alessandro L.

    2015-01-01

    Background: Violence against women is a serious social problem and affects mainly young women. This study aimed to evaluate sexual violence against women in Campina Grande, Brazil. Methods: A retrospective study with analysis of 886 forensic medical reports of sexual violence from the Institute of Legal Medicine of Campina Grande, Brazil, was conducted between January 2005 and December 2009. Sociodemographic variables related to victims, offenders and aggressions were analyzed. Significance level of 5% was adopted. Results: Two hundred and ninety-one cases of rape (32.8%) were confirmed, the majority of victims aged between 0 and 19 years (89.9%), were single (98.8%) and had low educational level (86.9%), with association with marital status (P = 0.02). The sex offender was known to the victim in 84.2% of cases and in 93.8% of cases, he acted alone. There was an association between rape and the relationship with the offenders (P = 0.01) and the age of the offenders (P = 0.03). The rape occurred in most cases at the home of victims (49.3%), with the use of violence in 72.3% of cases, but only 5.7% of the victims exhibited physical injuries. There was an association between rape and variables date of occurrence (P = 0.001), previous virginity (P = 0.001) and violence during practice (P = 0.001). Conclusion: Over one third of women were victims of rape, predominantly adolescents, unmarried and with low educational level. The offenders were known to the victims, and acted alone in most situations, making use of physical violence. PMID:26811812

  15. Women's motivations to have sex in casual and committed relationships with male and female partners.

    PubMed

    Armstrong, Heather L; Reissing, Elke D

    2015-05-01

    Women report a wide variety of reasons to have sex (e.g., Meston & Buss, 2010), and while it is reasonable to assume that those reasons may vary based on the context of the relationship, this assumption has not yet been tested. The purpose of this study was to explore how relationship type, sexual attraction, and the gender of one's partner interact and affect the sexual motivations of women. A total of 510 women (361 who reported exclusively other-sex attraction and 149 who reported same-sex/bisexual attraction) completed the YSEX? questionnaire. Participants rated their sexual motivations for casual sex and sex in a committed relationship with male and/or female partners, depending on reported sexual attraction. Results showed that relationship type affected reported motivation for sex: physical motivations were more strongly endorsed for casual sex, whereas emotional motivations were more strongly endorsed for sex in committed relationships. No significant differences in motivation were reported between women who reported same-sex attraction and those who did not. Women who reported bisexual attraction and identified as being lesbian, bisexual, or another sexual minority reported no significant differences in motivation for sex with male or female partners. The results of this study highlight the importance of relationship context when discussing sexual motivation and suggest a high degree of similarity in motivation for women, regardless of sexual orientation or gender of partner. PMID:25567073

  16. Non-consensual sex within pre-marital relationships: experiences of young women in India.

    PubMed

    Santhya, K G; Francis Zavier, A J

    2014-01-01

    In India, little is known about the prevalence of non-consensual sex within pre-marital relationships and factors correlated with such experience, although a sizeable proportion of young people engage in pre-marital relationships. Drawing on qualitative and quantitative data from a representative study of youth in six Indian states, this paper examines the extent to which young women who had had pre-marital sex had experienced non-consensual sex, that is, sex by persuasion or force, and factors associated with it. Analysis is restricted to 821 young women who reported pre-marital sex. Of those who had had pre-marital sex, 33% reported that they were either persuaded (14%) or forced (19%) to engage in sex. Young women residing in urban areas and in communities reportedly characterised by physical fights among youth were more likely than their respective counterparts to have experienced sex by persuasion. Young women who had delayed sexual initiation and those who displayed self-efficacy were less likely than others to experience forced sex. Young women who had experienced geographic mobility in adolescence and who had witnessed parental violence were more likely than others to report forced sex. Finally, those in southern states were less likely than their northern counterparts to experience forced sex. PMID:24261824

  17. [Access to sexual health care for women who have sex with women in So Paulo, Brazil].

    PubMed

    Barbosa, Regina Maria; Facchini, Regina

    2009-01-01

    This article focuses on the relationship between health care for women who have sex with women and representations of gender, sexuality, and the body. The study used ethnographic observation and in-depth interviews held from 2003 to 2006, with 30 women ranging from 18 to 45 years of age, belonging to different social segments, backgrounds, and sexual identities, living in Greater Metropolitan So Paulo. Analysis of the material pointed to greater difficulty in accessing gynecological care for lower-income women, those who had never had sex with men, or those with masculine body language. Not only the negative representations and experiences in relation to health services, but also identity constructions concerning gender and sexuality, are related to difficulties in accessing health care. Although a large share of the relevant international literature emphasizes the relationship between homophobia and decreased access to health services, the findings suggest that although situations involving discrimination are a reality, they were not considered impediments to the search for care, and were more associated with reporting of erotic practices and preferences at the services. PMID:19684936

  18. Sex differences in cardiovascular health: does sexism influence women's health?

    PubMed

    Molix, Lisa

    2014-08-01

    This commentary provides a brief overview of theory and research that supports the idea that sexism may be related to the disproportionate negative cardiovascular health outcomes in women. It describes sexism as a stressor and outlines its association with a variety of health outcomes as evidence for why sex disparities should be examined within the context of pervasive inequities. To date, population-based studies have not explicitly examined the relationship between sexism and cardiovascular disease, but smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of 2 types of sexism (ie, hostile and benevolent) and that daily or within-day designs be used to assess cognitive, behavioral and physiological responses to everyday sexist experiences. PMID:25054736

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

    PubMed Central

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

    2012-01-01

    Background Social and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines. Methods Female bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues. Results Of 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment - trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34–49.90), economic environment - sex without a condom to make more money (AOR = 1.52, 95% CI 1.01–2.30), policy environment - sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49–4.48), and individual risk - substance use (AOR = 2.36, 95% CI = 1.28–4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons. Conclusions Factors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability. PMID:22448241

  20. Predictors of Injection Cessation and Relapse among Female Sex Workers who Inject Drugs in Two Mexican-US Border Cities.

    PubMed

    West, Brooke S; Abramovitz, Daniela; Staines, Hugo; Vera, Alicia; Patterson, Thomas L; Strathdee, Steffanie A

    2016-02-01

    We know little about predictors of injection drug cessation and relapse among female sex workers who inject drugs (FSW-PWID) at the US-Mexico border. Among HIV-negative FSW-PWID taking part in a behavioral intervention study in Tijuana and Ciudad Juárez, Cox regression was used to identify predictors of time to first cessation of injection, which was defined as reporting not having injected drugs for a period of 4 months or longer, and among that subset, we examined predictors of time to injection relapse. Among 440 women, 84 (19 %) reported ceasing injection during follow-up (median time to cessation = 9.3 months); of these, 30 (35 %) reported relapse to injection (median time to relapse = 3.5 months). The rate of injection cessation was lower for women reporting trading sex prior to age 18 (adj. hazard ratio (HR) = 0.64, 95 % confidence interval (CI) = 0.41-1.01), ever being sexually abused (adj. HR = 0.44, 95 % CI = 0.27-0.71), and a higher number of vaginal sex acts with casual clients (adj. HR = 0.99 per transaction, 95 % CI = 0.98-1.00). The rate of cessation was higher for women who spent more hours on the streets on a typical day (adj. HR = 1.04/h, 95 % CI = 1.01-1.08) and who lived in Tijuana vs. Ciudad Juárez (adj. HR = 2.15, 95 % CI = 1.14-4.07). The rate of relapse was higher among women reporting regular drug use with clients (adj. HR = 2.17, 95 % CI = 0.96-4.89) and those scoring higher on a risk injection index (adj. HR = 2.04, 95 % CI = 1.15-3.61). The rate of relapse was lower for FSW-PWID with higher than average incomes (adj. HR = 0.40, 95 % CI = 0.18-0.89). These findings have important implications for the scale-up of methadone maintenance treatment programs (MMTPs) in Mexico and indicate a need for gender-specific programs that address sexual abuse experiences and economic vulnerabilities faced by FSW-PWID. PMID:26696001

  1. Auxiliary Women Workers in the Legal Sector: Traversing Subjectivities and "Self" to Learn through Work

    ERIC Educational Resources Information Center

    Cavanagh, Jillian Maria

    2012-01-01

    This study is about female auxiliary workers in the Australian legal sector. The purpose is to explore the impact of subjectivities on women workers and how they negotiate their positionality to participate in meaningful work and learning. The study is grounded in theories of identity and socio-cultural perspectives of subjectivity, agentic action…

  2. Auxiliary Women Workers in the Legal Sector: Traversing Subjectivities and "Self" to Learn through Work

    ERIC Educational Resources Information Center

    Cavanagh, Jillian Maria

    2012-01-01

    This study is about female auxiliary workers in the Australian legal sector. The purpose is to explore the impact of subjectivities on women workers and how they negotiate their positionality to participate in meaningful work and learning. The study is grounded in theories of identity and socio-cultural perspectives of subjectivity, agentic action

  3. "Not Everything That the Bourgeois World Created Is Bad": Aesthetics and Politics in Women Workers' Education

    ERIC Educational Resources Information Center

    Tamboukou, Maria

    2015-01-01

    In this paper, I look into the papers of Fannia Cohn, an immigrant labour organizer, who served the Education Department of the International Ladies' Garment Workers' Union (ILGWU) between 1918 and 1962 and became one of its few women vice-presidents. As an internationally recognized figure in the history of workers' education, Cohn left a rich…

  4. Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health

    PubMed Central

    Zaidi, Sidra S.; Ocholla, Akinyi M.; Otieno, Rena A.

    2016-01-01

    Abstract Purpose: To describe sexual and reproductive health characteristics of women who have sex with women (WSW) in Kenya's three most populous cities: Kisumu, Mombasa, and Nairobi. Although the last decade has shown an upsurge of health-related research studies in African sexual minority populations, these studies have generally concentrated on the health status of men who have sex with men to the exclusion of WSW. This study presents the first findings on Kenyan WSW's sexual and reproductive health. Methods: A community-based, cross-sectional survey was conducted among 280 women who were at least 18 years old, had at least one female sexual partner in the past three years, and were Kenyan residents. Results: A significant proportion of participants reported that they had at least one male sexual partner in the past three years (38.9%), ever had an abortion (13.2%), been infected with at least one sexually transmitted infection (STI) in the past three years (33.9%), and been tested for HIV at least once (88.9%). Of the women who reported having been tested for HIV, 9.4% (7.5% of the total sample) received a positive test result. Some women noted that they were open with their doctors about their sexual orientation, and that their doctors had not reacted negatively to this information. Conclusion: WSW in Kenya are at risk for negative sexual and reproductive health outcomes, including HIV, STIs, unplanned pregnancy, and unsafe abortion, positioning these women as a critical population for public health efforts. Some WSW actively exercise their agency in making important health decisions. Therefore, this study indicates a need to incorporate WSW's health concerns within Kenyan national health policy programming. PMID:26684690

  5. Collaborating for consensus: Considerations for convening Coalition stakeholders to promote a gender-based approach to addressing the health needs of sex workers.

    PubMed

    Silverman, Basha; Champney, Joanna; Steber, Sara-Ann; Zubritsky, Cynthia

    2015-08-01

    Women involved in sex work experience myriad challenges, such as poverty, illiteracy, low social status and gender inequity, as they struggle to access healthcare. These challenges place them at high risk for poor health outcomes. The purpose of this article is to describe the formation of a strong cross-system Coalition representing both the criminal justice and healthcare systems to address the health needs of sex workers in Delaware. The Delaware Coalition for Health and Justice implemented a Coalition-building strategy to design interventions and streamline systems to promote health and reduce criminal justice contact for sex workers. The sequential intercept model was utilized to organize Coalition membership and build consensus among varied stakeholders. The model assisted the Coalition in understanding differing primary objectives for key system programs, recognizing the limitations and barriers of each stakeholder group, sharing findings and discovering opportunities for partnership, and engaging stakeholders in designing and providing a comprehensive "systems" approach. This work suggests that aligning the criminal justice, healthcare, and community social services in a systemic process to build consensus can result in the implementation of effective systems change initiatives that address gender disparities and promote the health of justice-involved women. PMID:25559949

  6. HIV-1 Negative Female Sex Workers Sustain High Cervical IFNε, Low Immune Activation and Low Expression of HIV-1 Required Host Genes

    PubMed Central

    Abdulhaqq, Shaheed A.; Zorrilla, Carmen; Kang, Guobin; Yin, Xiangfan; Tamayo, Vivian; Seaton, Kelly E.; Joseph, Jocelin; Garced, Sheyla; Tomaras, Georgia D.; Linn, Kristin A.; Foulkes, Andrea S.; Azzoni, Livio; VerMilyea, Matthew; Coutifaris, Christos; Kossenkov, Andrew V.; Showe, Louise; Kraiselburd, Edmundo N.; Li, Qingsheng; Montaner, Luis J.

    2015-01-01

    Sex workers within high HIV endemic areas are often a target population where anti-HIV prophylactic strategies are tested. We hypothesize that in women with high levels of genital exposure to semen changes in cervicovaginal mucosal and/or systemic immune activation will contribute to a decreased susceptibility to HIV-1 infection. To address this question, we assessed sexual activity, immune activation status (in peripheral blood), as well as cellular infiltrates and gene expression in ectocervical mucosa biopsies in female sex workers [FSW] (n=50), as compared to control women [CG] (n=32). FSW had low to absent HIV-1 specific immune responses with significantly lower CD38 expression on circulating CD4+ or CD8+ T-Cells (both: p<0.001) together with lower cervical gene expression of genes associated with leukocyte homing and chemotaxis. FSW also had increased levels of Interferon-ε gene and protein expression in the cervical epithelium together with reduced expression of genes associated with HIV-1 integration and replication. A correlative relationship between semen exposure and elevated type-1 IFN expression in FSW was also established. Overall, our data suggest that long-term condomless sex work can result in multiple changes within the cervicovaginal compartment that would contribute to sustaining a lower susceptibility for HIV-1 infection in absence of HIV-specific responses. PMID:26555708

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

    ERIC Educational Resources Information Center

    Huq, Nafisa Lira; Chowdhury, Mahbub Elahi

    2012-01-01

    In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and…

  8. Prevalence of HIV, Herpes Simplex Virus-2, and Syphilis in male sex partners of pregnant women in Peru

    PubMed Central

    Clark, Jesse L; Konda, Kelika A; Munayco, Cesar V; Pún, Monica; Lescano, Andres G; Leon, Segundo R; Pajuelo, Jose; Suarez-Ognio, Luis; Klausner, Jeffrey D; Coates, Thomas J; Cáceres, Carlos F

    2008-01-01

    Background: Sexually active heterosexual men may represent an important risk factor for HIV infection and STI transmission to their female partners and unborn children, though little is known about the prevalence of STIs in this population. We sought to determine the prevalence of HIV, herpes simplex virus type 2 (HSV-2), and syphilis infection and associated risk behaviors among male sex partners of pregnant women in Peru. Methods: Survey and seroprevalence data were collected from 1,835 male partners of pregnant women in four cities in Peru. Serum was tested for antibodies to HIV, HSV-2, and syphilis. Results: Among the 1,835 male participants, HIV prevalence was 0.8% (95% CI = 0.5–1.4%), HSV-2 16.0% (95% CI = 14.3–17.8%), and syphilis 1.6% (95% CI = 1.0–2.2%). Additionally, 11.0% reported a lifetime history of intercourse with men, and 37.1% with female sex workers. Unprotected intercourse with men during the previous year was reported by 0.9% and with female sex workers by 1.2%. Conclusion: Pregnant women's sex partners reported lifetime sexual contact with core risk groups, had an elevated prevalence of HSV-2, and demonstrated the potential to spread HIV and other STIs to their partners. Though the prevalence of HIV in the population was not significantly higher than observed in other samples of heterosexuals in Peru, the risk of HIV transmission to their female partners may be exacerbated by their increased prevalence of HSV-2 infection. Further study of heterosexual populations is necessary to fully understand the epidemiology of HIV/STIs in Latin America. PMID:18284696

  9. Retention in HIV care among female sex workers in the Dominican Republic: implications for research, policy and programming.

    PubMed

    Zulliger, Rose; Maulsby, Cathy; Barrington, Clare; Holtgrave, David; Donastorg, Yeycy; Perez, Martha; Kerrigan, Deanna

    2015-04-01

    There are clear benefits of retention in HIV care, yet millions of people living with HIV are sub-optimally retained. This study described factors from Andersen's behavioral model that were associated with retention in HIV care among 268 female sex workers (FSWs) living with HIV in the Dominican Republic using two measures of retention: a 6-month measure of HIV clinic attendance and a measure that combined clinic attendance and missed visits. FSWs who ever attended HIV care reported high rates (92 %) of 6-month attendance, but 37 % reported missed visits. Using the combined retention measure, the odds of being retained in HIV care were higher among FSWs with more positive perceptions of HIV service providers [adjusted odds ratio (AOR) 1.17; 95 % confidence interval (CI) 01.09, 1.25] and lower among women who reported recent alcohol consumption (AOR 0.50; 95 % CI 0.28, 0.92) and self-stigmatizing beliefs related to sex work (AOR 0.93; 95 % CI 0.88, 0.98). These findings support the hypothesis that retention in HIV care may be best determined through a combined measure as missed visits are an important mechanism to identify in-care patients who require additional support. PMID:25566761

  10. Worker role identity development of women with disabilities who experience domestic violence.

    PubMed

    Helfrich, Christine A; Badiani, Chaula; Simpson, Emily K

    2006-01-01

    This two-year longitudinal qualitative study explored worker role identity development of seven women with disabilities who experienced domestic violence. Yearly semi-structured interviews and monthly follow up calls elucidated the meaning of work in women's lives and the development of role identity during transitions from shelters to the community. Participants aged 26-47, were from two domestic violence shelters and an independent living center in the Midwestern United States. Data analyses, using constant comparative methods, a peer team and member checking, revealed that women's work roles remained in a state of identity diffusion. Identity diffusion in the worker role was delineated into three themes: role ambivalence, impact of disability, and relationship of the worker role to other roles. Study findings suggest a conflict between staff urgency to support women's return to work and economic self-sufficiency, and women's readiness to assume stronger work identities. PMID:17006009

  11. Peer Outreach Work as Economic Activity: Implications for HIV Prevention Interventions among Female Sex Workers

    PubMed Central

    George, Annie; Blankenship, Kim M.

    2015-01-01

    Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers’ economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers’ relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers. PMID:25775122

  12. A Framework for Sexual Decision-Making Among Female Sex Workers in Jamaica.

    PubMed

    Bailey, Althea; Figueroa, J Peter

    2016-05-01

    The Jamaican government has provided targeted HIV and sexually transmitted infection prevention, treatment, and other services for female sex workers (FSW) since 1989. HIV prevalence among FSW declined from 20 to 12 % between 1989 and 1994, then to 9 % in 2005, 5 % in 2008, and 4.1 % in 2011. This article distills the literature and two decades of experience working with FSW in Jamaica. Drawing on the constant comparative method, we put forward an innovative conceptual framework for explaining sexual decision-making and risk behaviors within both transactional and relational sexual situations. This framework helps fill the gaps in existing models that focus on individual behaviors. The model identifies interactions between environmental and structural elements of sex work, and three individual-level factors: risk perception, perceived relationship intimacy, and perceived control, as the four primary mediating factors influencing sexual decision-making among FSW. We propose that other factors such as violence, socioeconomic vulnerability, and policy/legal frameworks influence sexual decision-making through these primary mediating factors. This conceptual model may offer a useful framework for planning and evaluating prevention interventions among sex workers. However, it remains to be tested in order to establish its value. PMID:25836026

  13. Substance Use among Male Sex Workers in Vietnam: Prevalence, Onset, and Interactions with Sexual Risk

    PubMed Central

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

    2014-01-01

    Background HIV research in Vietnam has focused primarily on its large heroin injector population. Data on men who have sex with men [MSM], particularly the large and growing population of men who exchange sex for money or other material rewards, male sex workers [MSWs], is very limited. Methods Data derive from a cross-sectional study of MSW, age 16-35, recruited using community sampling methods in three cities in 2010-2011, including Hanoi, Ho Chi Minh City [HCMC], and Nha Trang City (n=710). Assessments included demographic characteristics, substance use, sexual risk, and use of health services. A series of “event” questions were used to assess the influence of alcohol and drugs on sexual risk. Results Both tobacco and alcohol are initiated at a young age and most participants currently use both substances overall across all three cities. While alcohol and tobacco use precede the initiation of sex work, stimulant and opiate use are initiated following the initiation of sex work. There was substantial overlap between substance use and sexual risk, and this overlap was strongest in sexual events involving male and female elective partners rather than sex work clients. Conclusion Although rates of HIV infection in this group are low, this may be an artifact of the young age of the sample. High rates of drug use, including alcohol, tobacco and illicit drugs, coupled with high rates of ulcerative STIs such as HPV, suggest the potential for rapid amplification of STI/HIV risk among MSW and their complex sex partnering networks. PMID:25488636

  14. Low HIV and high STD among commercial sex workers in a brothel in Bangladesh: scope for prevention of larger epidemic.

    PubMed

    Sarkar, S; Islam, N; Durandin, F; Siddiqui, N; Panda, S; Jana, S; Corbitt, G; Klapper, P; Mandal, D

    1998-01-01

    The present study documents the first systematic assessment of a brothel in Bangladesh in terms of sexually transmitted disease (STD) and human immunodeficiency virus (HIV). A cross sectional study was undertaken on brothel-based commercial sex workers (CSWs) selected systematic random sampling to assess the prevalence of STDs and HIV among CSWs in a brothel setting. Two hundred and ninety-six CSWs were selected from a brothel with a population of 593 women. Following informed consent, endocervical and blood samples were obtained for the diagnosis of genital chlamydia, gonorrhoea, HIV and syphilis respectively. In addition, another 170 consecutive blood samples were collected from the total CSW population for HIV tests. All blood samples for HIV testing were made anonymous by removing patient identifiers before testing. Endocervical specimens were tested by polymerase chain reaction (PCR) for the diagnosis of genital chlamydia and gonorrhoea. Syphilis and HIV infections were diagnosed by serology. One hundred and sixty-nine (57.1%) of the women were Treponema pallidum haemagglutination (TPHA)-positive, 20 (6.8%) of the women were Venereal Disease Research Laboratory (VDRL)-positive at a greater than 1:8 dilution. Eighty-two (28%) of the women were found to be infected either by gonorrhoea or chlamydia. No HIV antibody was found in any of the 466 blood samples. A high prevalence of STDs and low prevalence of HIV in the CSWs in Bangladesh suggest potential for the rapid spread of HIV once it is introduced in this high-risk population. The opportunity to control STD and HIV infection in this population should not be missed, in order to prevent a large epidemic in the future. PMID:9518015

  15. Vaginal douching and sexually transmitted infections among female sex workers: a cross-sectional study in three provinces in China.

    PubMed

    Li, Jing; Jiang, Ning; Yue, Xiaoli; Gong, Xiangdong

    2015-05-01

    Though vaginal douching is a common practice among female sex workers that could increase the risk of HIV and adverse reproductive health outcomes, it has drawn limited attention. From November 2010 to January 2011, a convenience sample of female sex workers was recruited in three cities in China. Face-to-face interviews were conducted to gather socio-demographic and behavioural information. Blood samples were collected for syphilis serological tests. Endo-cervical swabs were collected and tested for Neisseria gonorrhoeae and Chlamydia trachomatis by polymerase chain reaction. A logistic regression model was used to determine factors associated with vaginal douching and the association between vaginal douching and sexually transmitted infection. A total of 1032 eligible female sex workers were enrolled. The overall prevalence of any sexually transmitted infection (syphilis, Chlamydia trachomatis or Neisseria gonorrhoeae) and vaginal douching with disinfectant were 23.4% and 23.1%, respectively. Factors independently associated with douching practice included study sites, venue types, ethnicity, having regular partner and sexually transmitted infection history. No significant association was found between vaginal douching and current sexually transmitted infection. Vaginal douching with disinfectant after sex with clients seemed to be a prevalent practice among female sex workers in China. Prevention programmes targeting female sex workers should incorporate components about the adverse health outcomes associated with vaginal douching. PMID:25015933

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

    PubMed

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

    2014-01-01

    Global literature on female sex workers suggests that being in an intimate relationship is associated with barriers to practising safe sex behaviours. Condom use within intimate relationships is often seen as a sign of infidelity and fosters mistrust which could affect longevity, trust and intimacy within partnerships. Using qualitative data from Devadasi sex workers and their intimate male partners in Bagalkot District, Karnataka, India, we examined both partners' perspectives to understand the quality and dynamics of these relationships and the factors that influence condom use in intimate relationships. Our thematic analysis of individual interviews conducted in May 2011 with 20 couples suggests that many Devadasi sex workers and their intimate partners define their relationships as 'like marriage' which reduced their motivation to use condoms. Evidence from this study suggests that active participation in sex workers' collectives (sanghas) can increase condom use, education and family planning services, among other things, and could be helpful for both Devadasis and their intimate partners to better understand and accept safer sexual practices. Our work has direct implications for designing couple-based health interventions for traditional Devadasi sex workers and their intimate partners in India. PMID:25162730

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

    PubMed

    Pals, Heili; Waren, Warren

    2014-01-01

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

  18. The Syndemic Condition of Psychosocial Problems and HIV Risk Among Male Sex Workers in Ho Chi Minh City, Vietnam

    PubMed Central

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

    2015-01-01

    In Vietnam, the co-occurrence (i.e., syndemic) of psychosocial factors (e.g., depression and substance use) may disproportionately burden male sex workers and increase their HIV risk. A comprehensive survey was conducted among 300 male sex workers in Ho Chi Minh City, Vietnam in 2010. We performed logistic regression to examine the association between the syndemic variable a count score of the number of 5 psychosocial conditions endorsed and unprotected anal sex (UAS) in the past. One-third of participants reported any UAS, and 42% reported ? 2 psychosocial health problems. In multivariable models, experiencing ? 4 psychosocial health problems was significantly associated with UAS. Every unit increase in number of psychosocial health problems was associated with a 25%30% increase in odds of UAS. Understanding the syndemic condition and its association with HIV risk among male sex workers in Vietnam may lead to the development of more effective, comprehensive interventions. PMID:24081899

  19. Examining HIV infection among male sex workers in Bangkok, Thailand: a comparison of participants recruited at entertainment and street venues.

    PubMed

    Toledo, Carlos A; Varangrat, Anchalee; Wimolsate, Wipas; Chemnasiri, Tareerat; Phanuphak, Praphan; Kalayil, Elizabeth J; McNicholl, Janet; Karuchit, Samart; Kengkarnrua, Kamolset; van Griensven, Frits

    2010-08-01

    HIV prevalence and associated factors were examined among male sex workers (MSWs, N = 414) in Bangkok, Thailand. Cross-sectional venue-day-time sampling was used to collect data in entertainment and street venues. Chi-square and logistic regression were used to identify HIV risk factors. HIV prevalence was 18.8% overall, but differences were found between MSW recruited in entertainment and street venues. Significant relationships were found between several demographic, behavioral, exposure to HIV prevention, and other characteristics, and recruitment location. In multivariate analyses, being sexually attracted to men was significantly associated with HIV infection among both groups of sex workers. In addition, among street-based sex workers, not having had sex with a woman in the past 3 months, having ever had a sexually transmitted disease symptom, and not having a friend to talk to about personal problems were significantly associated with HIV infection. PMID:20707691

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

    PubMed Central

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

    2012-01-01

    Aims To identify factors associated with time to initiation of (1) sex work prior to injecting drugs, (2) injection drug use, and (3) concurrent sex work and injection drug use (i.e., initiated at the same age) among female sex workers who currently inject drugs (FSW-IDU). Design Parametric survival analysis of baseline data for time to initiation event. Setting Tijuana and Ciudad Juarez situated on the Mexico-U.S. border. Participants 575 FSW-IDUs aged ≥18. Measurements Interview-administered surveys assessing context of sex work and injection drug use initiation. Findings Nearly half (n=256) initiated sex work prior to beginning to inject, a third (n=163) initiated injection first, and a quarter (n=136) initiated both sex work and injection drug use concurrently. Low education and living in Ciudad Juarez accelerated time to sex work initiation. Being from a southern Mexican state and initiating drug use with inhalants delayed the time to first injection drug use. Having an intimate partner encourage entry into sex work and first injecting drugs to deal with depression accelerated time to initiating sex work and injection concurrently. Early physical abuse accelerated time to initiating sex work and injection, and substantially accelerated time to initiation of both behaviors concurrently. Conclusions Among female sex workers who currently inject drugs in two Mexican-US border cities, nearly half appear to initiate sex work prior to beginning to inject, nearly one third initiate injection drug use before beginning sex work, and one quarter initiate both behaviors concurrently. Predictors of these three trajectories differ, and this provides possible modifiable targets for prevention. PMID:22775475

  1. High prevalence of syphilis among street-based female sex workers in Nanchang, China

    PubMed Central

    Tao, Xiao Hua; Jiang, Tao; Shao, Dan; Xue, Wei; Ye, Fa Shun; Wang, Ming; He, Mei Hua

    2014-01-01

    Background: Female sex workers (FSWs) play a critical role in the heterosexual transmission of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) in China. Several studies reported that street-based FSWs have higher risk behaviors than establishment-based FSWs. Therefore, street-based FSWs should be specifically targeted for HIV and STIs intervention programs. Objectives: This study aims to investigate the prevalence rates and risk factors of HIV and syphilis among FSWs in Nanchang, China. Materials and Methods: Using convenience sampling methods, 361 street-based FSWs were recruited from August 2011 to February 2012. All participants completed an anonymous questionnaire on socioeconomic and sex behavioral information and were tested for HIV and syphilis. Risk for HIV and syphilis infection was assessed using univariate and multivariate logistic regression analyses. Results: No HIV infections were found. The prevalence rate of syphilis was 43.5%. Nearly 46.1% of street-based FSWs reported having education for no more than 6 years. Having reproductive tract infections at current visit, duration of sex work more than 5 years, indulgence in unprotected sex trade in the last time, unprotected sex trade in the last month, and unprotected sex with boyfriend or spouse in the last month were reported by 35.2%, 43.5%, 33.8%, 60.4%, and 93.1% street-based FSWs, respectively. In multivariate logistic regression analysis, having reproductive tract infections at current visit [odds ratio (OR), 12.10; 95% confidence interval (CI), 6.01-24.37], duration of sex work more than five years (OR, 4.26; 95% CI, 2.40-7.54), and unprotected sex trade in the last month (OR, 1.85; 95% CI, 1.06-3.22) were independently associated with syphilis infection. Conclusion: The prevalence rate of syphilis among street-based FSWs is very high. Most street-based FSWs in our survey had low education, long experience of commercial sex, and high rate of inconsistent condom use. Comprehensive interventions targeting this high-risk group, especially scaling up screening and ensuring consistent use of condoms during sex are needed. PMID:25396127

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2014-08-01

    Despite research on the health and safety of mobile and migrant populations in the formal and informal sectors globally, limited information is available regarding the working conditions, health, and safety of sex workers who engage in short-term mobility and migration. The objective of this study was to longitudinally examine work environment, health, and safety experiences linked to short-term mobility/migration (i.e., worked or lived in another city, province, or country) among sex workers in Vancouver, Canada, over a 2.5-year study period (2010-2012). We examined longitudinal correlates of short-term mobility/migration (i.e., worked or lived in another city, province, or country over the 3-year follow-up period) among 646 street and off-street sex workers in a longitudinal community-based study (AESHA). Of 646 sex workers, 10.84 % (n = 70) worked or lived in another city, province, or country during the study. In a multivariate generalized estimating equations (GEE) model, short-term mobility/migration was independently correlated with older age (adjusted odds ratio (AOR) 0.95, 95 % confidence interval (CI) 0.92-0.98), soliciting clients in indoor (in-call) establishments (AOR 2.25, 95 % CI 1.27-3.96), intimate partner condom refusal (AOR 3.00, 1.02-8.84), and barriers to health care (AOR 1.77, 95 % CI 1.08-2.89). In a second multivariate GEE model, short-term mobility for sex work (i.e., worked in another city, province, or country) was correlated with client physical/sexual violence (AOR 1.92, 95 % CI 1.02-3.61). In this study, mobile/migrant sex workers were more likely to be younger, work in indoor sex work establishments, and earn higher income, suggesting that short-term mobility for sex work and migration increase social and economic opportunities. However, mobility and migration also correlated with reduced control over sexual negotiation with intimate partners and reduced health care access, and mobility for sex work was associated with enhanced workplace sexual/physical violence, suggesting that mobility/migration may confer risks through less control over work environment and isolation from health services. Structural and community-led interventions, including policy support to allow for more formal organizing of sex work collectives and access to workplace safety standards, remain critical to supporting health, safety, and access to care for mobile and migrant sex workers. PMID:25055750

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2009-11-01

    India's National AIDS Control Organization (NACO) provides free first-line antiretroviral treatment (ART) at government centers for people living with HIV. To assist in developing policies and programs to ensure equity in ART access, we explored barriers to ART access among female sex workers (FSWs) living with HIV in Chennai. Between August and November 2007, we conducted three focus group discussions and two key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family/social, health care system/programmatic, and individual levels. Major barriers included fear of adverse consequences of disclosure of HIV status due to stigma and discrimination associated with HIV and sex work, lack of family support, negative experiences with health care providers, lack of adequate counseling services at government centers and by outreach workers employed by nongovernmental organizations (NGOs), perceived biased treatment of FSWs who are not referred by NGOs, lack of adequate knowledge about ART, and fatalism. Barriers can be addressed by: creating effective measures to reduce stigma associated with HIV/AIDS and sex work at the familial, societal, and health care system levels; incorporating information about ART into targeted interventions among FSWs; training counselors at government hospitals and NGO outreach workers on treatment issues; improving infrastructure and staffing levels at government centers to allow adequate time and privacy for counseling; and implementing government mass media campaigns on ART availability. Finally, it is crucial that NACO begin monitoring ART coverage of FSWs and other marginalized populations to ensure equitable ART access. PMID:19821725

  6. Victimization in off-street sex industry work.

    PubMed

    O'Doherty, Tamara

    2011-07-01

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

  7. The "Quare" Women: Reformers and Settlement Workers in the Kentucky Mountains.

    ERIC Educational Resources Information Center

    Duff, Betty Parker

    Among the many outside influences on Appalachian culture in the late 19th-early 20th centuries were reformers and educators, many of them women who came to the mountains to work as teachers, settlement workers, and nurses. This paper focuses on settlement schools in eastern Kentucky as the locus of interaction between reformers and mountain women.…

  8. The health of women temporary agricultural workers in Canada: a critical review of the literature.

    PubMed

    Edmunds, Kathryn; Berman, Helene; Basok, Tanya; Ford-Gilboe, Marilyn; Forchuk, Cheryl

    2011-12-01

    Among high-income countries such as Canada, there is growing dependency on "low skilled" temporary foreign workers in a variety of sectors. The purpose of this review is to critically synthesize and analyze the theoretical and empirical literature on gendered and temporary migration in the context of globalization and the health of temporary agricultural workers, particularly women in Canadian programs. While the social sciences literature contains well-developed conceptualizations of gendered migration, the research has focused on women in feminized occupations such as domestic work. Multidisciplinary searches produced only 11 research and review publications on the gendered constraints or health of temporary agricultural workers in Canada. Further investigation is needed to explore and integrate the strengths, resiliencies, and health-care needs of women migrant agricultural workers in Canada, as well as the barriers they face, within the intersecting and gendered forces of inequities at all levels: local, national, and global. PMID:22435309

  9. Women in Management: Strategies for Removing the Barriers.

    ERIC Educational Resources Information Center

    Mirides, Ellyn; Cote, Andre

    1980-01-01

    Looks at the status of women in management and identifies barriers to the upward mobility of women workers, including sex-role stereotyping, hiring biases, organizational procedures, managers' attitudes, and women's own self-concepts. (Author/JM)

  10. The Effect of the Sexual Composition of a Group on Discrimination against Women and Sex-Role Attitudes.

    ERIC Educational Resources Information Center

    Toder, Nancy L.

    1980-01-01

    Undergraduates in mixed-sex groups evaluated female-authored articles. Subjects in all-women groups did not show sex discrimination. Female subjects in mixed-sex groups endorsed more profeminist ideas. Participation in an all-women's group may elicit a more positive image of women. (Author)

  11. Violence against Chinese female sex workers from their stable partners: a hierarchical multiple regression analysis.

    PubMed

    Zhang, Chen; Li, Xiaoming; Su, Shaobing; Hong, Yan; Zhou, Yuejiao; Tang, Zhenzhu; Shen, Zhiyong

    2015-01-01

    Limited data are available regarding risk factors that are related to intimate partner violence (IPV) against female sex workers (FSWs) in the context of stable partnerships. Out of the 1,022 FSWs, 743 reported ever having a stable partnership and 430 (more than half) of those reported experiencing IPV. Hierarchical multivariate regression revealed that some characteristics of stable partners (e.g., low education, alcohol use) and relationship stressors (e.g., frequent friction, concurrent partnerships) were independently predictive of IPV against FSWs. Public health professionals who design future violence prevention interventions targeting FSWs need to consider the influence of their stable partners. PMID:24730642

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

    PubMed Central

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

    2014-01-01

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

  13. Female sex workers and their gatekeepers in China: implications for HIV/STI prevention.

    PubMed

    Hong, Yan; Zhang, Chen; Li, Xiaoming; Zhou, Yuejiao; Guo, Weigui

    2014-10-01

    Female sex workers (FSWs) play a key role in HIV/AIDS transmission and their gatekeepers play a crucial role in shaping their behaviors. Limited studies are available on the relationship between FSWs and gatekeepers. In the current study we used an ethnographic approach to examine the dynamic and multidimensional relationship of FSWs and their gatekeepers from the perspectives of both parties. We recruited 38 FSWs and 16 gatekeepers from different types of commercial sex venues in Guangxi, China, and conducted in-depth individual interviews. Our data suggest that FSWs and gatekeepers maintain an interdependent and reciprocal relationship during their business practice, but gatekeepers exert significant influence and control over FSWs. Designing culturally appropriate HIV/STI-prevention programs requires us to take advantage of the unique and crucial roles of gatekeepers. We conclude with a call for structural interventions to protect FSWs' occupational health and safety. PMID:25147221

  14. Correlates of Mental Depression Among Female Sex Workers in Southern India.

    PubMed

    Patel, Sangram Kishor; Saggurti, Niranjan; Pachauri, Saroj; Prabhakar, Parimi

    2015-11-01

    Mental health is an integral part of overall health status but has been a largely neglected issue in the developing world especially among female sex workers (FSWs). This study examines the prevalence and correlates of major depression among FSWs in southern India. Major depression was assessed using Patient Health Questionnaire-2 depression scale data from a cross-sectional Behavioral Tracking Survey, 2010-2011 conducted among FSWs (n = 1986) in Andhra Pradesh, a state in southern India. Almost two-fifths of FSWs (39%) reported major depression. Multivariate logistic regression analysis shows a significant association between major depression and the following characteristics for FSWs: low autonomy, alcohol use, experience of violence, police arrest, inconsistent condom use with clients, mobility for sex work, and being HIV positive or not wanting to disclose HIV status. Research and advocacy efforts are needed to ensure that the mental health issues of marginalized groups are appropriately addressed in HIV prevention programs. PMID:26307144

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

    PubMed

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

    2013-12-01

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

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

    PubMed Central

    2012-01-01

    Background Female sex workers (FSWs) are vulnerable to sexually transmitted infections (STIs) and encounter socio-economic and health problems, including STIs/HIV, unintended pregnancy and complications from unsafe abortion, stigma, violence, and drug addiction. Reducing risks associated with sex work requires an understanding of the social and cultural context in which sex workers live and work. This study aimed to explore the working environment and perceived risks among FSWs in Savannakhet province in Laos. Methods Five focus group discussions (FGDs) and seven interviews were conducted with FSWs in Kaysone Phomvihan district in Laos. Latent content analysis was used to analyze the transcribed text. Results The results revealed that the FSWs were aware of risks but they also talked about benefits related to their work. The risks were grouped into six categories: STIs/HIV, unintended pregnancy, stigma, violence, being cheated, and social and economic insecurity. The reported benefits were financial security, fulfilling social obligations, and sexual pleasure. The FSWs reported using a number of strategies to reduce risks and increase benefits. Conclusions The desire to be self-sufficient and earn as much money as possible put the FSWs in disadvantaged and vulnerable situations. Fear of financial insecurity, obligations to support one’s family and the need to secure the future influenced FSWs’ decisions to have safe or unsafe sex. The FSWs were, however, not only victims. They also had some control over their lives and working environment, with most viewing their work as an easy and good way of earning money. PMID:23164407

  17. Occupational safety and HIV risk among female sex workers in China: A mixed-methods analysis of sex-work harms and mommies

    PubMed Central

    Yi, Huso; Zheng, Tiantian; Wan, Yanhai; Mantell, Joanne E.; Park, Minah; Csete, Joanne

    2013-01-01

    Female sex workers (FSWs) in China are exposed to multiple work-related harms that increase HIV vulnerability. Using mixed-methods, we explored the social-ecological aspects of sexual risk among 348 FSWs in Beijing. Sex-work harms were assessed by property stolen, being underpaid or not paid at all, verbal and sexual abuse, forced drinking; and forced sex more than once. The majority (90%) reported at least one type of harm, 38% received harm protection from ‘mommies’ (i.e., managers) and 32% reported unprotected sex with clients. In multivariate models, unprotected sex was significantly associated with longer involvement in sex work, greater exposure to harms, and no protection from mommies. Mommies’ protection moderated the effect of sex-work harms on unprotected sex with clients. Our ethnography indicated that mommies played a core role in sex-work networks. Such networks provide a basis for social capital; they are not only profitable economically, but also protect FSWs from sex-work harms. Effective HIV prevention interventions for FSWs in China must address the occupational safety and health of FSWs by facilitating social capital and protection agency (e.g., mommies) in the sex-work industry. PMID:22375698

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

    PubMed Central

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

    2014-01-01

    Introduction Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. Methods We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5–65% in Kenya and Ukraine; 10–70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012–2016 and, compared to status quo when all interventions are held constant. Results Optimistic but feasible coverage (65%–70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. Discussion A community empowerment approach to HIV prevention and access to universal ART for female sex workers is a promising human rights-based solution to overcoming the persistent burden of HIV among female sex workers across epidemic settings. PMID:24516580

  19. Endogenous sex hormones, metabolic syndrome, and diabetes in men and women.

    PubMed

    Kim, Catherine; Halter, Jeffrey B

    2014-04-01

    Endogenous sex hormones predict impairments of glucose regulation. Cross-sectional studies suggest that lower levels of testosterone in men and higher levels in women increase risk of metabolic syndrome and diabetes, whereas lower levels of sex hormone binding globulin in both men and women increase risk of metabolic syndrome and diabetes. In a systematic review, we summarize existing longitudinal studies, which suggest similar patterns. However, these studies are often limited to a single sex steroid measure. Whether these associations are primarily a marker of adiposity, and whether these associations differ between younger eugonadal vs older hypogonadal adults is also uncertain. The impact of exogenous sex steroid therapy may not reflect relationships between sex hormones and impaired glucose regulation that occur without supplementation. Therefore, examination of endogenous sex steroid trajectories and obesity trajectories within individuals might aid our understanding of how sex steroids contribute to glucose regulation. PMID:24585109

  20. Alcohol Use and Transactional Sex among Women in South Africa: Results from a Nationally Representative Survey

    PubMed Central

    Magni, Sarah; Christofides, Nicola; Johnson, Saul; Weiner, Renay

    2015-01-01

    Background Transactional sex is a risk factor for HIV infection. Alcohol use may increase the risk of transactional sex. No nationally-representative studies have examined the relationship between multiple dimensions of alcohol use and transactional sex in women in South Africa. The aim of the study was to examine the relationship between alcohol dependence, binge drinking and frequency of drinking in the past month and transactional sex in adult women in South Africa. Methods A cross-sectional study using multi-stage, cluster sampling collected data from a nationally representative sample of 5,969 women aged 16–55 years in 2012. The analysis conducted for this paper was restricted to women reporting sexual activity in the past 12 months (n = 3,594). Transactional sex was defined as having received money/gifts in exchange for sex with any sex partner in the past year. Alcohol use measures included: alcohol dependence (≥2 positive responses to the CAGE questionnaire); binge drinking (≥4 drinks for women on one occasion); and drinking frequency in the previous month. Logistic regression models were built to test the hypotheses that each dimension of alcohol use was associated with transactional sex. Results About 6.3% (n = 225) of sexually active women reported transactional sex. Almost a third (30.6%) of sexually active women had ever drunk alcohol, and 19.2% were current (past month) drinkers. Among lifetime drinkers, 28.0% were alcohol dependent and 56.6% were binge drinkers. Alcohol dependent women were twice as likely to report transactional sex (AOR 2.0, 95% CI 1.1–4.3, p<0.05) than those not alcohol dependent. Binge drinkers were 3.1 times more likely to have had transactional sex (95% CI 1.5–6.6, p<0.01) than non-binge drinkers. There was no significant relationship between frequency of drinking in the past month and transactional sex. Conclusion Alcohol dependency and binge drinking are significantly associated with transactional sex in South African women. HIV prevention programmes need to target these women, and address both their alcohol use, as well as the HIV risks associated with transactional sex. PMID:26683812

  1. Venue-Mediated Weak Ties in Multiplex HIV Transmission Risk Networks Among Drug-Using Male Sex Workers and Associates

    PubMed Central

    Wang, Peng; Ross, Michael W.; Williams, Mark L.

    2015-01-01

    Objectives. We investigated the structural characteristics of a multiplex HIV transmission risk network of drug-using male sex workers and their associates. Methods. Using a sample of 387 drug-using male sex workers and their male and female associates in Houston, Texas, we estimated an exponential random graph model to examine the venue-mediated relationships between individuals, the structural characteristics of relationships not linked to social venues, and homophily. We collected data in 2003 to 2004. The network comprised social, sexual, and drug-using relationships and affiliations with social venues. Results. Individuals affiliated with the same social venues, bars, or street intersections were more likely to have nonreciprocated (weak) ties with others. Sex workers were less likely than were other associates to have reciprocated (strong) ties to other sex workers with the same venues. Individuals tended to have reciprocated ties not linked to venues. Partner choice tended to be predicated on homophily. Conclusions. Social venues may provide a milieu for forming weak ties in HIV transmission risk networks centered on male sex workers, which may foster the efficient diffusion of prevention messages as diverse information is obtained and information redundancy is avoided. PMID:25880956

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

    PubMed

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

    2016-05-01

    In light of limited data on structural determinants of access and retention in antiretroviral therapy (ART) among sex workers, we examined structural correlates of ART use among sex workers living with HIV over time. Longitudinal data were drawn from a cohort of 646 female sex workers in Vancouver, Canada (2010-2012) and linked pharmacy records on ART dispensation. We used logistic regression with generalized estimating equations (GEE) to examine correlates of gaps in ART use (i.e., treatment interruptions or delayed ART initiation), among HIV seropositive participants (n = 74). Over a 2.5-year period, 37.8 % of participants experienced gaps in ART use (i.e., no ART dispensed in a 6-month period). In a multivariable GEE model, younger age, migration/mobility, incarceration, and non-injection drug use independently correlated with gaps in ART use. In spite of successes scaling-up ART in British Columbia, younger, mobile, or incarcerated sex workers face persistent gaps in access and retention irrespective of drug use. Community-based, tailored interventions to scale-up entry and retention in ART for sex workers should be further explored in this setting. PMID:26148850

  3. Sexual difference in juvenile-hormone titer in workers leads to sex-biased soldier differentiation in termites.

    PubMed

    Toga, Kouhei; Hanmoto, Shutaro; Suzuki, Ryutaro; Watanabe, Dai; Miura, Toru; Maekawa, Kiyoto

    2016-04-01

    In termites, the soldier caste, with its specialized defensive morphology, is one of the most important characteristics for sociality. Most of the basal termite species have both male and female soldiers, and the soldier sex ratio is almost equal or only slightly biased. However, in the apical lineages (especially family Termitidae), there are many species that have soldiers with strongly biased sex ratio. Generally in termites, since high juvenile hormone (JH) titer is required for soldier differentiation from a worker via a presoldier stage, it was hypothesized that the biased soldier-sex ratio was caused by differences in JH sensitivity and/or JH titer between male and female workers. Therefore, we focused on the presoldier differentiation and the worker JH titer in species with only male soldiers (Nasutitermes takasagoensis) and with both male and female soldiers (Reticulitermes speratus) in natural conditions. In the former species, there are four types of workers; male minor, male medium, female medium and female major workers, and presoldiers differentiate from male minor workers. First, we tried to artificially induce presoldiers from male and female workers. In N. takasagoensis, the presoldier differentiation rate and mortality was significantly higher in male minor workers. Morphological analyses showed that both male and female induced presoldiers possessed normal soldier-specific morphologies. It was suggested that female workers, from which soldiers do not differentiate under natural conditions, also maintained the physiological and developmental potential for soldier differentiation. In R. speratus, however, no differences were observed in solder differentiation rate and mortality between male and female workers. Second, the JH titers of each sex/type of workers were quantified by high performance liquid chromatography-mass spectrometry in two different seasons (April and December). The results showed that, in N. takasagoensis, JH titer in male minor workers was consistently higher than those in other worker types. In R. speratus, in contrast, there were no significant differences in JH titers between male and female workers. These results suggested that, in N. takasagoensis, male minor workers maintain JH titers at a high level throughout a year, and this may cause the male-biased presoldier differentiation. PMID:26868724

  4. Developing an App for College Women in Abusive Same-Sex Relationships and Their Friends.

    PubMed

    Bloom, Tina; Gielen, Andrea; Glass, Nancy

    2016-06-01

    Young women experiencing dating violence in same-sex relationships face significant barriers to help for safety planning. Therefore, our team developed a tailored smartphone safety decision aid app for dating violence survivors and their peers. College women survivors of same-sex dating violence, peers, and college staff reviewed the app, identifying users' barriers to information, resources, and services and key strategies for dissemination, inclusiveness, and safety for the app. Findings support the use of the app to assist college women experiencing same-sex dating violence and peers to connect with resources and develop tailored safety plans to reduce violence and increase their safety. PMID:26515797

  5. Factors Associated with Bacterial Vaginosis among Women Who Have Sex with Women: A Systematic Review

    PubMed Central

    Forcey, Dana S.; Vodstrcil, Lenka A.; Hocking, Jane S.; Fairley, Christopher K.; Law, Matthew; McNair, Ruth P.; Bradshaw, Catriona S.

    2015-01-01

    Background Women who have sex with women (WSW) have a higher burden of bacterial vaginosis (BV) than heterosexual women; studies of risk factors specific to this population are limited. We summarised current knowledge regarding risk factors for BV among WSW by systematic review. Methods This systematic review was conducted according to the PRISMA statement. PUBMED, EMBASE, Web of Science and The Cochrane Library were searched to 31st December, 2014. Inclusion criteria: 1) WSW included in the study population; 2) accepted BV diagnostic method; 3) investigated or could extrapolate factors(s) associated with BV acquisition, persistence or transmission in WSW specifically by comparing BV positive to BV negative women. Search was limited to English-language publications. Results A limited number of studies have investigated BV in WSW. Of 71 unique references, 18 full-text articles were assessed and 14 studies fulfilled inclusion criteria. BV was positively associated with higher numbers of female partners, both lifetime and in the three months prior to diagnosis, and confirmed BV in a female partner, but inconsistently associated with partners’ BV history or symptoms. BV was not associated with ethnicity, vaginal douching or hormonal contraception. The impact of specific sexual activities, male sexual contact, smoking and the menstrual cycle varied considerably between study populations. Conclusion BV in WSW is associated with increased numbers of recent and past female partners and confirmed BV in a female partner. There are limited studies of BV in WSW populations, and research is needed to further elucidate risk factors for BV among WSW. However these data provide epidemiological evidence that BV risk in women is directly related to exposure to other female partners and a partner with BV, providing support for the concept that BV is likely to be transmitted between women. Systematic Review Registration Number CRD42014009536 (PROSPERO) PMID:26675816

  6. The Relationships among Sex Role Orientations, General Attitudes Toward Women, and Specific Attitudes Toward Women in a Managerial Role.

    ERIC Educational Resources Information Center

    Irvine, Jacqueline Jordan

    Results are reported of a study to determine whether androgynous persons (characterized as lacking stereotypic concepts of maleness and femaleness) have more positive attitudes toward women than persons of other sex role orientations. Specifically, the study examines attitudes toward appropriate societal roles and the appropriate role of women in…

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

    PubMed Central

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

    2015-01-01

    Introduction Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. Methods A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. Results This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. Conclusion This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers. PMID:26405486

  8. Risk perception of sexually transmitted infections and HIV in Nigerian commercial sex workers in Barcelona: a qualitative study

    PubMed Central

    Coma Auli, Núria; Mejía-Lancheros, Cília; Berenguera, Anna; Pujol-Ribera, Enriqueta

    2015-01-01

    Objective This study aimed to determine in detail the risk perception of sexually transmitted infections (STIs) and HIV, and the contextual circumstances, in Nigerian commercial sex workers (CSWs) in Barcelona. Design A qualitative study with a phenomenological approach. Setting Raval area in Barcelona. Participants 8 CSWs working in Barcelona. Methods A phenomenological study was carried out with Nigerian CSWs in Barcelona. Sampling was theoretical, taking into account: different age ranges; women with and without a partner; women with and without children; and women participating or not in STI/HIV-prevention workshops. Information was obtained by means of eight semistructured individual interviews. An interpretative content analysis was conducted by four analysts. Results Illegal immigrant status, educational level, financial situation and work, and cultural context had mixed effects on CSW knowledge of, exposure to, and prevention and treatment of STI and HIV. CSWs were aware of the higher risk of STI associated with their occupation. They identified condoms as the best preventive method and used them during intercourse with clients. They also implemented other preventive behaviours such as personal hygiene after intercourse. Control of sexual services provided, health education and healthcare services had a positive effect on decreasing exposure and better management of STI/HIV. Conclusions Nigerian CSWs are a vulnerable group because of their poor socioeconomic status. The perception of risk in this group and their preventive behaviours are based on personal determinants, beliefs and experiences from their home country and influences from the host country. Interventions aimed at CSWs must address knowledge gaps, risk behaviours and structural elements. PMID:26078307

  9. The embodiment of tourism among bisexually-behaving Dominican male sex workers.

    PubMed

    Padilla, Mark B

    2008-10-01

    While theories of "structure" and social inequality have increasingly informed global health efforts for HIV prevention--with growing recognition of the linkages between large-scale political and economic factors in the distribution and impact of the HIV/AIDS epidemic--there is still little theorization of precisely how structural factors shape the very bodies and sexualities of specific populations and groups. In order to extend the theoretical understanding of these macro-micro linkages, this article examines how the growth of the tourism industry in the Dominican Republic has produced sexual practices and identities that reflect both the influence of large-scale structural processes and the resistant responses of local individuals. Drawing on social science theories of political economy, embodiment, and authenticity, I argue that an understanding of patterns of sexuality and HIV risk in the region requires analysis of how political-economic transformations related to tourism intersect with the individual experiences and practices of sexuality on the ground. The analysis draws on long-term ethnographic research with bisexually behaving male sex workers in two cities in the Dominican Republic, including participant observation, in-depth interviews, focus groups, and surveys. By examining the global and local values placed on these men's bodies and the ways sex workers use their bodies to broker tourists' pleasure, we may better understand how the large-scale structures of the tourism industry are linked to the specific meanings and practices of sexuality. PMID:18506615

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

    PubMed Central

    2013-01-01

    Introduction Research on the intimate partnerships of female sex workers (FSWs) tends to focus on the risks associated with these relationships. This paper takes as its starting point that the situation of FSWs is better understood by including knowledge of the benefits of their intimate partnerships. Specifically, we employ the conceptual framework provided by emergent research examining intimacy as a complex fusion of affective and instrumental dimensions among sex workers. This perspective allows us to frame information about FSWs’ intimate partnerships within a behaviour-structural approach that is helpful for identifying how intimate partnerships can be a source of both benefit as well as increased risk to FSWs. Methods Our results are based on a mixed-methods study carried out in the summer of 2011 in Kibera, Kenya. We conducted face-to-face interviews (n=30) with a non-probability sample of FSWs stratified by age who self-identified as Human Immune Virus positive (HIV+). We asked about participants’ involvement in current and past intimate partnerships, and whether these relationships had a positive or negative impact on their health and well‒being. Results Participants currently in intimate partnerships had fewer clients and thus lower incomes than those without intimate partnerships. Participants presently with partners were also more likely to receive some financial support from partners, to report lower intimate partner violence, and to narrate higher partner emotional support and greater assistance with medications. These participants were also more likely to have disclosed their sex work and HIV+ statuses to their partners. Intimate partnerships, on the other hand, showed increased risk of economic vulnerability and emotional dependence for FSWs. This became especially problematic for those participants in fragile relationships. Despite these variations, none of the differences between the two groups were statistically significant. Conclusions Intimacy and transactional relations are bound up with one another and intersect with the structural realities and vulnerabilities; this is the case for sex workers in well-resourced and resourced-constrained countries alike. Rather than treating intimate partnerships as distinct from transactional relationships, FSWs’ relationships should be viewed on a continuum of risk and support. PMID:24006868

  11. Social and cultural contexts of HIV risk behaviors among Thai female sex workers in Bangkok, Thailand.

    PubMed

    Nemoto, Tooru; Iwamoto, Mariko; Sakata, Maria; Perngparn, Usaneya; Areesantichai, Chitlada

    2013-01-01

    Recently, the number of indirect female sex workers (FSWs) who work at bars/clubs and massage parlors is substantially increasing in Thailand; however, there are huge gaps in knowledge about HIV risk behaviors among indirect FSWs. This study aimed to describe and understand HIV risk behaviors among Thai FSWs in Bangkok in relation to sociocultural factors and work environment (e.g., bars/clubs, massage parlors, brothels, and street). Based on venue-based purposive sampling methods, Thai FSWs were recruited for qualitative interviews (n=50) and survey interviews (n=205). Based on mixed methods, the study revealed that HIV risk and substance use behaviors among FSWs significantly differed depending on work venues, although there were no significant differences between work venues on some key risk behaviors (e.g., inconsistent condom use with primary partners and customers; willingness to engage in unsafe sex with customers). A multiple linear regression analysis revealed that FSWs who had used illicit drugs, were young, had low levels of self-esteem, or reported STIs had frequently engaged in unprotected vaginal sex with customers. Also, FSWs who worked at bars/clubs, were young, had higher income, or reported STIs had frequently engaged in sex with customers under the influence of alcohol. Qualitative interviews illustrated FSWs' alcohol and drug use due to their stressful life (e.g., long working hours and a large number of customers) and easy access to alcohol and drugs. FSWs had shown inaccurate knowledge about HIV prevention methods and engaged in risky behaviors, such as washing vagina with water or toothpaste after having had sex with customers. The HIV prevention strategies in Thailand need to be re-structured through implementing evidence-based HIV prevention intervention programs for FSWs, which must address sociocultural factors (e.g., self-esteem) and alcohol and drug use specific to work venues. PMID:23082928

  12. Social and Cultural Contexts of HIV Risk Behaviors among Thai Female Sex Workers in Bangkok, Thailand

    PubMed Central

    Nemoto, Tooru; Iwamoto, Mariko; Sakata, Maria

    2015-01-01

    Recently, the number of indirect female sex workers (FSWs) who work at bars/clubs and massage parlors is substantially increasing in Thailand; however, there are huge gaps in knowledge about HIV risk behaviors among indirect FSWs. This study aimed to describe and understand HIV risk behaviors among Thai FSWs in Bangkok in relation to sociocultural factors and work environment (e.g., bars/clubs, massage parlors, brothels, and street). Based on venue-based purposive sampling methods, Thai FSWs were recruited for qualitative interviews (n = 50) and survey interviews (n = 205). Based on mixed methods, the study revealed that HIV risk and substance use behaviors among FSWs significantly differed depending on work venues, although there were no significant differences between work venues on some key risk behaviors (e.g., inconsistent condom use with primary partners and customers; willingness to engage in unsafe sex with customers). A multiple linear regression analysis revealed that FSWs who had used illicit drugs, were young, had low levels of self-esteem, or reported STIs had frequently engaged in unprotected vaginal sex with customers. Also, FSWs who worked at bars/clubs, were young, had higher income, or reported STIs had frequently engaged in sex with customers under the influence of alcohol. Qualitative interviews illustrated FSWs’ alcohol and drug use due to their stressful life (e.g., long working hours and a large number of customers) and easy access to alcohol and drugs. FSWs had shown inaccurate knowledge about HIV prevention methods and engaged in risky behaviors, such as washing vagina with water or toothpaste after having had sex with customers. The HIV prevention strategies in Thailand need to be re-structured through implementing evidence-based HIV prevention intervention programs for FSWs, which must address sociocultural factors (e.g., self-esteem) and alcohol and drug use specific to work venues. PMID:23082928

  13. Characteristics of Female Sex Workers With US Clients in Two Mexico-US Border Cities

    PubMed Central

    STRATHDEE, STEFFANIE A.; LOZADA, REMEDIOS; SEMPLE, SHIRLEY J.; OROZOVICH, PRISCI; PU, MINYA; STAINES-OROZCO, HUGO; FRAGA-VALLEJO, MIGUEL; AMARO, HORTENSIA; DELATORRE, ADELA; MAGIS-RODRíGUEZ, CARLOS; PATTERSON, THOMAS L.

    2009-01-01

    Background HIV prevalence is increasing among female sex workers (FSWs) in Tijuana and Ciudad Juarez, 2 Mexican cities on the US border. Quasilegal prostitution in both cities attracts large numbers of sex tourists. We compared FSWs with and without US clients in both cities. Methods FSWs aged ≥18 years reporting unprotected sex with ≥1 client within the last 2 months, who were not knowingly HIV-infected, were enrolled in a behavioral intervention study. At baseline, participants underwent interviews, antibody testing for HIV and syphilis, and vaginal swabs for detecting gonorrhea and Chlamydia. Logistic regression identified factors associated with reporting >1 US client. Results Of 924 FSWs, 69% had US clients. Median age and duration in sex work were 32 and 4 years. Prevalence of HIV, infectious syphilis (titer ≥1:8), gonorrhea, Chlamydia, and any STI was 6%, 14%, 6%, 13%, and 27%, respectively. Compared with other FSWs, FSWs with US clients were more likely to have syphilis titers ≥1:8 (16% vs. 10%, P = 0.01), gonorrhea (8% vs. 2%, P <0.001) or any STI, including HIV (30% vs. 20%, P = 0.002). Factors independently associated with having US clients were: living in Tijuana, being younger, speaking English, being paid more for having sex without a condom, having >250 clients in the last 6 months, having syphilis titers ≥1:8, and injecting drugs. Conclusions In these border cities, FSWs reporting US clients were more likely to have current STIs and to engage in higher-risk behaviors. Intensified binational prevention efforts involving both FSWs and their clients are urgently needed. PMID:18032996

  14. HIV Risk Behaviours Differ by Workplace Stability Among Mexican Female Sex Workers With Truck Driver Clientele

    PubMed Central

    Chen, Nadine E.; Strathdee, Steffanie A.; Rangel, Gudelia; Patterson, Thomas L.; Uribe-Salas, Felipe J.; Rosen, Perth; Villalobos, Jorge; Brouwer, Kimberly C.

    2012-01-01

    Background In a study of female sex workers (FSWs) servicing truck driver clients in Mexican border cities, we evaluated differences in HIV/STI risk behaviours determined by workplace. Design and Methods Our study was cross-sectional and its population comprised 100 FSWs from Nuevo Laredo (US border) and 100 FSWs from Ciudad Hidalgo (Guatemalan border). The main outcome was primary place of sex work defined as unstable (street, vehicle, gas station, etc.) vs stable (bar, brothel, and hotel). Logistic regression was used to identify correlates associated with trading sex at unstable workplaces in the last month. Results Of the FSWs surveyed, 18% reported an unstable workplace. The majority of FSWs surveyed were young (<30 years), single, had <9th grade education, and had worked in the sex trade for a median of 4.9 years. After controlling for study site, FSWs with unstable vs stable workplaces were more likely to have a majority/all truck driver clientele, but were less likely to have visited a gynaecologist in the last year (OR 0.1, 95% CI 0.03-0.4) or ever had an HIV test (OR 0.1, 95% CI 0.06-0.3), and there was a trend towards lower condom use self-efficacy scores (OR 0.8 per unit increase, 95% CI 0.7-1.0). On multivariate regression, unstable workplace was associated with having majority/all truck driver clientele, being surveyed in Nuevo Laredo, and decreased odds of ever having an HIV test. Conclusions Among Mexican FSWs with truck driver clients, providing safe indoor spaces for sex work may help facilitate public health interventions that improve HIV/STI prevention and reproductive health outcomes. PMID:24724056

  15. GLOBAL EPIDEMIOLOGY OF HIV AMONG FEMALE SEX WORKERS: INFLUENCE OF STRUCTURAL DETERMINANTS

    PubMed Central

    Shannon, K; Strathdee, SA; Goldenberg, SM; Duff, P; Mwangi, P; Rusakova, M; Reza-Paul, S; Lau, J; Deering, K; Pickles, M; Boily, M-C

    2014-01-01

    SUMMARY Female sex workers (FSWs) bear a disproportionately large burden of HIV infection worldwide. Despite decades of research and programme activity, the epidemiology of HIV and the role that structural determinants have in mitigating or potentiating HIV epidemics and access to care for FSWs is poorly understood. We reviewed available published data for HIV prevalence and incidence, condom use, and structural determinants among this group. Only 87 (43%) of 204 unique studies reviewed explicitly examined structural determinants of HIV. Most studies were from Asia, with few from areas with a heavy burden of HIV such as sub-Saharan Africa, Russia, and eastern Europe. To further explore the potential effect of structural determinants on the course of epidemics, we used a deterministic transmission model to simulate potential HIV infections averted through structural changes in regions with concentrated and generalised epidemics, and high HIV prevalence among FSWs. This modelling suggested that elimination of sexual violence alone could avert 17% of HIV infections in Kenya (95% uncertainty interval [UI] 1–31) and 20% in Canada (95% UI 3–39) through its immediate and sustained effect on non-condom use) among FSWs and their clients in the next decade. In Kenya, scaling up of access to antiretroviral therapy among FSWs and their clients to meet WHO eligibility of a CD4 cell count of less than 500 cells per μL could avert 34% (95% UI 25–42) of infections and even modest coverage of sex worker-led outreach could avert 20% (95% UI 8–36) of infections in the next decade. Decriminalisation of sex work would have the greatest effect on the course of HIV epidemics across all settings, averting 33–46% of HIV infections in the next decade. Multipronged structural and community-led interventions are crucial to increase access to prevention and treatment and to promote human rights for FSWs worldwide. PMID:25059947

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

    PubMed

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

    2015-01-01

    Female sex workers (FSWs) bear a disproportionately large burden of HIV infection worldwide. Despite decades of research and programme activity, the epidemiology of HIV and the role that structural determinants have in mitigating or potentiating HIV epidemics and access to care for FSWs is poorly understood. We reviewed available published data for HIV prevalence and incidence, condom use, and structural determinants among this group. Only 87 (43%) of 204 unique studies reviewed explicitly examined structural determinants of HIV. Most studies were from Asia, with few from areas with a heavy burden of HIV such as sub-Saharan Africa, Russia, and eastern Europe. To further explore the potential effect of structural determinants on the course of epidemics, we used a deterministic transmission model to simulate potential HIV infections averted through structural changes in regions with concentrated and generalised epidemics, and high HIV prevalence among FSWs. This modelling suggested that elimination of sexual violence alone could avert 17% of HIV infections in Kenya (95% uncertainty interval [UI] 1-31) and 20% in Canada (95% UI 3-39) through its immediate and sustained effect on non-condom use) among FSWs and their clients in the next decade. In Kenya, scaling up of access to antiretroviral therapy among FSWs and their clients to meet WHO eligibility of a CD4 cell count of less than 500 cells per ?L could avert 34% (95% UI 25-42) of infections and even modest coverage of sex worker-led outreach could avert 20% (95% UI 8-36) of infections in the next decade. Decriminalisation of sex work would have the greatest effect on the course of HIV epidemics across all settings, averting 33-46% of HIV infections in the next decade. Multipronged structural and community-led interventions are crucial to increase access to prevention and treatment and to promote human rights for FSWs worldwide. PMID:25059947

  17. Community Influences on Married Women's Safer Sex Negotiation Attitudes in Bangladesh: A Multilevel Analysis.

    PubMed

    Jesmin, Syeda S; Cready, Cynthia M

    2016-02-01

    The influence of disadvantaged or deprived community on individuals' health risk-behaviors is increasingly being documented in a growing body of literature. However, little is known about the effects of community characteristics on women's sexual attitudes and behaviors. To examine community effects on married women's safer sex negotiation attitudes, we analyzed cross-sectional data from the 2011 Bangladesh Demographic and Health Surveys on a sample of 15,134 married women in 600 communities. We estimated two multilevel logistic regression models. Model 1, which included only individual-level variables, showed that women's autonomy/empowerment, age, and HIV knowledge had significant associations with their safer sex negotiation attitudes. We did not find any socioeconomic status gradient in safer sex negotiation attitudes at the individual level. Adding community-level variables in Model 2 significantly improved the fit of the model. Strikingly, we found that higher community-level poverty was associated with greater positive safer sex negotiation attitudes. Prevailing gender norms and overall women's empowerment in the community also had significant effects. While research on community influences calls for focusing on disadvantaged communities, our research highlights the importance of not underestimating the challenges that married women in economically privileged communities may face in negotiating safer sex. To have sufficient and equitable impact on married women's sexual and reproductive health, sexual and reproductive health promotion policies and programs need to be directed to women in wealthier communities as well. PMID:26162431

  18. Condom use within non-commercial partnerships of female sex workers in southern India

    PubMed Central

    2011-01-01

    Background Although female sex workers (FSWs) report high levels of condom use with commercial sex clients, particularly after targeted HIV preventive interventions have been implemented, condom use is often low with non-commercial partners. There is limited understanding regarding the factors that influence condom use with FSWs’ non-commercial partners, and of how programs can be designed to increase condom use with these partners. The main objectives of this study were therefore to describe FSWs’ self-reported non-commercial partners, along with interpersonal factors characterizing their non-commercial partnerships, and to examine the factors associated with consistent condom use (CCU) within non-commercial partnerships. Methods This study used data collected from cross-sectional questionnaires administered to 988 FSWs in four districts in Karnataka state in 2006-07. We used bivariate and multivariable logistic regression analysis to examine the relationship between CCU (i.e., ‘always’ compared to ‘never’, ‘sometimes’ or ‘frequently’) with non-commercial partners of FSWs (including the respondents’ husband or main cohabiting partner [if not married] and their most recent non-paying partner [who is neither a husband nor the main cohabiting partner, and with whom the FSW had sex within the previous year]) and interpersonal factors describing these partnerships, as well as social and environmental factors. Weighting and survey methods were used to account for the cluster sampling design. Results Overall, 511 (51.8%) FSWs reported having a husband or cohabiting partner and 247 (23.7%) reported having a non-paying partner. CCU with these partners was low (22.6% and 40.3% respectively). In multivariable analysis, the odds of CCU with FSWs’ husband or cohabiting partner were 1.8-fold higher for FSWs whose partner knew she was a sex worker (adjusted odds ratio [AOR]: 1.84, 95% confidence intervals[CI]: 1.02-3.32) and almost 6-fold higher if the FSW was unmarried (AOR: 5.73, 95%CI: 2.79-11.76]. CCU with FSWs’ non-paying partner decreased by 18% for each one-year increase in the duration of the relationship (AOR: 0.82, 95%CI: 0.68-0.97). Conclusions This study revealed important patterns and interpersonal determinants of condom use within non-commercial partnerships of FSWs. Integrated structural and community-driven HIV/STI prevention programs that focus on gender and reduce sex work stigma should be investigated to increase condom use in non-commercial partnerships. PMID:22376171

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2009-01-01

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

  1. Prevalence of HIV Infection and Predictors for Syphilis Infection among Female Sex Workers in Southern China

    PubMed Central

    Lu, Fan; Jia, Yujiang; Sun, Xinhua; Wang, Lan; Liu, Wei; Xiao, Yan; Zeng, Gang; Li, Chunmei; Liu, Jianbo; Cassell, Holly; Chen, Huey T; Vermund, Sten H

    2009-01-01

    The purpose of this study was to assess the prevalence and risk factors for syphilis infection among female sex workers (FSWs) in Liuzhou City, Guangxi Zhuang Autonomous Region, southern China. A cross-sectional study recruited FSWs using a venue-based method and subsequent snowball sampling with mapping strategies. Questionnaire-based interviews were conducted to collect demographic and behavioral information. Blood was tested for syphilis (RPR with TPPA confirmation) and HIV (EIA with Western blot confirmation) infections. Of the 362 eligible participants, 81.7% were non-local residents (60.5% from other parts of Guangxi and 21.2% were non-Guangxi residents); 58.0% belonged to non-Han minority ethnic groups; 37.5% reported inconsistent condom use with their clients and 71.2% reported inconsistent condom use with their regular sex partners during the past month. Nearly 10% reported having had sex with drug users. The prevalence rates for HIV and syphilis infections were 2.3% and 11.0%, respectively. Almost half (46.6%) of participants reported having had STD symptoms. Inconsistent condom use with clients in the past month (AOR=5.0; 95%CI=1.8-13.8), less education (OR=2.6; 95% CI=1.1-7.4), and HIV infection (AOR=8.1; 95%CI=1.1-68.5) were independently associated with syphilis infection. PMID:19323011

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  4. Working Women Portrayed on Evening Television Programs

    ERIC Educational Resources Information Center

    Kaniuga, Nancy; And Others

    1974-01-01

    Even television programs are thought to distort the real-life occupational distribution of women workers by favoring sex stereotypes and representing a narrow range of portrayed occupations for women. (Author)

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

    PubMed Central

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

    2012-01-01

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

  6. Are Women Safer Workers? A New Look at the Data.

    ERIC Educational Resources Information Center

    Root, Norman; Daley, Judy R.

    1980-01-01

    Provides a comprehensive look at female work-related injuries and illnesses by occupation, industry, and specific characteristic of the injury. Most injury cases were accounted for by younger women employed in manufacturing industries. Women in traditionally male-dominated jobs suffer the same injuries with the same frequency as their male…

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

    PubMed Central

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

    2013-01-01

    This mixed methods study examined the prevalence and characteristics of physical and sexual abuse and depression symptoms among 624 injection drug-using female sex workers (FSW-IDUs) in Tijuana and Ciudad Juarez, Mexico; a subset of 47 from Tijuana also underwent qualitative interviews. Linear regressions identified correlates of current depression symptoms. In the interviews, FSW-IDUs identified drug use as a method of coping with the trauma they experienced from abuse that occurred before and after age 18 and during the course of sex work. In a multivariate linear regression model, two factors—ever experiencing forced sex and forced sex in the context of sex work—were significantly associated with higher levels of depression symptoms. Our findings suggest the need for integrated mental health and drug abuse services for FSW-IDUs addressing history of trauma as well as for further research on violence revictimization in the context of sex work in Mexico. PMID:23737808

  8. Prevalence of HIV and Other Sexually Transmitted Infections among Female Sex Workers in Kisumu, Western Kenya, 1997 and 2008

    PubMed Central

    Vandenhoudt, Hilde M.; Langat, Lilian; Menten, Joris; Odongo, Fredrick; Oswago, Simon; Luttah, Geoffrey; Zeh, Clement; Crucitti, Tania; Laserson, Kayla; Vulule, John; Buve, Anne

    2013-01-01

    Background In 1997, a survey in Kisumu found a prevalence of HIV infection among female sex workers (FSW) of 75%. Only 50% reported using a condom with the last client. In 2008, we conducted another survey to collect data to inform an intervention targeting FSW in Kisumu. Methods In 2008 FSW were recruited by respondent-driven sampling. Women completed a questionnaire and were tested for HIV and other sexually transmitted infections (STIs). Multiple logistic regression analysis was done to explore factors associated with HIV-infection, and with condom use. Prevalence of HIV infection was compared in the two surveys from 1997 and 2008. Multivariate analysis was used to assess whether a change in HIV prevalence between the two surveys could be explained by changes in socio-demographic characteristics and/or behavioral factors. Results 481 FSW participated in the 2008 study. HIV prevalence was 56.5% (95% CI 52.0–61.6). Factors independently associated with HIV were age older than 29 years; being a widow; STI treatment in the past year; herpes simplex virus Type-2 infection; bacterial vaginosis; and trichomoniasis. Condom use with last client was reported by 75.0% (95% CI 70.9–78.9). Predictors of condom use with the last client were age older than 29 years; higher price paid by last client; ever having been tested for HIV. Predictors of unprotected sex were being drunk during last sex act; usually having sex during menses; and STI treatment in the past year. The odds ratio of HIV infection associated with year of survey was 0.49 (95% CI 0.33–0.75) after adjusting for socio-demographic and behavioral factors. Conclusions The prevalence of HIV among FSW in Kisumu was found to be lower in 2008 than in 1997, while reported condom use was higher. However, access to HIV/STI prevention and care services needs to improve to further decrease HIV transmission between FSW and their clients. PMID:23372801

  9. The balancing act: exploring stigma, economic need and disclosure among male sex workers in Ho Chi Minh City, Vietnam.

    PubMed

    Closson, Elizabeth F; Colby, Donn J; Nguyen, Thi; Cohen, Samuel S; Biello, Katie; Mimiaga, Matthew J

    2015-01-01

    In Vietnam, there is an emerging HIV epidemic among men who have sex with men (MSM). Male sex workers engage in high-risk sexual behaviours that make them particularly vulnerable to HIV infection. In 2010, 23 MSM in Ho Chi Minh City (HCMC) who recently received payment for sex with another man completed in-depth qualitative interviews exploring motivations for sex work, patterns of sex work disclosure and experiences of social stigma. Interviews were recorded, transcribed and translated into English and analysed using a qualitative descriptive approach. Low wages, unstable employment and family remittances were motivating factors for MSM in HCMC to sell sex. Participants described experiences of enacted and felt social stigma related to their involvement in sex work. In response, they utilised stigma management techniques aimed at concealment of involvement in sex work. Such strategies restricted sexual communication with non-paying sex partners and potentially limited their ability to seek social support from family and friends. Departing from decontextualized depictions of sex work disclosure, our findings describe how decisions to reveal involvement in sex work are shaped by social and structural factors such as social stigma, techniques to minimise exposure to stigma, economic imperatives and familial responsibilities. PMID:25555192

  10. The balancing act: Exploring stigma, economic need and disclosure among male sex workers in Ho Chi Minh City, Vietnam

    PubMed Central

    Closson, Elizabeth F.; Colby, Donn J.; Nguyen, Thi; Cohen, Samuel S.; Biello, Katie; Mimiaga, Matthew J.

    2014-01-01

    In Vietnam, there is an emerging HIV epidemic among men who have sex with men (MSM). Male sex workers (MSWs) engage in high-risk sexual behaviours that make them particularly vulnerable to HIV infection. In 2010, 23 MSM in Ho Chi Minh City (HCMC) who recently received payment for sex with another man completed in-depth qualitative interviews exploring motivations for sex work, patterns of sex work disclosure and experiences of social stigma. Interviews were recorded, transcribed and translated into English and analysed using a qualitative descriptive approach. Low wages, unstable employment, and family remittances were motivating factors for MSM in HCMC to sell sex. Participants described experiences of enacted and felt social stigma related to their involvement in sex work. In response, they utilized stigma management techniques aimed at concealment of involvement in sex work. Such strategies restricted sexual communication with non-paying sex partners and potentially limited their ability to seek social support from family and friends. Departing from decontextualized depictions of sex work disclosure, our findings describe how decisions to reveal involvement in sex work are shaped by social and structural factors such as social stigma, techniques to minimize exposure to stigma, economic imperatives and familial responsibilities. PMID:25555192

  11. Career Satisfaction and Perceptions of Sex Discrimination among Women Student Affairs Professionals.

    ERIC Educational Resources Information Center

    Blackhurst, Anne E.

    2000-01-01

    Surveys women student affairs professionals to determine their satisfaction with the student affairs profession, their perceptions of sex discrimination, and the relationship between perceptions of sex discrimination and career satisfaction. Results indicate that satisfaction with the student affairs profession appears to be related to perceptions…

  12. Sex-trafficking, Violence, Negotiating Skill, and HIV Infection in Brothel-based Sex Workers of Eastern India, Adjoining Nepal, Bhutan, and Bangladesh

    PubMed Central

    Sarkar, Kamalesh; Bal, Baishali; Mukherjee, Rita; Chakraborty, Sekhar; Saha, Suman; Ghosh, Arundhuti; Parsons, Scott

    2008-01-01

    A community-based cross-sectional study was conducted among brothel-based sex workers of West Bengal, eastern India, to understand sex-trafficking, violence, negotiating skills, and HIV infection in them. In total, 580 sex workers from brothels of four districts participated in the study. A pretested questionnaire was introduced to study their sociodemography, sex-trafficking, violence, and negotiating skills. Blood sample of 4–5 mL was collected from each sex worker using an unlinked anonymous method to study their HIV status. Data were edited and entered into a computer using the Epi Info software (6.04d version). Both univariate and multivariate analyses were done to find out any association between HIV and relevant risk factors. Results of the study revealed that a sizeable number of the participants were from Nepal (9%) and Bangladesh (7%). The seroprevalence of HIV was strikingly higher among Nepalese (43%) than among Bangladeshis (7%) and Indians (9%). Almost one in every four sex workers (24%) had joined the profession by being trafficked. Violence at the beginning of this profession was more among the trafficked victims, including those sold by their family members (57%) compared to those who joined the profession voluntarily (15%). The overall condom negotiation rate with most recent two clients was 38%. By multivariate analysis, HIV was significantly associated with sexual violence (odds ratio=2.3; 95% confidence interval 1.2–4.5). The study has documented that the trafficked victims faced violence, including sexual violence, to a greater magnitude, and sexual violence was associated with acquiring HIV in them. There is a need for an in-depth study to understand the problem of trafficking and its consequences. PMID:18686555

  13. Sex-trafficking, violence, negotiating skill, and HIV infection in brothel-based sex workers of eastern India, adjoining Nepal, Bhutan, and Bangladesh.

    PubMed

    Sarkar, Kamalesh; Bal, Baishali; Mukherjee, Rita; Chakraborty, Sekhar; Saha, Suman; Ghosh, Arundhuti; Parsons, Scott

    2008-06-01

    A community-based cross-sectional study was conducted among brothel-based sex workers of West Bengal, eastern India, to understand sex-trafficking, violence, negotiating skills, and HIV infection in them. In total, 580 sex workers from brothels of four districts participated in the study. A pretested questionnaire was introduced to study their sociodemography, sex-trafficking, violence, and negotiating skills. Blood sample of 4-5 mL was collected from each sex worker using an unlinked anonymous method to study their HIV status. Data were edited and entered into a computer using the Epi Info software (6.04d version). Both univariate and multivariate analyses were done to find out any association between HIV and relevant risk factors. Results of the study revealed that a sizeable number of the participants were from Nepal (9%) and Bangladesh (7%). The seroprevalence of HIV was strikingly higher among Nepalese (43%) than among Bangladeshis (7%) and Indians (9%). Almost one in every four sex workers (24%) had joined the profession by being trafficked. Violence at the beginning of this profession was more among the trafficked victims, including those sold by their family members (57%) compared to those who joined the profession voluntarily (15%). The overall condom negotiation rate with most recent two clients was 38%. By multivariate analysis, HIV was significantly associated with sexual violence (odds ratio=2.3; 95% confidence interval 1.2-4.5). The study has documented that the trafficked victims faced violence, including sexual violence, to a greater magnitude, and sexual violence was associated with acquiring HIV in them. There is a need for an in-depth study to understand the problem of trafficking and its consequences. PMID:18686555

  14. Homelessness among a cohort of women in street-based sex work: the need for safer environment interventions

    PubMed Central

    2011-01-01

    Background Drawing on data from a community-based prospective cohort study in Vancouver, Canada, we examined the prevalence and individual, interpersonal and work environment correlates of homelessness among 252 women in street-based sex work. Methods Bivariate and multivariate logistic regression using generalized estimating equations (GEE) was used to examine the individual, interpersonal and work environment factors that were associated with homelessness among street-based sex workers. Results Among 252 women, 43.3% reported homelessness over an 18-month follow-up period. In the multivariable GEE logistic regression analysis, younger age (adjusted odds ratio [aOR] = 0.93; 95%confidence interval [95%CI] 0.93-0.98), sexual violence by non-commercial partners (aOR = 2.14; 95%CI 1.06-4.34), servicing a higher number of clients (10+ per week vs < 10) (aOR = 1.68; 95%CI 1.05-2.69), intensive, daily crack use (aOR = 1.65; 95%CI 1.11-2.45), and servicing clients in public spaces (aOR = 1.52; CI 1.00-2.31) were independently associated with sleeping on the street. Conclusions These findings indicate a critical need for safer environment interventions that mitigate the social and physical risks faced by homeless FSWs and increase access to safe, secure housing for women. PMID:21838894

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

    PubMed Central

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

    2013-01-01

    Background Circular migration and injection drug use increase the risk of HIV transmission in sending communities. We describe female sex workers who are injection drug users’ (FSW-IDUs) circular migration and drug use behaviors. Methods Between 2008-2010, 258 migrant FSW-IDUs residing in Tijuana and Ciudad Juarez, Mexico responded to questionnaires. Results 24% of FSW-IDUs were circular migrants. HIV prevalence was 3.3% in circular migrants and 6.1% in non-circular migrants; 50% of circular and 82% of non-circular migrants were unaware of their HIV infection. Among circular migrants, 44% (n=27) consumed illicit drugs in their birthplace; 70% of these (n=20) injected drugs and one-half of injectors shared injection equipment in their birthplace. Women reporting active social relationships were significantly more likely to return home. Discussion Circular migrant FSW-IDUs exhibit multiple HIV risks and opportunities for bridging populations. Regular HIV testing and treatment and access to substance use services is critical for FSW-IDUs and their sexual/drug-using contacts. PMID:21833727

  16. The Cost of Providing Combined Prevention and Treatment Services, Including ART, to Female Sex Workers in Burkina Faso

    PubMed Central

    Cianci, Fiona; Sweeney, Sedona; Konate, Issouf; Nagot, Nicolas; Low, Andrea; Mayaud, Philippe; Vickerman, Peter

    2014-01-01

    Background Female Sex workers (FSW) are important in driving HIV transmission in West Africa. The Yerelon clinic in Burkina Faso has provided combined preventative and therapeutic services, including anti-retroviral therapy (ART), for FSWs since 1998, with evidence suggesting it has decreased HIV prevalence and incidence in this group. No data exists on the costs of such a combined prevention and treatment intervention for FSW. This study aims to determine the mean cost of service provision per patient year for FSWs attending the Yerelon clinic, and identifies differences in costs between patient groups. Methods Field-based retrospective cost analyses were undertaken using top-down and bottom-up costing approaches for 2010. Expenditure and service utilisation data was collated from primary sources. Patients were divided into groups according to full-time or occasional sex-work, HIV status and ART duration. Patient specific service use data was extracted. Costs were converted to 2012 US$. Sensitivity analyses considered removal of all research costs, different discount rates and use of different ART treatment regimens and follow-up schedules. Results Using the top-down costing approach, the mean annual cost of service provision for FSWs on or off ART was US$1098 and US$882, respectively. The cost for FSWs on ART reduced by 29%, to US$781, if all research-related costs were removed and national ART monitoring guidelines were followed. The bottom-up patient-level costing showed the cost of the service varied greatly across patient groups (US$505–US$1117), primarily due to large differences in the costs of different ART regimens. HIV-negative women had the lowest annual cost at US$505. Conclusion Whilst FSWs may require specialised services to optimise their care and hence, the public health benefits, our study shows that the cost of ART provision within a combined prevention and treatment intervention setting is comparable to providing ART to other population groups in Africa. PMID:24950185

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

    PubMed Central

    2012-01-01

    Background Violence and mobility have been identified as critical factors contributing to the spread of HIV worldwide. This study aimed to assess the independent and combined associations of mobility and violence with sexual risk behaviors and HIV, STI prevalence among female sex workers (FSWs) in India. Methods Data were drawn from a cross-sectional, bio-behavioral survey conducted among 2042 FSWs across five districts of southern India in 200506. Regression models were used to estimate odds ratios and 95% confidence intervals (CIs) for sexual risk behaviors and HIV infection based on experience of violence and mobility after adjusting for socio-demographic and sex work related characteristics. Results One-fifth of FSWs (19%) reported experiencing violence; 68% reported travelling outside their current place of residence at least once in the past year and practicing sex work during their visit. Mobile FSWs were more likely to report violence compared to their counterparts (23% vs. 10%, p?sex with occasional (adjusted OR: 2.86, 95% CI: 1.764.65) and regular clients (adjusted OR: 2.07, 95% CI: 1.403.06). Conclusions The findings indicate that mobility and violence were independently associated with HIV infection. Notably, the combined effect of mobility and violence posed greater HIV risk than their independent effect. These results point to the need for the provision of an enabling environment and safe spaces for FSWs who are mobile, to augment existing efforts to reduce the spread of HIV/AIDS. PMID:22967276

  18. Risk Factors for HIV Acquisition in a Prospective Nairobi-Based Female Sex Worker Cohort.

    PubMed

    McKinnon, Lyle R; Izulla, Preston; Nagelkerke, Nico; Munyao, Julius; Wanjiru, Tabitha; Shaw, Souradet Y; Gichuki, Richard; Kariuki, Cecilia; Muriuki, Festus; Musyoki, Helgar; Gakii, Gloria; Gelmon, Lawrence; Kaul, Rupert; Kimani, Joshua

    2015-12-01

    With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6-3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63-0.91), minimum charge/sex act (aHR 2.74, 0.82-9.15, for low vs. intermediate; aHR 5.70, 1.96-16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03-17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58-14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98-13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001-1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages. PMID:26091706

  19. Prevalence of forced sex and associated factors among women and men in Kisumu, Kenya.

    PubMed

    Adudans, Maureen K; Montandon, Michele; Kwena, Zachary; Bukusi, Elizabeth A; Cohen, Craig R

    2011-12-01

    Sexual violence is a well-recognized global health problem, albeit with limited population-based data available from sub-Saharan Africa. We sought to measure the prevalence of forced sex in Kisumu, Kenya, and identify its associated factors. The data were drawn from a population-based cross-sectional survey. A two-stage sampling design was used: 40 clusters within Kisumu municipality were enumerated and households within each cluster selected by systematic random sampling. Demographic and sexual histories, including questions on forced sex, were collected privately using a structured questionnaire. The prevalence of forced sex was 13% (women) and 4.5% (men). After adjusting for age and cluster, forced sex among women was associated with transactional sex (OR 2.33; 95%CI 1.38-3.95), having more than two lifetime partners (OR 1.9; 95%CI 1.20-3.30), having postprimary education (OR 1.49; 95%CI 1.04-2.14) and a high economic status (OR 1.87; 95%CI 1.2-2.9). No factors were significantly associated with forced sex among the male respondents. Intimate partners were the most common perpetrators of forced sex among both women (50%) and men (62.1%). Forced sex prevention programs need to target the identified associated factors, and educate the public on the high rate of forced sex perpetrated by intimate partners. PMID:22571110

  20. Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report.

    PubMed

    Mallampalli, Monica P; Carter, Christine L

    2014-07-01

    Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions. PMID:24956068

  1. Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

    PubMed Central

    Mallampalli, Monica P.

    2014-01-01

    Abstract Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions. PMID:24956068

  2. Sex Work and Its Associations With Alcohol and Methamphetamine Use Among Female Bar and Spa Workers in the Philippines

    PubMed Central

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

    2014-01-01

    To assess the prevalence of sex work and its associations with substance use among female bar/spa workers in the Philippines (N = 498), workers from 54 bar or spa venues in Metro Manila (20092010) were surveyed on demographics, drug/alcohol use, abuse history, and sex work. Their median age was 23 years and 35% engaged in sex work. Sex work was independently associated with methamphetamine use (19% vs 4%; adjusted odds ratio [AOR] =2.9, 95% confidence interval [CI] = 1.36.2), alcohol use with patrons (49% vs. 27%;AOR = 1.9, 95% CI = 1.13.4), and alcohol intoxication during sex (50% vs. 24%; AOR = 2.0, 95% CI = 1.23.5), but inversely associated with daily alcohol use (13% vs. 16%;AOR = 0.2, 95% CI = 0.10.5). Additional significant covariates included sexual abuse history, younger age, and not having a higher education. Findings suggest that interventions with sex workers in bars and spas should focus on methamphetamine use, alcohol use contexts, and violence victimization, to better meet the needs of this population. PMID:23343641

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

    PubMed

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

    2014-03-01

    To assess the prevalence of sex work and its associations with substance use among female bar/spa workers in the Philippines (N = 498), workers from 54 bar or spa venues in Metro Manila (2009-2010) were surveyed on demographics, drug/alcohol use, abuse history, and sex work. Their median age was 23 years and 35% engaged in sex work. Sex work was independently associated with methamphetamine use (19% vs 4%; adjusted odds ratio [AOR] =2.9, 95% confidence interval [CI] = 1.3-6.2), alcohol use with patrons (49% vs. 27%; AOR = 1.9, 95% CI = 1.1-3.4), and alcohol intoxication during sex (50% vs. 24%; AOR = 2.0, 95% CI = 1.2-3.5), but inversely associated with daily alcohol use (13% vs. 16%; AOR = 0.2, 95% CI = 0.1-0.5). Additional significant covariates included sexual abuse history, younger age, and not having a higher education. Findings suggest that interventions with sex workers in bars and spas should focus on methamphetamine use, alcohol use contexts, and violence victimization, to better meet the needs of this population. PMID:23343641

  4. Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities

    PubMed Central

    Semple, Shirley J.; Stockman, Jamila K.; Pitpitan, Eileen V.; Strathdee, Steffanie A.; Chavarin, Claudia V.; Mendoza, Doroteo V.; Aarons, Gregory A.; Patterson, Thomas L.

    2015-01-01

    Background Globally, client-perpetrated violence against female sex workers (FSWs) has been associated with multiple health-related harms, including high-risk sexual behavior and increased exposure to HIV/STIs. This study examined correlates of client-perpetrated sexual, physical, and economic violence (e.g., robbery) against FSWs in 13 cities throughout Mexico. Methods FSWs (N = 1,089) who were enrolled in a brief, evidence-based, sexual risk reduction intervention for FSWs (Mujer Segura) were interviewed about their work context, including experiences of violence perpetrated by clients, sexual risk and substance use practices, financial need, and social supports. Three broad categories of factors (sociodemographic, work context, behavioral and social characteristics of FSWs) were examined as correlates of sexual, physical, and economic violence. Results The prevalence of different types of client-perpetrated violence against FSWs in the past 6 months was: sexual (11.7%), physical (11.8%), economic (16.9%), and any violence (22.6%). Greater financial need, self-identification as a street worker, and lower perceived emotional support were independently associated with all three types of violence. Alcohol use before or during sex with clients in the past month was associated with physical and sexual violence. Using drugs before or during sex with clients, injection drug use in the past month, and population size of city were associated with sexual violence only, and FSWs’ alcohol use score (AUDIT-C) was associated with economic violence only. Conclusions Correlates of client-perpetrated violence encompassed sociodemographic, work context, and behavioral and social factors, suggesting that approaches to violence prevention for FSWs must be multi-dimensional. Prevention could involve teaching FSWs strategies for risk avoidance in the workplace (e.g., avoiding use of alcohol with clients), enhancement of FSWs’ community-based supports, development of interventions that deliver an anti-violence curriculum to clients, and programs to address FSWs’ financial need by increasing their economic opportunities outside of the sex trade. PMID:26599083

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

    PubMed

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

    2013-12-01

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

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

    PubMed Central

    2013-01-01

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

  7. DECLINING PREVALENCE OF HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS AMONG FEMALE SEX WORKERS IN JOS, NORTH-CENTRAL NIGERIA

    PubMed Central

    Ogbe, AE; Sagay, AS; Imade, GE; Musa, J; Pam, VC; Egah, D; Onwuliri, V; Short, R

    2015-01-01

    BACKGROUND Female Sex Workers (FSWs) are key reservoirs of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) from which transmission to the general population fuels epidemics. STIs amplify HIV infectiousness and susceptibility. We determined the status of HIV and STIs among brothel-based FSWs in Jos as part of an ongoing prevention intervention. METHOD Between January and May 2012, consenting consecutive brothel-based FSWs were recruited from previously designated brothels across Jos. HIV counseling and testing as well as screening for gonorrhoea, syphilis, trichomonasis, candidasis and Bacteria vaginosis (BV) were performed. Positive cases were provided free treatment and follow-up at Solat Women Hospital, Jos. Ethical clearance was obtained from Jos University Teaching Hospital (JUTH) ethical committee. RESULT Two hundred FSWs aged 27.6 ± 4.6 years (range 15–55 years) were recruited and of these, 47 (23.5%) were HIV Positive, 20 (10.0%) had syphilis, 9 (4.5%) had Neisseria gonorrhea, 3 (1.5%) had Trichomonas vaginalis and 86 (43.0%) had BV. The association between HIV and bacterial vaginosis was statistically significant (OR of 2.2, 95% CI of 1.1–4.2, P-value=0.02). In comparison to similar prevalence in 2006, the current findings represent 51.5% decline in HIV prevalence, 40.8% decline for syphilis and over 83.3% decline in prevalence for Trichomonas vaginalis. There was no significant change in the prevalence of Neisseria gonorrhoea and BV. CONCLUSION The prevalence of HIV and STIs among brothel-based FSWs in Jos remain unacceptably high, although, there is a declining trend. A comprehensive HIV prevention program targeting these women is required to block transmission to the general population. PMID:25335372

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

    PubMed Central

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

    2013-01-01

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

  9. The interaction of drug use, sex work, and HIV among transgender women.

    PubMed

    Hoffman, Beth R

    2014-06-01

    Transgender women have a higher prevalence of drug use, HIV, drug use, and sex work than the general population. This article explores the interaction of these variables and discusses how sex work and drug use behaviors contribute to the high rates of HIV. A model predicting HIV rates with sex work and drug use as well as these behaviors in the transgender woman's social network is presented. Challenges to intervening with transgender women, as well as suggestions and criteria for successful interventions, are discussed. PMID:24779504

  10. Feasibility and Acceptability of Cell Phone Diaries to Measure HIV Risk Behavior Among Female Sex Workers

    PubMed Central

    Hensel, Devon J.; Fortenberry, J. Dennis; Garfein, Richard S.; Gunn, Jayleen K. L.; Wiehe, Sarah E.

    2015-01-01

    Individual, social, and structural factors affecting HIV risk behaviors among female sex workers (FSWs) are difficult to assess using retrospective surveys methods. To test the feasibility and acceptability of cell phone diaries to collect information about sexual events, we recruited 26 FSWs in Indianapolis, Indiana (US). Over 4 weeks, FSWs completed twice daily digital diaries about their mood, drug use, sexual interactions, and daily activities. Feasibility was assessed using repeated measures general linear modeling and descriptive statistics examined event-level contextual information and acceptability. Of 1,420 diaries expected, 90.3 % were completed by participants and compliance was stable over time (p > .05 for linear trend). Sexual behavior was captured in 22 % of diaries and participant satisfaction with diary data collection was high. These data provide insight into event-level factors impacting HIV risk among FSWs. We discuss implications for models of sexual behavior and individually tailored interventions to prevent HIV in this high-risk group. PMID:24643312

  11. Strategies for recruiting steady male partners of female sex workers for HIV research

    PubMed Central

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

    2014-01-01

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

  12. Strategies for recruiting steady male partners of female sex workers for HIV research.

    PubMed

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

    2015-02-01

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

  13. Exploring Stigma by Association among Front-Line Care Providers Serving Sex Workers

    PubMed Central

    Phillips, Rachel; Benoit, Cecilia

    2013-01-01

    Stigma by association, also referred to as “courtesy stigma,” involves public disapproval evoked as a consequence of associating with stigmatized persons. While a small number of sociological studies have shown how stigma by association limits the social support and social opportunities available to family members, there is a paucity of research examining this phenomenon among the large network of persons who provide health and social services to stigmatized groups. This paper presents results from a primarily qualitative study of the work-place experiences of a purposive sample of staff from an organization providing services to sex workers. The findings suggest that stigma by association has an impact on staff health because it shapes both the workplace environment as well as staff perceptions of others' support. At the same time, it is evident that some staff, owing to their more advantaged social location, are better able to manage courtesy stigma than others. PMID:24289946

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

    PubMed Central

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Ntseane, Peggy Gabo

    2004-01-01

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