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Pacar and Tamu: Indonesian women sex workers' relationships with men.
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
Wolffers, I; Triyoga, R S; Basuki, E; Yudhi, D; Deville, W; Hargono, R
Effectiveness of an Adapted Evidence-Based Woman-Focused Intervention for Sex Workers and Non-Sex Workers: The Women's Health CoOp in South Africa
South Africa's concurrent epidemics of HIV, substance use, and gender-based violence point to the urgent need for interventions that address the intersectional nature of these issues. A community-based randomized trial assessed the efficacy of an adapted evidence-based Woman-Focused HIV intervention addressing all three issues with sex workers and non-sex workers. At 6-month follow-up, non-sex workers in the Woman-Focused intervention reported
Wendee M. Wechsberg; William A. Zule; Winnie K. Luseno; Tracy L. Kline; Felicia A. Browne; Scott P. Novak; Rachel Middlesteadt Ellerson
When Street Sex Workers Are Mothers
Many women who engage in street sex work experience pregnancies and become mothers. Unfortunately, little research has examined how their pregnancies and parenting impact themselves as street sex workers and their street sex work. In this qualitative research study, 16 mothers who were currently involved in street sex work in a Midwestern city of the United States participated in semistructured
Christine M. Sloss; Gary W. Harper
"... But Then He Became My Sipa": The Implications of Relationship Fluidity for Condom Use Among Women Sex Workers in Antananarivo, Madagascar
Increasing evidence indicates that sex workers use condoms less consistently with regular (i.e., nonpaying) partners than with clients. Few studies have examined the extent to which these 2 categories are mutually exclusive. In an ethnographic study of women's sex work in Antananarivo, Madagascar, we examined how the meaning of women sex workers� sexual relationships could shift among 3 different forms of sex work. Condom use was less likely in forms in which the distinction between client and lover (sipa in Malagasy) was fluid. For many sex workers, therefore, relationships they understood to be intimate imparted the greatest health vulnerability. It is important to examine the influence of the meaning of sexual relationships on condom use for HIV prevention. Policy implications for HIV prevention work with sex workers are considered.
Hindin, Michelle J.; Nathanson, Constance A.; Rakotoarison, Paul Ghislain; Razafintsalama, Violette
Women of courage: commercial sex workers mobilize for HIV / AIDS prevention in Nigeria.
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
Williams, E E
Motherhood and HIV risk among female sex workers in Andhra Pradesh, India: the need to consider women's life contexts.
This study examines whether the challenges of motherhood among female sex workers (FSW) are linked with vulnerability to sexual risk factors for HIV. FSW at least 18 years of age (n = 850) were recruited through respondent driven sampling for a survey on HIV risk in the Rajahmundry area of Andhra Pradesh, India. Logistic regression models adjusted for demographic characteristics were used to assess the relation between reported caretaking challenges and sexual risk indicators for HIV. In adjusted logistic regression models, FSW who reported three or more children in their household or current child health concerns were significantly less likely to report consistent condom use (adjusted odds ratios (AORs) range: 0.5-0.6) and more likely to take more money for sex without a condom (both AORs: 2.5). Women who reported current child health concerns were also more likely to report an STI symptom in the past 6 months (AOR = 1.6; 95 % confidence interval: 1.1-2.3). Findings suggest that challenging responsibilities related to caretaking of children are associated with heightened vulnerability to HIV risk among FSW. Such findings add to the cumulating evidence urging for the implementation of HIV prevention interventions that consider the multiple challenges across various domains of women's lives. PMID:22782790
Reed, E; Silverman, J G; Stein, B; Erausquin, J T; Biradavolu, M; Rosenberg, A; Blankenship, K M
Perceived discrimination and smoking among rural-to-urban migrant women working as restaurant/hotel workers and sex workers in China
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.
Shin, Sanghyuk S.; Wan, Xia; Wang, Qian; Raymond, H. Fisher; Liu, Huilin; Ding, Ding; Yang, Gonghuan; Novotny, Thomas E.
ERIC Educational Resources Information Center
This report indicates that although during the last 55 years the ranks of women workers have risen from only one out of five to two out of five of all workers, the profile of the average woman worker has greatly changed from that of a 28-year-old single factory worker or clerk of 1920 to that of a 35-year-old woman of today who may be found in any�
Women's Bureau (DOL), Washington, DC.
Governing sex workers in Timor Leste.
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
Harrington, Carol
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.
: Studies completed over the past 15 years have consistently demonstrated the importance of community-level determinants in potentiating or mitigating risks for the acquisition and transmission of HIV. Structural determinants are especially important in mediating HIV risk among key populations, including men who have sex with men, people who inject drugs, sex workers of all genders, and transgender women. The objective of this systematic review was to synthesize the evidence characterizing the community-level determinants that potentiate or mitigate HIV-related outcomes for key populations. The results of the review suggest that although health communication programs represent community-level strategies that have demonstrated the effectiveness in increasing the uptake of HIV testing and decreasing the experienced stigma among people living with HIV, there are limited studies focused on key populations in low- and middle-income settings. Moreover, interpretation from the 22 studies that met inclusion and exclusion criteria reinforce the importance of the continued measurement of community-level determinants of HIV risks and of the innovation in tools to effectively address these risks as components of the next generation of the HIV response. Consequently, the next generation of effective HIV prevention science research must improve our understanding of the multiple levels of HIV risk factors, while programming for key populations must address each of these risk levels. Failure to do so will cost lives, harm communities, and undermine the gains of the HIV response. PMID:25007203
Baral, Stefan; Holland, Claire E; Shannon, Kate; Logie, Carmen; Semugoma, Paul; Sithole, Bhekie; Papworth, Erin; Drame, Fatou; Beyrer, Chris
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.
Estebanez, P.; Fitch, K.; Najera, R.
Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa
BACKGROUND: This study examined cross-sectional data collected from substance-using female sex workers (FSW) and non-sex workers (non-SW) in Pretoria, South Africa, who entered a randomized controlled trial. METHODS: Women who reported alcohol use and recently engaging in sex work or unprotected sex were recruited for a randomized study. The study sample (N = 506) comprised 335 FSW and 171 female
Wendee M Wechsberg; Li-Tzy Wu; William A Zule; Charles D Parry; Felicia A Browne; Winnie K Luseno; Tracy Kline; Amanda Gentry
ERIC Educational Resources Information Center
This document consists of one page chapters each documenting women's roles in changing the conditions for U.S. workers during and after the industrial revolution. Each chapter is a series of period style drawings with captions detailing the story of that particular incident and cartoon balloons offering humorous comments from the participants. The�
Huck, Gary; Gilmore, Peter
HIV prevention among female sex workers in Africa.
Sex work occurs to meet the demand for sexual services and is a universal phenomenon. In Africa sex work takes many forms and is an important source of income for many women. Yet sex worker reproductive health needs remain largely unmet. The criminalisation of sex work; community and service provider stigma; violence; substance use and limited access to health services and prevention commodities contribute to the high HIV burden evident among female sex workers in Africa. Following UNAIDS' three pillar approach to HIV prevention and sex work we present an overview of current opportunities, barriers and suggestions to improve HIV prevention policy and programming for sex work in Africa. Universal access to a comprehensive package of HIV services is the first pillar. Reproductive health commodities; voluntary and anonymous HIV counselling and testing; treatment of sexually transmitted infections, HIV and opportunistic infections; harm reduction for substance use and psychosocial support services make up the recommended package of services. The second pillar is a sex worker-supportive environment. The inclusion of sex worker programmes within national HIV strategic planning; sex worker-led community mobilisation and the establishment of sex work community networks (comprised of sex workers, health service providers, law enforcers and other stakeholders) enable effective programme implementation and are recommended. The reduction of sex worker vulnerability and addressing structural issues form the final pillar. The decriminalisation of sex work; development of supportive policy; gender equality and economic development are key factors that need to be addressed to increase sex worker resilience. Evidence supports the public health benefit of human rights based approaches to HIV prevention; moralistic and restrictive policy and laws towards sex work are harmful and should be removed. The establishment of these pillars will increase sex worker safety and enhance the inclusiveness of the HIV response. PMID:23237073
Scheibe, A; Drame, F M; Shannon, K
Demography and sex work characteristics of female sex workers in India
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
Rakhi Dandona; Lalit Dandona; G Anil Kumar; Juan Pablo Gutierrez; Sam McPherson; Fiona Samuels; Stefano M Bertozzi
Women Youth Workers and Outdoor Education.
ERIC Educational Resources Information Center
A study examined personal and professional development experienced by women youth workers participating in five 5-day, residential, single-sex, outdoor education courses in England. Analysis of diaries and poetry at the end of the courses and questionnaires completed 1 year later by participants and their managers yielded findings in the areas of�
Collins, Di
Mujer Mas Segura (Safer Women): a combination prevention intervention to reduce sexual and injection risks among female sex workers who inject drugs
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
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Sex Work Venue and Condom Use among Female Sex Workers in Senggigi, Indonesia
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.
Safika, Iko; Levy, Judith A.; Johnson, Timothy P.
Sex worker health: San Francisco style
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.
Cohan, D; Lutnick, A; Davidson, P; Cloniger, C; Herlyn, A; Breyer, J; Cobaugh, C; Wilson, D; Klausner, J
Adolescent female sex workers: invisibility, violence and HIV.
A large number of female sex workers are children. Multiple studies demonstrate that up to 40% of women in prostitution started this work prior to age 18. In studies across India, Nepal, Thailand and Canada, young age at entry to sex work has been found to heighten vulnerability to physical and sexual violence victimisation in the context of prostitution, and relates to a two to fourfold increase in HIV infection. Although HIV risk reduction among adult female sex workers has been a major focus of HIV prevention efforts across the globe, no public health interventions, to date, have addressed the increased hazards and HIV risk faced by adolescent female sex workers. Beyond the structural barriers that limit access to this vulnerable group, historical tensions between HIV prevention and child protection agencies must be overcome in order to develop effective strategies to address this large scale yet little recognised human rights and HIV-related crisis. PMID:21357241
Silverman, Jay G
Preparing for Civil Disobedience: Indian Sex Workers and the Law
This article deals with the reform of prostitution laws in India. It begins with an outline of the current legislative framework available in this regard and then critically evaluates the various alternatives to the framework that have been proposed through the 1990s by the Indian government, universities and research institutions, the Indian women's movement and sex-worker organizations. After undertaking an
Prabha Kotiswaran
ERIC Educational Resources Information Center
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�
Wells, Jean A.
ERIC Educational Resources Information Center
This examination of structural changes in the U.S. economy and its effect on the role of working women presents a policy agenda for alleviating some of the economic strains facing today's working woman. Material is arranged into 3 parts. Part 1 provides an historical backdrop and discusses women's shift out of housework, women as providers, and�
Barrett, Nancy S.
Sex Workers as Safe Sex Advocates: Sex Workers Protect Both Themselves and the Wider Community From HIV.
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
Bates, Julie; Berg, Rigmor
Sexual safety practices of massage parlor-based sex workers and their clients.
The Outreach and Research in Community Health Initiatives and Development (ORCHID) project examines social and structural factors that contribute to HIV/AIDS risk among women working in Vancouver's indoor sex industry and their clients. From 2006 to 2009, two mixed method studies were undertaken in ORCHID: one exploring experiences of women working in the indoor sex industry, mainly in massage parlors, and the other exploring experiences of men as sex "buyers." Both studies emphasize sexual health and safety, risk and protective behaviors, and related contextual factors. No analyses examining the sexual health and safety practices of massage parlor-based sex workers and clients exist in the Canadian context. To address this gap, we analyze two survey datasets - with 118 sex workers and 116 clients. Upon comparing demographics of sex workers and clients, we discuss their condom use and sexually transmitted infections (STI) and HIV testing practices. Sex workers and clients reported high rates of condom use for vaginal/anal intercourse. While both groups reported lower rates of condom use for oral sex during sex transactions, clients did so to a greater extent (p < 0.001). Condom use with noncommercial sex partners was reported to be less consistent by both groups. STI testing was higher among sex workers than clients (p < 0.001). Initiatives targeting clients of massage parlor-based sex workers for STI education and testing are needed. Future research should investigate how different types of relationships between sex workers and clients impact their sexual safety practices. PMID:24617632
Kolar, Kat; Atchison, Chris; Bungay, Vicky
Drug use among sex workers in Hungary.
Drug use and sex work are both controversial issues with multiple interesting connections. This article presents findings from the first-ever survey on drug use and sex work in Hungary. The study aimed to chart the prevalence, function, and problems of drug use among various groups of sex workers. Survey forms were collected from 510 participants (average age 29.5 years, 91% female) in and near Budapest over a period of six months. The results show that sex workers have manifold higher lifetime prevalence, 84.3%, of illicit drug use compared with the prevalence of the Hungarian general young adult population, 20.9%. In our sample, it was very rare to perform sex work for alcohol or drugs (5%) or for money to purchase alcohol or drugs (20%). Findings also indicate notable relationships between location-based sex work types and the drugs used. One-third of the street sex workers reported regular amphetamine use, but none reported regular cocaine use. On the contrary, no escorts reported regular amphetamine use, but 38% admitted to regular cocaine use. The location of sex work may pose an additional occupational health risk factor for substance use. Regular use of alcohol was twice as typical (64%) for sex workers who were employed in bars, in salons/parlors, or alone in rented apartments than it was for those working in other indoor locations (33-34%). Furthermore, 74% of street sex workers smoked tobacco compared with 17% of escorts. Problem drug use was roughly estimated by asking the participants about the main problem domains (medical, legal, social, etc.) from the Addiction Severity Index instrument. The most problematic drug was amphetamine, and the most frequent problem was prolonged or excessive drug use. These main findings may contribute to more focused planning of health intervention services, harm reduction measures, outreach programs, and specific treatments. PMID:23906122
M�r�, Levente; Simon, Katalin; S�rosi, P�ter
Sex workers in agricultural areas: Their drugs, their children.
Most research on female sex workers is urban-based, emphasizing economic necessity and risk-taking. Few authors discuss sex workers and their children. The objective of the present study was to ethnographically explore the influence of street life on childrearing by women involved in sex work in agricultural areas of the southeastern USA. Interviews took place with 38 women. Findings suggest that the sampled women followed the usual paths into substance use. Most began using substances before they began sex work, at which time use escalated to crack-cocaine. Children of 32 of the 34 women who were mothers were living separately from their mothers. None the less, mothers took an interest in children's wellbeing, and many visited them whenever possible. Their principal concern was assuring that children were raised in the best way available. One daughter followed her mother into sex work, and a few older children drank moderately. Several children had experienced abuse from persons other than parents, but the long-term effects of this abuse are unknown. PMID:16864221
Bletzer, Keith V
Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers
Objective To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution.Design Prospective observational study.Setting Vancouver, Canada during 2006-8.Participants Female sex workers 14 years of age or older (inclusive of transgender women) who used illicit drugs (excluding marijuana) and engaged in street level sex work. Main outcome measure Self reported
Kate Shannon; T Kerr; S A Strathdee; J Shoveller; J S Montaner; M W Tyndall
Never innocent victims: street sex workers in Canadian print media.
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
Strega, Susan; Janzen, Caitlin; Morgan, Jeannie; Brown, Leslie; Thomas, Robina; Carri�re, Jeannine
Alcohol Use, Unprotected Sex, and Sexually Transmitted Infections Among Female Sex Workers in China
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.
Wang, Bo; Li, Xiaoming; Stanton, Bonita; Zhang, Lei; Fang, Xiaoyi
Unprotected sex with their clients among low-paying female sex workers in southwest China
Background 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. Methods 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. Results 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. Discussion 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.
Zhang, Chen; Li, Xiaoming; Hong, Yan; Zhou, Yuejiao; Liu, Wei; Stanton, Bonita
Effects of government registration on unprotected sex among female sex workers in Tijuana, Mexico
Background Sex work is partially regulated in Tijuana, but little is known of its health effects. A recent behavioral intervention among female sex workers (FSWs) decreased incidence of HIV/STIs by 40%. We evaluated effects of sex worker regulation on condom use among FSWs randomized to this intervention. Methods FSWs aged ?18 years who reported unprotected sex with ?1 client in the last 2 months and whether they were registered with Tijuana�s Municipal Health Department underwent a brief, theory-based behavioral intervention to increase condom use. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, C. trachomatis and N. gonorrhoeae. Negative binomial regression was used to determine the effect of registration on numbers of unprotected sex acts and cumulative HIV/STI incidence. Results Of 187 women, 83 (44%) were registered. Lack of registration was associated with higher rates of unprotected sex (rate ratio: 1.7, 95% CI: 1.2�2.3), compared to FSWs who were registered, after controlling for potential confounders. Conclusions Registration predicted increased condom use among FSWs enrolled in a behavioral intervention. Public health programs designed to improve condom use among FSWs may benefit from understanding the impact of existing regulation systems on HIV risk behaviors.
Sirotin, Nicole; Strathdee, Steffanie A.; Lozada, Remedios; Abramovitz, Daniela; Semple, Shirley J.; Bucardo, Jesus; Patterson, Thomas L.
Reframing the Interpretation of Sex Worker Health: A Behavioral-Structural Approach
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.
Tuminez, Astrid S.
Women Workers as Users of Computer Technology.
ERIC Educational Resources Information Center
Discussion of expectations, trends, and implications of growth of computer technology and its effect on women workers argues that the experience of women is different from that of men in the nature of jobs in which women are found, their training and education, home-family conflict, and discrimination. The impact on women of increasing�
Larwood, Laurie
Typology of older female sex workers and sexual risk for HIV infection in China: a qualitative study.
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 30s and to develop typology of older women sex workers. Semi-structured in-depth interviews were conducted with 63 older women sex workers and six focus-group interviews with stakeholders in three cities in China in 2012. Data were analysed inductively using constant comparative method. The mean age of participants was 43 years and the mean age of entry into sex work was 39 years. The primary reasons for entry into sex work included 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 worker's unique characteristics and target factors that impede safer-sex practices. PMID:23998493
Hao, Chun; Liu, Hongjie; Sherman, Susan G; Jiang, Baofa; Li, Xiaojing; Xu, Yongfang; Jiang, Zhenxia; Zang, Chunpeng
History of sex trafficking, recent experiences of violence, and HIV vulnerability among female sex workers in coastal Andhra Pradesh, India
Synopsis Findings from female sex workers in southern India indicate that women who enter sex work via trafficking are exposed to unique HIV vulnerabilities. Objectives To estimate the prevalence of sex trafficking as a mode of entry into sex work, and to examine associations between sex trafficking and recent violence experiences and HIV vulnerability among female sex workers (FSWs). Methods In a cross-sectional study in 2006 in coastal Andhra Pradesh, India, 812 FSWs were recruited via respondent-driven sampling to take part in an oral survey of their experiences in sex work. Results One in 5 (19.3%) FSWs met the UN definition of sex trafficking. Women trafficked into sex work were more likely than other FSWs to report recent violence experiences (adjusted odds ratio [AOR], 1.93; 95% confidence interval [CI], 1.32�2.81), more clients per week (AOR, 1.63; 95% CI, 1.11�2.41), and more days of sex work per week (AOR, 1.76; 95% CI, 1.18�2.63), and were less likely to report use of FSW-focused services (AOR, 0.60; 95% CI, 0.42�0.86). No significant differences emerged regarding HIV knowledge or consistent condom use. Conclusion There was a high prevalence of sex trafficking. A history of sex trafficking was associated with a greater vulnerability to recent violence and HIV risk behaviors, underscoring the need for increased attention to the public health needs of trafficked populations.
Gupta, Jhumka; Reed, Elizabeth; Kershaw, Trace; Blankenship, Kim M.
Female Sex Worker Social Networks and STI/HIV Prevention in South China
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.
Tucker, Joseph D.; Peng, Hua; Wang, Kaidi; Chang, Helena; Zhang, Sen-Miao; Yang, Li-Gang; Yang, Bin
From Client to Pimp: Male Violence against Female Sex Workers
ERIC Educational Resources Information Center
The present study explores intimate partner violence (IPV) among female sex workers from the red-light area based in Mumbai, India. Using a grounded theory approach, in-depth interviews were conducted with ten sex workers to explore their experiences of IPV in the context of commercial sex work. Narratives were analyzed and themes constructed. A�
Karandikar, Sharvari; Prospero, Moises
Client retention and health among sex workers in Nairobi, Kenya.
It is still a small body of research that directly addresses female sex workers' relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi's FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers' practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer. PMID:22434396
Izugbara, Chimaraoke O
Sex workers in Kenya, numbers of clients and associated risks: an exploratory survey.
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
Elmore-Meegan, Michael; Conroy, Ron�n M; Agala, C Bernard
Exploring the impact of underage sex work among female sex workers in two Mexico-US border cities.
Although sex work and younger age increase HIV vulnerability, empirical data regarding the impacts of underage sex work are lacking. We explored associations between features of the risk environment, sex work, and drug use history, and underage sex work entry among 624 female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico. Forty-one percent (n = 253) of women began sex work as minors, among whom HIV and any STI/HIV prevalence were 5.2 and 60.7%. Factors independently associated with increased odds of underage sex work were inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe sharing. Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry. These results underscore the importance of efforts to prevent underage sex work and the wider factors contributing to HIV risk among vulnerable youth and underage FSWs. PMID:22012147
Goldenberg, Shira M; Rangel, Gudelia; Vera, Alicia; Patterson, Thomas L; Abramovitz, Daniela; Silverman, Jay G; Raj, Anita; Strathdee, Steffanie A
Exploring the impact of underage sex work among female sex workers in two Mexico-U.S. border cities
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.
Goldenberg, Shira M; Rangel, Gudelia; Vera, Alicia; Patterson, Thomas L; Abramovitz, Daniela; Silverman, Jay G; Raj, Anita; Strathdee, Steffanie A
More Than a Sex Machine: Accomplishing Masculinity Among Chinese Male Sex Workers in the Hong Kong Sex Industry
Situated in the masculinity and deviance literature, this article examines a �deviant� masculinity, that of the male sex worker, and presents the ways men who engage in sex work cope with the job. Based on in-depth interviews of Chinese male sex workers (n�=�18) in the Hong Kong sex industry, I argue that the stigma management techniques these men employ are
Travis S. K. Kong
"Over here, it's just drugs, women and all the madness": The HIV risk environment of clients of female sex workers in Tijuana, Mexico
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.
Goldenberg, Shira; Strathdee, Steffanie A.; Gallardo, Manuel; Rhodes, Tim; Wagner, Karla D.; Patterson, Thomas L.
Sex Workers� Perspectives on Condom Use for Oral Sex with Clients: A Qualitative Study
The authors conducted in-depth interviews with 46 female brothel-based sex workers to explore their perceived barriers and approaches in getting clients to use condoms for oral sex. Reasons given by sex workers for not using condoms for oral sex as compared to vaginal sex included self-perception of low vulnerability to AIDS and sexually transmitted infections, misconceptions on transmission of the
Wong Mee Lian; Roy Chan; Sharon Wee
Beyond Compassion: Children of Sex Workers in Kolkata's Sonagachi
ERIC Educational Resources Information Center
In 2005, children of sex workers from Kolkata's Sonagachi red-light district formed their own collective, Amra Padatik ("We are Foot Soldiers"), to work for gaining dignity for their mothers and claiming their own rights as children of sex workers. In this article the authors speak to AP's founder members to demystify the culture of fear�
Sircar, Oishik; Dutta, Debolina
The sexual health of female sex workers compared with other women in England: analysis of cross-sectional data from genitourinary medicine clinics
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.
Mc Grath-Lone, Louise; Marsh, Kimberly; Hughes, Gwenda; Ward, Helen
Minority Women Workers: A Statistical Overview. (Revised.)
ERIC Educational Resources Information Center
The status of minority women workers in 1976 is examined, particularly in relationship to their white counterparts, under the following topic headings: (1) labor force participation; (2) unemployment status; (3) reasons for unemployment; (4) unemployment during the recession; (5) occupations; (6) marital status; (7) women heads of families; (8)�
Women's Bureau (DOL), Washington, DC.
Condom use, power and HIV\\/AIDS risk: sex-workers bargain for survival in Hillbrow\\/Joubert Park\\/Berea, Johannesburg
Through interviews with 50 female sex-workers in the Hillbrow\\/Berea\\/Joubert Park area of Johannesburg, this paper explores sexual negotiations between men and women in the sex industry. This paper focuses on factors that affect sexual decision-making including safer sex practices. In moving beyond approaches that emphasize women's �powerlessness� in sexual negotiation, this article focuses on ways in which sex-workers capitalize on
Janet Maia Wojcicki; Josephine Malala
Sex with sex workers among latino day laborers in Suburban Maryland.
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
Bianchi, Fernanda T; Reisen, Carol A; Gonzales, Felisa A; Arroyo, Juan C; Zea, Maria Cecilia; Poppen, Paul J
ERIC Educational Resources Information Center
Opportunities for woman-initiated HIV prevention methods among female sex workers in southern China.
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
Weeks, Margaret R; Abbott, Maryann; Liao, Susu; Yu, Wang; He, Bin; Zhou, Yuejiang; Wei, Liu; Jiang, Jingmei
Sexual Coercion, HIV-Related Risk, and Mental Health Among Female Sex Workers in China
We performed this study to examine the association of sexual coercion with HIV-related risk behaviors and suicidal thoughts and attempts among female sex workers (FSWs) in Guangxi, China. Four hundred fifty-four FSWs in 57 entertainment establishments (including shampooing salons, massage parlors, and restaurants) were interviewed between March and May 2004. Fifteen percent of the women reported having been coerced into
Bo Wang; Xiaoming Li; Bonita Stanton; Xiaoyi Fang; Hongmei Yang; Ran Zhao; Yan Hong
Violence victimisation, sexual risk and sexually transmitted infection symptoms among female sex workers in Thailand
Background\\/ObjectivesCommercial sex work is a primary context for heterosexual HIV\\/AIDS transmission. Violence victimisation is considered to compromise women's ability to protect against HIV and other sexually transmitted infections (STI); little research has investigated violence as it relates to sexual risk and STI among female sex workers (FSW). This study sought to compare sexual risk and STI symptoms among FSW based
Michele R Decker; Heather L McCauley; Dusita Phuengsamran; Surang Janyam; George R Seage; Jay G Silverman
Circumstances, experiences and processes surrounding women's entry into sex work in India.
Evidence suggests that in India, the early stages of a woman's career as a sex worker may be an important period to target for HIV and sexually transmitted infection prevention. Before such an intervention is designed and implemented, it is necessary to first understand the life circumstances of women at the start of their sex work careers. We performed a review to bring together available literature pertaining to entry into sex work in India and to highlight knowledge gaps. We found that historical traditions of dedication into sex work, financial insecurity, family discord, violence and coercion, and desire for financial independence are commonly reported reasons for entering into sex work. We also found that families and the broader sex worker community play an important role in the early stages of a woman's sex work career. We suggest that HIV-prevention programmes in India would substantially benefit from a deeper understanding of the life circumstances of new and young women sex workers. Further research should be conducted focusing on family and community involvement in women's entry into sex work, and on the important period of time after a woman's first commercial sex encounter, but before self-identification as a sex worker. PMID:24236895
McClarty, Leigh M; Bhattacharjee, Parinita; Blanchard, James F; Lorway, Robert R; Ramanaik, Satyanarayana; Mishra, Sharmistha; Isac, Shajy; Ramesh, B M; Washington, Reynold; Moses, Stephen; Becker, Marissa L
1969 Handbook on Women Workers.
ERIC Educational Resources Information Center
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�
Women's Bureau (DOL), Washington, DC.
From violence to sex work: agency, escaping violence, and HIV risk among establishment-based female sex workers in Tijuana, Mexico.
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
Choudhury, Shonali M; Anglade, Debbie; Park, Kyuwon
Dyspareunia: Painful Sex for Women
... 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- ...
Sex work in Mexico: vulnerability of male, travesti, transgender and transsexual sex workers
In Mexico, male sex workers (MSW) and travesti, transgender and transsexual (TTT) sex workers are among the groups most affected by HIV. They suffer from stigma and discrimination, yet are often absent from the design of programmes and HIV prevention campaigns. The objective of this study was to provide an account of the social context in which MSW and TTT
Cesar Infante; Silvia Magali Cuadra
Foster Care History and HIV Infection among Drug-Using African American Female Sex Workers
Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research.
Surratt, Hilary L.; Kurtz, Steven P.
Occupational health and safety among commercial sex workers.
The concept of occupational health and safety (OHS) for commercial sex workers has rarely been investigated, perhaps because of the often informal nature of the workplace, the associated stigma, and the frequently illegal nature of the activity. We reviewed the literature on health, occupational risks, and safety among commercial sex workers. Cultural and local variations and commonalities were identified. Dimensions of OHS that emerged included legal and policing risks, risks associated with particular business settings such as streets and brothels, violence from clients, mental health risks and protective factors, alcohol and drug use, repetitive strain injuries, sexually transmissible infections, risks associated with particular classes of clients, issues associated with male and transgender commercial sex workers, and issues of risk reduction that in many cases are associated with lack of agency or control, stigma, and legal barriers. We further discuss the impact and potential of OHS interventions for commercial sex workers. The OHS of commercial sex workers covers a range of domains, some potentially modifiable by OHS programs and workplace safety interventions targeted at this population. We argue that commercial sex work should be considered as an occupation overdue for interventions to reduce workplace risks and enhance worker safety. PMID:21808944
Ross, Michael W; Crisp, Beth R; M�nsson, Sven-Axel; Hawkes, Sarah
Facts on Women Workers of Minority Races.
ERIC Educational Resources Information Center
This booklet on women workers of minority races includes all races in a minority other than white, Negroes constituting about 90 percent of all persons other than white in the United States; Spanish-speaking persons are included in the white population. The following topics are encompassed; labor force participation; unemployment; marital status;�
Women's Bureau (DOL), Washington, DC.
Generational sex work and HIV risk among Indigenous women in a street-based urban Canadian setting.
In Canada, Indigenous women are over-represented 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 women. In multivariate logistic regression model, Aboriginal women remained three 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 three-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
Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio; Shannon, Kate
Sexual and health behaviour of commercial sex workers in Benin City, Edo State, Nigeria.
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
Asowa-Omorodion, F I
ERIC Educational Resources Information Center
Women's Bureau (DOL), Washington, DC.
Queens versus workers: sex-ratio conflict in eusocial Hymenoptera
Studies of sex-ratio conflict in the eusocial Hymenoptera (ants, bees and wasps) have provided the most rigorous tests of kin selection theory. The hymenopteran haplodiploid system of sex determination generally renders workers more closely related to their sisters than to their brothers, whereas queens are equally related to their sons and daughters. Kin selection theory therefore predicts that resource allocation
Natasha J. Mehdiabadi; Hudson Kern Reeve; Ulrich G. Mueller
Symbolic capital and health: the case of women's sex work in Antananarivo, Madagascar.
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
Stoebenau, Kirsten
Migration status, work conditions and health utilization of female sex workers in three South African cities.
Intersections between migration and sex work are underexplored in southern Africa, a region with high internal and cross-border population mobility, and HIV prevalence. Sex work often constitutes an important livelihood activity for migrant women. In 2010, sex workers trained as interviewers conducted cross-sectional surveys with 1,653 female sex workers in Johannesburg (Hillbrow and Sandton), Rustenburg and Cape Town. Most (85.3%) sex workers were migrants (1396/1636): 39.0% (638/1636) internal and 46.3% (758/1636) cross-border. Cross-border migrants had higher education levels, predominately worked part-time, mainly at indoor venues, and earned more per client than other groups. They, however, had 41% lower health service contact (adjusted odds ratio = 0.59; 95% confidence interval = 0.40-0.86) and less frequent condom use than non-migrants. Police interaction was similar. Cross-border migrants appear more tenacious in certain aspects of sex work, but require increased health service contact. Migrant-sensitive, sex work-specific health care and health education are needed. PMID:23238581
Richter, Marlise; Chersich, Matthew F; Vearey, Jo; Sartorius, Benn; Temmerman, Marleen; Luchters, Stanley
Sex trafficking of women and girls.
Sex trafficking involves some form of forced or coerced sexual exploitation that is not limited to prostitution, and has become a significant and growing problem in both the United States and the larger global community. The costs to society include the degradation of human and women's rights, poor public health, disrupted communities, and diminished social development. Victims of sex trafficking acquire adverse physical and psychological health conditions and social disadvantages. Thus, sex trafficking is a critical health issue with broader social implications that requires both medical and legal attention. Healthcare professionals can work to improve the screening, identification, and assistance of victims of sex trafficking in a clinical setting and help these women and girls access legal and social services. PMID:23687554
Deshpande, Neha A; Nour, Nawal M
Women, Sex and Modern Society: The Sex Lives of Readers of a Dutch Women's Magazine
The purpose of this study was to examine the frequency to which heterosexual women engage in a range of sexual activities, such as sexual fantasizing and engaging in cybersex, and to examine women's level of satisfaction with their sex lives. In addition, we explored the role of age in women's sexual activities and satisfaction levels. A total of 4,470 heterosexual
Pieternel Dijkstra; Dick P. H. Barelds
Joining and leaving sex work: experiences of women in Kigali, Rwanda.
Although sex work can bring significant economic benefit there are serious downsides, not least vulnerability to adverse sexual health outcomes. Focus-groups discussions and in-depth interviews were conducted with 70 female sex workers to explore the context in which they started sex work, their motivations to leave, and their experiences of trying to leave. The pathway to becoming a sex worker was underscored by poverty, with disruptive events leading to increasing vulnerability and increasingly difficult life choices. A sizeable minority of women became sex workers while working as house-girls, a position associated with financial, physical and sexual vulnerability. The majority of participants were still working as sex workers, citing financial reasons for not leaving. Motivations to leave sex work included experiencing a frightening incident, peer pressure and concerns about dependent children. Those who left often described a change in their financial circumstances that enabled them to leave. Some had left but had returned to sex work following a financial crisis or because they found their new life too hard. House-girls are particularly vulnerable and therefore an appropriate focus for prevention. Programmes assisting women to leave need to include financial safety nets so that a time of financial difficulty does not necessitate a return to sex work. PMID:22937751
Ingabire, Marie Chantal; Mitchell, Kirstin; Veldhuijzen, Nienke; Umulisa, Marie Michelle; Nyinawabega, Jeanine; Kestelyn, Evelyne; Van Steijn, Minouk; Van De Wijgert, Janneke; Pool, Robert
Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada--a qualitative study
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.
Krusi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K
Anal sex, vaginal sex and HIV risk among female sex workers in Papua New Guinea.
Female sex workers (FSW) are considered one of the key affected populations in Papua New Guinea at risk of acquiring HIV. An integrated bio-behavioral survey of sex workers in Port Moresby was conducted to determine the nature and extent of this risk. About half (51.1 %) of the 411 FSW who reported having any sexual intercourse with clients had engaged in both anal and vaginal intercourse with clients in the last 6 months. In spite of having poorer HIV knowledge (OR95 % CI = 0.14-0.34), FSW who had anal intercourse with clients were significantly more likely to have used a condom at the last vaginal intercourse with a client (OR95 % CI = 1.04-2.87). Similarly, FSW who had anal intercourse with regular and casual partners were significantly more likely to have used a condom at the last vaginal intercourse. Those who engaged in both anal and vaginal intercourse with clients had similar condom use for both vaginal and anal intercourse, with the majority (78.1 %) using a condom at the last occasion for both vaginal and anal intercourse. These FSW may have different risk and protective factors that affect their use of condom during sexual intercourse. Further research is needed to investigate this difference between those who practice anal intercourse and those who do not in order to provide evidence for better programming. PMID:24264727
Kelly-Hanku, Angela; Rawstorne, Patrick; Kupul, Martha; Worth, Heather; Shih, Patti; Man, Wing Young Nicola
Sex work in Mexico: vulnerability of male, travesti, transgender and transsexual sex workers.
In Mexico, male sex workers (MSW) and travesti, transgender and transsexual (TTT) sex workers are among the groups most affected by HIV. They suffer from stigma and discrimination, yet are often absent from the design of programmes and HIV prevention campaigns. The objective of this study was to provide an account of the social context in which MSW and TTT sex workers live, by focusing on their sexual identities, sexual practices and vulnerability to HIV. Data collection took place in Mexico City and involved observational work together with 36 in-depth interviews. Findings reveal a differentiation of vulnerability by sub-group. In general, vulnerability is influenced by the social context, stigma related to homosexuality and sex work, as well as sex workers' access to scarce social capital and the lack of response in terms of social and health programmes. In order to diminish the vulnerability of MSW and TTT sex workers and reduce their risk of HIV infection, preventive measures are needed which take into account their specific health and social needs, promote meaningful participation and the encourage respect for human rights. PMID:19140056
Infante, Cesar; Sosa-Rubi, Sandra G; Cuadra, Silvia Magali
Preference for Sex of Child Among Primiparous Women
Primiparous American women (N = 140) were questioned during their third trimester concerning their choice of sex of offspring and their willingness to use sex preselection techniques (if available). Eighty-two women expressed no preference for sex of offspring; of the remaining 58, 33 chose girls and 25 chose boys. Of the 26 women who indicated they would have used preselection
Roberta Steinbacher; Faith D. Gilroy
Sex Ratios and Women's Roles: A Cross-National Analysis.
ERIC Educational Resources Information Center
Tests several hypotheses derived from the Guttentag-Secord theory which relates societal-level sex ratios to women's status and roles. Finds that the effects of sex ratio on women's roles are more pronounced in developed countries but that correlations between sex ratio and certain dimensions of women's roles provide little support for the theory.�
South, Scott J.; Trent, Katherine
British Columbia: sex workers granted standing to challenge Criminal Code.
On 12 October 2010, a majority of the Court of Appeal of British Columbia allowed the appeal of Shari Kiselbach and the Downtown Eastside Sex Workers United against Violence Society (SWUAV) regarding their standing to challenge provisions of the Criminal Code concerning prostitution. PMID:21688706
Chu, Sandra Ka Hon
Recruitment of Caribbean female commercial sex workers at high risk of HIV infection
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.
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
[Harm reduction program with sex workers].
In Nantes, the M�decins du Monde bus goes out three nights a week to meet women working as prostitutes. The objective is to create a connection, to inform and to prevent the risks inherent to their activity. In this article a nurse shares with us the experience of her round. PMID:24881240
Henriquet, Ma�wenn
Multiple risks among male and transgender sex workers in Pakistan.
Using data from a qualitative study and a subsequent quantitative survey among 918 male and transgender sex workers (MTSW), we explore the context of multiple risks they face. We show that over one-fifth of MTSW have sex with IDU clients. Combined with high levels of risk behavior and very low levels of risk reduction and knowledge, the extent of sexual networking with men who inject drugs contributes further to the sex workers' health risks. Our findings suggest that isolated interventions with single-risk groups are unlikely to be sufficient to control the spread of the epidemic in Pakistan. We highlight the need for integrated approaches to risk reduction programs among MTSW and IDUs. PMID:19856740
Collumbien, Martine; Chow, Jaime; Qureshi, Ayaz Ahmed; Rabbani, Aliya; Hawkes, Sarah
Occupational hazards and coping strategies of sex workers in southwestern Nigeria.
The researcher investigated occupational hazards of sex work and determined coping strategies adopted by female sex workers in Nigeria. Participants were 112 female sex workers selected from three urban towns in southwestern Nigeria. An instrument titled "Questionnaire on Sex Work" adapted from Akinnawo ( 1995 ) was administered to collect information on factors influencing the growth of the sex industry, occupational hazards in the industry, and coping mechanisms adopted by sex workers. It was found that the majority of sex workers joined the profession for socioeconomic reasons. Reported occupational hazards include poor health, risk of sexually transmitted diseases (STDs), police harassment, and loss of social prestige. PMID:23311907
Popoola, Bayode Isaiah
The 'healthy brothel': the context of clinical services for sex workers in Hillbrow, South Africa.
Conventional health services often present barriers to sex workers seeking health care resulting in untreated sexually transmitted infections (STI) and increased risk of HIV infection. A brothel-based clinic was established to provide STI treatment for sex workers who worked in the inner city suburb of Hillbrow, South Africa. Qualitative research demonstrated that the clinic was acceptable to women in terms of service quality, accessibility, and efficacy, and positively influenced health-seeking behaviours, health awareness, and condom use. The intervention also transformed the image of the hotels from sites of 'dirt and disease' into 'healthy brothels'. The paper concludes that clinical services offered on site are a viable alternative to the provision of conventional clinical services. PMID:16923648
Stadler, Jonathan; Delany, Sinead
Acceptability and feasibility of continuous diaphragm use among sex workers in Madagascar
Objectives: The diaphragm, a woman controlled, reusable contraceptive device, might prevent some sexually transmitted infections (STIs). We assessed the acceptability and feasibility of use of silicone Wide-Seal Arcing Diaphragms (Milex Products, Chicago, IL, USA) by sex workers in Madagascar. Methods: Over 8 weeks, we evaluated method acceptability by examining patterns of and problems with women's diaphragm use. We also evaluated several measures of study feasibility, including recruitment and follow up methods. Results: 91 women from three cities (Antananarivo, Tamatave, and Mahajanga) participated, and 87 (96%) completed follow up. At enrolment, participants reported a median of six sex acts with five clients in the previous week. During the follow up period, participants reported a median of three sex acts with three clients during the previous 2 days, and self reported continuous diaphragm use during the previous day increased from 87% to 93%. Seven women became pregnant (incidence 53 pregnancies per 100 woman years). Self reported use of male condoms and diaphragms was fairly constant over the study period: women reported condom use in 61% to 70% of acts and diaphragms in 95% to 97% of acts. The number of participants reporting diaphragm problems decreased from 15 (16%) at the first visit to six (7%) at the final visit. 20 women (22%) needed replacement devices during follow up because their original diaphragms were lost, were the wrong size, or became seriously damaged. Conclusions: Given the high use and steady decrease in reported problems during the study, we believe diaphragms are acceptable and feasible in this resource poor, low education sex worker population.
Behets, F; Turner, A; Van Damme, K; Rabenja, N; Ravelomanana, N; Zeller, K; Rasolofomanana, J
Occupational Health of Women Construction Workers in the Unorganised Sector
This study was undertaken to assess the occupational health status of women workers in the construction industry by evaluating incidences of occupational health disorders. One thousand and fifty-two workers were selected by stratified random sampling, medically examined and subject to relevant interviews, examinations and investigations. Over three-fourths of the women and almost all men reported working for 10 to 12
Ram Lakhani
Resilience and syndemic risk factors among African-American female sex workers.
Research on street-based female sex workers documents a multitude of problems faced by these women, such as substance use, HIV risk, mental health problems, victimization, and homelessness. The presence of problems such as these is understood as a syndemic, or co-occurrence of two or more risk factors that act synergistically to create an excess burden of disease. However, the syndemic framework has not previously incorporated the examination of resilience to understand what protective factors enable female sex workers to cope with syndemic risk. Using 562 baseline interviews from street-based African-American female sex workers enrolled in a randomized intervention trial, this study is the first to investigate expressions of resilience among this vulnerable population. Specifically, these analyses examine high levels of resilience, as measured by personal mastery, in order to understand the contributions of syndemic risk factors and protective factors on the expression of resilience. In bivariate logistic regression models, women with high resilience reported significantly higher odds of high school education, greater access to transportation, and more social support, in addition to lower odds of foster care history, homelessness, substance dependence, severe mental distress, victimization, and HIV risk. In the multivariate model, higher odds of high school education and increased social support, in addition to lower odds of mental distress and HIV risk remained associated with high resilience. The findings suggest specific targets for intervention to assist female sex workers in coping with syndemic risk factors and achieving better health outcomes. These include the prioritizing of education and training opportunities and the enhancement of social support. PMID:23905671
Buttram, Mance E; Surratt, Hilary L; Kurtz, Steven P
Advancing sex and gender competency in medicine: sex & gender women's health collaborative
Research conducted to date has deepened our understanding of sex and gender differences in the etiology, diagnosis, treatment, and outcomes for many conditions that affect both women and men. The Sex and Gender Women�s Health Collaborative (SGWHC) is supported by the coordinated efforts of our founding partners: the American Medical Women�s Association, the American College of Women�s Health Physicians and Society for Women�s Health Research to address the gaps in medical education with regard to sex and gender competency in the care of women. The SGWHC initiated and continues to build a novel digital resource library of sex and gender specific materials to be adopted and adapted into medical education and clinical practice, residing @ http://www.sgwhc.org. This article presents a case for the inclusion of sex and gender focused content into medical curricula and describes a means for students, faculty, and practitioners to access a centralized, interactive repository for these resources.
Sexual practices, identities and health among women who have sex with women in Lesotho - a mixed-methods study.
Despite the high prevalence of HIV and STIs among women in Africa and the growing literature on HIV and STIs among women who have sex with women, research on the sexual health of women who have sex with women in Africa is scant. This study used mixed methods to describe sexual identity, practices and health among women who have sex with women in Lesotho. Most respondents (48%) described themselves as lesbian, 29% as bisexual and 23% as heterosexual. Almost half (45%) had disclosed their same-sex attraction to family, but only 25% had done so with healthcare workers. A total of 8% reported having HIV. Self-reported HIV was associated with having three or more male partners, having male and female partners at the same time and having a history of STIs. Gender norms, the criminalisation of homosexuality, varied knowledge of, and access to, safer-sex strategies, and mixed experiences of HIV/STI testing and sexual healthcare provided social and structural contexts for HIV- and STI-related vulnerability. PMID:24237008
Poteat, Tonia; Logie, Carmen; Adams, Darrin; Lebona, Judith; Letsie, Puleng; Beyrer, Chris; Baral, Stefan
Understanding survival sex: young women, homelessness and intimate relationships
This article seeks to explore gendered experiences of homelessness through an examination of survival sex. Survival sex is usually understood to be the exchange of sex for material support, however, this research found a greater complexity in the intimate relationships being undertaken by young women experiencing homelessness. In-depth interviews were conducted with 15 young women aged 18�25 years living in
Juliet Watson
Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study
Purpose. To assess the prevalence and associated factors of unprotected sex with injecting drug users (IDUs) among a sample of female sex workers (FSWs) in Iran. Methods. This cross-sectional study included 144 FSWs who were interviewed as a part of Unhide HIV Risk Study, a national behavioral survey focusing on various high-risk populations, including IDUs, FSWs, and Men who have Sex with Men (MSMs) in 2009. The survey was conducted in eight provinces in Iran using respondent-driven sampling. Participants' sociodemographic status, HIV knowledge, and HIV attitude were analyzed via logistic regression to determine the predictors of unprotected sex with IDU(s) during the past month. Results. Nineteen percent of FSWs reported at least one occasion of unprotected sex with IDU(s) in the month preceding the study. Higher educational level (OR = ?0.653, 95%CI = ?1.192 to ?0.115), perceived HIV risk (OR = ?1.047, 95%CI = ?2.076 to ?0.019), and perceived family intimacy during childhood (OR = ?1.104, 95%CI = ?1.957 to ?0.251) were all independently associated with lower odds of having unprotected sex with IDU(s) in the month preceding the study. Age, marital status, living condition, HIV knowledge, and perceived behavioral control did not affect the odds of FSWs having sex with IDUs. Conclusion. Perceived HIV risk, which is a modifiable factor, seems to be a promising target for harm reduction interventions amongst Iranian female sex workers. Data presented here may aid in reducing or eliminating the role of sex workers as a bridge for HIV transmission from IDUs to the general population in Iran.
Ahmadi, Khodabakhsh; Rezazade, Majid; Nafarie, Mohammad; Moazen, Babak; Yarmohmmadi Vasel, Mosaieb; Assari, Shervin
Human papillomavirus infections among Hungarian female sex workers.
The purpose of this study was to assess the human papillomavirus (HPV) prevalence in cervical, oropharyngeal and anal samples of the high-risk population of Hungarian female sex workers (FSWs). HPV testing of swab specimens from FSWs (n = 34) using polymerase chain reaction (PCR) methodology was performed. Results were compared with control group (n = 52) matched for age. Questionnaires were used to obtain data regarding participants' sexual behaviour. Data were analysed using SPSS. HPV DNA was detected in at least one location in a great majority of FSWs (82.4%), compared with 46.2% of the general female population (P < 0.05). Both the cervical and the anal samples of sex workers showed higher infection rates than those of controls (64.7% vs. 34.6% and 50.0% vs. 15.4%, respectively, P < 0.05). High-risk HPV prevalence was also significantly higher in sex workers (55.9% vs. 25.0%, P < 0.05). A significantly higher proportion of FSWs had a history of genital warts (26.5% vs. 3.8%, P < 0.05). The results suggest that condom use may not result in adequate protection from HPV infection. The high infection rates among FSWs should be viewed as a priority group for HPV and cervical cancer prevention programmes since they are sources of HPV infection for the general population. PMID:23957436
Marek, E; Dergez, T; D'cruz, G; Bozsa, S; Cseh, A; Szilard, I; Benczik, M; Kiss, I; Varszegi, D; Vilagi, S; Ember, I; Gocze, P
The 'Stolen Generations' of Mothers and Daughters: Child Apprehension and Enhanced HIV Vulnerabilities for Sex Workers of Aboriginal Ancestry
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.
Duff, Putu; Bingham, Brittany; Simo, Annick; Jury, Delores; Reading, Charlotte; Shannon, Kate
Male sex workers in C�rdoba, Argentina: sociodemographic characteristics and sex work experiences
Objective .To report on the sociodemographic characteristics and work experiences of 3 1 male sex workers (MSWs) in the city of C�rdoba, Argentina. Methods .Information on each of the MSWs was collected using a questionnaire that co v - ered his personal characteristics and his work background, self-assessed general health status , and use of health and social services. Scales
Rodrigo Mari�o; Victor Minichiello; Carlos Disogra
Determinants of safer?sex behaviors of brothel female commercial sex workers in Jakarta, Indonesia
A cross?sectional survey was conducted in Kramat Tunggak, an official brothel complex in Northern Jakarta. The objectives were to investigate factors that influence the female commercial sex workers' consistent practice of condom use. These factors were classified into personal behaviors and external factors, such as government programs and the brothel managers' and the clients' attitudes towards condom use. After controlling
Steven L. Gortmaker
Determinants of condom breakage among female sex workers in Karnataka, India
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.
Prevalence and determinants of hepatitis C virus infection among female drug injecting sex workers in Glasgow
Background Few studies of the prevalence of hepatitis C virus (HCV) infection have focussed on women who work as street sex workers to finance their drug use. Methods The investigators report the survey findings of such a population in Glasgow. All women attending the health and social care drop-in centre, situated in Glasgow's "Red Light Area", during a four-week period in 1999 were invited to participate in a survey involving the provision of a saliva sample for anonymous HCV testing and the self-completion of a questionnaire seeking demographic, sexual and injecting practice data. Results Of the 223 women who attended, 51% agreed to participate. Of the 98 women who provided a sufficient saliva sample, 64% (95% CI: 54%�74%) tested HCV antibody positive; 98% of those who tested positive had ever injected drugs. Adjusting for the 85% sensitivity of the saliva test, the HCV antibody prevalence among IDU sex workers sampled was 81%; a rate which is considerably higher than those recorded, contemporaneously, among Glasgow IDUs generally. Two factors were independently associated with HCV antibody positivity in saliva: ever shared needles and syringes (adjusted OR 5.7, 95% CI 2�16) and number of times imprisoned (adjusted OR 7.3, 95% CI 1.4�39, for more than five times compared to zero times). Conclusion Women who engage in street sex work to finance their drug habit are a particularly desperate, chaotic and vulnerable population. This study demonstrates that their HCV infection risk may be greater than that for other IDUs. Those responsible for designing interventions to prevent HCV infection among IDUs should consider the special needs of this group.
Taylor, Avril; Hutchinson, Sharon J; Gilchrist, Gail; Cameron, Sheila; Carr, Susan; Goldberg, David J
The female condom: a promising but unavailable method for Dominican sex workers, their clients, and their partners.
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
van Dijk, Marieke G; Pineda, Diana Lara; Grossman, Daniel; Sorhaindo, Annik; Garc�a, Sandra G
Sex Workers Perspectives on Strategies to Reduce Sexual Exploitation and HIV Risk: A Qualitative Study in Tijuana, Mexico
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.
Goldenberg, Shira M.; Engstrom, David; Rolon, Maria Luisa; Silverman, Jay G.; Strathdee, Steffanie A.
High risk of HIV in non-brothel based female sex workers in India
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,
Rakhi Dandona; Lalit Dandona; Juan Pablo Gutierrez; Anil G Kumar; Sam McPherson; Fiona Samuels; Stefano M Bertozzi
Patterns of sexually transmitted diseases in female sex workers in Surabaya, Indonesia.
Sex workers and their clients as core groups of high frequency transmitters play a dominant role in the transmission of HIV and other sexually transmitted diseases (STDs). In Surabaya, Indonesia, little is known about the prevalence of STDs in various sex establishments. We conducted an STD prevalence survey of 1873 female sex workers in Surabaya, Indonesia. We did not find any sex workers with HIV infection. Prevalence rates of other STDs (chlamydia, gonorrhoea, serological test for syphilis positive, and/or trichomoniasis) in female sex workers were 48% in brothels (n = 696), 42% on the streets (n = 192), 16% in massage parlours (n = 344), 25% in barber shops (n = 150), 17% at call-girl houses (n = 73), and 10% in nightclubs (n = 418). Sex workers from the brothels had the highest prevalence rates of gonorrhoea (24%) and trichomoniasis (8%), while sex workers from the streets and the barber shop had the highest rates of serological test for syphilis (STS) positive (30%) and chlamydia (18%). STD rates decreased with an increase in age (except for STS positive), an increase in education, a decrease in the number of sex partners, and condom use in the previous week. Condom use in the previous week was universally low among sex workers, especially among sex workers from the brothels (14%). Sex workers from the brothels had STD rates about 4 times higher than sex workers from the nightclubs (adjusted odds ratio of 4.4). Although the HIV seroprevalence rate is currently low, widespread prostitution and high rates of STDs in sex workers warrant programmes to avert a potential explosion of HIV transmission. Because sex workers from the brothels in Surabaya have high rates of STDs and low use of condoms but good cooperation with local authorities, STD preventive measures should focus on this group. PMID:9292347
Joesoef, M R; Linnan, M; Barakbah, Y; Idajadi, A; Kambodji, A; Schulz, K
"This area has been declared a prostitution free zone": discursive formations of space, the state, and trans "sex worker" bodies.
The mayorally instituted and police-enforced Prostitution Free Zones in Washington, DC, serve as a tool of nation-state disciplinarity, wherein many transgender women of color, viewed as ideologically suspect, are profiled as "sex workers," facing police harassment and arrest. This article explores here how this process is not merely about sex work but rather about discourses that are evoked in the displacement of the always-already displaced-racial, sexed, and gendered "others" through interviews with activists and trans community members, as well as District of Columbia government publications. PMID:21740214
Edelman, Elijah Adiv
Violence as a Barrier for HIV Prevention among Female Sex Workers in Argentina
Background Violence against female sex workers (FSWs) has been increasingly reported as an important determinant of HIV infection risk. This study explores the frequency of different violent experiences (sexual abuse, rejection, beating and imprisonment) among FSWs in Argentina and its association with condom use and HIV and T. pallidum prevalence. Methods A convenience sample of 1255 FSWs was included in a cross-sectional study conducted between October 2006 and November 2009. Results Sexual abuse was reported by 24.1% (219/907) of women. A total of 34.7% (42/1234) reported rejection experiences, 21.9% (267/1215) reported having been beaten and 45.4% (561/1236) stated having been arrested because of their sex work activity. There was a higher frequency of inconsistent condom use with clients among FSWs who had experienced sexual abuse, rejection, and police detention. A higher frequency of HIV and T. pallidum infection was detected among FSWs who reported having been arrested by the police. Conclusion The study shows for the first time the frequency of different violent situations among FSWs in Argentina. The association between violence against sex workers, condom use and STI prevalence demonstrated here calls for measures to reduce stigma and violence against FSWs. Such violent experiences may increase vulnerability to STI through coerced unprotected sex.
Pando, Maria A.; Coloccini, Romina S.; Reynaga, Elena; Rodriguez Fermepin, Marcelo; Gallo Vaulet, Lucia; Kochel, Tadeusz J.; Montano, Silvia M.; Avila, Maria M.
Predictors of Sexual Risk Reduction Among Mexican Female Sex Workers Enrolled in a Behavioral Intervention Study
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.
Strathdee, Steffanie A.; Mausbach, Brent; Lozada, Remedios; Staines-Orozco, Hugo; Semple, Shirley J.; Abramovitz, Daniela; Fraga-Vallejo, Miguel; de la Torre, Adela; Amaro, Hortensia; Martinez-Mendizabal, Gustavo; Magis-Rodriguez, Carlos; Patterson, Thomas L.
Sex and Women with Cancer -- Overview
... and sex Radiation and sex Chemotherapy (chemo) and sex Hormone treatment and sex To learn more about your ... Your Area Cancer Information Cancer Basics Cancer Prevention & Detection Signs & Symptoms of Cancer Treatments & Side Effects Cancer ...
Evaluation of STD\\/HIV Prevention Needs of Low and Middle-Income Female Sex Workers in Ho Chi Minh City, Vietnam
The Ho Chi Minh City (HCMC) AIDS Committee is concerned about providing prevention and sexually transmitted disease (STD) services to increasing numbers of female sex workers (FSWs). We interviewed 250 non-brothel-based FSWs in HCMC in 1997, including 100 detained women at a rehabilitation center, and 150 women soliciting on the street (low income) and in bars (middle income). The majority
Le Truong Giang; Nguyen Thanh Son; Le Thuy Lan Thao; Lan Vu; Esther Sid Hudes; Christina Lindan
Sex Role Attributions of American-Indian Women.
ERIC Educational Resources Information Center
Examines the sex role attributes of American-Indian women as compared to a predominately White normative group using the short form of the Bem Sex Role Inventory. Results indicate a significant difference on the masculine subscale between the two groups with American-Indian women having higher scores. Provides implications for mental health�
Portman, Tarrell Awe Agahe
The use of the Internet by gay and bisexual male escorts: sex workers as sex educators
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
J. T. Parsons; J. A. Koken; D. S. Bimbi
Sex Differences in Relationship between Stress Responses and Lifestyle in Japanese Workers
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.
Suzuki, Akiko; Akamatsu, Rie
HIV-related risk perception among female sex workers in Nigeria
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.
Ankomah, Augustine; Omoregie, Godpower; Akinyemi, Zacch; Anyanti, Jennifer; Ladipo, Olaronke; Adebayo, Samson
University Student Beliefs about Sex: Men vs. Women
ERIC Educational Resources Information Center
Analysis of survey data from 326 undergraduates at a large southeastern university revealed significant differences between men and women in their sexual beliefs. Specifically, men were more likely to think that oral sex is not sex; that cybersex is not cheating, that men can't tell if a woman is faking orgasm and that sex frequency drops in�
Knox, David; Zusman, Marty; McNeely, Andrea
Transactional sex risk and STI among HIV-infected female sex workers and HIV-infected male clients of FSWs in India
To describe sex risk behaviors of HIV-infected female sex workers (FSWs) and HIV-infected male clients of FSWs, to evaluate associations between risky transactional sex and number of unprotected transactional sex episodes, and to assess the association between unprotected transactional sex and self-reported sexually transmitted infection (STI). Adult HIV-infected FSWs (n=211) and HIV-infected male clients (n=205) were surveyed in Mumbai about demographics, STI, and past 90-day and past year sex and substance use histories. Gender-stratified Poisson regression models were used to evaluate associations between four risky transactional sex behaviors (number of transactional sex partners; alcohol use before transactional sex; anal transactional sex; and transactional sex with a known HIV-infected partner) and number of unprotected transactional sex episodes; logistic regression was used to assess the association between unprotected transactional sex and self-reported STI. Twenty-nine percent of females and 7% of males reported any unprotected transactional sex episodes in the past 90 days. Thirty-nine percent of females and 12% of males reported past year STI. Among males, a greater number of transactional sex partners was associated with more unprotected transactional sex episodes (adjusted incidence rate ratio [IRR]=8.2, 95% confidence interval [CI]=1.8�38.4 highest vs. lowest tertile), and any unprotected transactional sex was associated with a higher odds of self-reported STI in the past year (adjusted odds ratio [AOR]=5.6, 95% CI=1.4�22.4). For women, risky transactional sex behaviors were not associated with condom non-use, and unprotected sex was negatively associated with STI (AOR=0.4, 95% CI=0.2�0.9). Reports of condom use during transactional sex were high for these samples. However, standard predictors of unprotected transactional sex (i.e., greater number of partners) and STI (i.e., unprotected sex) only held true for males. Further research is needed to guide an understanding of sex risk and STI among HIV-infected FSWs in India.
Raj, Anita; Saggurti, N.; Cheng, Debbie M.; Dasgupta, Anindita; Bridden, Carly; Pradeshi, Manojkumar; Samet, J. H.
Region of birth, sex, and agricultural work of immigrant Latino farm workers: the MICASA study.
Agricultural work is hazardous, and immigrant workers perform the majority of production tasks, yet there are few data describing agricultural work and use of protective measures by demographic characteristics. We examined cross-sectionally the influence of region of birth (Mexico vs. Central America) and sex on agricultural work and use of protective measures in the MICASA cohort of immigrant Latino farm workers in Mendota, California. Of 445 participants, 293 (65.8%) were born in Mexico (163 men, 130 women) and 152 (34.2%) were born in Central America (80 men, 72 women). Men worked on average 74.4 more days than women (95% CI 62.0, 86.9) and were more likely to perform tasks requiring high levels of training or strength, such as machine operation, pruning, picking, planting, and irrigation; more likely to work in dusty conditions; and more likely to work directly with pesticides. Women predominated in packing. Respondents from Mexico were more likely to work with tomatoes and less likely to work with melon and lettuce. Central America-born respondents were less likely to engage in planting, irrigation, and pesticide use. Use of task-appropriate personal protective measures on at least a half-time basis was rare, with the exception of persons working with pesticides (a group limited to men) and for facial scarves among Central American women. Further work should focus on identifying barriers to use of preventive measures and programs to further their use. Educational models accounting for cultural factors and driving social norm change, employer engagement, and use of community health workers (promotores) may be helpful in promoting use of preventive measures. PMID:24897916
McCurdy, S A; Stoecklin-Marois, M T; Tancredi, D J; Bennett, D H; Schenker, M B
Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk.
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-�-vis men. PMID:11824924
Gysels, Marjolein; Pool, Robert; Nnalusiba, Betty
Standards and Policy Statements of Special Interest to Women Workers.
National Technical Information Service (NTIS)
The report presents standards adopted at ILO regional conferences and ILO meetings on women's rights to equal opportunity (anti-sex discrimination) in employment opportunity and working conditions (equal pay, occupational health, occupational safety), and...
Risks for Acquisition of Bacterial Vaginosis Among Women Who Report Sex with Women: A Cohort Study
BackgroundBacterial vaginosis (BV) is common in women who have sex with women. While cross-sectional data support a role for sexual transmission, risks for incident BV have not been prospectively studied in this group.Methodology\\/Principal FindingsWe studied risks for BV acquisition in a prospective cohort study of women (age 16�35 years) who reported sex with other women (?1 partner, prior year). Women
Jeanne M. Marrazzo; Katherine K. Thomas; Tina L. Fiedler; Kathleen Ringwood; David N. Fredricks; Landon Myer
Endogenous Sex Hormone Levels in Postmenopausal Women with Alzheimer's Disease
A cross-sectional study examined whether there was a difference in endogenous serum sex hormone levels between community-dwell- ing postmenopausal women with Alzheimer's disease (AD) and healthy controls. Total morning levels of serum estrone, estradiol, androstenedione, testosterone, and cortisol were measured in 52 non- depressed women with AD and 60 postmenopausal women who were neither depressed nor cognitively impaired. Estradiol was
A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use and STD history
The present study aims to investigate the perspective relations between HIV\\/AIDS and condom-related knowledge, condom use, history of sexually transmitted diseases (STDs) and predictive factors of condom use by female sex workers (FSW) who were sent to the Women Re-education Center (WRC) in Shenzhen, People's Republic of China. Seven hundred and one FSW were interviewed. Whereas respondents had attained certain
J. T. F. Lau; H. Y. Tsui; P. C. Siah; K. L. Zhang
HIV vulnerability and condom use among migrant women factory workers in Puebla, Mexico.
International migration is associated with increased HIV vulnerability, but little is known about the vulnerability of internal migrants. This qualitative study explored perceptions of HIV and condom use among Mexican migrant female factory workers. Migration and male sexual infidelity contributed to increased HIV vulnerability and unprotected sex was ubiquitous. The dominant cultural discourse that dichotomizes "good" (monogamous) and "bad" (sexually stigmatized) women, and male partner's resistance, were barriers to condom use. Women's positive attitudes toward the dual protection (pregnancy and sexually transmitted infections) offered by condoms and sexual agency expressed by refusing unwanted sexual contact are resources for HIV prevention. PMID:20461602
Kendall, Tamil; Pelcastre, Blanca Estela
Social-Environmental Factors and Protective Sexual Behavior Among Sex Workers: The Encontros Intervention in Brazil
Objectives. We sought to determine the association of social�environmental factors with condom use and sexually transmitted infections (STIs) among 420 sex workers participating in an STI/HIV prevention study in Corumb�, Brazil, to inform future intervention efforts. Methods. Participants provided urine samples for polymerase chain reaction testing of chlamydia and gonorrhea and responded to multi-item scales addressing perceived social cohesion, participation in networks, and access to and management of resources. We conducted multivariate log-linear and negative binomial regression analyses of these data. Results. Increased social cohesion was inversely associated with number of unprotected sex acts in the preceding week among women (adjusted incidence rate ratio [IRR] = 0.80; P < .01), and there was a marginal association among men (adjusted IRR = 0.41; P = .08). Women's increased participation in social networks was associated with a decrease in frequency of unprotected sex acts (adjusted IRR = 0.83; P = .04), as was men's access to and management of social and material resources (IRR = 0.15; P = .01). Social�environmental factors were not associated with STIs. Conclusions. The social context within which populations negotiate sexual behaviors is associated with condom use. Future efforts to prevent STI/HIV should incorporate strategies to modify the social environment.
Donini, Angela; Diaz, Juan; Chinaglia, Magda; Reingold, Arthur; Kerrigan, Deanna
HIV prevention programmes for female sex workers in Andhra Pradesh, India: outputs, cost and efficiency
BACKGROUND: Female sex workers and their clients play a prominent role in the HIV epidemic in India. Systematic data on the outputs, cost and efficiency for HIV prevention programmes for female sex workers in India are not readily available to understand programme functioning and guide efficient use of resources. METHODS: Detailed output and cost data for the 2002�2003 fiscal year
Lalit Dandona; Pratap Sisodia; SG Prem Kumar; YK Ramesh; A Anod Kumar; M Chalapathi Rao; Elliot Marseille; M Someshwar; Nell Marshall; James G Kahn
Sexual Assault in the Lives of Urban Sex Workers: A Descriptive and Comparative Analysis
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
Janice Du Mont; Margaret J. McGregor
Prevalence and correlates of sexual risk among male and female sex workers in Tijuana, Mexico
We investigated prevalence and correlates of sexual risk behaviours among male and female sex workers in Tijuana, Mexico, the busiest border crossing area on the US � Mexico border, analysing survey data from a purposive, cross-sectional sample of male and female sex workers who worked in a range of indoor and outdoor settings. Logistic regression was used to determine factors
Yasmina Katsulis; Alesha Durfee
Sex trade workers' narratives of sexual violence: a field investigation.
A total of 119 sex trade workers were interviewed about sexually violent experiences. Up to three narratives were elicited: a remarkable, positive (control) event (POS), a well-remembered sexual assault (WELL), and a poorly recalled sexual assault (POOR). The results demonstrated that WELL narratives contained more details than POS narratives despite the fact that the respective experiences were older. WELL narratives were also associated with higher intoxication and more rehearsal than POS narratives. POOR narratives were as detailed as POS narratives. WELL narratives were associated with more PTSD symptoms than POOR narratives. No weapon focus effect and no differences in peritraumatic dissociation were observed to explain this difference. This study was the first to demonstrate great within-participants variability of narrative details in accounts of sexual violence. The findings challenge common opinions in the eyewitness literature. Implications for expert testimony and credibility assessment are discussed. PMID:22356561
Griesel, Dorothee; Yuille, John C
Sex, Menopause, and CultureSexual Orientation and the Meaning of Menopause for Women's Sex Lives
Past research finds that after menopause some women experience negative changes such as vaginal dryness, decreased libido, and decreased orgasm quality; very little research inquires about positive changes. In contrast, this study shifts the research focus from whether women experience menopausal changes to how women view any changes in sex life. Based on 30 in-depth interviews with heterosexual and lesbian
Julie A. Winterich
When can ants discriminate the sex of brood? A new aspect of queen-worker conflict.
The stage in preimaginal ontogeny at which the sexes can first be distinguished has important implications for queen-worker conflict in social insects. If workers are unable to sex larvae at an early instar, their opportunity to control colony reproductive strategies may be limited. In addition, by concealing the sex of her sons for some portion of development, the queen could protect them from the workers' attempts to substitute their own sons or to skew the numerical sex ratio. In a series of choice experiments, workers of the carpenter ant, Camponotus floridanus, failed to discriminate the sex of several stages of larvae but did retrieve female pupae significantly more rapidly than male pupae. Our results suggest that in this species, sex may not become detectable until pupation, which is consistent with sexual deception as an aspect of queen control. Images
Nonacs, P; Carlin, N F
The �Natasha� experience: Migrant sex workers from the former Soviet Union and Eastern Europe in Turkey
Women have been migrating across the world in increasing numbers and the sex industry remains one option for work in host countries. While there is currently much controversy over whether sex work is �forced� versus �voluntary,� the underground nature of the sex industry, combined with prevalent restrictions on illegal\\/undocumented immigration in host countries, creates working and living conditions for women
Leyla G�l��r; P?nar ?lkkaracan
Moving beyond safe sex to women-controlled safe sex: A concept analysis
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.
Alexander, Kamila A.; Coleman, Christopher L.; Deatrick, Janet A.; Jemott, Loretta S.
Situating HIV risk in the lives of formerly trafficked female sex workers on the Mexico-US border.
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
Collins, Shane P; Goldenberg, Shira M; Burke, Nancy J; Bojorquez-Chapela, Ietza; Silverman, Jay G; Strathdee, Steffanie A
Situating HIV risk in the lives of formerly trafficked female sex workers on the Mexico-US border
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.
Collins, Shane P.; Goldenberg, Shira M.; Burke, Nancy J.; Bojorquez, Ietza; Silverman, Jay G.; Strathdee, Steffanie A.
Legal Service Needs and Utilization of Women Who Trade Sex
Women who trade sex for money or drugs experience extensive victimization and criminalization and could benefit from legal\\u000a services. In this study, 91 women currently trading sex disclosed experiences of community, intimate partner, societal, and\\u000a police abuse, and a history of arrests and incarcerations. The majority of respondents indicated a need for services to help\\u000a with abuse, violence, and\\/or legal
Christine M. Sloss; Gary W. Harper
Personality characteristics of male clients of female commercial sex workers in Australia.
The personality characteristics of male clients of female sex workers and their motivations for seeking the services of sex workers were examined. It was hypothesized that clients of sex workers would differ from nonclients in that they would adopt less feminine sex roles, exhibit lower social-sexual effectiveness, and show higher levels of sensation-seeking behavior. Sixty-six clients of sex workers and 60 nonclients volunteered to complete a short questionnaire to assess demographic characteristics, sex role, social-sexual effectiveness, and sensation-seeking behavior. Clients and nonclients did not differ on demographic variables such as age, education, marital status, or occupation. However, clients were significantly less feminine in sex-role orientation, scored lower in social-sexual effectiveness, and scored higher on sensation seeking. Closer analysis of the client group revealed the existence of two distinct subgroups. The first was characterized by low social-sexual effectiveness and appeared motivated to visit sex workers because of an interpersonal need for intimacy. The second was characterized by high sensation seeking and appeared motivated to visit sex workers because of a need for novelty and variety in sexual encounters. PMID:10842724
Xantidis, L; McCabe, M P
HIV vulnerabilities of sex-trafficked Indian women and girls
Objective To qualitatively explore potential mechanisms that may confer heightened risk for HIV infection among survivors of sex trafficking in India. Methods Case narratives of 61 repatriated women and girls who reported being trafficked into sex work and were receiving services at an NGO in Mysore, India, were reviewed. Narratives were analyzed to examine potential sources of HIV risk related to sex trafficking. Results Participants were aged 14�30 years. Among the 48 women and girls tested for HIV, 45.8% were HIV positive. Narratives described very low levels of autonomy, with control exacted by brothel managers and traffickers. Lack of control appeared to heighten trafficked women and girls� vulnerability to HIV infection in the following ways: use of violent rape as a means of coercing initiation into sex work, inability to refuse sex, inability to use condoms or negotiate use, substance use as a coping strategy, and inadequate access to health care. Conclusion Sex trafficked women and girls lack autonomy and are rendered vulnerable to HIV infection through several means. Development of HIV prevention strategies specifically designed to deal with lack of autonomy and reach sex-trafficked women and girls is imperative.
Gupta, Jhumka; Raj, Anita; Decker, Michele R.; Reed, Elizabeth; Silverman, Jay G.
The Use of Female Commercial Sex Workers' Services by Latino Day Laborers
ERIC Educational Resources Information Center
This article reports the characteristics of Latino day laborers who have sex with female commercial sex workers (CSWs). A sample of 450 day laborers in Los Angeles was used. Multivariate logistic regression was used to determine the association of independent variables with the likelihood of having sex with a CSW. Overall, 26% of the 450 day�
Galvan, Frank H.; Ortiz, Daniel J.; Martinez, Victor; Bing, Eric G.
Women and the Economy: A Bibliography and Review of the Literature on Sex Differentiation in the Labor Market.
ERIC Educational Resources Information Center
The booklet presents (1) a bibliography of approximately 660 references to literature about sex discrimination in the labor market and (2) an expository review of recent research about male/female differences in earnings and occupational assignments. The bibliography is divided into 12 content categories. These include earnings of women workers,�
Kohen, Andrew I.; And Others
Reducing Intimate and Paying Partner Violence Against Women Who Exchange Sex in Mongolia: Results From a Randomized Clinical Trial
Women who exchange sex for money or other goods, that is, female sex workers, are at increased risk of experiencing physical and sexual violence from both paying and intimate partners. Exposure to violence can be exacerbated by alcohol use and HIV\\/STI risk. The purpose of this study is to examine the efficacy of a HIV\\/STI risk reduction and enhanced HIV\\/STI
Catherine E. Carlson; Jiehua Chen; Mingway Chang; Altantsetseg Batsukh; Aira Toivgoo; Marion Riedel; Susan S. Witte
Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study
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.
Life-circumstances, working conditions and HIV risk among street and nightclub-based sex workers in Lusaka, Zambia.
The principal objective of this study was to conduct formative research among sex workers in Lusaka, Zambia, to understand how sex workers' perceptions of their personal identity influences safer sex practices. In-depth interviews were conducted with 20 sex workers in Lusaka, Zambia, including both nightclub and street-based sex workers. Findings indicate important differences of self perception and identity between nightclub-based sex workers and street-based sex workers. The latter have a professional identity and are willing to be publicly acknowledged as sex workers. This makes it easier for them to convince clients to use condoms. In contrast, nightclub-based sex workers are less likely to wish to be identified as sex workers. They are motivated by the desire to meet a man who will perhaps marry them and change their lives. As a consequence, they do not publicly acknowledge their risk of STI/HIV infection and many go against their better judgement by not using condoms. Factors such as the stigmatization of sex work, the harassment of sex workers and the lack of protection available to them interact with sex workers' perceptions of their personal identities and influence their ability to take precautions during high-risk sexual encounters. PMID:21972903
Agha, Sohail; Chulu Nchima, Mwaba
Single-Sex Schooling and Women's Education.
ERIC Educational Resources Information Center
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�
Bauch, Patricia A.
Improving the Welfare of Women Factory Workers: Lessons from Indonesia.
ERIC Educational Resources Information Center
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�
White, Mary C.
Seeking Authenticity: Women and Learning in the Catholic Worker Movement
ERIC Educational Resources Information Center
Oral history interviews form the basis of an investigation into both the context and the everyday actions that contributed to the learning environment for women within the Catholic Worker Movement during the 1930s and 1940s. Findings reveal that narrators (a) were grounded in a variety of learning environments including family, Catholic Church,�
Parrish, Marilyn McKinley; Taylor, Edward W.
The epidemiology of serum sex hormones in postmenopausal women
Serum sex hormones may be related to the risk of several diseases including osteoporosis, heart disease, and breast and endometrial cancer in postmenopausal women. In the current report, the authors examined the epidemiology of serum sex hormones in 176 healthy, white postmenopausal women (mean age 58 years) recruited from the metropolitan Pittsburgh, Pennsylvania, area. The data were collected during 1982-1983; none of the women were on estrogen replacement therapy. Serum concentrations of estrone, estradiol, testosterone, and androstenedione were measured by a combination of extraction, column chromatography, and radioimmunoassay. Neither age nor time since menopause was a significant predictor of sex hormones. The degree of obesity was a major determinant of estrone and estradiol. The estrone levels of obese women were about 40% higher than the levels of nonobese women. There was a weak relation between obesity and the androgens. Cigarette smokers had significantly higher levels of androstenedione than nonsmokers, with little difference in serum estrogens between smokers and nonsmokers. Both estrone and estradiol levels tended to decline with increasing alcohol consumption. Physical activity was an independent predictor of serum estrone. More active women had lower levels of estrone. There was a positive relation of muscle strength with estrogen levels. The data suggest interesting relations between environmental and lifestyle factors and serum sex hormones. These environmental and lifestyle factors are potentially modifiable and, hence, if associations between sex hormones and disease exist, modification of these factors could affect disease risks.
Cauley, J.A.; Kuller, L.H.; LeDonne, D. (Univ. of Pittsburgh, PA (USA)); Gutai, J.P. (Wayne State Univ., Detroit, MI (USA)); Powell, J.G. (East Carolina School of Medicine, Greenville, NC (USA))
Pragati: an empowerment programme for female sex workers in Bangalore, India
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.
Euser, Sjoerd M.; Souverein, Dennis; Rama Narayana Gowda, Pushpalatha; Shekhar Gowda, Chandra; Grootendorst, Diana; Ramaiah, Rajendra; Barot, Snehal; Kumar, Sunil; Jenniskens, Francoise; Kumar, Shiv; Den Boer, Jeroen W.
The association between sex segregation, working conditions, and sickness absence among employed women
Methods: The study group consisted of 1075 women employed as nurses, assistant nurses, medical secretaries, or metal workers who answered a questionnaire comprising 218 questions on women's health and living conditions. Sickness absence was collected from employers' and social insurance registers. Results: Women working in the male dominated occupation had in general higher sickness absence compared to those working in female dominated occupations. However, metal workers at female dominated work sites had 2.98 (95% CI 2.17 to 3.79) sick-leave spells per woman and year compared to 1.70 (95% CI 1.29 to 2.10) among those working with almost only men. In spite of a better physical work environment, female metal workers at a female dominated work site had a higher sickness absence than other women, which probably could be explained by the worse psychosocial work environment. Working with more women also had a positive association to increased frequency of sick-leave spells in a multivariate analysis including several known indicators of increased sick-leave. Conclusions: There was an association between sickness absence and sex segregation, in different directions at the occupational and work site level. The mechanism behind this needs to be more closely understood regarding selection in and out of an occupation and a certain work site.
Hensing, G; Alexanderson, K
Natural history of Mycoplasma genitalium Infection in a Cohort of Female Sex Workers in Kampala, Uganda
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.
Vandepitte, Judith; Weiss, Helen A.; Kyakuwa, Nassim; Nakubulwa, Susan; Muller, Etienne; Buve, Anne; Van der Stuyft, Patrick; Hayes, Richard; Grosskurth, Heiner
Alcohol Consumption Patterns and Sexual Risk Behavior among Female Sex Workers in two South Indian Communities
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.
Heravian, Anisa; Solomon, Raja; Krishnan, Gopal; Vasudevan, CK; Krishnan, AK; Osmand, Thomas; Ekstrand, Maria L.
Sex Trafficking and Initiation-Related Violence, Alcohol Use, and HIV Risk Among HIV-Infected Female Sex Workers in Mumbai, India
Female sex workers (FSWs) are the group at greatest risk for human immunodeficiency virus (HIV) infection in India. Women and girls trafficked (ie, forced or coerced) into sex work are thought to be at even greater risk because of high exposure to violence and unprotected sex, particularly during the early months of sex work, that is, at initiation. Surveys were completed with HIV-infected FSWs (n = 211) recruited from an HIV-related service organization in Mumbai, India. Approximately 2 in 5 participants (41.7%) reported being forced or coerced into sex work. During the first month in sex work, such FSWs had higher odds of sexual violence (adjusted odds ratio [AOR], 3.1; 95% confidence interval [CI], 1.6�6.1), ?7 clients per day (AOR, 3.3; 1.8�6.1), no use of condoms (AOR, 3.8, 2.1�7.1), and frequent alcohol use (AOR, 1.9; 1.0�3.4) than HIV-infected FSWs not entering involuntarily. Those trafficked into sex work were also at higher odds for alcohol use at first sex work episode (AOR, 2.2; 95% CI, 1.2�4.0). These results suggest that having been trafficked into sex work is prevalent among this population and that such FSWs may face high levels of sexual violence, alcohol use, and exposure to HIV infection in the first month of sex work. Findings call into question harm reduction approaches to HIV prevention that rely primarily on FSW autonomy.
Raj, Anita; Cheng, Debbie M.; Decker, Michele R.; Coleman, Sharon; Bridden, Carly; Pardeshi, Manoj; Saggurti, Niranjan; Samet, Jeffrey H.
Sex trafficking and initiation-related violence, alcohol use, and HIV risk among HIV-infected female sex workers in Mumbai, India.
Female sex workers (FSWs) are the group at greatest risk for human immunodeficiency virus (HIV) infection in India. Women and girls trafficked (ie, forced or coerced) into sex work are thought to be at even greater risk because of high exposure to violence and unprotected sex, particularly during the early months of sex work, that is, at initiation. Surveys were completed with HIV-infected FSWs (n = 211) recruited from an HIV-related service organization in Mumbai, India. Approximately 2 in 5 participants (41.7%) reported being forced or coerced into sex work. During the first month in sex work, such FSWs had higher odds of sexual violence (adjusted odds ratio [AOR], 3.1; 95% confidence interval [CI], 1.6-6.1), ? 7 clients per day (AOR, 3.3; 1.8-6.1), no use of condoms (AOR, 3.8, 2.1-7.1), and frequent alcohol use (AOR, 1.9; 1.0-3.4) than HIV-infected FSWs not entering involuntarily. Those trafficked into sex work were also at higher odds for alcohol use at first sex work episode (AOR, 2.2; 95% CI, 1.2-4.0). These results suggest that having been trafficked into sex work is prevalent among this population and that such FSWs may face high levels of sexual violence, alcohol use, and exposure to HIV infection in the first month of sex work. Findings call into question harm reduction approaches to HIV prevention that rely primarily on FSW autonomy. PMID:22043037
Silverman, Jay G; Raj, Anita; Cheng, Debbie M; Decker, Michele R; Coleman, Sharon; Bridden, Carly; Pardeshi, Manoj; Saggurti, Niranjan; Samet, Jeffrey H
Estimates of the number of female sex workers in different regions of the world
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.
Vandepitte, J; Lyerla, R; Dallabetta, G; Crabbe, F; Alary, M; Buve, A
Violence against Chinese female sex workers in Hong Kong: from understanding to prevention.
Violence against sex workers is considered a global phenomenon. Despite this, very little is known about the patterns and nature of this form of violence. This article is concerned with violence against Chinese female sex workers in Hong Kong. Based on a systematic analysis of 75 police case files, it was found that violent attacks on sex workers display clear temporal and spatial patterns, and that perpetrators share certain characteristics. The article concludes that violence against female sex workers in the Chinese context is largely opportunity driven and goes on to argue that situational measures offer the greatest potential for preventive gains. Barriers to effective implementation such as the inappropriate or unfavourable responses of the government, the police, community leaders, and local residents toward commercial sexual activity are also discussed. PMID:22419521
Li, Jessica C M
Consistent condom use dynamics among sex workers in Central America: 1997-2000.
The paper aims to provide evidence on consistent condom use dynamics among sex workers in Central America between 1997 and 2000, and to examine the most important predictors of use behaviour important for policy and programme interventions in the region. Data on 3500 sex workers, 1500 from 1997 and 2000 from the year 2000, were analysed. The samples represented sex workers in low socioeconomic neighbourhoods who met their clients at known sex establishments or by the roadside. Sex workers were more likely to have used condoms consistently in 2000 than in 1997 (Odds Ratio (OR) = 1.4, p < or = 0.05). Sex workers who discussed condoms with their partners or lovers used them consistently with all clients more than those who did not (OR = 1.3, p < or = 0.10). Knowledge of condom advantages had a positive influence on consistent use. Sex workers who reported using condoms to prevent pregnancy or STDs used them consistently with all clients more than those who did not (OR = 1.2, and 1.3 respectively, p < or = 0.10). The source of condoms is an important predictor of consistent condom use. Sex workers who bought condoms from health establishments or from brothels used them consistently more than those who did not (both OR = 1.3, p < or = 0.10, and p < or = 0.05, respectively). Self-efficacy had a positive effect on consistent condom use. Sex workers who reported that they would use condoms even if clients offered to pay more for unprotected sex used them consistently with all clients more than those who did not (OR = 18, p < or = 0.001). The findings suggest that having condom skill is positively related to condom use. Sex workers who had all four skills used condoms more consistently than those who had none (OR = 1.6, p < or = 0.01). In order to increase consistent condom use and avert more incidences of HIV/AIDS and other STIs, programme interventions need to use the most efficient way to provide quality information, and provide repeated training on condom negotiation and use skills to sex workers. PMID:16082856
Oladosu, Muyiwa
The tide cannot be turned without us: sex workers and the global response to HIV.
Improved knowledge, better programmes and policies, effective treatment and other scientific developments have reduced levels of new HIV infections globally. Evidence shows that programmes that prevent HIV among sex workers and their clients are most successful when all aspects of vulnerability are addressed and when they are underpinned by policy that advances human rights. This is particularly important in the context of the introduction of antiretroviral-based HIV prevention, which could have harmful consequences if not well planned. In this context, law and policy on sex work should not be limited to aiming to deliver medicine and services to sex workers in dangerous working conditions. A high-priority aim should be to ensure that the law enables commercial sex to take place in the safest possible conditions. To achieve this, the meaningful involvement of sex workers at all levels of the response is crucial. However, although that has been recognized in theory, it has not been achieved in practice. PMID:23993060
Overs, Cheryl; Loff, Bebe
Suicidal Behavior Among Female Sex Workers in Goa, India: The Silent Epidemic
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.
Wayal, Sonali; Cowan, Frances; Mabey, David; Copas, Andrew; Patel, Vikram
Health outcomes among women trafficked for sex in the United States: a closer look.
Human trafficking is recognized as a major public health problem and a tragic transnational crime. Little is known about the health outcomes of victims of human trafficking. This study identifies the relationship of risk factors to physical, sexual, and mental health outcomes in three groups of women (N = 38) exploited for sex in the United States: international trafficking victims, domestic trafficking victims, and nontrafficked sex workers. To date this is the first study to examine the impact of risk factors on health outcomes using a sample of women trafficked for sex in the United States that includes both domestic and international victims. Overall, findings suggest that the experiences in sex work of domestic trafficking victims were dissimilar to those of international trafficking victims. Moreover, domestic trafficking victims displayed poorer health outcomes compared to international trafficking victims. In terms of risk factors, a higher percentage of women involved in street prostitution reported sexual health problems, co-occurring health issues, and addiction. Childhood physical/sexual victimization was related to poor physical health. PMID:23295378
Muftic, Lisa R; Finn, Mary A
Medical, demographical and social aspects of syphilis: the case of infected sex workers in Greece during Interwar.
The aim of this research is to present syphilis among women described as "indecent" according to the records of the Venereal Diseases Hospital "Andreas Syggros", which is located in Athens, during the period 1931-1935. In impoverished Greece of the Interwar period, factors such as criminal ignorance, or lack of information on sexually transmitted diseases (STDs) along with inadequate health controls of sex workers, resulted in a dramatic spread of syphilis, whereas "Andreas Syggros" hospital accommodated thousands of patients. The inflow of 1.300.000 Greek refugees from Asia Minor, after the Greek defeat by the Turkish army in the war of 1922, resulted in a notable change in the demographics of the country, while the combination of miserable living conditions, unemployment, economic crisis of the Interwar period, political instability and dysfunction of the State led to an increased number of illegal sex workers and syphilis outbreaks. Despite the introduction of an ad hoc Act to control STDs since 1923, the State was unable to limit the transmissibility of syphilis and to control prostitution. Unfortunately, the value of this historical paradigm is borne out by a contemporary example, i.e. the scandal of HIV seropositive sex workers in -beset by economic crisis- Greece in May 2012. It turns out that ignorance, failure to comply with the law, change in the mentality of the citizens in an economically ruined society, and most notably dysfunction of public services during periods of crisis, are all risk factors for the spread of serious infectious diseases. PMID:25068236
Pagratis, N; Tsiamis, C; Mandyla, M; Bampounis, C; Anoyatis-Pele, D
HIV Infection, Syphilis, and Behavioral Risks in Brazilian Male Sex Workers
To describe the epidemiology of HIV and syphilis infection and sexual practices among male sex workers, we studied 434 transvestites and 96 �hustlers� recruited by peers in the metropolitan area of S�o Paulo, Brazil, from 1992 to 1998. Participants were young adults with low education levels who had recently immigrated to S�o Paulo and supported themselves primarily through sex work.
Jo�o Luiz Grandi; Samuel Goihman; Mirtes Ueda; George W. Rutherford
Developing human rights-based strategies to improve health among female sex workers in Rwanda.
How governments should address sex work is a topic of current debate in Rwanda and other countries. Some constituencies propose harsher punishment of sex workers as the cornerstone of an improved policy. We argue that an adequate policy response to sex work in the Rwandan context must prioritize public health and reflect current knowledge of the social determinants of health. This does not imply intensified repression, but a comprehensive agenda of medical and social support to improve sex workers' access to health care, reduce their social isolation, and expand their economic options. Evidence from social epidemiology converges with rights-based arguments in this approach. Recent field interviews with current and former sex workers strengthen the case, while highlighting the need for further social scientific and epidemiological analysis of sex work in Rwanda. Rwanda has implemented some measures that reflect a rights-based perspective in addressing sex work. For example, recent policies seek to expand access to education for girls and support sex workers in the transition to alternative livelihoods. These policies reinforce the model of solidarity-based public health action for which Rwanda has been recognized. Whether such measures can maintain traction in the face of economic austerity and ideological resistance remains to be seen. PMID:21178192
Binagwaho, Agn�s; Agbonyitor, Mawuena; Mwananawe, Aimable; Mugwaneza, Placidie; Irwin, Alec; Karema, Corine
Opportunities for Woman-Initiated HIV Prevention Methods among Female Sex Workers in Southern China
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
Maryann Abbott; Susu Liao; Wang Yu; Bin He; Yuejiang Zhou; Liu Wei; Jingmei Jiang
'We are despised in the hospitals': sex workers' experiences of accessing health care in four African countries.
Sex workers in east and southern Africa are exposed to multiple occupational health and safety risks. Detailed understanding of barriers to accessing care would optimise design of improved services for this population. In this study, trained sex workers conducted 55 in-depth interviews and 12 focus group discussions with 106 female, 26 male and 4 transgender sex workers across 6 urban sites in Kenya, Zimbabwe, Uganda and South Africa. Data were analysed thematically, following an interpretive framework. Participants cited numerous unmet health needs, including diagnosis and treatment for sexually transmitted infections and insufficient access to condoms and lubricant. Denial of treatment for injuries following physical assault or rape and general hostility from public-sector providers was common. Resources permitting, many sex workers attended private services, citing higher quality and respect for dignity and confidentiality. Sex workers in southern Africa accessed specialised sex worker clinics, reporting mostly positive experiences. Across sites, participants called for additional targeted services, but also sensitisation and training of public-sector providers. Criminalisation of sex workers and associated stigmatisation, particularly of transgender and male sex workers, hinder HIV-prevention efforts and render access to mainstream healthcare precarious. Alongside law reform, sex worker-led peer outreach work should be strengthened and calls by sex workers for additional targeted services heeded. PMID:23414116
Scorgie, Fiona; Nakato, Daisy; Harper, Eric; Richter, Marlise; Maseko, Sian; Nare, Prince; Smit, Jenni; Chersich, Matthew
Women, sex and marriage. Restraint as a feminine strategy.
The expression of sexuality varies in different cultures, and most societies attempt to control sexuality through the institution of marriage. In the West, the availability of cheap, effective contraceptives separated sex from reproduction and promoted the sexual liberation of women. Today, while divorce is common, sexually liberated people nevertheless engage in a form of serial monogamy. Sexual liberation in the West causes women to be exploited by men and creates instability in nuclear families. In India, feminism is tempered by a belief that familial rights have precedence over individual rights. India women practice sexual self-denial after being widowed to protect their children and to gain power and respect in the community. The power of chastity was illustrated by Mahatma Gandhi who marshalled his spiritual forces to fight for independence. The stories of many individual women illustrate how they attain status and prestige through chastity. Other women maintain absolute marital faithfulness as a marital strategy to control wayward husbands. These women deemphasize their roles as wives and emphasize their roles as mothers. The children of such women often recognize their sacrifices and become their strongest allies. On the other hand, examples of women who have chosen sexual freedom show that such a choice places them at the mercy of men, makes them social outcasts, and causes other women to distrust them as competitors for their husbands. In patriarchal societies, women can not win if they try to mimic men's capacity for irresponsible sex. Sexual freedom can only work for women in matrilineal communities that shun marriage in favor of strong ties within a woman's natal family. Indian women rooted in the extended family enjoy the resilience and flexibility attendant upon playing a larger role than simply pleasing men. Opting for sexual restraint can be an effective though costly strategy to achieve the sympathy and support of an extended family when a man is being sexually irresponsible. PMID:12348107
Kishwar, M
Cervical human papillomavirus infection among female sex workers in southern Vietnam
Background Cervical cancer is the most frequently diagnosed malignancy among women in southern Vietnam where its incidence is one of the highest observed worldwide. Results Cervical HPV DNA infection was measured in a cross-sectional sample of 282 female sex workers (FSW) in Soc Trang province in southern Vietnam. HPV DNA was detected in 85% of FSW and prevalence did not vary by age. Thirty-five HPV genotypes were detected; HPV 52 was the most common type. Half of HPV-positive women were infected with oncogenic types and 37% were infected with multiple genotypes. The prevalence of oncogenic HPV infection was lower among FSW with more formal education (adj. prevalence ratio = 0.63, 95% CI 0.42�0.93), those servicing 25 or more clients per month (adj. PR = 0.66 95% CI 0.48�0.92), and those engaging in withdrawal prior to ejaculation (adj. PR = 0.68, 95% CI 0.53�0.87). Oncogenic HPV prevalence was higher among FSW with regular male partners who had other female partners (adj. PR = 1.75, 95% CI 1.34�2.28) and FSW who were HIV+ (adj. PR = 1.42, 95% CI 1.08�1.88). Conclusion Our results demonstrate that although cervical HPV infection is extremely common among FSW in southern Vietnam, prevalence varies by education level, sexual activity, habits of regular partners, and HIV status.
Hernandez, Brenda Y; Vu Nguyen, Thuong
Utilisation of sexual health services by female sex workers in Nepal
Background The Nepal Demographic Health Survey (NDHS) in 2006 showed that more than half (56%) of the women with sexually transmitted infections (STIs), including HIV, in Nepal sought sexual health services. There is no such data for female sex workers (FSWs) and the limited studies on this group suggest they do not even use routine health services. This study explores FSWs use of sexual health services and the factors associated with their use and non-use of services. Methods This study aimed to explore the factors associated with utilisation of sexual health services by FSWs in the Kathmandu Valley of Nepal, and it used a mixed-method approach consisting of an interviewer administered questionnaire-based survey and in-depth interviews. Results The questionnaire survey, completed with 425 FSWs, showed that 90% FSWs self-reported sickness, and (30.8%) reported symptoms of STIs. A quarter (25%) of those reporting STIs had never visited any health facilities especially for sexual health services preferring to use non-governmental clinics (72%), private clinics (50%), hospital (27%) and health centres (13%). Multiple regression analysis showed that separated, married and street- based FSWs were more likely to seek health services from the clinics or hospitals. In- depth interviews with 15 FSWs revealed that FSWs perceived that personal, structural and socio-cultural barriers, such as inappropriate clinic opening hours, discrimination, the judgemental attitude of the service providers, lack of confidentiality, fear of public exposure, and higher fees for the services as barriers to their access and utilisation of sexual health services. Conclusion FSWs have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints. The 'education' to change individual behaviour, health worker and community perceptions, as well as the training of the health workers, is necessary.
A systematic review of the correlates of violence against sex workers.
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
Deering, Kathleen N; Amin, Avni; Shoveller, Jean; Nesbitt, Ariel; Garcia-Moreno, Claudia; Duff, Putu; Argento, Elena; Shannon, Kate
Prevalence and correlates of sexual risk among male and female sex workers in Tijuana, Mexico.
We investigated prevalence and correlates of sexual risk behaviours among male and female sex workers in Tijuana, Mexico, the busiest border crossing area on the US - Mexico border, analysing survey data from a purposive, cross-sectional sample of male and female sex workers who worked in a range of indoor and outdoor settings. Logistic regression was used to determine factors that were associated with sexual risk-taking, defined as failing to use a condom with last client. In bivariate regression models, gender, work setting (e.g., indoor vs. outdoor), poverty, engaging in survival sex, marital status and perceived drug addiction were correlated with sexual risk. When controlling for work location, housing insecurity, poverty, survival sex, marital status and perceived drug addiction, male sex workers were still 10 times more likely than female sex workers (FSW) to engage in sex without a condom during their last encounter with a client. And, although FSW were significantly more likely than males to have used a condom with a client, they were significantly less likely than males to have used a condom with their regular partner. Future research should further examine how gender shapes sexual risk activities in both commercial and non-commercial relationships. PMID:22304493
Katsulis, Yasmina; Durfee, Alesha
Sexual and physical violence against female sex workers in Kenya: a qualitative enquiry.
Few studies in Africa provide detailed descriptions of the vulnerabilities of female sex workers (FSW) to sexual and physical violence, and how this impacts on their HIV risk. This qualitative study documents FSW's experiences of violence in Mombasa and Naivasha, Kenya. Eighty-one FSW who obtained clients from the streets, transportation depots, taverns, discos and residential areas were recruited through local sex workers trained as peer counsellors to participate in eight focus-group discussions. Analysis showed the pervasiveness of sexual and physical violence among FSW, commonly triggered by negotiation around condoms and payment. Pressing financial needs of FSW, gender-power differentials, illegality of trading in sex and cultural subscriptions to men's entitlement for sex sans money underscore much of this violence. Sex workers with more experience had developed skills to avoid threats of violence by identifying potentially violent clients, finding safer working areas and minimising conflict with the police. Addressing violence and concomitant HIV risks and vulnerabilities faced by FSW should be included in Kenya's national HIV/AIDS strategic plan. This study indicates the need for multilevel interventions, including legal reforms so that laws governing sex work promote the health and human rights of sex workers in Kenya. PMID:21390890
Okal, Jerry; Chersich, Matthew F; Tsui, Sharon; Sutherland, Elizabeth; Temmerman, Marleen; Luchters, Stanley
Indian men's use of commercial sex workers: prevalence, condom use, and related gender attitudes
Background/Objectives Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past-year CSW contact, condom non-use therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. Methods The nationally representative Indian National Family Health Survey-3 (NFHS-3) was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past-year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past-year CSW contact and inconsistent condom use. Results Approximately 1 in 100 ( 0.9%) Indian men reported past-year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never-married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (AOR=1.64; 95% CI 1.24, 2.17) and justification of violence against wives (AOR=1.41; 95% CI 1.03, 1.93). Conclusions Men's past-year CSW contact was concentrated among young and unmarried Indian men; condom non-use with CSWs was common. Traditional gender ideologies appeared to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk sub-populations and indicating that gender ideologies should be addressed.
Decker, Michele R.; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G.
Characterization of Vaginal Flora and Bacterial Vaginosis in Women Who Have Sex with Women
Bacterial vaginosis (BV) may be common among women who report having sex with women (WSW) and frequently occurs in both members of monogamous couples. The results of Gram staining of a vaginal smear were consistent with BV in 81 (25%) and intermediate in 37 (11%) of 326 WSW included in this study. Lactobacilli were detected in 64% of subjects, and
Kathy Agnew; Kathleen Stine
Understanding STI Risk and Condom Use Patterns by Partner Type Among Female Sex Workers in Peru
While brothel-based sex work is regulated by the Peruvian government, there is little data on STI risk factors reported by female sex workers (FSW). This study compared high risk behaviors among 120 Peruvian FSW from government regulated brothels with both clients and non-commercial partners. Our study found that 12% of FSW reported unprotected vaginal sex with clients (compared to 75% with non-commercial partners), and 42% reported unprotected anal sex with clients (compared to 87% with non-commercial partners). Group differences were observed in the expectation to have oral sex (32% for partners vs 60% for clients; p<0.01), and a history of anal sex (65% for partners vs 32% for clients; p<0.01) and both vaginal and anal sex with the same partners (46% for partners vs 25% for clients; p<0.001). These findings suggest that FSW constitute an important bridge population for STI/HIV transmission in Peru.
Kinsler, Janni J; Blas, Magaly M; Cabral, Alejandra; Carcamo, Cesar; Halsey, Neal; Brown, Brandon
A Study of the Sex Role Attitudes of Incarcerated Juvenile Delinquents toward Women.
ERIC Educational Resources Information Center
Examined sex-role attitudes toward women of incarcerated White male (n=30) and Black male (n=30) juvenile delinquents. Found significant differences in sex role attitudes toward women between first-born and later-born juvenile delinquents and sex role attitudes toward women relative to available norms. (Author/CM)
Roundtree, George A.; And Others
Sex with women among men who have sex with men in China: prevalence and sexual practices.
Men who have sex with men and women (MSMW) are a potential bridge population for transmitting HIV to heterosexual women. This study assessed key characteristics of this subgroup of men who have sex with men (MSM) in China. Of 1141 eligible MSM, 45.6% reported bisexual behaviors. Besides marriage as a strong predictor (odds ratio: 23.90, 95% confidence interval: 14.29-39.98), older age (1.12, 1.10-1.15) and lower education (or no college education) (1.98, 1.52-2.59) were also independently associated with having ever had sex with women. MSMW reported higher proportions of alcohol drinking, heterosexual/bisexual orientation, and preference for an insertive role in anal sex than men who had sex with men only; but there was no statistically significant difference between two groups in prevalence of HIV and syphilis infections and in history of sexually transmitted infections. HIV prevention intervention programs should break the bridging role of HIV transmission in MSMW population. PMID:23931683
Tao, Jun; Ruan, Yuhua; Yin, Lu; Vermund, Sten H; Shepherd, Bryan E; Shao, Yiming; Qian, Han-Zhu
Alcohol use and client-perpetrated sexual violence against female sex workers in China
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.
Zhang, Chen; Li, Xiaoming; Stanton, Bonita; Hong, Yan; Chen, Yiyun; Shan, Qiao; Liu, Wei; Zhou, Yuejiao
Have sex will travel: romantic �sex tourism� and women negotiating modernity in the Sinai
Since the 1970s, studies on western women's ethnosexual tourist�local relationships have tended to focus on the beaches of the Caribbean and have come to one of two main conclusions � either they are no different from the overtly exploitative relationships of heterosexual male sex tourists or they are different because they involve a softer, caring element of romance. This article
Jessica Jacobs
Drug use and risk behaviours among injecting drug users: a comparison between sex workers and non-sex workers in Sydney, Australia
Background This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU) who report engaging in sex work for money or drugs and regular injecting drug users who do not. Methods Cross sectional data collected from regular IDU interviewed as part of the New South Wales (NSW) Illicit Drug Reporting System (IDRS) in 2003 were analysed. Results IDU who reported engaging in sex work were more likely to be female, and identify as being of Aboriginal and/or Torres Strait Islander descent. They initiated injecting drug use at a significantly younger age and were more likely to report injection related problems than IDU who had not engaged in sex work. There were no differences in the drug classes used, but findings suggested that the sex workers tended to be more frequent users of crystalline methamphetamine (ice) and benzodiazepines. Conclusion The similarities between these groups were more striking than the differences. Further research, examining a larger sample is needed to clarify whether injecting drug users who are sex workers have heavier use patterns.
Roxburgh, Amanda; Degenhardt, Louisa; Breen, Courtney
Sex Ratio and Women's Career Choice: Does a Scarcity of Men Lead Women to Choose Briefcase Over Baby?
Although the ratio of males to females in a population is known to influence behavior in nonhuman animals, little is known about how sex ratio influences human behavior. We propose that sex ratio affects women's family planning and career choices. Using both historical data and experiments, we examined how sex ratio influences women's career aspirations. Findings showed that a scarcity
Kristina M. Durante; Vladas Griskevicius; Jeffry A. Simpson; Stephanie M. Cant�; Joshua M. Tybur
Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: a national population-based survey
Summary Background We assessed prevalences of seven sexually transmitted infections (STIs) in Peru, stratified by risk behaviours, to help to define care and prevention priorities. Methods In a 2002 household-based survey of the general population, we enrolled randomly selected 18�29-year-old residents of 24 cities with populations greater than 50?000 people. We then surveyed female sex workers (FSWs) in these cities. We gathered data for sexual behaviour; vaginal specimens or urine for nucleic acid amplification tests for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; and blood for serological tests for syphilis, HIV, and (in subsamples) herpes simplex virus 2 (HSV2) and human T-lymphotropic virus. This study is a registered component of the PREVEN trial, number ISRCTN43722548. Findings 15?261 individuals from the general population and 4485 FSWs agreed to participate in our survey. Overall prevalence of infection with HSV2, weighted for city size, was 13�5% in men, 13�6% in women, and 60�6% in FSWs (all values in FSWs standardised to age composition of women in the general population). The prevalence of C trachomatis infection was 4�2% in men, 6�5% in women, and 16�4% in FSWs; of T vaginalis infection was 0�3% in men, 4�9% in women, and 7�9% in FSWs; and of syphilis was 0�5% in men, 0�4% in women, and 0�8% in FSWs. N gonorrhoeae infection had a prevalence of 0�1% in men and women, and of 1�6% in FSWs. Prevalence of HIV infection was 0�5% in men and FSWs, and 0�1% in women. Four (0�3%) of 1535 specimens were positive for human T-lymphotropic virus 1. In men, 65�0% of infections with HIV, 71�5% of N gonorrhoeae, and 41�4% of HSV2 and 60�9% of cases of syphilis were in the 13�3% who had sex with men or unprotected sex with FSWs in the past year. In women from the general population, 66�7% of infections with HIV and 16�7% of cases of syphilis were accounted for by the 4�4% who had been paid for sex by any of their past three partners. Interpretation Defining of high-risk groups could guide targeting of interventions for communicable diseases�including STIs�in the general Peruvian population. Funding Wellcome Trust-Burroughs Wellcome Fund Infectious Disease Initiative and US National Institutes of Health.
Carcamo, Cesar P; Campos, Pablo E; Garcia, Patricia J; Hughes, James P; Garnett, Geoff P; Holmes, King K
A Profile of HIV Risk Factors in the Context of Sex Work Environments among Migrant Female Sex Workers in Beijing, China
Migrant female sex workers (FSWs) are one of the most at-risk populations for HIV in China. This study demonstrates how multiple risk factors are situated and vary by types of sex work environments in a sample of 348 migrant FSWs in Beijing. Participants reported high rates of clients' refusal to use condoms (76%), unsafe sex with both clients (32%), non-paid regular partners (e.g., boyfriend or husband) (76%), and a STI symptom (79%) last year. Only 22% of FSWs had been tested for HIV. Risk factors were compared by three types of sex work environments: (1) entertainment establishments, (2) personal services sectors, and (3) street-based venues, including roadside brothels. Street-based FSWs, compared to the other FSWs, were more likely to be older, married with children, migrate from rural areas, and be arrested by police, and less likely to be educated, have contact with prevention services, be knowledgeable about HIV, and be tested for HIV. The FSWs in entertainment establishments were more likely than street-based FSWs to have reported being physically, verbally, and/or sexually abused by clients. Multiple discriminant analysis distinguished a profile of two different groups of risk factors: (1) police arrest, lack of protection from violence, access to prevention and health care, and HIV knowledge, and (2) verbal and physical abuse and clients' refusal of condom use. In the massive internal migration in China, disadvantages in economic sectors drive women to become involved in sex work. HIV prevention strategies must target socio-structural factors embedded in sex work environments.
Yi, Huso; Mantell, Joanne E.; Wu, Rongrong; Lu, Zhao; Zeng, Jing; Wan, Yanhai
High-Risk Human Papillomavirus Is Associated with HIV Acquisition among South African Female Sex Workers
Background. Mounting evidence suggests an association between human papillomavirus (HPV) and HIV acquisition. This study aimed to explore this association among South African female sex workers (FSWs). Methods. We used data from 88 HIV-negative FSWs who participated in a vaginal gel (COL-1492) trial. Cervicovaginal rinse samples, obtained before HIV-seroconversion, were genotyped into high-risk (HR-) and low-risk (LR-) HPV. HIV-adjusted hazard ratios (aHRs) and 95% confidence intervals (CI) were estimated using Cox survival analysis. Results. HR- and LR-HPV prevalences were 70.5% (95% CI?:?60.5�79.2) and 60.2% (95% CI?:?49.9�70.0), respectively. Twenty-five women HIV seroconverted. Controlling for background characteristics and other sexually transmitted infections, HIV aHR increased by a factor of 1.7 (95% CI?:?1.01�2.7, Plinear trend = 0.045) for an increase of one unit of the number of HR-HPV genotypes. Conclusions. HIV seroconversion among FSWs is associated with genital HR-HPV infection. Further investigation is warranted, including testing the possible protective effect of available HPV vaccines on HIV acquisition.
Auvert, Bertran; Marais, Dianne; Lissouba, Pascale; Zarca, Kevin; Ramjee, Gita; Williamson, Anna-Lise
Induced abortion, contraceptive use, and dual protection among female sex workers in Moscow, Russia
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.
Decker, Michele R.; Yam, Eileen A.; Wirtz, Andrea L.; Baral, Stefan D.; Peryshkina, Alena; Mogilnyi, Vladmir; Beyrer, Chris
Women and Sex at Midlife: Desire, Dysfunction, and Diversity
Arewomen likely to experience more sexual and relationship satisfaction in midlife than in earlier periods of their lives?\\u000a Which women are, and why? Does a woman experience heterosexual partner sex more positively when she is no longer responsible\\u000a for birth control or parenting? In what ways, if any, do the sexual relations of aging lesbians improve over time? Arewomen\\u000a who
Maureen C. McHugh
HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia
Objectives: To establish the prevalence of HIV, syphilis, and sexual risk behaviour among three groups of men who have sex with men in Jakarta, Indonesia, and to investigate sexual links between these men and broader heterosexual populations.Methods: Anonymous, cross sectional surveys among community recruited transgender and male sex workers and self recognised men who have sex with men (MSM) were
E Pisani; P Girault; M Gultom; N Sukartini; J Kumalawati; S Jazan; E Donegan
Predictors of Unsafe Sex among At-Risk Heterosexual Women
Despite widespread intervention efforts to curtail the spread of HIV, heterosexual transmission of HIV continues to drive the HIV/AIDS epidemic in the United States, especially among women. Research has shown that knowledge about HIV and AIDS is relatively great, even among persons who engage in high rates of risky sexual behaviors. This begs the question: What characteristics underlie and are predictive of involvement in unprotected sex? The objective of this paper is to examine the factors that are associated with engaging in unprotected sex in a population of urban, at-risk, heterosexually-active women. Conceptually, the research is guided by the notion of understanding risk and, theoretically, by the Theory of Gender and Power. Face-to-face structured interviews were conducted with 178 sexually active adult at-risk heterosexual women in Atlanta, Georgia. Street outreach efforts were used to identify potential study participants, and ethnographic mapping and targeted sampling procedures guided the recruitment process. Using a multivariate path analysis approach, three factors�marital status, having two drug-abusing parents, and negative attitudes toward condom use�were identified as predictors of unsafe sex. Further exploration of the latter measure yielded two factors that were statistically-significant multivariate predictors of attitudes toward using condoms: age and self-esteem level. Structural equation modeling was used to assess the fit of a risk-prediction model containing all of these measures, and it was shown to be supported quite strongly by the data.
Elifson, Kirk W.; Klein, Hugh; Sterk, Claire E.
HIV, HBV, and HCV molecular epidemiology among trans (transvestites, transsexuals, and transgender) sex workers in Argentina.
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
Carobene, Mauricio; Bolcic, Federico; Far�as, Mar�a Sol Dos Ramos; Quarleri, Jorge; Avila, Mar�a Mercedes
Clients of sex workers in different regions of the world: hard to count
Objectives To estimate the proportion of the male population that reports having paid for sex in different regions. Methods Clients of sex workers were identified from representative samples of men asked in face?to?face interviews whether they had had sex in exchange for money or whether they had paid for sex, in the last 12?months. A total of 78 national household surveys and nine city based surveys were selected for inclusion. Where such surveys were not available, results of behavioural surveillance surveys and of research studies were also used. Using national estimates, a median percentage of men who reported paying for sex was calculated for each region. Results The median percentage of men who exchanged sex for money in the last 12?months in all regions was around 9�10%, with estimates from 13% to 15% in Central African region, 10 to 11% in Eastern and southern Africa, and 5�7% in Asia and Latin America. Estimates for men who paid sex were much lower at around 2�3% with ranges from 7% in the South African region to 1% in Asia and West Africa. Conclusions Although errors of measurement and critical issues of definitions and interpretation exist, this compilation represents a first attempt to obtain reasonably coherent estimates of the proportion of men who were clients of sex workers at regional level. Large discrepancies between regions were found. Further improvements in national estimates will be critical to monitor coverage of HIV prevention programmes for sex workers and clients, and to improve estimates of national HIV infection prevalence levels in low and concentrated HIV epidemics.
Carael, M; Slaymaker, E; Lyerla, R; Sarkar, S
Molecular definition of vaginal microbiota in East African commercial sex workers.
Resistance to HIV infection in a cohort of commercial sex workers living in Nairobi, Kenya, is linked to mucosal and antiinflammatory factors that may be influenced by the vaginal microbiota. Since bacterial vaginosis (BV), a polymicrobial dysbiosis characterized by low levels of protective Lactobacillus organisms, is an established risk factor for HIV infection, we investigated whether vaginal microbiology was associated with HIV-exposed seronegative (HESN) or HIV-seropositive (HIV(+)) status in this cohort. A subset of 44 individuals was selected for deep-sequencing analysis based on the chaperonin 60 (cpn60) universal target (UT), including HESN individuals (n = 16), other HIV-seronegative controls (HIV-N, n = 16), and HIV(+) individuals (n = 12). Our findings indicate exceptionally high phylogenetic resolution of the cpn60 UT using reads as short as 200 bp, with 54 species in 29 genera detected in this group. Contrary to our initial hypothesis, few differences between HESN and HIV-N women were observed. Several HIV(+) women had distinct profiles dominated by Escherichia coli. The deep-sequencing phylogenetic profile of the vaginal microbiota corresponds closely to BV(+) and BV(-) diagnoses by microscopy, elucidating BV at the molecular level. A cluster of samples with intermediate abundance of Lactobacillus and dominant Gardnerella was identified, defining a distinct BV phenotype that may represent a transitional stage between BV(+) and BV(-). Several alpha- and betaproteobacteria, including the recently described species Variovorax paradoxus, were found to correlate positively with increased Lactobacillus levels that define the BV(-) ("normal") phenotype. We conclude that cpn60 UT is ideally suited to next-generation sequencing technologies for further investigation of microbial community dynamics and mucosal immunity underlying HIV resistance in this cohort. PMID:21531840
Schellenberg, John J; Links, Matthew G; Hill, Janet E; Dumonceaux, Tim J; Kimani, Joshua; Jaoko, Walter; Wachihi, Charles; Mungai, Jane Njeri; Peters, Geoffrey A; Tyler, Shaun; Graham, Morag; Severini, Alberto; Fowke, Keith R; Ball, T Blake; Plummer, Francis A
Molecular Definition of Vaginal Microbiota in East African Commercial Sex Workers ? �
Resistance to HIV infection in a cohort of commercial sex workers living in Nairobi, Kenya, is linked to mucosal and antiinflammatory factors that may be influenced by the vaginal microbiota. Since bacterial vaginosis (BV), a polymicrobial dysbiosis characterized by low levels of protective Lactobacillus organisms, is an established risk factor for HIV infection, we investigated whether vaginal microbiology was associated with HIV-exposed seronegative (HESN) or HIV-seropositive (HIV+) status in this cohort. A subset of 44 individuals was selected for deep-sequencing analysis based on the chaperonin 60 (cpn60) universal target (UT), including HESN individuals (n = 16), other HIV-seronegative controls (HIV-N, n = 16), and HIV+ individuals (n = 12). Our findings indicate exceptionally high phylogenetic resolution of the cpn60 UT using reads as short as 200 bp, with 54 species in 29 genera detected in this group. Contrary to our initial hypothesis, few differences between HESN and HIV-N women were observed. Several HIV+ women had distinct profiles dominated by Escherichia coli. The deep-sequencing phylogenetic profile of the vaginal microbiota corresponds closely to BV+ and BV? diagnoses by microscopy, elucidating BV at the molecular level. A cluster of samples with intermediate abundance of Lactobacillus and dominant Gardnerella was identified, defining a distinct BV phenotype that may represent a transitional stage between BV+ and BV?. Several alpha- and betaproteobacteria, including the recently described species Variovorax paradoxus, were found to correlate positively with increased Lactobacillus levels that define the BV? (�normal�) phenotype. We conclude that cpn60 UT is ideally suited to next-generation sequencing technologies for further investigation of microbial community dynamics and mucosal immunity underlying HIV resistance in this cohort.
Schellenberg, John J.; Links, Matthew G.; Hill, Janet E.; Dumonceaux, Tim J.; Kimani, Joshua; Jaoko, Walter; Wachihi, Charles; Mungai, Jane Njeri; Peters, Geoffrey A.; Tyler, Shaun; Graham, Morag; Severini, Alberto; Fowke, Keith R.; Ball, T. Blake; Plummer, Francis A.
The Effect of a Structural Intervention for Syphilis Control Among 3597 Female Sex Workers: A Demonstration Study in South China
Background.?Syphilis has made a rapid resurgence in China, especially among high-risk groups including female sex workers (FSWs). Methods.?Two cities in each of 3 provinces in South China were chosen and allocated to intervention or control arms. The intervention consisted of enhancing community-based syphilis screening outreach intervention with comprehensive sexually transmitted infection services at designated clinics while the control maintained routine intervention activities. Generalized linear modeling was used to examine effect of the intervention on incident syphilis infection. Results.?A total of 8275 women were eligible, and 3597 women enrolled (n�=�2011 in control arm, n�=�1586 in intervention arm) in the study. The median follow-up duration was 375 days (interquartile range, 267�475). Syphilis incidence density in the intervention group was reduced by 70% (95% confidence interval, 53%�81%) compared with the incidence in the control arm. The syphilis prevention intervention benefits were robust among FSWs at low-tier venues, individuals with less than high school education, migrants, and women who did not report condom use during the last episode of sex. Conclusions.?Integrated sexually transmitted infection and human immunodeficiency virus prevention strategies substantially reduce syphilis incidence among FSWs, especially among those at low-tier venues. This intervention suggests the need for scaling up comprehensive FSW programs in China.
Wang, Baoxi; Wang, Qian-Qiu; Yin, Yue-Ping; Liang, Guo-Jun; Jiang, Ning; Gong, Xiang-Dong; Yang, Bin; Zhou, Yue-Jiao; Liu, Qiao; Huan, Xi-Ping; Yang, Li-Gang; Tan, Guang-Jie; Pei, Dong-Nu; Tucker, Joseph D.; Chen, Xiang-Sheng
Behavior, knowledge, attitude, and other characteristics of men who had sex with female commercial sex workers in Kenya.
We examined sociodemographic characteristics, knowledge, behavior, and attitude of men who had sex with commercial sex workers (CSWs) in Kenya. About 15% of the men had sex with CSWs. Men who had two or more partners, were away from home five or more times in the past year, and used condoms consistently with their last three partners were likely to have had sex with CSWs (odds ratio [OR] = 2.70, p = .000; OR = 1.43, p = .044; OR = 2.50, p = .000, respectively). Men with better knowledge of HIV/AIDS prevention methods were likely to have had sex with CSWs (OR = 1.62, p = .004). As expected, having had sex with CSWs was associated with higher risk of sexually transmitted infection (OR = 3.62, p = .000). This unexpected association between knowledge and behavior could be bidirectional or reverse causality. Nonetheless, knowledge in prevention has not been translated to practice and change in behavior. These processes require continuous efforts, including assertive campaigns on sexual practices and behaviors. PMID:19477766
Hong, Rathavuth
Transactional sex risk across a typology of rural and urban female sex workers in Indonesia: a mixed methods study.
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
Puradiredja, Dewi Ismajani; Coast, Ernestina
Young Sex-Workers in Ho Chi Minh City Telling Their Life Stories
ERIC Educational Resources Information Center
In this study the life stories of 22 sex-workers (age 15-18 years) in Vietnam are organized into three thematic narratives depicting how the girls presented their lives. Poverty, lack of job alternatives and the responsibility to share in the support of their families led the girls into prostitution. Strong family ties gave many girls�
Rubenson, Birgitta; Hanh, Le Thi; Hojer, Bengt; Johansson, Eva
Age Differences among Female Sex Workers in the Philippines: Sexual Risk Negotiations and Perceived Manager Advice
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.
Urada, Lianne A.; Malow, Robert M.; Santos, Nina C.; Morisky, Donald E.
Demographic Correlates of Constant Condom Use among Sex Workers in Tangail, Dhaka, Bangladesh
ERIC Educational Resources Information Center
Consistent condom use, particularly by promiscuous individuals, is a major safeguard against sexually transmitted diseases, including HIV/AIDS. This study examines some demographic factors that may affect such use among Bangladeshi female commercial sex workers at a brothel in Tangail (n = 196; mean age = 23.44 years), and the streets of Dhaka (n�
Eva, Nilufar Akter; Munakata, Tsunetsugu; Onuoha, Francis N.
"Who Is Helsinki" Sex Workers Advise Improving Communication for Good Participatory Practice in Clinical Trials
ERIC Educational Resources Information Center
After premature closures in 2004 of biomedical human immunodeficiency virus (HIV) prevention trials involving sex workers in Africa and Asia, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Global Advocacy for HIV Prevention (AVAC) undertook consultations to establish better participatory guidelines for such trials in order to address�
Ditmore, Melissa Hope; Allman, Dan
Survival times of pre-1950 US women radium dial workers
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.
Stehney, A.F.
Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers?
Some quantitative behavioral studies in the USA have concluded that bisexually behaving Latino men are less likely than White men to disclose to their female partners that they have engaged in same-sex risk behavior and/or are HIV-positive, presumably exposing female partners to elevated risk for HIV infection. Nevertheless, very little theoretical or empirical research has been conducted to understand the social factors that promote or inhibit sexual risk disclosure among Latino men who have sex with men (MSM), and much of the existing literature has neglected to contextualize disclosure patterns within broader experiences of stigma and social inequality. This paper examines decisions about disclosure of sex work, same-sex behavior, and sexual risk for HIV among male sex workers in two cities in the Dominican Republic. Data derive from long-term ethnography and qualitative in-depth interviews with 72 male sex workers were used to analyze the relationships among experiences of stigma, social inequality, and patterns of sexual risk disclosure. Thematic analysis of interviews and ethnographic evidence revealed a wide range of stigma management techniques utilized by sex workers to minimize the effects of marginality due to their engagement in homosexuality and sex work. These techniques imposed severe constraints on men�s sexual risk disclosure, and potentially elevated their own and their female partners� vulnerability to HIV infection. Based on the study�s findings, we conclude that future studies of sexual risk disclosure among ethnic minority MSM should avoid analyzing disclosure as a decontextualized variable, and should seek to examine sexual risk communication as a dynamic social process constrained by hierarchical systems of power and inequality.
Padilla, Mark; Castellanos, Daniel; Guilamo-Ramos, Vincent; Reyes, Armando Matiz; Sanchez Marte, Leonardo E.; Soriano, Martha Arredondo
Characterization of vaginal flora and bacterial vaginosis in women who have sex with women.
Bacterial vaginosis (BV) may be common among women who report having sex with women (WSW) and frequently occurs in both members of monogamous couples. The results of Gram staining of a vaginal smear were consistent with BV in 81 (25%) and intermediate in 37 (11%) of 326 WSW included in this study. Lactobacilli were detected in 64% of subjects, and 42% of subjects had H(2)O(2)-producing strains. BV was associated with a higher lifetime number of female sex partners, failure to always clean an insertive sex toy before use, and oral-anal sex with female partners. Neither recent douching nor sexual practices with male partners were associated with BV. Vaginal smears from each partner were concordant in 55 (95%) of 58 monogamous couples; BV was present in both partners in 16 couples (28%) (P<.001, compared with expected distribution). BV was common among subjects who did not douche, who did not have concurrent sex with male partners, or who did not have a new sex partner, which suggests that other risk factors for BV exist. These data support the hypothesis that sexual exchange of vaginal secretions is a possible mechanism for acquisition of BV. PMID:12001048
Marrazzo, Jeanne M; Koutsky, Laura A; Eschenbach, David A; Agnew, Kathy; Stine, Kathleen; Hillier, Sharon L
Sexual Debut of Young Black Women Who Have Sex with Women: Implications for STI/HIV Risk
ERIC Educational Resources Information Center
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�
Timm, Tina M.; Reed, Sarah J.; Miller, Robin Lin; Valenti, Maria T.
Sex Ratios, Economic Power, and Women's Roles: A Theoretical Extension and Empirical Test.
ERIC Educational Resources Information Center
Tested hypotheses concerning sex ratios, women's roles, and economic power with data from 111 countries. Found undersupply of women positively associated with proportion of women who marry and fertility rate; inversely associated with women's average age at marriage, literacy rate, and divorce rate. Suggests women's economic power may counteract�
South, Scott J.
Female sex workers incarcerated in New York City jails: prevalence of sexually transmitted infections and associated risk behaviors
Objectives Sexually transmitted infections (STIs) are an important cause of morbidity among incarcerated women and female sex workers (FSW). Little is known about FSW incarcerated in New York City (NYC) jails. We reviewed jail health records to identify the STI and HIV prevalence among newly incarcerated FSW in NYC jails. We also examined the relationship of demographics and self-reported clinical and risk behaviour history with FSW status and compared FSW with non-FSW incarcerated women to identify FSW predictors and, guide NYC jail programme planning and policy. Methods We retrospectively reviewed routinely collected jail health record data to identify the prevalence of chlamydia (Ct), gonorrhoea (Ng) and HIV infection among women newly incarcerated in NYC jails in 2009�2010 (study period) and studied the relationship of STIs, demographics and self-reported clinical and risk behaviour history with FSW status. Results During the study period, 10?828 women were newly incarcerated in NYC jails. Of these, 10?115 (93%) women were tested for Ct and Ng; positivity was 6.2% (95% CI 5.7% to 6.7%) and 1.7% (95% CI 1.4% to 1.9%), respectively. Nine percent had HIV infection. Seven hundred (6.5%) were defined as FSW. FSW were more likely to have Ct (adjusted OR (AOR): 1.55; 95% CI 1.17 to 2.05; p<0.0001) but not Ng or HIV. FSW were more likely to report age 20�24?years, reside in boroughs other than Manhattan, ?6 prior incarcerations, ?2 incarcerations during the study period, condom use with current sex partners, multiple sex partners and current drug use. Conclusions Women incarcerated in NYC jails had high rates of Ct, Ng, and HIV infection. FSW were at higher risk for Ct than non-FSW incarcerated women. These findings are being used to design targeted interventions to identify FSW, provide clinical and preventive services in jail and coordinate care with community partners.
Parvez, Farah; Katyal, Monica; Alper, Howard; Leibowitz, Ruth; Venters, Homer
Clients of sex workers in Switzerland: it makes sense to counsel and propose rapid test for HIV on the street, a preliminary report
BACKGROUND: Clients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. METHOD: This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. For
Esther-Am�lie Diserens; Patrick Bodenmann; Chantal N'Garambe; Anne Ansermet-Pagot; Marco Vannotti; Eric Masserey; Matthias Cavassini
Sex Hormone Binding Globulin and Sex Steroids Among Premenopausal Women in the Diabetes Prevention Program
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.
Pi-Sunyer, Xavier; Barrett-Connor, Elizabeth; Stentz, Frankie B.; Murphy, Mary Beth; Kong, Shengchun; Nan, Bin; Kitabchi, Abbas E.
Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator
Background Physical and sexual violence heighten STI/HIV risk for women in sex work. Against this backdrop, we describe the nature of abuse against women in sex work, and its STI/HIV implications, across perpetrators. Methods Adult women involved in sex work (n?=?35) in Baltimore, MD participated in an in-depth interview and brief survey. Results Physical and sexual violence were prevalent, with 43% reporting past-month abuse. Clients were the primary perpetrators; their violence was severe, compromised women�s condom and sexual negotiation, and included forced and coerced anal intercourse. Sex work was a factor in intimate partner violence. Police abuse was largely an exploitation of power imbalances for coerced sex. Conclusions Findings affirm the need to address physical and sexual violence, particularly that perpetrated by clients, as a social determinant of health for women in sex work, as well as a threat to safety and wellbeing, and a contextual barrier to HIV risk reduction.
Who are the preferential targets for intervention programs related to the female condom among sex workers in southern China?
The authors used a cluster analysis approach to investigate which female sex workers (FSW) are preferential targets for female condom (FC) intervention programs in southern China. Cross-sectional 6-month (N = 316) and 12-month (N = 217) postintervention surveys of FSW were analyzed. Based on FC attitudes and beliefs, initially suggesting FC use to a partner, practicing insertion, total times ever used, and willingness to use in the future, cluster analysis apportioned women into two clusters, with 50.6% and 58.1% of participants in the likely future FC users group at 6 months and 12 months, respectively. Likely future FC users tended to be from boarding houses, older, currently or previously married, experienced with childbirth, with current multiple sex partners, longer history of sex work, and more unprotected sexual encounters. Focusing FC programs on sectors of the community with more FSW who are likely to use FC may be more cost-effective for enhancing FC acceptability and usage. PMID:23837812
Wang, Yanhong; Liao, Susu; Jiang, Jingmei; Weeks, Margaret R; Nie, Li; Li, Jianghong; He, Bin; Zhou, Yuejiao; Li, Fei; Dunn, Jennifer; Zhang, Qingning
Understanding out-migration among female sex workers in South India
BACKGROUND Migrant sex workers are known to be vulnerable to HIV. There is substantial female sex worker (FSW) mobility between the borders of Maharashtra and Karnataka, but little programming emphasis on migrant FSWs in India. We sought to understand the individual/cultural, structural and contextual determinants of migration among FSWs from Karnataka. METHODS A cross sectional face-to-face interview of 1567FSWs from 142 villages in 3 districts of northern Karnataka, India was conducted from January�June 2008. Villages having 10+FSWs, a large number of whom were migrant, were selected following mapping of FSWs. Multinomial logistic regression was conducted to identify characteristics associated with migrant (travelled for ?2weeks outside the district past year) and mobile (travelled for <2weeks outside the district past year) FSWs; adjusting for age and district. RESULTS Compared to non-migrants, migrant FSWs were more likely to be brothel than street-based (AOR 5.7; 95%CI 1.6�20.0), have higher income from sex work (AOR 42.2; 12.6�142.1), speak >2languages (AOR 5.6%; 2.6�12.0), have more clients (AORper client 2.9; 1.2�7.2) and have more sex acts/day (AORper sex act 3.5; 1.3�9.3). Mobile FSWs had higher income from sex work (AOR=13.2; 3.9�44.6) relative to non-migrants, but not as strongly as for migrant FSWs. CONCLUSION Out-migration of FSWs in Karnataka was strongly tied to sex work characteristics; thus, the structure inherent in sex work should be capitalized on when developing HIV preventive interventions. The important role of FSWs in HIV epidemics, coupled with the potential for rapid spread of HIV with migration, requires the most effective interventions possible for mobile and migrant FSWs.
Banandur, Pradeep; Ramnaik, Satyanarayana; Manhart, Lisa E.; Buzdugan, Raluca; Mahapatra, Bidhubhushan; Isac, Shajy; Halli, Shiva S; Washington, Reynold G; Moses, Stephen; Blanchard, James F
Violence, condom breakage and HIV infection among female sex workers in Benin, West Africa
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.
Tounkara, Fatoumata K.; Diabate, Souleymane; Guedou, Fernand A.; Ahoussinou, Clement; Kintin, Frederic; Zannou, Djimon M.; Kpatchavi, Adolphe; Bedard, Emmanuelle; Bietra, Raphael; Alary, Michel
Prevalence and correlates of client-perpetrated abuse among female sex workers in two Mexico-u.s. Border cities.
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 (IPV), 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
Ulibarri, Monica D; Strathdee, Steffanie A; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L
Implementing for results: Program analysis of the HIV/STI interventions for sex workers in Benin
HIV response has entered a new era shaped by evidence that the combination of interventions impacts the trajectory of the epidemic. Even proven interventions, however, can be ineffective if not to scale, appropriately implemented, and with the right combination. Benin is among the pioneering countries that prioritized HIV prevention for sex workers and clients early on. Effective implementation up to 2006 resulted in consistent condom use among sex workers increasing from 39% to 86.2% and a decline in prevalence of gonorrhea from 5.4% to 1.6%. This study responds to the growing concern that, although proven interventions for female sex workers (FSWs) were expanded in Benin since 2008, indicators of coverage and behaviors are far from satisfactory. The quest to better understand implementation and how to render service delivery efficient and effective resonates with increased emphasis in the international arena on return for investments. Quantitative and qualitative methods were utilized to collect data. The output measured is the number of sex workers seeking Sexually Transmitted Infection (STI) care at user-friendly STI Clinics (SCs). Data were collected for 2010�2011 in nine regions of Benin. While recognizing that commitment to scale up is commendable, the study revealed deficiencies in program design and implementation that undermine outcomes. The selected mix of interventions is not optimal. Allocation of funds is not proportionate to the needs of FSW across regions. Only 5 of 41 SCs were fully functional at time of study. Free distribution of condoms covers only 10% of needs of FSWs. Funding and financing gaps resulted in extended interruptions of services. Successful HIV prevention in Benin will depend on the effective and efficient implementation of well-funded programs in sex work setting. Resources should be aligned to local sex work typology and presence in communities. A national framework defining an appropriate mix of interventions, management structure, referral mechanisms, and operational standards is required to guide rigorous implementation. Health services, in particular functional and user-friendly SCs coupled with mechanisms that link community-based work and health facilities should be strengthened to ensure STI care/anti-retroviral treatment expansion. Without leadership of sex workers, any attempt to end HIV will be unsuccessful.
Semini, Iris; Batona, Georges; Lafrance, Christian; Kessou, Leon; Gbedji, Eugene; Anani, Hubert; Alary, Michel
Vulnerabilities, health needs and predictors of high-risk sexual behaviour among female adolescent sex workers in Kunming, China
Objectives This study assessed social and behavioural predictors for sexual risk taking and sexually transmitted infections (STIs) including HIV among adolescent female sex workers (FSWs) from Kunming, China. Additionally, health services needs and use were assessed. Methods A cross-sectional survey was conducted in 2010. Using snowball and convenience sampling, self-identified FSWs were recruited from four urban areas in Kunming. Women consenting to participate were administered a semi-structured questionnaire by trained interviewers identified from local peer-support organisations. Following interview, a gynaecological examination and biological sampling to identify potential STIs were undertaken. Descriptive and multivariable logistic regression analyses were performed. Results Adolescent FSWs had a mean age of 18.2?years and reported numerous non-paying sexual partners with very low rate of consistent condom use (22.2%). Half (50.3%) the respondents had sex while feeling drunk at least once in the past week, of whom 56.4% did not use condom protection. STI prevalence was high overall (30.4%) among this group. Younger age, early sexual debut, being isolated from schools and family, short duration in sex work, and use of illicit drugs were found to be strong predictors for unprotected sex and presence of an STI. Conversely, having access to condom promotion, free HIV counselling and testing, and peer education were associated with less unprotected sex. The majority reported a need for health knowledge, free condoms and low-cost STI diagnosis and treatment. Conclusions There is an urgent need to improve coverage, accessibility and efficiency of existing interventions targeting adolescent FSWs.
Zhang, Xu-Dong; Temmerman, Marleen; Li, Yan; Luo, Wei; Luchters, Stanley
Use of barrier protection for sexual activity among women who have sex with women
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.
Rowen, Tami S.; Breyer, Benjamin N.; Lin, Tzu-Chin; Li, Chin-Shang; Robertson, Patricia A.; Shindel, Alan W.
Factors associated with drinking alcohol before visiting female sex workers among men in Sichuan Province, China
Alcohol use in commercial sex is highly prevalent globally and alcohol use in conjunction with sexual activity might increase the probability of risky behaviors, and. 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.
Yang, Cui; Latkin, Carl; Luan, Rongsheng; Nelson, Kenrad
"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
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.
Effects of hazardous and harmful alcohol use on HIV incidence and sexual behaviour: a cohort study of Kenyan female sex workers
Aims To investigate putative links between alcohol use, and unsafe sex and incident HIV infection in sub-Saharan Africa. Methods A cohort of 400 HIV-negative female sex workers was established in Mombasa, Kenya. Associations between categories of the Alcohol Use Disorders Identification Test (AUDIT) and the incidence at one year of unsafe sex, HIV and pregnancy were assessed using Cox proportional hazards models. Violence or STIs other than HIV measured at one year was compared across AUDIT categories using multivariate logistic regression. Results Participants had high levels of hazardous (17.3%, 69/399) and harmful drinking (9.5%, 38/399), while 36.1% abstained from alcohol. Hazardous and harmful drinkers had more unprotected sex and higher partner numbers than abstainers. Sex while feeling drunk was frequent and associated with lower condom use. Occurrence of condom accidents rose step-wise with each increase in AUDIT category. Compared with non-drinkers, women with harmful drinking had 4.1-fold higher sexual violence (95% CI adjusted odds ratio [AOR]?=?1.9-8.9) and 8.4 higher odds of physical violence (95% CI AOR?=?3.9-18.0), while hazardous drinkers had 3.1-fold higher physical violence (95% CI AOR?=?1.7-5.6). No association was detected between AUDIT category and pregnancy, or infection with Syphilis or Trichomonas vaginalis. The adjusted hazard ratio of HIV incidence was 9.6 comparing women with hazardous drinking to non-drinkers (95% CI?=?1.1-87.9). Conclusions Unsafe sex, partner violence and HIV incidence were higher in women with alcohol use disorders. This prospective study, using validated alcohol measures, indicates that harmful or hazardous alcohol can influence sexual behaviour. Possible mechanisms include increased unprotected sex, condom accidents and exposure to sexual violence. Experimental evidence is required demonstrating that interventions to reduce alcohol use can avert unsafe sex.
Sex work and risky sexual behaviors among foreign entertainment workers in urban Singapore: findings from Mystery Client Survey.
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
Wong, Mee-Lian; Chan, Roy; Tan, Hiok Hee; Yong, Eunice; Lee, Lionel; Cutter, Jeffrey; Tay, Joanne; Koh, David
Chinese Immigrant Women Workers' Mediated Negotiations With Constraints On Their Cultural Identities
Based on ethnographic fieldwork, this study examines the cultural identities of Chinese immigrant women workers in American society, that is, how the women negotiate with white supremacist cultural values that seek to interpellate them through their everyday use of media. I argue that through certain Chinese ethnic newspapers' cultural discourses, white supremacist cultural values penetrate the women's private lives and
Yu Shi
Prevalence and predictors of cervicitis in female sex workers in Peru: an observational study
Background Cervicitis is a syndrome of cervical inflammation and a common condition in female sex workers (FSW), a subpopulation vulnerable to sexually transmitted infections. Local data is essential for guiding syndromic management of cervicitis in FSW working in Peru. We sought to describe the prevalence and etiologies of cervicitis in this population. We also aimed to identify sociodemographic, behavioral and biological factors associated with cervicitis, including bacterial vaginosis (BV), a condition with a possible role in cervicitis. Methods FSW 18�years of age or older presenting to a free public sexual health clinic in Callao-Lima, Peru were eligible for inclusion upon consent. 467 participants completed a face-to-face questionnaire and underwent genital examination. Vaginal, endocervical and blood samples were collected and tested for C. trachomatis (CT), N. gonorrhea (GC), T. vaginalis (TV), BV, HIV and Human T-Cell Lymphotropic Virus ?1. Logistic regression was used to determine whether sociodemographic, behavioral, or other sexual health related characteristics were associated with the diagnosis of cervicitis. Results Cervicitis was detected in 99 (24.9%) of 397 FSW. The presence of cervicitis was unable to be determined in 70 participants. In women with cervicitis, CT was present in 4.6% (4/87), TV in 4.0% (4/99), GC in 0% (0/87) and no pathogen was detected on cervical microbiology in 91.9% (91/99). BV was detected on vaginal microbiology in 36.9% (31/84) of cervicitis cases. BV was more common in women with cervicitis, however this association did not reach statistical significance (aOR?=?1.47 [0.87, 2.48], p?=?0.15). Other STI were not associated with cervicitis. Regular clinic attendance (aOR?=?0.54 [0.34, 0.87], p?=?0.01) and Ecuadorian nationality (aOR?=?0.31 [0.13, 0.76], p?=?0.01) were associated with reduced risk of cervicitis. Conclusions Cervicitis was common in FSW working Peru and was predominantly nongonococcal and non-chlamydial in etiology. Further study is warranted to clarify the role of BV and other emerging cervicitis pathogens in this population. The current Peruvian program of free health checks for FSW may be effective for reducing rates of cervicitis. The protective effect of Ecuadorian nationality prompts further study.
Implications of PEPFAR's anti-prostitution pledge for HIV prevention among organizations working with sex workers.
Even though the United States President's Emergency Plan for AIDS Relief (PEPFAR) has facilitated access to treatment for people living with HIV/AIDS across the planet, sex workers are not as fortunate. In this article, based on an oral abstract presentation at AIDS 2010, Melissa Ditmore and Dan Allman present a case-story analysis of the implementation of PEPFAR's anti-prostitution pledge. PMID:21413636
Ditmore, Melissa; Allman, Dan
Young Sex-Workers in Ho Chi Minh City Telling Their Life Stories
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 connectedness; earning a well-needed income provided
Birgitta Rubenson; Le Thi Hanh; Bengt H�jer; Eva Johansson
Cost effectiveness of targeted HIV prevention interventions for female sex workers in India
ObjectiveTo ascertain the cost effectiveness of targeted interventions for female sex workers (FSW) under the National AIDS Control Programme in India.MethodsA compartmental mathematical Markov state model was used over a 20-year time horizon (1995�2015) to estimate the cost effectiveness of FSW targeted interventions, with a health system perspective. The incremental costs and effects of FSW targeted interventions were compared against
Shankar Prinja; Pankaj Bahuguna; Shalini Rudra; Indrani Gupta; Manmeet Kaur; S M Mehendale; Susmita Chatterjee; Samiran Panda; Rajesh Kumar
Mobilizing collective identity to reduce HIV risk among sex workers in Sonagachi, India: the boundaries, consciousness, negotiation framework.
The significantly low rate of HIV infection and high rate of condom use among sex workers in Kolkata, India is partially attributable to a community-led structural intervention called the Sonagachi Project which mobilizes sex workers to engage in HIV education, formation of community-based organizations and advocacy around sex work issues. This research examines how Sonagachi Project participants mobilize collective identity and the manner in which collective identity influences condom use. Using purposive sampling methods, 46 Sonagachi Project participants were selected in 2005 for in-depth qualitative interviews. Taylor and Whittier's (Taylor, V & Whittier, N (1992). Collective identities in social movement communities: lesbian feminist mobilization. In A. Morris & C. Mueller (Eds.) Frontiers in social movement theory. New Haven, CT: Yale University Press) model of identity-formation through boundaries, consciousness and negotiation was used to interpret results. Subjects mobilized collective identity by (1) building boundaries demarcating in-group sex workers from out-group members, (2) raising consciousness about sex work as legitimate labor and the transformative change that results from program participation, and (3) negotiating identity with out-group members. This research establishes a conceptual link between the boundaries, consciousness and negotiation framework of collective identity mobilization and condom use. Condom use among sex workers is motivated by each element of the boundaries, consciousness and negotiation model: condoms mark boundaries, enunciate the consciousness that sex with clients is legitimate labor, and help negotiate the identity of sex workers in interactions with clients. PMID:18455855
Ghose, Toorjo; Swendeman, Dallas; George, Sheba; Chowdhury, Debasish
Mobilizing collective identity to reduce HIV risk among sex workers in Sonagachi, India: The boundaries, consciousness, negotiation framework
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.
Ghose, Toorjo; Swendeman, Dallas; George, Sheba; Chowdhury, Debasish
Can rights stop the wrongs? Exploring the connections between framings of sex workers' rights and sexual and reproductive health
Background There is growing interest in the ways in which legal and human rights issues related to sex work affect sex workers� vulnerability to HIV and abuses including human trafficking and sexual exploitation. International agencies, such as UNAIDS, have called for decriminalisation of sex work because the delivery of sexual and reproductive health services is affected by criminalisation and social exclusion as experienced by sex workers. The paper reflects on the connections in various actors� framings between sex workers sexual and reproductive health and rights (SRHR) and the ways that international law is interpreted in policing and regulatory practices. Methods The literature review that informs this paper was carried out by the authors in the course of their work within the Paulo Longo Research Initiative. The review covered academic and grey literature such as resources generated by sex worker rights activists, UN policy positions and print and online media. The argument in this paper has been developed reflectively through long term involvement with key actors in the field of sex workers� rights. Results International legislation characterises sex work in various ways which do not always accord with moves toward decriminalisation. Law, policy and regulation at national level and law enforcement vary between settings. The demands of sex worker rights activists do relate to sexual and reproductive health but they place greater emphasis on efforts to remove the structural barriers that limit sex workers� ability to participate in society on an equal footing with other citizens. Discussion and conclusion There is a tension between those who wish to uphold the rights of sex workers in order to reduce vulnerability to ill-health and those who insist that sex work is itself a violation of rights. This is reflected in contemporary narratives about sex workers� rights and the ways in which different actors interpret human rights law. The creation of regulatory frameworks around sex work that support health, safety and freedom from abuse requires a better understanding of the broad scope of laws, policies and enforcement practices in different cultural contexts and economic settings, alongside reviews of UN policies and human rights conventions.
Chinese Sex-Role Conceptions: A Double Edged Sword for Women.
ERIC Educational Resources Information Center
Although Chinese government policies officially support the equality of the sexes, stereotyped views about the nature of men and women often serve to perpetuate discrimination and to keep women in inferior positions. Women are often segregated into lower paying jobs because of stereotypical views about what is natural for women to do. Despite�
Korabik, Karen
Low sex hormone�binding globulin is associated with the metabolic syndrome in postmenopausal women
Although an association between the metabolic syndrome and hyperandrogenism has been suggested in women with polycystic ovarian syndrome, few studies have investigated this relationship in postmenopausal women. We measured estradiol, testosterone, and sex hormone�binding globulin (SHBG) and calculated the free androgen index (FAI) in 212 postmenopausal women not using hormone therapy in the Women's Health Study. A modified definition of
Melissa E. Weinberg; JoAnn E. Manson; Julie E. Buring; Nancy R. Cook; Ellen W. Seely; Paul M. Ridker; Kathryn M. Rexrode
Seroincidence and Phylogeny of Human Immunodeficiency Virus Infections in a Cohort of Commercial Sex Workers in Montevideo, Uruguay.
National Technical Information Service (NTIS)
A cohort study involving 60 human immunodeficiency virus (HIV) negative male transvestite commercial sex workers (CSWs) was conducted in Montevideo, Uruguay in 1999 2001. Serum samples were tested for HIV by an enzyme-linked immunosorbent assay screening ...
D. Ruchansky J. Vinoles J. C. Russ M. Serra S. Sosa-Estani
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
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.
Suryawanshi, Dipak; Bhatnagar, Tarun; Deshpande, Sucheta; Zhou, Weiwei; Singh, Pankaj; Collumbien, Martine
Reducing intimate and paying partner violence against women who exchange sex in Mongolia: results from a randomized clinical trial.
Women who exchange sex for money or other goods, that is, female sex workers, are at increased risk of experiencing physical and sexual violence from both paying and intimate partners. Exposure to violence can be exacerbated by alcohol use and HIV/STI risk. The purpose of this study is to examine the efficacy of a HIV/STI risk reduction and enhanced HIV/STI risk reduction intervention at decreasing paying and intimate partner violence against Mongolian women who exchange sex and engage in harmful alcohol use. Women are recruited and randomized to either (a) four sessions of a relationship-based HIV/STI risk reduction intervention (n = 49), (b) the same HIV/STI risk reduction intervention plus two additional motivational interviewing sessions (n = 58), or (c) a four session control condition focused on wellness promotion (n = 59). All the respondents complete assessments at baseline (preintervention) as well as at immediate posttest, 3 and 6 months postintervention. A multilevel logistic model finds that women who participated in the HIV/STI risk reduction group (OR = 0.14, p < .00), HIV/STI risk reduction and motivational interview group (OR = 0.46, p = .02), and wellness (OR = 0.20, p < .00) group reduced their exposure to physical and sexual violence in the past 90 days. No significant differences in effects are observed between conditions. This study demonstrates the efficacy of a relationship-based HIV/STI risk reduction intervention, a relationship-based HIV/STI risk reduction intervention combined with motivational interviewing, and a wellness promotion intervention in reducing intimate and paying partner violence against women who exchange sex in Mongolia. The findings have significant implications for the impact of minimal intervention and the potential role of peer networks and social support in reducing women's experiences of violence in resource poor settings. PMID:22366477
Carlson, Catherine E; Chen, Jiehua; Chang, Mingway; Batsukh, Altantsetseg; Toivgoo, Aira; Riedel, Marion; Witte, Susan S
Alcohol Use Among Female Sex Workers and Male Clients: An Integrative Review of Global Literature
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.
Li, Qing; Li, Xiaoming; Stanton, Bonita
A Psychosocial Study of Male-to-Female Transgendered and Male Hustler Sex Workers in S�o Paulo, Brazil
This study examined sociodemographic variables, personality characteristics, and alcohol and drug misuse among male sex workers\\u000a in the city of Santo Andr�, S�o Paulo, Brazil. A total of 45 male-to-female transgender sex workers and 41 male hustlers were\\u000a evaluated in face-to-face interviews at their place of work from 2008 to 2010. A �snowball� sampling procedure was used to\\u000a access this
Fernanda Cestaro Prado Cortez; Douglas Pieter Boer; Danilo Antonio Baltieri
HIV, HBV, and HCV Infections Among Drug-Involved, Inner-City, Street Sex Workers in Miami, Florida
This study describes the rates of HIV, HBV, and HCV seropositivity among drug-involved, female street sex workers in low-income, inner-city sections of Miami, Florida; further, their sociodemographic characteristics, drug use, and sexual risk behaviors were assessed; and predictors of infection were reported. A sample of 586 sex workers was recruited through targeted sampling methods, interviewed, and counseled and tested for
James A. Inciardi; Hilary L. Surratt; Steven P. Kurtz
High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need
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.
Prevalence and Correlates of Non-Disclosure of HIV Serostatus to Sex partners among HIV-Infected Female Sex Workers and HIV-infected Male Clients of Female Sex Workers in India
This study examines non-disclosure of HIV serostatus to sex partners among HIV-infected adults involved with transactional sex in Mumbai, India. Surveys were conducted with HIV-infected female sex workers (n = 211) and infected male clients (n = 205) regarding HIV knowledge, awareness of sex partners� HIV serostatus, alcohol use, transactional sex involvement post-HIV diagnosis and non-disclosure of HIV serostatus. Gender-stratified multiple logistic regression models were used for analysis. Non-disclosure of one�s serostatus to all sex partners was reported by almost three-fifths of females and two-fifths of males. Predictors of non-disclosure included lack of correct knowledge about HIV and no knowledge of sex partners� HIV serostatus. Among females, recent alcohol consumption also predicted non-disclosure. Among males, 10 + paid sexual partners in the year following HIV diagnosis predicted non-disclosure. Secondary HIV prevention efforts in India require greater focus on HIV disclosure communication and integrated alcohol and sexual risk reduction.
Raj, Anita; Mahapatra, Bidhubhusan; Cheng, Debbie M.; Coleman, Sharon; Bridden, Carly; Battala, Madhusudana; Silverman, Jay G.; Pardeshi, Manoj H.; Samet, Jeffrey H.
Non-consensual sex within pre-marital relationships: experiences of young women in India.
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
Santhya, K G; Francis Zavier, A J
Is Military Sexual Trauma Associated with Trading Sex Among Women Veterans Seeking Outpatient Mental Health Care?
A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks
Jennifer L. Strauss; Christine E. Marx; Julie C. Weitlauf; Karen M. Stechuchak; Kristy Straits-Tr�ster; Ayaba W. Worjoloh; Christina B. Sherrod; Maren K. Olsen; Marian I. Butterfield; Patrick S. Calhoun
Sex Differences in Cardiovascular Health: Does Sexism Influence Women's Health?
: 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
Molix, Lisa
Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences
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.
Urada, Lianne A.; Morisky, Donald E.; Pimentel-Simbulan, Nymia; Silverman, Jay G.; Strathdee, Steffanie A.
Testing Commercial Sex Workers for Sexually Transmitted Infections in Victoria, Australia: An Evaluation of the Impact of Reducing the Frequency of Testing
Background The frequency of testing sex workers for sexually transmitted infections (STIs) in Victoria, Australia, was changed from monthly to quarterly on 6 October 2012. Our aim was to determine the impact of this change to the clients seen at the Melbourne Sexual Health Centre (MHSC). Methods Computerised medical records of all clients attending at MHSC from 7 October 2011 to 7 October 2013 were analysed. Results Comparing between the monthly and quarterly testing periods, the number of consultations at MSHC with female sex workers (FSW) halved from 6146 to 3453 (p<0.001) and the consultation time spent on FSW reduced by 40.6% (1942 h to 1153 h). More heterosexual men (p<0.001), and women (p<0.001) were seen in the quarterly testing period. The number of STIs diagnosed in the clinic increased from 2243 to 2589 from the monthly to quarterly period, respectively [15.4% increase (p<0.001)]. Up to AU$247,000 was saved on FSW testing after the shift to quarterly testing. Conclusions The change to STIs screening frequency for sex workers from monthly to quarterly resulted in a 15% increase in STI diagnoses in the clinic and approximate a quarter of a million dollars was diverted from FSW testing to other clients. Overall the change in frequency is likely to have had a beneficial effect on STI control in Victoria.
Chow, Eric P. F.; Fehler, Glenda; Chen, Marcus Y.; Bradshaw, Catriona S.; Denham, Ian; Law, Matthew G.; Fairley, Christopher K.
Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study
ERIC Educational Resources Information Center
In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and�
Huq, Nafisa Lira; Chowdhury, Mahbub Elahi
Predictors of willingness to use HIV pre-exposure prophylaxis among female sex workers in Southwest China.
This research examined predictors of willingness to use pre-exposure prophylaxis (PrEP) among female sex workers (FSW) in Southwest China. The final sample included 395 women (mean age=26.73 years, SD=6.74 years) who were predominantly of Han majority ethnicity (84.6%) and had completed middle-school education or lower (63.0%). Participants were recruited initially from commercial sex venues (e.g., saunas, massage parlors) in the cities of Nanchang, Luizhou, Nanning, Urumqi, and Karamay as well as two districts of Chongqing municipality and subsequently via snowball procedures. They completed a battery of self-report measures assessing beliefs about HIV and PrEP, psychosocial influences, demographics and willingness to use HIV PrEP. Willingness to use HIV PrEP was predicted by high levels of trust in physicians and more reported unmet interpersonal belongingness needs. Beyond these factors, willing and unwilling groups were differentiated on the basis of intervention-specific beliefs (perceived stigma and self-efficacy in use of PrEP). Together, findings suggested interpersonal factors should be considered in concert with perceptions of intervention characteristics in assessing motivations to enroll in PrEP within this particular at-risk group. PMID:23062151
Jackson, Todd; Huang, Ailong; Chen, Hong; Gao, Xiao; Zhang, Yan; Zhong, Xiaoni
The relative numbers of women and men are changing dramatically in China, but the consequences of these imbalanced sex ratios have received little attention. We merge data from the Chinese Health and Family Life Survey with community-level data from Chinese censuses to examine the relationship between cohort- and community-specific sex ratios and women�s partnering behavior. Consistent with demographic-opportunity theory and sociocultural theory, we find that high sex ratios (indicating more men relative to women) are associated with an increased likelihood that women marry before age 25. However, high sex ratios are also associated with an increased likelihood that women engage in premarital and extramarital sexual relationships and have had more than one sexual partner, findings consistent with demographic-opportunity theory but inconsistent with sociocultural theory.
Trent, Katherine; South, Scott J.
The Power of Prestige: Why Young Men Report Having more Sex Partners than Young Women
In a survey of 48 men and 61 women from a southwestern US college, the gender difference in reported number of sex partners\\u000a was mediated by the degree to which individuals felt that men and women who had many sexual partners were prestigious. In\\u000a addition, men cared about the quantity and quality of their sex partners more than women did
Peter K. Jonason; Terri D. Fisher
'Where sex ends and emotions begin': love and HIV risk among female sex workers and their intimate, non-commercial partners along the Mexico-US border.
This study explores the affective dimensions of female sex workers' relationships with their intimate, non-commercial partners and assesses how emotions shape each partner's sexual and drug-related risk within their relationship. We draw on qualitative data from a study of HIV, sexually transmitted infections and high-risk behaviours among female sex workers and their non-commercial partners in Tijuana and Ciudad Ju�rez, Mexico, to illustrate that these couples share relationships based on love, trust, respect and emotional and material support. These relationships range in emotional intensity, which shapes partners' decisions not to use condoms with each other. Drugs were important in most couples' relationships. Among injectors, syringe sharing was common and represented both a sign of care and a pragmatic reaction to conditions of material scarcity. Our findings suggest that couple-based HIV interventions to address dual sexual and drug-related risks should be tailored to the emotional dynamics of sex workers' intimate relationships. PMID:23473586
Syvertsen, Jennifer L; Robertson, Angela M; Palinkas, Lawrence A; Rangel, M Gudelia; Martinez, Gustavo; Strathdee, Steffanie A
Where Sex Ends and Emotions Begin: Love and HIV Risk among Female Sex Workers and their Intimate, Non-Commercial Partners along the Mexico-U.S. Border
This study explores the affective dimensions of female sex workers� relationships with their intimate, non-commercial partners and assesses how emotions shape each partner�s sexual and drug-related risk within their relationship. We draw on qualitative data from a study of HIV, sexually transmitted infections, and high risk behaviours among female sex workers and their non-commercial partners in Tijuana and Ciudad Ju�rez, Mexico, to illustrate that these couples share relationships based on love, trust, respect, and emotional and material support. These relationships ranged in emotional intensity, which shaped partners� decisions not to use condoms with each other. Drugs were important in most couples� relationships. Among injectors, syringe sharing was common and represented both a sign of care and a pragmatic reaction to conditions of material scarcity. Our findings suggest that couple-based HIV interventions to address dual sexual and drug-related risks should be tailored to the emotional dynamics of sex workers� intimate relationships.
Syvertsen, Jennifer L.; Robertson, Angela M.; Palinkas, Lawrence A.; Rangel, M. Gudelia; Martinez, Gustavo; Strathdee, Steffanie A.
The Syndemic Condition of Psychosocial Problems and HIV Risk Among Male Sex Workers in Ho Chi Minh City, Vietnam.
In Vietnam, the co-occurrence (i.e., "syndemic") of psychosocial factors (e.g., depression and substance use) may disproportionately burden male sex workers and increase their HIV risk. A comprehensive survey was conducted among 300 male sex workers in Ho Chi Minh City, Vietnam in 2010. We performed logistic regression to examine the association between the syndemic variable-a count score of the number of five psychosocial conditions endorsed-and unprotected anal sex (UAS) in the past. One-third of participants reported any UAS, and 42�% reported ?2 psychosocial health problems. In multivariable models, experiencing ?4 psychosocial health problems was significantly associated with UAS. Every unit increase in number of psychosocial health problems was associated with a 25-30�% increase in odds of UAS. Understanding the syndemic condition and its association with HIV risk among male sex workers in Vietnam may lead to the development of more effective, comprehensive interventions. PMID:24081899
Biello, Katie B; Colby, Donn; Closson, Elizabeth; Mimiaga, Matthew J
Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in Northern Mexico
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.
Morris, Meghan D.; Lemus, Hector; Wagner, Karla D.; Martinez, Gustavo; Lozada, Remedios; Gomez, Rangel Maria Gudelia; Strathdee, Steffanie A.
A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.
To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs. PMID:23970652
Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan
Sex-specific interaction effects of age, occupational status, and workplace stress on psychiatric symptoms and allostatic load among healthy Montreal workers.
Socio-demographics and workplace stress may affect men and women differently. The aim of this cross-sectional study was to assess sex-specific interactions among age, occupational status, and workplace Demand-Control-Support (D-C-S) factors in relation to psychiatric symptoms and allostatic load levels representing multi-systemic "wear and tear". It was hypothesized that beyond main effects, D-C-S factors would be moderated by occupational status and age in sex-specific directions predictive of subjective psychiatric symptoms and objective physiological dysregulations. Participants included healthy male (n?=?81) and female (n?=?118) Montreal workers aged 20 to 64 years (Men: M?=?39.4 years, SD?=?11.3; Women: M?=?42.8 years, SD?=?11.38). The Job Content Questionnaire was administered to assess workplace D-C-S factors that included psychological demands, decisional latitude, and social support. Occupational status was coded using the Nam--Powers--Boyd system derived from the Canadian census. Psychiatric symptoms were assessed using the Beck Anxiety Scale and the Beck Depression Inventory II. Sex-specific allostatic load indices were calculated based on fifteen biomarkers. Regression analyses revealed that higher social support was associated with less depressive symptoms in middle aged (p?=?0.033) and older men (p?=?0.027). Higher occupational status was associated with higher allostatic load levels for men (p?=?0.035), while the reverse occurred for women (p?=?0.048). Women with lower occupational status but with higher decision latitude had lower allostatic load levels, as did middle-aged (p?=?0.031) and older women (p?=?0.003) with higher psychological demands. In summary, age and occupational status moderated workplace stress in sex-specific ways that have occupational health implications. PMID:23952366
Juster, Robert-Paul; Moskowitz, D S; Lavoie, Joel; D'Antono, Bianca
Varicose Veins in Women Cotton Workers. An Epidemiological Study in England and Egypt
The prevalence of varicose veins was studied in 504 women cotton workers in England and 467 in Egypt, by a standardized questionary and a specially developed method of examination. The English mill population showed a much higher prevalence of varicose veins than the Egyptian, probably owing to environmental rather than ethnic reasons.Among the European women the prevalence of varicose veins
Siza Mekky; R. S. F. Schilling; Joan Walford
The Impact of Homelessness on Recent Sex Trade among Pregnant Women in Drug Treatment
This study is a secondary data analysis aimed to examine the influence of recent homelessness on recent sex trade among pregnant women in drug treatment after controlling for psychiatric comorbidity, age, education, and race. Eighty-one pregnant women from a drug treatment program in Baltimore, Maryland attended an in-person interview and completed the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorders-IV for Axis I disorders, the HIV Risk Behavior Interview, and demographic questionnaires, which assessed psychiatric symptoms, recent homelessness, and sexual risk behavior respectively. Women who experienced recent homelessness had a 4.74 greater odds of having recently traded sex than women who had not been recently homeless, suggesting that homelessness uniquely influences sex trade beyond psychiatric status, which was also a significant correlate of recent sex trade. Addressing both homelessness and psychiatric problems may effectively reduce sex trade and risk for infectious diseases, which could adversely impact maternal and child health outcomes.
Brown, Qiana L.; Cavanaugh, Courtenay E.; Penniman, Typhanye V.; Latimer, William W.
Women as Co-Facilitators of Groups for Male Sex Offenders
This paper presents the findings of a small research project conducted with male participants, and women co-facilitators, of a support group for male sex offenders. The project, which was conducted through the use of group and individual interviews, invited participants to express their opinions about the role of women co-facilitators. The data indicate that women have a valuable role to
Sharon McCallum
Policy Statement on Sex Work New Policy Statement
In 1993, the National Association of Social Workers (NASW) Assembly of Delegates passed a resolution directing the Assembly to adopt a policy statement on sex work. From Jane Addams to present day, social workers have worked with women in the sex industry. There is a continuum of experiences, research, and theories on sex work. From forced trafficking of children, abuse
Lacey M. Sloan; Stephanie Wahab
Toward an understanding of the context of anal sex behavior in ethnic minority adolescent women.
Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18�years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits. PMID:24963851
Champion, Jane Dimmitt; Roye, Carol F
Seriously Mentally Ill Women's Safer Sex Behaviors and the Theory of Reasoned Action
Seriously mentally ill women at risk for HIV infection (n = 96) participated in structured interviews assessing sexual and substance use behavior over a 3-month period. The majority of the women (63.5%) did not use condoms. Consistent with the Theory of Reasoned Action, condom use attitudes and perceived social norms about safer sex were associated with safer sex intentions. Supplementing TRA variables with safer sex self-efficacy explained additional variance in safer sex intentions. Greater safer sex intentions were related to both greater condom use and to less frequent unprotected intercourse. In addition, less frequent sex after drug use and a less fatalistic outlook were associated with less frequent unprotected intercourse. Life circumstances specific to this population are particularly important to examine to improve the effectiveness of risk reduction interventions for seriously mentally ill women.
Randolph, Mary E.; Pinkerton, Steven D.; Somlai, Anton M.; Kelly, Jeffrey A.; Gibson, Richard H.; Hackl, Kristin
HIV Risk Perception and Behavior among Sex Workers in Three Major Urban Centers of Mozambique
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.
Langa, Judite; Sousa, Cesar; Sidat, Mohsin; Kroeger, Karen; McLellan-Lemal, Eleanor; Belani, Hrishikesh; Patel, Shama; Shodell, Daniel; Shodell, Michael; Benech, Irene; Needle, Richard
HIV Risk Perception and Behavior among Sex Workers in Three Major Urban Centers of Mozambique.
HIV risk perceptions and behaviors of 236 commercial sex workers from three major Mozambican urban centers were studied using the International Rapid Assessment, Response and Evaluation (I-RARE) methodology. All were offered HIV testing and, in Maputo, syphilis testing was offered as well. Sixty-three of the 236 opted for HIV testing, with 30 (48%) testing positive for HIV. In Maputo, all 30 receiving HIV tests also had syphilis testing, with 6 (20%) found to be positive. Results include interview excerpts and qualitative results using I-RARE methodology and AnSWR-assisted analyses of the interviews and focus group sessions. PMID:24736653
Langa, Judite; Sousa, C�sar; Sidat, Mohsin; Kroeger, Karen; McLellan-Lemal, Eleanor; Belani, Hrishikesh; Patel, Shama; Shodell, Daniel; Shodell, Michael; Benech, Irene; Needle, Richard
Occupational safety and HIV risk among female sex workers in China: A mixed-methods analysis of sex-work harms and mommies
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.
Yi, Huso; Zheng, Tiantian; Wan, Yanhai; Mantell, Joanne E.; Park, Minah; Csete, Joanne
Prevalence of gonococcal and chlamydial infections in commercial sex workers in a Peruvian Amazon city.
This study aims to characterize the prevalence of gonococcal and chlamydial infections among commercial sex workers (CSWs) in Iquitos, Peru, which provides a thriving market for CSWs and, consequently, sexually transmitted diseases (STDs) and to correlate those findings with social/behavioral characteristics. About 100 CSWs, recruited through street (n = 37) and brothel outreach (n = 67), were interviewed through questionnaires. Urine specimens were collected for gonorrhea and chlamydial testing. Findings revealed that registered CSWs were significantly more likely to have worked in the sex trade for more than 5 years, report 10 or more sex partners per week, and to work in brothels. Nonetheless, there were no significant differences in age, average charge for sex, or STD prevalence between registered and unregistered CSWs. Overall, 28% of CSWs were positive for chlamydia (22%) and gonorrhea (14%). Furthermore, a number of CSWs stated that they did not know whether they were at risk or assessed their risk as being low for contracting gonorrhea or AIDS. There was no significant association between self-perception of STD risk and STD prevalence. High infection rates, lack of knowledge regarding HIV/AIDS and STD risk assessment, and other high-risk behaviors prevalent among this population stress the need for STD intervention programs and risk reduction behavior. PMID:10029985
Paris, M; Gotuzzo, E; Goyzueta, G; Aramburu, J; Caceres, C F; Castellano, T; Jordan, N N; Vermund, S H; Hook, E W
Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan
Background We sought to describe differences in individual and structural vulnerabilities faced by female sex workers (FSWs) in Pakistan between 2006 and 2011, and to characterise risk factors for inconsistent condom use and HIV prevalence in this population. Methods To describe differences in vulnerabilities, we analysed behavioural data from serial cross-sectional surveys conducted across nine cities in 2006 and 2011. Using data from 12 cities in 2011, we used logistic regression to characterise risk factors for (a) inconsistent condom use in the past month (N=6987), and (b) HIV (N=4301). Results Compared to FSWs in 2006, FSWs in 2011 were significantly more likely to solicit clients via cell phones, and to report a larger client volume and anal sex with clients, but also consistent condom use with clients (30.0% vs 23.6% in 2006). In 2011, independent risk factors for inconsistent condom use with clients included: recent sexual violence, recent sex with a person who injects drugs, and absence of programme exposure. HIV prevalence was 0.63% (95% CI 0.43% to 0.92%) in 2011, and was associated with a recent history of injection drug use and absence of programme exposure. Conclusions While condom use with clients was higher in 2011, protective behaviours remained low and vulnerabilities related to sex work may have risen. HIV is emerging in this population and an adaptive HIV prevention programme that addresses different vulnerabilities and the intersection of sexual networks with injection drug use is needed.
Mishra, Sharmistha; Thompson, Laura H; Sonia, Altaf; Khalid, Nosheen; Emmanuel, Faran; Blanchard, James F
Syphilis infection among female sex workers in Nagaland, Northeast India: analysing their vulnerability to the infection.
This paper describes the sex work characteristics and factors associated with syphilis among female sex workers (FSWs) in Dimapur district of high HIV prevalence Indian state, Nagaland. The study recruited 426 FSWs in 2006 using respondent-driven sampling. The prevalence of syphilis was 21.1% and HIV prevalence was 11.7%. Approximately half were under 25 years of age. Clients were solicited mainly in public places (32.7%), while hotels/lodges/rented rooms were the most common places of entertainment (57.2%). Condom use during the last sex was 36.5% with occasional and 27% with regular clients. Being married, being widowed/divorced/separated, being illiterate or having a history of drug use increased the likelihood of syphilis infection. Entertaining clients in bars/booze joints decreased the probability of syphilis. FSWs who moved between soliciting in public places or bars/booze joints and then entertaining in hotels/lodges/rented rooms had a higher vulnerability to syphilis. In summary, we found that the vulnerability to syphilis among mostly young FSWs in Dimapur varied according to their sex work characteristics, marital and educational status and drug use habits. They may be more vulnerable to HIV and sexually transmitted infections (HIV/STIs) due to the low rate of condom use. The findings have direct implications for HIV/STI prevention programmes in Northeast India. PMID:23514833
Medhi, G K; Mahanta, J; Hazarika, I; Armstrong, G; Adhikary, R; Mainkar, M; Paranjape, R S
Sex worker victimization, modes of working, and location in New South Wales, Australia: a geography of victimization.
This article examines the association among victimization, modes of sex working, and the locations used by sex workers through an analysis of "Ugly Mug" reports detailing 528 crime acts in 333 reported incidents in New South Wales (NSW), Australia. These forms, voluntarily lodged between 2000 and 2008 by members of NSW's estimated 10,000 sex worker population, suggest that street-based work has a higher victimization rate than other modes of working, including escort work, work in commercial premises, and private work. Although this ostensibly supports the commonly held view that "outdoor" working is more dangerous than "indoor" work, this analysis suggests that most instances of victimization actually occur in private spaces. Hence, it is argued that risks of victimization in sex work are influenced by a variety of environmental characteristics relating to concealment, control, and isolation, suggesting that not all off-street locations are equally safe. We conclude with recommendations for policy regarding sex work. PMID:22741540
Prior, Jason; Hubbard, Phil; Birch, Philip
Epidemic Impacts of a Community Empowerment Intervention for HIV Prevention among Female Sex Workers in Generalized and Concentrated Epidemics
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.
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
Sex-Role Self-Concept and Attitudes Related to Occupational Daydreams and Future Fantasies of College Women.
ERIC Educational Resources Information Center
Explored the relationship of sex-role self-concept and general attitudes toward women's roles, to patterns of career preferences and to career salience among (N=50) undergraduate women. Results indicated women who differed in sex-role self-concept remembered different occupational daydreams; and liberal women's current career choices were in more�
Yanico, Barbara J.
Transactional sex amongst young people in rural northern Tanzania: an ethnography of young women's motivations and negotiation
BACKGROUND: Material exchange for sex (transactional sex) may be important to sexual relationships and health in certain cultures, yet the motivations for transactional sex, its scale and consequences are still little understood. The aim of this paper is to examine young women's motivations to exchange sex for gifts or money, the way in which they negotiate transactional sex throughout their
Joyce Wamoyi; Daniel Wight; Mary Plummer; Gerry Hilary Mshana; David Ross
Circulating Sex Steroids, Sex Hormone-Binding Globulin, and Longitudinal Changes in Forearm Bone Mineral Density in Postmenopausal Women and Men: The Troms� Study
Bone loss during advancing age in women and men is partly the result of sex steroid deficiency. As the contribution of circulating\\u000a sex steroids and sex hormone-binding globulin (SHBG) to bone loss remains uncertain, we sought to determine whether levels\\u000a of sex steroids or SHBG predict change in bone mineral density (BMD) in women and men. A population-based study in
�shild Bj�rnerem; Nina Emaus; Gro K. R. Berntsen; Ragnar M. Joakimsen; Vinjar F�nneb�; Tom Wilsgaard; P�l �ian; Ego Seeman; Bj�rn Straume
Syphilis and HIV prevalence among commercial sex workers in Central Java, Indonesia: risk-taking behavior and attitudes that may potentiate a wider epidemic.
A cross-sectional study was conducted on 200 commercial sex workers (CSWs) from two brothel communities in Central Java, Indonesia, to determine the seroprevalence of syphilis and HIV and characterize associated knowledge, beliefs, and risk-taking behaviors. A questionnaire was administered and blood drawn for HIV and syphilis serologies. Focus groups with a total of 20 women were also conducted at both communities to supplement survey data. The mean CSW age was 27.3 years; mean number of clients seen per day was 2.27. The prevalence of syphilis and HIV were 7.5% and 0.5%, respectively. Thirty percent said they and their partners never used condoms during sex, and only 3.0% said they always used condoms. The most common client groups were truck drivers and sailors. While Central Java appears to remain in a pre-epidemic state, there is enormous potential for a significant increase in HIV and STD transmission. PMID:14746667
Sugihantono, A; Slidell, M; Syaifudin, A; Pratjojo, H; Utami, I M; Sadjimin, T; Mayer, Kenneth H
Alcohol and sexual risk behavior among migrant female sex workers and male workers in districts with high in-migration from four high HIV prevalence states in India.
This paper examines the association between alcohol use and sexual risk in two critical migrant populations living within the same geographical areas--migrant men and female sex-workers (FSWs). Data are drawn from two independent surveys of migrant FSWs and male workers in 14 districts of four high HIV prevalent Indian states. In the paper we have examined the independent effects of degree of mobility and alcohol use prior to sex on HIV risk behaviors. Nearly two-thirds of FSWs and a similar proportion of male migrant workers, as well as nine out of ten clients of FSWs consume alcohol. More than half of the FSWs and their clients consumed alcohol prior to sex. The practice of alcohol use prior to sex among both FSWs and their clients has a significant association with inconsistent condom use during paid as well as unpaid sex, and these effects are independent of degree of mobility. The results suggest a need for developing an in-depth understanding of the role of alcohol in accentuating HIV risk particularly among migrant populations who move frequently from one place another. PMID:20574634
Verma, Ravi K; Saggurti, Niranjan; Singh, Ajay K; Swain, Suvakanta N
Cardiovascular disease in women: Sex differences in presentation, risk factors, and evaluation
Cardiovascular disease (CVD) is the leading cause of mortality in women. Pathophysiology, risk factors, clinical presentation,\\u000a and outcomes of coronary artery disease (CAD) differ in women, and a better understanding of the sex differences in these\\u000a factors will potentially lead to a slowing of this epidemic in women. Often forgotten, women have higher complication rates\\u000a post revascularization and higher in-hospital
Donna M. Polk; Tasneem Z. Naqvi
Benefits and constraints of intimate partnerships for HIV positive sex workers in Kibera, Kenya
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.
Evaluation of Sexually Transmitted Diseases/Human Immunodeficiency Virus Intervention Programs for Sex Workers in Calcutta, India
Background and Objective The Sonagachi Project in Calcutta, India, organized sex workers to improve working conditions. Goal To compare rates of sexually transmitted diseases between the Sonagachi Project and other areas in which only the National AIDS Control Organization (NACO) interventions were implemented. Study A cross-sectional survey of randomly selected female sex workers. Results There was no difference in the prevalence of all STDs between the 2 areas; both were lower than reported in other surveys in 1992. Analysis using propensity scores also failed to demonstrate any difference. The number of preventive activities was similar in the Sonagachi and NACO-only areas but was more prevalent than in 1992. Sex workers in the Sonagachi area had better treatment-seeking behavior and attitudes. Both the Sonagachi and NACO strategies have resulted in lower STD rates, but the Sonagachi Project also increased the proportion who had an optimistic attitude and increased prevention and treatment-seeking behavior.
Female sex workers and access to social and health services in Catalonia: Influence of region of origin and place of work.
The objectives of the study were to describe the use of social and health services (SHS) of female sex workers (FSW) in Catalonia according to place of work and region of origin, and explore the barriers these women encountered when accessing these services. Quantitative and qualitative methods were combined. A questionnaire-based survey (n = 400) was conducted from October 2009 to January 2010, and complemented by focus group discussions technique (n = 23). More than 60% of FSW had used health services (HS) in the last 6 months (no differences by context of work and region of origin). Nevertheless, there were differences in the characteristics of health resources used. Although all women in clubs contracted the private HS provided by the club itself, they were those who least benefited from social services (SS), in particular Eastern-Europe women (24.6% in the last 6 months). The stigma and discrimination that FSW women suffer were one of the main barriers to access SHS. Women from Eastern Europe who worked in clubs were the most isolated and vulnerable women. Access to the public health system must continue to be provided for all FSW, assuring confidentiality and diminishing the burden associated with discrimination which they generally feel. PMID:23216369
Folch, C; Lazar, C; Ferrer, L; Sanclemente, C; Casabona, J
Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia
Objectives HIV prevalence among Cambodian female sex workers (FSW) is among the highest in Southeast Asia. We describe HIV prevalence and associated risk exposures in FSW sampled serially in Phnom Penh, Cambodia (Young Women's Health Study (YWHS)), before and after the implementation of a new law designed to combat human trafficking and sexual exploitation. Design Cross-sectional analysis of baseline data from two prospective cohorts. Setting Community-based study in Phnom Penh, Cambodia. Participants Women aged 15�29?years, reporting ?2 sexual partners in the last month and/or engaged in transactional sex in the last 3?months, were enrolled in the studies in 2007 (N=161; YWHS-1), and 2009 (N=220; YWHS-2) following information sessions where 285 and 345 women attended. Primary outcomes HIV prevalence, sexual risk behaviour, amphetamine-type stimulant (ATS) and alcohol use, and work-related factors were compared in the two groups, enrolled before and after implementation of the new law. Results Participants in the two cohorts were similar in age (median 25?years), but YWHS-2 women reported fewer sex partners, more alcohol use and less ATS use. A higher proportion of YWHS-2 compared with YWHS-1 women worked in entertainment-based venues (68% vs 31%, respectively). HIV prevalence was significantly lower in the more recently sampled women: 9.2% (95% CI 4.5%�to 13.8%) vs 23% (95% CI 16.5% to 29.7%). Conclusions Sex work context and risk have shifted among young FSW in Phnom Penh, following implementation of anti-prostitution and anti-trafficking laws. While both cohorts were recruited using the same eligibility criteria, more recently sampled women had lower prevalence of sexual risk and HIV infection. Women engaging more directly in transactional sex have become harder to sample and access. Future prevention research and programmes need to consider how new policies and demographic changes in FSW impact HIV transmission.
Page, Kimberly; Stein, Ellen; Sansothy, Neth; Evans, Jennifer; Couture, Marie-Claude; Sichan, Keo; Cockroft, Melissa; Mooney-Somers, Julie; Phlong, Pisith; Kaldor, John; Maher, Lisa
Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia
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.
Maher, Lisa; Mooney-Somers, Julie; Phlong, Pisith; Couture, Marie-Claude; Kien, Serey Phal; Stein, Ellen; Bates, Anna Juong; Sansothy, Neth; Page, Kimberly
Working Women Portrayed on Evening Television Programs
ERIC Educational Resources Information Center
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)
Kaniuga, Nancy; And Others
Condom use within non-commercial partnerships of female sex workers in southern India
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.
HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China
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.
Jin, Xia; Smith, Kumi; Chen, Ray Y.; Ding, Guowei; Yao, Yan; Wang, Haibo; Qian, Han-Zhu; Chang, Dongfang; Wang, Guixiang; Wang, Ning
Hombre Seguro (Safe Men): a sexual risk reduction intervention for male clients of female sex workers
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.
Prevalence of HIV Infection and Predictors for Syphilis Infection among Female Sex Workers in Southern China
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.
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
Women and the Economy: A Bibliography and a Review of the Literature on Sex Differentiation in the Labor Market.
ERIC Educational Resources Information Center
The first two-thirds of the document is a bibliography on women in the labor market which is divided into 27 categories and sub-categories, the major headings of which are: historical perspective, the supply of female labor in the labor market, earnings of women workers, occupations of women workers (covers occupational distribution, academic and�
Kohen, Andrew I.; And Others
Too Many Men?: Sex Ratios and Women's Partnering Behavior in China
The relative numbers of women and men are changing dramatically in China, but the consequences of these imbalanced sex ratios have received little empirical attention. We merge data from the Chinese Health and Family Life Survey with community-level data from Chinese censuses to examine the relationship between cohort- and community-specific sex ratios and women's partnering behavior. Consistent with demographic-opportunity theory
Katherine Trent; Scott J. South
Caught between different worlds: how transgendered women may be "forced" into risky sex.
We qualitatively explored reasons why transgendered women may engage in sexual risk that could lead to HIV infection. Specifically, we conducted this investigation with transgendered women identifying as Black/African American. Interviews from 17 participants were audio taped and analyzed. Four themes emerged. Women commonly reported they had a strong need/desire to be loved by men. Many stated they had and would engage in unprotected sex to obtain and preserve such a relationship. Nearly all were currently using female hormones. Nine obtained their hormones through non-medical means including the Internet, transgendered friends, and street vendors. For these women hormone injections often involved sharing needles/syringes. Selling sex was a common practice and many women did so without the benefit of condom use. Finally, women experienced multiple forms of societal discrimination. By being caught between worlds (straight, gay, male, and female) transgendered women may be placed into situations where avoiding HIV risk is extremely difficult. PMID:17599263
Crosby, Richard A; Pitts, Nicole L
Prevalence and Characteristics of Abuse Experiences and Depression Symptoms among Injection Drug-Using Female Sex Workers in Mexico
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.
Ulibarri, Monica D.; Hiller, Sarah P.; Lozada, Remedios; Rangel, M. Gudelia; Stockman, Jamila K.; Silverman, Jay G.; Ojeda, Victoria D.
Too Many Men? Sex Ratios and Women's Partnering Behavior in China
ERIC Educational Resources Information Center
The relative numbers of women and men are changing dramatically in China, but the consequences of these imbalanced sex ratios have received little empirical attention. We merge data from the Chinese Health and Family Life Survey with community-level data from Chinese censuses to examine the relationship between cohort- and community-specific sex�
Trent, Katherine; South, Scott J.
Sex-trafficking, Violence, Negotiating Skill, and HIV Infection in Brothel-based Sex Workers of Eastern India, Adjoining Nepal, Bhutan, and Bangladesh
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.
Sarkar, Kamalesh; Bal, Baishali; Mukherjee, Rita; Chakraborty, Sekhar; Saha, Suman; Ghosh, Arundhuti; Parsons, Scott
Sex-trafficking, violence, negotiating skill, and HIV infection in brothel-based sex workers of eastern India, adjoining Nepal, Bhutan, and Bangladesh.
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
Sarkar, Kamalesh; Bal, Baishali; Mukherjee, Rita; Chakraborty, Sekhar; Saha, Suman; Ghosh, Arundhuti; Parsons, Scott
Prevalence of forced sex and associated factors among women and men in Kisumu, Kenya.
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
Adudans, Maureen K; Montandon, Michele; Kwena, Zachary; Bukusi, Elizabeth A; Cohen, Craig R
Circular Migration by Mexican Female Sex Workers Who are Injection Drug Users: Implications for HIV in Mexican Sending Communities
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.
Ojeda, Victoria D.; Burgos, Jose Luis; Hiller, Sarah P.; Lozada, Remedios; Rangel, Gudelia; Vera, Alicia; Artamonova, Irina; Rodriguez, Carlos Magis
The Cost of Providing Combined Prevention and Treatment Services, Including ART, to Female Sex Workers in Burkina Faso
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.
Cianci, Fiona; Sweeney, Sedona; Konate, Issouf; Nagot, Nicolas; Low, Andrea; Mayaud, Philippe; Vickerman, Peter
Youth, violence and non-injection drug use: nexus of vulnerabilities among lesbian and bisexual sex workers.
Despite increasing evidence of enhanced HIV risk among sexual minority populations, and sex workers (SWs) in particular, there remains a paucity of epidemiological data on the risk environments of SWs 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 SWs in Vancouver, Canada. Analysis drew on data from an open prospective cohort of street and hidden off-street SWs in Vancouver. Bivariate and multivariable logistic regressions 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 six 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 six 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 programmes 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
Lyons, Tara; Kerr, Thomas; Duff, Putu; Feng, Cindy; Shannon, Kate
Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report.
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
Mallampalli, Monica P; Carter, Christine L
Relationship between mobility, violence and HIV/STI among female sex workers in Andhra Pradesh, India
Background Violence and mobility have been identified as critical factors contributing to the spread of HIV worldwide. This study aimed to assess the independent and combined associations of mobility and violence with sexual risk behaviors and HIV, STI prevalence among female sex workers (FSWs) in India. Methods Data were drawn from a cross-sectional, bio-behavioral survey conducted among 2042 FSWs across five districts of southern India in 2005�06. Regression models were used to estimate odds ratios and 95% confidence intervals (CIs) for sexual risk behaviors and HIV infection based on experience of violence and mobility after adjusting for socio-demographic and sex work related characteristics. Results One-fifth of FSWs (19%) reported experiencing violence; 68% reported travelling outside their current place of residence at least once in the past year and practicing sex work during their visit. Mobile FSWs were more likely to report violence compared to their counterparts (23% vs. 10%, p?0.001). Approximately 1 in 5 tested positive for HIV. In adjusted models, FSWs reporting both mobility and violence as compared to their counterparts were more likely to be infected with HIV (Adjusted odds ratio (adjusted OR): 2.07, 95% CI: 1.42�3.03) and to report unprotected sex with occasional (adjusted OR: 2.86, 95% CI: 1.76�4.65) and regular clients (adjusted OR: 2.07, 95% CI: 1.40�3.06). Conclusions The findings indicate that mobility and violence were independently associated with HIV infection. Notably, the combined effect of mobility and violence posed greater HIV risk than their independent effect. These results point to the need for the provision of an enabling environment and safe spaces for FSWs who are mobile, to augment existing efforts to reduce the spread of HIV/AIDS.
Sex work and its associations with alcohol and methamphetamine use among female bar and spa workers in the Philippines.
To assess the prevalence of sex work and its associations with substance use among female bar/spa workers in the Philippines (N = 498), workers from 54 bar or spa venues in Metro Manila (2009-2010) were surveyed on demographics, drug/alcohol use, abuse history, and sex work. Their median age was 23 years and 35% engaged in sex work. Sex work was independently associated with methamphetamine use (19% vs 4%; adjusted odds ratio [AOR] =2.9, 95% confidence interval [CI] = 1.3-6.2), alcohol use with patrons (49% vs. 27%; AOR = 1.9, 95% CI = 1.1-3.4), and alcohol intoxication during sex (50% vs. 24%; AOR = 2.0, 95% CI = 1.2-3.5), but inversely associated with daily alcohol use (13% vs. 16%; AOR = 0.2, 95% CI = 0.1-0.5). Additional significant covariates included sexual abuse history, younger age, and not having a higher education. Findings suggest that interventions with sex workers in bars and spas should focus on methamphetamine use, alcohol use contexts, and violence victimization, to better meet the needs of this population. PMID:23343641
Urada, Lianne A; Strathdee, Steffanie A; Morisky, Donald E; Schilling, Robert F; Simbulan, Nymia P; Estacio, Leonardo R; Raj, Anita
Sex Work and Its Associations With Alcohol and Methamphetamine Use Among Female Bar and Spa Workers in the Philippines
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.
Urada, Lianne A.; Strathdee, Steffanie A.; Morisky, Donald E.; Schilling, Robert F.; Simbulan, Nymia P.; Estacio, Leonardo R.; Raj, Anita
An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.
Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50�% of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders. PMID:24151086
Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F
Challenging the stigmatization of female sex workers through a community-led structural intervention: learning from a case study of a female sex worker intervention in Andhra Pradesh, India
Structural interventions represent a potentially powerful approach to HIV prevention among female sex workers (FSW) that focus on changing the social context of risk rather than individual behavior. Community-led structural interventions (CLSI) represent a particular form of structural interventions whereby the collective energy of FSW is directed toward action to address the contextual factors that promote their risk. Among these
Kim M. Blankenship; Monica R. Biradavolu; Asima Jena; Annie George
The Interaction of Drug Use, Sex Work, and HIV Among Transgender Women.
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
Hoffman, Beth R
A Sustainable Behavioral Intervention to Increase Condom Use and Reduce Gonorrhea among Sex Workers in Singapore: 2Year Follow-up
Background.Prostitution is the most important source of transmission of AIDS and sexually transmitted diseases in Asia. We developed and evaluated the sustainability of an intervention to increase condom use and reduce gonorrhea among brothel-based sex workers in Singapore. The intervention focused on developing sex workers' negotiation skills, educating clients, and mobilizing support from peers and health staff in promoting condom
M. L. Wong; K. W. Roy Chan; David Koh
A study of HIV/STD infections amongst commercial sex workers in Kolkata (India). Part-III, clinical features of sexually transmitted diseases.
The clinical features of sexually transmitted disease (STD) infection in female sex workers found in a community based study in different red light areas of Kolkata are discussed in this paper. Out of 867 sex workers clinically examined in the clinics in their respective areas, 80.16% were having different signs and symptoms of sexually transmitted diseases. The vaginal discharge was the commonest feature present in 49.6% sex workers. The chronic vaginal discharge of more than a month was found in 47.44%, while 37.90% sex workers had vaginal discharge of less than one month. The genital ulcer was present in 25.03% (217) sex workers. The other sexually transmitted infection that was found includes genital warts 13.73%, scabies 12.11 and Inguinal bubo in 1.73% sex workers. The sex workers were also having other symptoms e.g. chronic weight loss, prolonged fever and chronic diarrhoea in 13.73% (119), 10.03% (87) and in 1.96% (17) sex workers respectively. PMID:15909751
Raut, D K; Pal, D; Das, A
Empowered Positions? Listening to Sexually Experienced Young Women Talking about Sex, Disappointments, and Compromise
ERIC Educational Resources Information Center
Purpose: This paper aims to discuss how sex and relationship education (SRE) could benefit from considering current levels of young women's empowerment in (hetero)sexual relationships and challenge popular notions of twenty-first century young women "having it all" and occupying powerful relational and sexual positions.�
Sieg, Ellen
Sex-Role Attitude Change of Young Women: Influential Factors from a Panel Study.
ERIC Educational Resources Information Center
A panel of 294 non-metropolitan Pennsylvania women was studied first in 1970 when they were high school sophomores and again in 1981 to assess the relationship between traditional and nontraditional role behaviors and changes in sex-role attitudes. As adolescents in 1970, the women were either extremely liberal or traditional. As young adults in�
Tallichet, Suzanne E.; Willits, Fern K.
Identity Diffusion as a Function of Sex-Roles in Adult Women.
ERIC Educational Resources Information Center
This study sought to demonstrate that the relative degree of adult female identity diffusion, as well as certain personality correlates, would be a function of specific sex roles and their combinations. Three groups of 32 women each were selected as married and noncareer, married and career, or unmarried and career women. They were administered a�
Jabury, Donald Eugene
Sex differences in viewing sexual stimuli: An eye-tracking study in men and women
Men and women exhibit different neural, genital, and subjective arousal responses to visual sexual stimuli. The source of these sex differences is unknown. We hypothesized that men and women look differently at sexual stimuli, resulting in different responses. We used eye tracking to measure looking by 15 male and 30 female (15 normal cycling (NC) and 15 oral contracepting (OC))
Heather A. Rupp; Kim Wallen
Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: longitudinal analysis from a randomized controlled trial
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
Social support and recovery among Mexican female sex workers who inject drugs
This qualitative study describes social support that female sex workers who inject drugs (FSW-IDUs) receive and recovery efforts in the context of relationships with family and intimate partners. We conducted thematic analysis of in-depth interviews with 47 FSW-IDUs enrolled in an intervention study to reduce injection/sexual risk behaviors in Tijuana, Mexico. FSW-IDUs received instrumental and emotional social support, which positively and negatively influenced recovery efforts. Participants reported how some intimate partners provided conflicting positive and negative support during recovery attempts. Problematic support (i.e., well-intended support with unintended consequences) occurred in strained family relationships, limiting the positive effects of support. Mexican drug treatment programs should consider addressing social support in recovery curricula through evidence-based interventions that engage intimate partners, children and family to better reflect socio-cultural and contextual determinants of substance abuse.
Hiller, Sarah; Syvertsen, Jennifer; Lozada, Remedios; Ojeda, Victoria D.
Exploring stigma by association among front-line care providers serving sex workers.
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
Phillips, Rachel; Benoit, Cecilia
The Role and Status of Women Workers in the United States and Japan. A Joint United States-Japan Study.
ERIC Educational Resources Information Center
The purpose of this joint study is to review the situation of women workers in Japan and the United States, to accelerate efforts necessary for the improvement of their status, to contribute to the solution of the problem of women workers, and to promote mutual understanding and cooperation between the two countries. Divided into three sections,�
Ministry of Labor, Tokyo (Japan). Women's and Minor's Bureau.
Equal Opportunities and Equal Treatment for Men and Women Workers: Workers with Family Responsibilities, Report V (2), International Labour Conference, 67th Session, 1981.
National Technical Information Service (NTIS)
The conference paper summarizes and analyzes the replies of governments of ILO member states to a request for observations on proposals for an ILO convention and ILO recommendation concerning equal opportunity for men and women workers with family respons...
Randomised controlled trial of alternative male and female condom promotion strategies targeting sex workers in Madagascar
Objectives To assess whether individual clinic?based counselling as a supplement to peer education for male and female condom promotion leads to greater use of protection and lower STI prevalence among sex workers in Madagascar already exposed to intensive male condom promotion. Methods In two public dispensaries in Madagascar, a total of 901 sex workers were randomly allocated between two alternative male and female condom promotion interventions: peer education only, or peer education supplemented with individual clinic?based counselling. Participants were followed for 12?months. Every 2?months they made clinic visits, where they were interviewed on condom use. Peer educators counselled all participants on condom use as they accompanied their assigned participants to study visits. Participants assigned to receive the supplemental intervention were counselled by a trained clinician following study interviews. Participants were tested and treated for chlamydia, gonorrhoea and trichomoniasis every 6?months. We used logistic regression to assess whether the more intensive intervention was associated with reduced STI prevalence. Use of protection with clients and non?paying partners was assessed by study arm, site, and visit. Results There was no statistically significant association between study arm and aggregated STI prevalence. No substantial differences in levels of reported protection were noted between study groups. Conclusions This study found little evidence for gains from more thorough clinical counselling on male and female condom use. These findings suggest that less clinically intensive interventions such as peer education could be suitable for male and female condom promotion in populations already exposed to barrier method promotion.
Hoke, Theresa H; Feldblum, Paul J; Van Damme, Kathleen; Nasution, Marlina D; Grey, Thomas W; Wong, Emelita L; Ralimamonjy, Louisette; Raharimalala, Leonardine; Rasamindrakotroka, Andry
Job Search and Sex Segregation: Does Sex of Social Contact Matter?
In this study, we investigate how the sex of the social contact women use to find jobs affects the segregation of women into jobs in female-dominated occupations. Using women in the Metropolitan Employer-Worker Survey (MEWS), we test two competing hypotheses from the literature. One body of literature argues that women who use men as social contacts in job search have
F. Carson Mencken; Idee Winfield
Women--Working More, Earning Less.
ERIC Educational Resources Information Center
Despite the increased number of women workers and sex fairness federal legislation, the earning power and job status of women workers has not increased. The earnings gap between men and women has actually widened. The author looks at ways to improve the situation through education and training. (MF)
Bomboy, Marylee
Knowledge, attitudes and experiences of sex trafficking by young women in Benin City, South-South Nigeria
Benin City, the headquarters of Edo State, is known to have one of the highest rates of international sex trafficking of young women in Nigeria. This study was designed to determine the knowledge, attitudes and experiences of young women in Benin City, towards international sex trafficking. A random household sample of 1456 women aged 15�25 years was interviewed with a
F. E. Okonofua; S. M. Ogbomwan; A. N. Alutu; Okop Kufre; Aghahowa Eghosa
Taking account of what young women want from school sex education : Two groups from Scotland and Uganda
Purpose � This study seeks to explore what young women want from their school-based sex education. Design\\/methodology\\/approach � Qualitative methods were used to explore the perspectives of two groups of young women from Uganda and Scotland. Findings � Of particular importance to all the young women were: a diverse sex education curriculum appropriate to the ages of the students, being
Sinead Cook
Mobility, risk behavior and HIV\\/STI rates among female sex workers in Kaiyuan City, Yunnan Province, China
BACKGROUND: The mobility of female sex workers (FSWs) is a factor in the geographic spread of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). This study describes FSW mobility patterns in a high risk area of China to identify factors associated with increased mobility, and to study the incidence and prevalence of HIV\\/STIs in this group. METHODS: 270
Haibo Wang; Ray Y Chen; Gerald B Sharp; Katherine Brown; Kumi Smith; Guowei Ding; Xia Jin; Junjie Xu; Ruiling Dong; Ning Wang
Sexually transmitted infections: prevalence, knowledge and treatment practices among female sex workers in a cosmopolitan city in Nigeria.
Sexually transmitted infections constitute economic burden for developing countries, exposure to causative agents is an occupational hazard for female sex workers. Targeted interventions for this population can reduce the incidence and prevalence of sexually transmitted infections including human immunodeficiency virus, but barriers exists which can hinder effective implementation of such programs. This descriptive cross sectional study sought to assess the prevalence, knowledge and treatment practices of sexually transmitted infections among brothel based female sex workers. Three hundred and twenty three consenting female sex workers were surveyed using pre tested, interviewer administered questionnaires. More than half of the respondents (54.2%) had poor knowledge of symptoms of sexually transmitted infections. Only 13.9% were aware that sexually transmitted infections could be asymptomatic. The self reported prevalence of symptomatic sexually transmitted infections was 36.5%. About half of those with sexually transmitted infectionss sought treatment in a hospital or health centre while 32.5% from a patent medicine vendor. Most respondents (53.8%) mentioned the perceived quality of care as the main reason for seeking treatment in their chosen place. More of the respondents with good knowledge of sexually transmitted infections reported symptoms compared to those with fair and poor knowledge. The knowledge of sexually transmitted infections among these female sex workers is poor and the prevalence is relatively high. Efforts to improve knowledge promote and encourage preventive as well as effective treatment practices must be made for this population. PMID:24069738
Sekoni, Adekemi O; Odukoya, Oluwakemi O; Onajole, Adebayo T; Odeyemi, Kofoworola A
Sexual risk behaviours and barriers to HIV testing among clients of female sex workers in Guatemala: a qualitative study.
Few interventions have targeted clients of female sex workers in Central America, despite their potential role in HIV/STI prevention. Semi-structured interviews were conducted with 30 clients of female sex workers on attitudes towards prevention of HIV/STIs, barriers to condom use and behaviour towards HIV/STI testing and treatment in Escuintla, Guatemala. Despite high knowledge of condoms as an HIV/STI preventive measure, the decision to use them was often based on the client's social judgment of the woman's sexual conduct. Regular clients reported lower condom use. Clients' risk perception diminished with the awareness of the public HIV/STI clinic addressed to female sex workers. Most preferred private clinics to increase confidentiality and were reluctant to take the HIV test for fear of a positive result. Outreach programmes offering HIV/STI counselling and testing to clients of female sex workers could increase their test uptake and health-seeking behaviour and reduce potential transmission to the general population. PMID:23627770
Lahuerta, Maria; Torrens, M�riam; Sabid�, Meritxell; Batres, Anabella; Casabona, Jordi
Cost-effectiveness of the female condom in preventing HIV and STDs in commercial sex workers in rural South Africa
We assessed the cost-effectiveness of the female condom (FC) in preventing HIV infection and other STDs among commercial sex workers (CSWs) and their clients in the Mpumulanga Province of South Africa. The health and economic outcomes of current levels of male condom (MC) use in 1000 CSWs who average 25 partners per year and have an HIV prevalence of 50.3%
Elliot Marseille; James G. Kahn; Kelvin Billinghurst; Joseph Saba
How to reach clients of female sex workers: a survey ''by surprise'' in brothels in Dakar, Senegal
Objective To describe the sampling techniques and survey procedures used in identifying male clients who frequent brothels to buy sexual services from female sex workers in Dakar, Senegal, with the aim of measuring the prevalence of human immunodeficiency virus (HIV) infection and investigating related risk behaviours. Methods Surveys were conducted in seven brothels in Dakar, Senegal. Clients were identified ''by
M. E. Gomes; G. D. Etheredge
Perceptions about HIV and Condoms and Consistent Condom Use among Male Clients of Commercial Sex Workers in the Philippines
ERIC Educational Resources Information Center
Because consistent condom use is an effective strategy in the prevention of sexually transmitted infections and HIV transmission, it is important to examine social cognitive influences of consistent condom use not only among female sex workers (FSWs) but also among their male clients, for whom less is known. Because little is known about how HIV�
Regan, Rotrease; Morisky, Donald E.
Characteristics of Activities That Affect the Development of Women's Same-Sex Relationships.
The author utilized semistructured interviews with 56 women to explore how a wide range of activities affected the development of the participants' same-sex attractions and relationships. The researcher was able to identify and describe some aspects of the process by which eight characteristics of activities that are more or less present in various social contexts have the potential to impact whether these contexts are more or less conducive or hindering to the development of women's same-sex attractions and relationships. Activities were more apt to nurture the development of the participants' same-sex attractions and relationships when the activity (a) included lesbians, (b) was composed primarily of women, (c) affirmed women, (d) facilitated bonding, (e) featured a climate of acceptance of lesbians/gays/bisexuals, (f) did not feature a climate that emphasized heteronormativity, (g) was perceived as gender neutral, and (h) generated or drew participants who were similar to each other. PMID:24885468
Davis-Delano, Laurel R
Street Workers and Internet Escorts: Contextual and Psychosocial Factors Surrounding HIV Risk Behavior among Men Who Engage in Sex Work with Other Men
Sex work has been associated with elevated risk for HIV infection among men who have sex with men (MSM) in many settings. This mixed methods study examined sexual risk among MSM sex workers in Massachusetts, collecting formative data on HIV risk behavior by sex worker type in order to gain a better understanding of how to tailor prevention interventions to this unique and high-risk subgroup of MSM. Two groups of MSM sex workers were recruited between January and March 2008: street workers (n?=?19) and internet escorts (n?=?13). Participants completed a semistructured qualitative interview and quantitative psychosocial assessment battery; interviews were conducted until redundancy in responses was achieved. Almost one third (31%) were HIV-infected. The majority of participants (69%) reported at least one episode of unprotected serodiscordant anal sex (either insertive or receptive) with a mean of 10.7 (SD?=?42.2) male sex partners of an unknown or different HIV serostatus in the past 12�months. Salient findings included: (a) internet sex workers reported being paid substantially more for sex than street sex workers; (b) inconsistent condom use, high rates of unprotected sex, and low rates of HIV status disclosure with sex work partners for both internet and street workers; general perceptions of a lack of trust on the part of sex work partners (i.e., telling them what they want to hear), offers of more money for unprotected sex; (c) contextual differences in risk taking: internet sex workers reported that they are more likely to engage in sexual risk-taking with noncommercial sex partners than sex partners who pay; (d) HIV status and STI history: two street workers became infected in the context of sex work, and 25% of the entire sample had never been tested for sexually transmitted infections (STI); and (e) motivations and reasons for doing sex work, such as the �lucrativeness� of sex work, as a means to obtain drugs, excitement, power, �why not?� attitude, and because social norms modeled this behavior. Study findings can be used to generate hypotheses for designing and providing tailored primary and secondary prevention interventions for this at-risk subgroup of MSM.
Reisner, Sari L.; Tinsley, Jake P.; Mayer, Kenneth H.; Safren, Steven A.
Alcohol Use and Sexual Risks: Use of the Alcohol Use Disorders Identification Test (AUDIT) Among Female Sex Workers in China
The association between alcohol use and sexual risks among female sex workers (FSWs) has been insufficiently studied. This article reports a cross-sectional study of the relationship between alcohol use risk, measured by the Alcohol Use Disorders Identification Test (AUDIT), and sexual risk behaviors among 1,022 FSWs in Guangxi, China. Bivariate analysis showed that FSWs at higher AUDIT levels tended to have earlier sexual initiation, younger age of involvement in the sex trade and were more vulnerable to sex under the influence of alcohol. Multivariate analysis revealed an independent association of problem drinking with both unprotected sex and a history of sexually transmitted diseases. Alcohol use in commercial sex shall be considered as an occupational hazard that requires immediate intervention. Future longitudinal studies are needed to confirm the association between alcohol use and sexual risks among this most-at-risk population.
Chen, Yiyun; Li, Xiaoming; Zhang, Chen; Hong, Yan; Zhou, Yuejiao; Liu, Wei
Alcohol use and sexual risks: use of the Alcohol Use Disorders Identification Test (AUDIT) among female sex workers in China.
The association between alcohol use and sexual risks among female sex workers (FSWs) has been insufficiently studied. This article reports a cross-sectional study of the relationship between alcohol use risk, measured by the Alcohol Use Disorders Identification Test (AUDIT), and sexual risk behaviors among 1,022 FSWs in Guangxi, China. Bivariate analysis showed that FSWs at higher AUDIT levels tended to have earlier sexual initiation, became involved in the sex trade at a younger age, and were more vulnerable to sex under the influence of alcohol. Multivariate analysis revealed an independent association of problem drinking with both unprotected sex and a history of sexually transmitted diseases (STDs). Alcohol use in commercial sex shall be considered as an occupational hazard that requires immediate intervention. Future longitudinal studies are needed to confirm the association between alcohol use and sexual risks among this most-at-risk population. PMID:23311906
Chen, Yiyun; Li, Xiaoming; Zhang, Chen; Hong, Yan; Zhou, Yuejiao; Liu, Wei
Condom Use Among Female Sex Workers in China: Role of Gatekeepers
Objective The objective of this study was to assess the potential role of gatekeepers of establishments in promoting condom use among female sex workers (FSWs) in China. Goals The goals of this study were to explore FSWs� perceptions of gatekeeper attitudes and support for condom use, and to assess their association with FSWs� practice, communication, intention, proper use, knowledge of correct use, and perceptions related to condom use. Study The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Results Perceived gatekeeper support for condom use was low among FSWs. Perceived support was positively associated with condom use communication with sexual partners, condom use frequency and intention, but not associated with proper condom use among FSWs. Perceived support was significantly associated with most condom use-related perceptions (e.g., self-efficacy of condom use, barriers to condom use, and perceived peer condom use) among FSWs. Conclusions Healthcare professionals should work with gatekeepers to create a supportive local environment for condom use in sex work establishments. Gatekeepers need to clearly articulate their support for condom use to the FSWs. Training and skill acquisition regarding correct use of condoms among FSWs will be necessary.
Factors associated with condom use negotiation by female sex workers in Bangladesh
Summary Negotiation for condom use by female sex workers (FSWs) with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 FSWs; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the seven days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street based FSWs respectively. Overall, 28.1% of FSWs negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2.�2.0), and self-perceived risk of HIV infection (AOR, 1.8 95% CI, 1.6�2.1) were positive predictors for condom negotiation. Compared to the hotel based FSWs, street (AOR, 0.6; 95% CI, 0.4�0.9), and brothel based FSWs (AOR, 0.7; 95% CI, 0.5�0.9) were less likely to negotiate for condom use. FSWs in Bangladesh are at high risk for STI/HIV infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by FSWs, and should be strengthened in commercial sex venues.
Alam, Nazmul; Chowdhury, Mahbub Elahi; Mridha, Malay K.; Ahmed, Anisuddin; Reichenbach, Laura J.; Streatfield, Peter Kim; Azim, Tasnim
Estimating the number of male sex workers with the capture-recapture technique in Nigeria.
Estimating the size of populations most affected by HIV such as men who have sex with men (MSM) though crucial for structuring responses to the epidemic presents significant challenges, especially in a developing society. Using capture-recapture methodology, the size of MSM-SW in Nigeria was estimated in three major cities (Lagos, Kano and Port Harcourt) between July and December 2009. Following interviews with key informants, locations and times when MSM-SW were available to male clients were mapped and designated as "hotspots". Counts were conducted on two consecutive weekends. Population estimates were computed using a standardized Lincoln formula. Fifty-six hotspots were identified in Kano, 38 in Lagos and 42 in Port Harcourt. On a given weekend night, Port Harcourt had the largest estimated population of MSM sex workers, 723 (95% CI: 594-892) followed by Lagos state with 620 (95%CI: 517-724) and Kano state with 353 (95%CI: 332-373). This study documents a large population of MSM-SW in 3 Nigerian cities where higher HIV prevalence among MSM compared to the general population has been documented. Research and programming are needed to better understand and address the health vulnerabilities that MSM-SW and their clients face. PMID:24689319
Adebajo, Sylvia B; Eluwa, George I; Tocco, Jack U; Ahonsi, Babatunde A; Abiodun, Lolade Y; Anene, Oliver A; Akpona, Dennis O; Karlyn, Andrew S; Kellerman, Scott
Given growing concern of the sexual risks associated with crystal methamphetamine use and the dearth of research characterizing the use of methamphetamine among street-based sex workers (FSWs), this study aimed to characterize the prevalence and individual, social, and structural contexts of crystal methamphetamine use among FSWs in a Canadian setting. Drawing on data from a prospective cohort, we constructed multivariate logistic models to examine independent correlates of crystal methamphetamine among FSWs over a two-year follow-up period using generalized estimating equations. Of a total of 255 street-based FSWs, 78 (32%) reported lifetime crystal methamphetamine use and 24% used crystal methamphetamine during the two-year follow-up period, with no significant associations between methamphetamine use and sexual risk patterns. In a final multivariate GEE model, FSWs who used crystal methamphetamine had a higher proportional odds of dual heroin injection (adjOR = 2.98, 95%CI: 1.35�5.22), having a primary male sex partner who procures drugs for them (adjOR = 1.79, 95%CI: 1.02�3.14), and working (adjOR = 1.62, 95%CI: 1.04�2.65) and living (adjOR = 1.41, 95%CI: 1.07�1.99) in marginalized public spaces. The findings highlight the crucial need to move beyond the individual to gender-focused safer environment interventions that mediate the physical and social risk environment of crystal methamphetamine use among FSWs.
Shannon, K; Strathdee, SA; Shoveller, J; Zhang, R; Montaner, JS; Tyndall, MW
Appropriating social citizenship: women's labour, poverty, and entrepreneurship in the manual workers union of Botswana.
Interrogating critiques of the 'African labour aristocracy' thesis, the article proposes that public service industrial-class manual workers in Botswana form, if not a labour 'aristocracy' in the sense first defined by Saul and Arrighi, then a marginal worker 'elite'. They are privileged in having a regular salary above minimum pay, augmented by periodic lump-sum gratuity payments. This sets them apart from the other low-paid workers in the private sector, casual workers in the informal economy and a vast army of unemployed job seekers. In the absence of a national unemployment benefit scheme in Botswana, the article explores some of the strategies deployed by women members of the Manual Workers Union in their attempts to contend with the spectre of future unemployment and impoverishment. In gender terms, the article highlights the independence, autonomy and decision-making capacity of women trade unionist leaders, who straddle the worlds of workers' rights and citizens' rights, and manoeuvre their way through the maze of rules and regulations they encounter in both. PMID:20879188
Werbner, Pnina
Prevalence of transmitted HIV-1 drug resistance among female sex workers and men who have sex with men in El Salvador, Central America.
Transmitted drug resistance has important implications for the successful use and management of therapy among persons infected with HIV. We estimated the prevalence of transmitted drug resistance in 145 samples from female sex workers (n = 47) and men who have sex with men (n = 98) in El Salvador. Samples were collected during March to September 2008, using a respondent driven sampling. The HIV-1 pol gene was sequenced to identify drug resistance mutations and transmitted drug resistance was scored as recommended by World Health Organization. Specimens were classified as recent or established infections using the Immunoglobulin G-Capture BED-Enzyme Immunoassay. The overall prevalence of transmitted drug resistance was 9.4% (95% CI: 4.7-16.1%), and was 5.9% for non-nucleoside reverse transcriptase inhibitors, 4.2% for nucleoside reverse transcriptase inhibitors, and 0.8% for protease inhibitors. Transmitted drug resistance prevalence was 10.3% (95% CI: 2.8-24.2%) among female sex workers, and 9.0% (95% CI: 3.6-17.6%) among men who have sex with men. Nineteen patients were classified as having recent infection (16.2%, 95% CI: 10.1-24.2%), while 98 patients (83.8%, 95% CI: 75.8-89.9%) were classified as having established infections. Transmitted drug resistance among recent and established infections was similar at 10.5% and 9.2%, respectively. This study shows that the prevalence of transmitted drug resistance is moderate among female sex workers and men who have sex with men in El Salvador. These results highlight the importance of transmitted drug resistance surveillance in a representative sample of recently infected patients following the World Health Organization guidelines. PMID:22930496
Murillo, Wendy; Lorenzana de Rivera, Ivette; Albert, Jan; Guardado, Mar�a Elena; Nieto, Ana Isabel; Paz-Bailey, Gabriela
Educated Immigrant Women Workers Doing Well with Change: Helping and Hindering Factors
ERIC Educational Resources Information Center
The authors investigated the strategies that helped or hindered 10 immigrant women workers to do well with change that affected their work. A total of 182 incidents were extracted and grouped into 9 categories: personal beliefs/traits/values, taking action, skills/education, personal challenges, self-care, relationships/support,�
Koert, Emily; Borgen, William A.; Amundson, Norman E.
HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil.
Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5-9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1-2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention. PMID:24617659
Fernandes, Fernanda R P; Mousquer, Gina J; Castro, Lisie S; Puga, Marco A; Tanaka, Tayana S O; Rezende, Grazielli R; Pinto, Clarice S; Bandeira, Larissa M; Martins, Regina M B; Francisco, Roberta B L; Teles, Sheila A; Motta-Castro, Ana R C
Gender Power Control, Sexual Experiences, Safer Sex Practices, and Potential HIV Risk Behaviors Among Young Asian-American Women
We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women�s perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women�s intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.
Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A.
Sex trade among young women attending family-planning clinics in Northern California
Objective To describe the prevalence and nature of sex trade in a clinic-based sample of young women and to evaluate associations with sexual and reproductive health. Methods A cross-sectional survey was conducted with women aged 16�29 years (n=1277) presenting to family-planning clinics in Northern California, USA. Results Overall, 8.1% of respondents indicated a lifetime history of trading sex for money or other resources. Sex trade was associated with unintended pregnancy (adjusted risk ratio [ARR] 1.27; 95% confidence interval [CI], 1.09�1.48), multiple abortions (ARR 1.63; 95% CI, 1.19�2.23), STI diagnosis (ARR 1.46; 95% CI, 1.27�1.68), and unwanted sex (vaginal ARR 3.64; 95% CI, 2.39�5.56; anal ARR 4.99; 95% CI, 2.17�11.50). Of the women ever involved in sex trade, 12 (37.3%) reported that their first such experience was before they were 18 years of age. Conclusion Approximately 1 in 12 participants had been involved in sex trade, illustrating the presence of patients with this history within the family-planning clinical setting. Sex trade was associated with multiple indicators of poor sexual and reproductive health. Family-planning clinics may represent an underused mechanism for engaging this high-risk population.
Decker, Michele R.; Miller, Elizabeth; McCauley, Heather L.; Tancredi, Daniel J.; Levenson, Rebecca R.; Waldman, Jeffrey; Schoenwald, Phyllis; Silverman, Jay G.
The mothering experiences of sex-trafficked women: between here and there.
This qualitative study focuses on the mothering experiences of women from the former Soviet Union (FSU) who were sex-trafficked to Israel. In-depth interviews were conducted with 8 women who gave birth either in the FSU or in Israel. The women's stories reflect 3 experiential spheres, those of "the good mother," "the sacrificing mother," and "the mother who wants for herself." These mothering spheres were found to exist against the backdrop of a life between 2 countries, where the women's mothering is split between "here" and "there." Furthermore, it was found that the women's sex-trafficking experience continually threatened to invade the 3 mothering spheres and destabilize the balance among them. The splits and conflicts among the mothering spheres are examined from a gendered perspective with emphasis on mother-daughter relationships and on the social constructions of mothering and prostitution. PMID:24164529
Peled, Einat; Parker, Ayelet
Sex-Role Identity, Sex-Role Attitudes, and Women's Achievement Motivation.
ERIC Educational Resources Information Center
Results from comparable studies on the experimental arousal of achievement motivation with female subjects are often inconsistent and contradictory with the findings for males. The sex-role identity, sex-role attitudes, and experimental arousal of achievement motivation were investigated for 180 female undergraduate subjects. Experimental and�
Jacobson, Sheryl F.
Sex differences in attraction to familiar and unfamiliar opposite-sex faces: men prefer novelty and women prefer familiarity.
Familiarity is attractive in many types of stimuli and exposure generally increases feelings of liking. However, men desire a greater number of sexual partners than women, suggesting a preference for novelty. We examined sex differences in preferences for familiarity. In Study 1 (N�=�83 women, 63 men), we exposed individuals to faces twice and found that faces were judged as more attractive on the second rating, reflecting attraction to familiar faces, with the exception that men's ratings of female faces decreased on the second rating, demonstrating attraction to novelty. In Studies 2 (N�=�42 women, 28 men) and 3 (N�=�51 women, 25 men), exposure particularly decreased men's ratings of women's attractiveness for short-term relationships and their sexiness. In Study 4 (N�=�64 women, 50 men), women's attraction to faces was positively related to self-rated similarity to their current partner's face, while the effect was significantly weaker for men. Potentially, men's attraction to novelty may reflect an adaptation promoting the acquisition of a high number of sexual partners. PMID:23740467
Little, Anthony C; DeBruine, Lisa M; Jones, Benedict C
Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal
Background Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs) and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. Methods This paper is based on a qualitative study of Female Sex Workers (FSWs) in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. Results The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients' resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. Conclusion This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO) to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work.
Women with Intellectual Disabilities Talk about Their Perceptions of Sex
ERIC Educational Resources Information Center
Background: Sexuality is learned through sexual socialisation that women with intellectual disabilities (IDs) understand and express. Rules of sexual engagement for these women can include barriers for their socialisation, intimate partner selection, and sexual expression. These rules can become more limiting when coupled with rules of femininity�
Bernert, D. J.; Ogletree, R. J.
Blood lead survey of children, pregnant women, professional drivers, street workers, and office workers in Trujillo, Peru.
In this pilot study, conducted in summer 2002, the authors measured blood lead levels (BLLs) for 118 subjects in the city of Trujillo, Peru, where leaded gasoline is in the process of being phased out. Subjects included bus drivers, combi (minivan) drivers, street vendors, newspaper vendors, traffic police, taxi drivers, gas station attendants, children living both near and distant from gas stations, pregnant women, and office workers (controls). The highest BLLs were 9.2 microg/dl and 9.3 microg/dl from a child who lived near a gas station and from a traffic policeman, respectively; however, all BLLs were below the U.S. Centers for Disease Control and Prevention's advisory level of concern (10 microg/dl). Office workers (n = 8) and pregnant women (n = 36) had significantly lower BLLs (geometric mean +/- standard deviation = 2.1 +/- 0.7 microg/dl, p < 0.022; and 2.5 +/- 1.1 microg/dl, p < 0.008, respectively) than total traffic-exposed workers (n = 48; 3.2 +/- 1.8 microg/dl). BLLs of children living near gas stations (n = 17; 3.7 +/- 2.2 microg/dl) were marginally higher (p = 0.07) than for children not living near gas stations (n = 9; 2.9 +/- 1.1 microg/dl). The study was limited by small sample size and the fact that the data were based on a convenience sample not fully representative of the cohorts studied. Nevertheless, the authors' findings suggest that leaded gasoline use in Trujillo continues to affect BLLs in traffic-exposed populations. PMID:16241040
Naeher, Luke P; Aguilar-Villalobos, Manuel; Miller, Todd
"Differently normal" and "normally different": negotiations of female embodiment in women's accounts of 'atypical' sex development.
During recent decades numerous feminist scholars have scrutinized the two-sex model and questioned its status in Western societies and medicine. Along the same line, increased attention has been paid to individuals' experiences of atypical sex development, also known as intersex or 'disorders of sex development' (DSD). Yet research on individuals' experiences of finding out about their atypical sex development in adolescence has been scarce. Against this backdrop, the present article analyses 23 in-depth interviews with women who in their teens found out about their atypical sex development. The interviews were conducted during 2009-2012 and the interviewees were all Swedish. Drawing on feminist research on female embodiment and social scientific studies on diagnosis, I examine how the women make sense of their bodies and situations. First, I aim to explore how the women construe normality as they negotiate female embodiment. Second, I aim to investigate how the divergent manners in which these negotiations are expressed can be further understood via the women's different access to a diagnosis. Through a thematic and interpretative analysis, I outline two negotiation strategies: the "differently normal" and the "normally different" strategy. In the former, the women present themselves as just slightly different from 'normal' women. In the latter, they stress that everyone is different in some manner and thereby claim normalcy. The analysis shows that access to diagnosis corresponds to the ways in which the women present themselves as "differently normal" and "normally different", thus shedding light on the complex role of diagnosis in their negotiations of female embodiment. It also reveals that the women make use of what they do have and how alignments with and work on norms interplay as normality is construed. PMID:24331903
Guntram, Lisa
The organization of sex work in low- and high-priced venues with a focus on the experiences of ethnic minority women working in these venues.
Prior research on female sex workers (FSW) in China, and their risk for HIV and STI, neglects the nuanced experiences of ethnic minority FSW. We conducted participant observations and in-depth interviews with 33 FSW and six venue bosses to describe the experiences of FSW and management structures in low and high-priced sex work venues in Liuzhou, China. In low-priced venues, FSW had more autonomy and stronger relationships with their ethnic minority peers. Mid- and high-priced venues had more formal management structures. Ethnic minority FSW working in higher priced venues experienced less support and kinship with their peers. HIV/STI prevention outreach activities occurred in all of the venues, but they were not tailored for different venue types or for ethnic minority FSW. Our findings provide guidance for tailoring public health programs that meet the needs of ethnic minority women working in different types of sex work venues. PMID:23912337
Liu, Qian; Zhuang, Kongshao; Henderson, Gail E; Shenglong, Quzhen; Fang, Jingwen; Yao, Huiqin; Qin, Jingxin; Yang, Yanzhen; Abler, Laurie
Gender inequity in the lives of women involved in sex work in Kampala, Uganda
Background Gender inequity is manifested in the social and economic burden women carry in relation to men. We investigate women's experiences of gender relations from childhood to adult life and how these may have led to and kept women in sex work. Methods Participants were drawn from an ongoing epidemiological cohort study of women working in high HIV/STI risk environments in Kampala. From over 1000 enrolled women, we selected 101 for a qualitative sub-study. This analysis focuses on 58 women who engaged in sex work either as a main job or as a side job. In-depth life history interviews were conducted to capture points of vulnerability that enhance gender inequity throughout their lives. Results Most participants were young, single parents, poorly educated, who occupied low skilled and poorly paying jobs. All women knew their HIV status and they disclosed this in the interview; 31 were uninfected while 27 said they were infected. Parental neglect in childhood was reported by many. Participants described experiences of violence while growing up sometimes perpetuated by relatives and teachers. Early unwanted pregnancies were common and for many led to leaving school. Some women stated a preference for multiple and short-term money-driven sexual relationships. Needing to earn money for child care was often the main reason for starting and persisting with sex work. Violence perpetrated by clients and the police was commonly reported. Alcohol and drug use was described as a necessary �evil� for courage and warmth, but sometimes this affected clear decision making. Many felt powerless to bargain for and maintain condom use. Leaving sex work was considered but rarely implemented. Conclusions Inequities in gender and power relations reduce economic and social opportunities for better lives among women and increase risky sexual behaviour. Interventions focused on these inequities that also target men are crucial in improving safer practices and reducing risk.
Mbonye, Martin; Nalukenge, Winifred; Nakamanya, Sarah; Nalusiba, Betty; King, Rachel; Vandepitte, Judith; Seeley, Janet
Family Sex Composition Preferences among Guatemalan Men and Women.
ERIC Educational Resources Information Center
The predominant preference among men and and women is for equal numbers of sons and daughters. Yet agreement between husbands and wives is low. Motivations for preferring equal numbers may differ between the rural and semiurban areas. (Author)
Pebley, Anne R.; And Others
Sex Work and Drug Use in a Subculture of Violence
ERIC Educational Resources Information Center
This article examines the subculture of violence thesis as it relates to female street sex workers in Miami. Interview and focus group methods were used to study the intersections of childhood trauma, drug use, and violent victimization among 325 women. Using targeted sampling, crack- and heroin-using sex workers were recruited through street�
Surratt, Hilary L.; Inciardi, James A.; Kurtz, Steven P.; Kiley, Marion C.
Correlates of Chlamydia and Gonorrhea Infection among Female Sex Workers: The Untold Story of Jiangsu, China
Objective(s) To estimate the prevalence of sexually transmitted infections (STIs) among female sex workers (FSWs) in the Jiangsu Province, China and measure the association of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections with their potential correlates. Design A cross-sectional study on a representative sample of FSWs in Yangzhou and Changzhou cities of Jiangsu was conducted. Methods 185 sex-work venues in Yangzhou and 174 in Changzhou were selected by stratified random sampling. 2972 FSWs (1108 in Yangzhou and 1864 in Changzhou), aged 15 years or more, who agreed to participate and provided blood sample for HIV and syphilis testing were interviewed in these venues. Cervical specimens from 849 randomly chosen participants were then tested for CT and NG. Results Proportions of young, school-educated, currently married FSWs who were living alone, migrated from other provinces and engaged in unprotected vaginal intercourse in past 3 months (UVI) were relatively high. Prevalence of HIV, syphilis, CT and NG were 0.20%, 4.88%, 14.61% and 5.42% respectively. Younger age, living alone or with persons other than partners/family members, engaging in UVI and having other STIs seemed to be associated with higher risk of CT or NG infection. Being divorced/widowed and working in middle/low-level venues were identified as additional risk factors for NG. Conclusions Based on a representative sample, this initial effort to identify the correlates of CT/NG infections among FSWs of Jiangsu revealed that focused interventions targeting high-risk FSWs are urgently required for controlling STI epidemics in Yangzhou and Changzhou where substantial number of STI cases were identified.
Jiang, Ning; Hu, Hai-Yang; Mahapatra, Tanmay; Yin, Yue-Ping; Mahapatra, Sanchita; Wang, Xiao-Liang; Chen, Xiang-Sheng; Lin, Nan; Zhang, Xun; Huan, Xi-Ping; Yang, Hai-Tao; Fu, Geng-Feng
Reaching the Unreachable: Providing STI Control Services to Female Sex Workers via Mobile Team Outreach
Background As part of a community-randomized trial of a multicomponent intervention to prevent sexually transmitted infections, we created Mobile Teams (MTs) in ten intervention cities across Peru to improve outreach to female sex workers (FSW) for strengthened STI prevention services. Methods Throughout 20 two-month cycles, MTs provided counseling; condoms; screening and specific treatment for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and vaginal Trichomonas vaginalis (TV) infections; and periodic presumptive metronidazole treatment for vaginal infections. Results MTs had 48,207 separate encounters with 24,814 FSW; numbers of sex work venues and of FSW reached increased steadily over several cycles. Approximately 50% of FSW reached per cycle were new. Reported condom use with last client increased from 73% to 93%. Presumptive metronidazole treatment was accepted 83% of times offered. Over 38 months, CT prevalence declined from 15�4% to 8�2%, and TV prevalence from 7�3% to 2�6%. Among participants in ?9 cycles, CT prevalence decreased from 12�9% to 6�0% (p <0�001); TV from 4�6% to 1�5% (p <0�001); and NG from 0�8% to 0�4% (p =0�07). Conclusions Mobile outreach to FSW reached many FSW not utilizing government clinics. Self-reported condom use substantially increased; CT and TV prevalences declined significantly. The community-randomized trial, reported separately, demonstrated significantly greater reductions in composite prevalence of CT, NG, TV, or high-titer syphilis serology in FSW in these ten intervention cities than in ten matched control cities.
Campos, Pablo E.; Buffardi, Anne L.; Carcamo, Cesar P.; Garcia, Patricia J.; Buendia, Clara; Chiappe, Marina; Garnett, Geoff P.; Xet-Mull, Ana Maria; Holmes, King K.
Men (and Women) as "Sellers" of Sex in Alcohol-Serving Venues in Cape Town, South Africa.
The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7 vs. 5.8�%). Overall, men who traded sex were similar to their female counterparts. Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men. PMID:23494405
Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Watt, Melissa H; Sikkema, Kathleen J; Skinner, Donald; Pieterse, Desiree; Cain, Demetria
The Impact of Homelessness on Recent Sex Trade among Pregnant Women in Drug Treatment.
This study is a secondary data analysis aimed to examine the influence of recent homelessness on recent sex trade among pregnant women in drug treatment after controlling for psychiatric comorbidity, age, education, and race. Eighty-one pregnant women from a drug treatment program in Baltimore, Maryland attended an in-person interview and completed the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorders-IV for Axis I disorders, the HIV Risk Behavior Interview, and demographic questionnaires, which assessed psychiatric symptoms, recent homelessness, and sexual risk behavior respectively. Women who experienced recent homelessness had a 4.74 greater odds of having recently traded sex than women who had not been recently homeless, suggesting that homelessness uniquely influences sex trade beyond psychiatric status, which was also a significant correlate of recent sex trade. Addressing both homelessness and psychiatric problems may effectively reduce sex trade and risk for infectious diseases, which could adversely impact maternal and child health outcomes. PMID:22754382
Brown, Qiana L; Cavanaugh, Courtenay E; Penniman, Typhanye V; Latimer, William W
20 Facts on Women Workers. Facts on Working Women No. 93-2.
ERIC Educational Resources Information Center
This bulletin summarizes some current information on working women into 20 short statements. Some of the highlights are the following: (1) about 58 percent of all women aged 16 and older (58 million) were labor force participants in 1992; (2) labor force participation for women was highest among those in the 35-44 age group---77 percent, with 73�
Women's Bureau (DOL), Washington, DC.
HIV Infection, Risk Factors, and Preventive Services Utilization among Female Sex Workers in the Mekong Delta Region of Vietnam
Background Risk behaviors among female sex workers (FSW) are considerable drivers of HIV infections in Vietnam, especially transmission between high-risk and low-risk groups. We assessed HIV prevalence and its correlates among FSWs, and the use of preventive services among this community in the Mekong Delta region, southern Vietnam. Methods A cross-sectional survey of 1,999 FSWs was carried out in five provinces including Ben Tre, Hau Giang, Kien Giang, Tien Giang, and Vinh Long between June, 2006 and June, 2007. We interviewed participants face-to-face in order to elicit information about their lives and potential risk factors, and we tested their sera to determine their HIV status. We then performed multivariate logistic regression analyses to investigate factors associated with HIV infection. Results Seventeen percent of the participating FSWs were street-based sex workers (SSWs) and the rest (83%) were entertainment establishment-based sex workers (ESWs). Unprotected sex with regular and casual clients in the past month was frequent among study participants (40.5% and 33.5% respectively). However, few respondents (1.3%) had ever injected drugs. Only 2.1% (95% confidence interval (CI): 1.6%�2.8%) of FSWs were found to be infected with HIV. HIV prevalence among SSWs was greater than among ESWs (3.8% vs. 1.8%, p?=?0.02, respectively). Increased risk for HIV infection was significantly associated with the number of clients per month (adjusted odd ratio (aOR)?=?2.65, 95% CI: 1.26�5.59). Conclusions Interventions to reduce unsafe sex and drug injection, and to increase uptake of HIV testing among FSWs are necessary. Differences in HIV prevalence and its correlates by type of sex work emphasize the importance of constrained contexts in shaping risk behaviors among FSWs; that should be considered in designing HIV prevention programs.
Pham, Quang Duy; Nguyen, Phuc Duy; Khuu, Nghia Van; Nguyen, Nhung Phuong; Bui, Duc Hoang; Thi Phan, Huong Thu; Nguyen, Long Thanh
Women's Unprotected Sex Intentions: Roles of Sexual Victimization, Intoxication, and Partner Perception.
Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence. PMID:23718552
Masters, N Tatiana; George, William H; Davis, Kelly Cue; Norris, Jeanette; Heiman, Julia R; Jacques-Tiura, Angela J; Gilmore, Amanda K; Nguyen, Hong V; Kajumulo, Kelly F; Otto, Jacqueline M; Stappenbeck, Cynthia A
Health-seeking behaviour of women selling sex in Lahore, Pakistan.
The aim of this study was to describe the knowledge and health-seeking behaviour related to sexually transmitted infections (STIs) and abortion among women selling sex in Lahore, Pakistan. This was a cross-sectional, community-based, quantitative study. A total of 730 women selling sex were recruited by respondent-driven sampling. A pretested structured questionnaire was administered through face-to-face interviews. The median age of the participants was 30 years. Thirteen percent of the participants said it was common for them to have an abnormal vaginal discharge. Seventy-five percent of the participants recognized STIs as either leucorrhoea or AIDS. Sixty-five percent of the participants complained of having suffered from STI(s) in the six months preceding the survey, of whom 28% sought treatment. Women selling sex who reported consistent condom use were 1.5 times (95% confidence interval [CI]: 1.1-2.2) more likely to seek treatment than women who did not report consistent condom use. The level of knowledge about STIs remains low among women selling sex in Lahore, Pakistan, and health-seeking behaviour for the management of STIs and abortions is influenced by ability to pay and ease of access in the private sector. PMID:21729955
Khan, M S; Unemo, M; Zaman, S; Lundborg, C St�lsby
Sexually transmitted infections and sexual behaviour among youth clients of hotel-based female sex workers in Dhaka, Bangladesh.
A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them. PMID:22930291
Haseen, F; Chawdhury, F A H; Hossain, M E; Huq, M; Bhuiyan, M U; Imam, H; Rahman, D M M; Gazi, R; Khan, S I; Kelly, R; Ahmed, J; Rahman, M
Are lesbians really women who have sex with women (WSW)? Methodological concerns in measuring sexual orientation in health research.
Varying measures of sexual orientation are used in women's health research. As they incorporate different dimensions, definitions, and categorical groupings, the comparability of results obtained across studies using different measures remains unknown. We examined the comparability of results using data from the U.S. 2002 National Survey of Family Growth (n = 6,356). Women were classified according to sexual orientation identity, sex of sex partners in the past year, and sex of sex partners over the lifetime. Associations with six health outcomes were compared across sexual orientation schemes. Associations differed in magnitude and statistical significance, even producing conflicting results. Our analyses resulted in a series of methodological recommendations for research on sexual minority women. Data on both behavioral and identity measures should be gathered in health research; identity groups should not be combined for analysis; and researchers should carefully consider which classification scheme(s) to use based on the theoretical basis for the study and the implications for informing interventions. PMID:19301530
Bauer, Greta R; Jairam, Jennifer A
Invisible victims: same-sex IPV in the National Violence Against Women Survey.
With intimate partner violence (IPV) among same-sex couples largely ignored by policy makers and researchers alike, accurately estimating the size of the problem is important in determining whether this minimal response is justified. As such, the present study is a secondary data analysis of the National Violence Against Women Survey and represents the first multiple variable regression analysis of U.S. adult same-sex IPV prevalence using a nationally representative sample (N = 14,182). Logistic regressions indicate that, independent of sex, respondents with a history of same-sex relationships are more likely to experience verbal, controlling, physical, and sexual IPV. Behaviorally "bisexual" respondents experience the highest IPV rates and are most likely to be victimized by an opposite-sex partner. Implications for future IPV research regarding sexual orientation and gender are discussed. PMID:20829231
Messinger, Adam M
Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa
Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs� health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa.
Risky Behaviors among HIV-Positive Female Sex Workers in Northern Karnataka, India.
Purpose. Little is known about the risky sexual behaviors of HIV-positive female sex workers (FSWs) in the developing world, which is critical for programmatic purposes. This study aims to shed light on their condom use with regular clients as well as husband/cohabiting partner, a first in India. Methods. Multivariate logistic regression analyses for consistent condom use with regular clients and husband/cohabiting partner are conducted for the sample of 606 HIV-positive FSWs. Results. Older FSWs are 90% less likely and nonmobile FSWs are 70% less likely to consistently use condoms. FSWs on ART are 3.84 times more likely to use condoms. Additionally, FSWs who changed their occupation after HIV diagnosis are 70% less likely to use condoms. FSWs who are currently cohabiting are more likely to consistently use condoms with repeat clients and are 3.22 times more likely to do so if they have felt stigma associated with being HIV-positive. FSWs who have multiple repeat clients, and who do not know the sexual behavior of these clients, are more likely to use condoms consistently. Conclusion. This study would help inform programs to target the following particularly vulnerable HIV-positive FSWs: those who are older, those who changed their occupation post-HIV diagnosis, and those who are nonmobile. PMID:23365728
Jadhav, Apoorva; Bhattacharjee, Parinita; Raghavendra, T; Blanchard, James; Moses, Stephen; Isac, Shajy; Halli, Shiva S
Psychological morbidity among female commercial sex workers with alcohol and drug abuse
Introduction: Substance abuse may act as precursors and also can form outcomes of sexual behaviors. The confluence of drug use, mental stressors, poverty, sexually transmitted diseases, low self-esteem and high-risk partners forms a fertile ground for psychological morbidity. Aim: To assess the psychological morbidity among female commercial sex workers (CSWs) who use alcohol and other substance abuse. Materials and Methods: One hundred consecutive CSWs with alcohol and drug abuse patients attending the psychiatric OPD at Victoria hospital were assessed clinically. Relevant investigations were also carried out. General health questionnaire and substance use disorder identification tests were administered. Results: A total of 100 cases between 30-40 years of age were taken up for the study. All were abusing alcohol with tobacco chewing or smoking being (64). Eighty-seven were married. Fifty of them being illiterate. Seventy-eight were suffering from physical illness. Two were HIV patient on treatment. Seventy-eight were having psychological morbidity (depression and adjustment disorder). Conclusion: Preventive interventions, targeting substance abuse and stimulating healthier-environments and providing economically independent.
Pandiyan, Kasthuri; Chandrasekhar, H.; Madhusudhan, S.
Sex Hormones in Postmenopausal Women Receiving Low-Dose Hormone Therapy: The Effect of BMI
The aim of our study was to evaluate the effect of BMI on the change in circulating sex hormone in postmenopausal women during 6 months of oral continuous combined low-dose hormone therapy (HT). Fifty postmenopausal women were allocated to receive daily one tablet containing combination of 17?-estradiol (1 mg)\\/norethindrone acetate (0.5 mg) for 6 months. Serum levels of follicle-stimulating hormone
Irene Lambrinoudaki; Eleni Armeni; Demetrios Rizos; Eythimios Deligeoroglou; Panagiotis Kofinakos; George Kaparos; Andreas Alexandrou; Maria Creatsa; Emmanuel Logothetis; Evangelia Kouskouni
Relationship between Insulin and Sex Hormone-Binding Globulin Levels during Weight Loss in Obese Women
Objective: The aim of this study was to assess the impact of insulin sensitivity on the relationship between sex hormone-binding globulin (SHBG) and insulin levels during active weight loss in euthyroid obese women. Research Design and Methods: The study population comprised 80 premenopausal overweight and obese (BMI ?27) women (mean age 41.44 � 10.03 years). Seventy patients were considered eligible
Fulya Akin; Mehmet Bastemir; Bunyamin Kaptanoglu
The Relation Between Sex Drive and Sexual Attraction to Men and Women: A Cross-National Study of Heterosexual, Bisexual, and Homosexual Men and Women
Recent research suggests that, for most women, high sex drive is associated with increased sexual attraction to both women\\u000a and men. For men, however, high sex drive is associated with increased attraction to one sex or the other, but not to both,\\u000a depending on men's sexual orientation (Lippa, R. A., 2006, Psychological Science, 17, 46�52). These findings were replicated in
Richard A. Lippa
Disjunctures for Women and Frontline Workers: Implementation of the Family Violence Option
This research uses analysis of qualitative interviews with 10 battered welfare clients and 15 frontline welfare workers to examine the implementation of the Family Violence Option (FVO) under welfare reform. States adopting the FVO agree to screen for domestic violence, refer identified victims to community resources, and waive program requirements that would endanger the women or with which they are unable to comply. The analyses find that none of the 10 clients in this study received these services. This lack of services reflects four critical disjunctures between the formal policy and the policy experienced by the clients. It also reveals several more basic structural factors that provide conflicting mandates to frontline workers. Frontline workers� discretionary behaviors enforce core rules related to welfare eligibility and reduce welfare caseloads but do not provide violencerelated services to victims.
Lindhorst, Taryn; Padgett, Julianna D.
Disjunctures for Women and Frontline Workers: Implementation of the Family Violence Option.
This research uses analysis of qualitative interviews with 10 battered welfare clients and 15 frontline welfare workers to examine the implementation of the Family Violence Option (FVO) under welfare reform. States adopting the FVO agree to screen for domestic violence, refer identified victims to community resources, and waive program requirements that would endanger the women or with which they are unable to comply. The analyses find that none of the 10 clients in this study received these services. This lack of services reflects four critical disjunctures between the formal policy and the policy experienced by the clients. It also reveals several more basic structural factors that provide conflicting mandates to frontline workers. Frontline workers' discretionary behaviors enforce core rules related to welfare eligibility and reduce welfare caseloads but do not provide violencerelated services to victims. PMID:18270548
Lindhorst, Taryn; Padgett, Julianna D
Working to Prevent HIV\\/STIs Among Women in the Sex Industry in a Rural Town of Hainan, China
We evaluated a two-phase HIV\\/STIs prevention intervention for female sex workers in a resource-limited rural town in Hainan\\u000a Province, China. The primary intervention strategy, conducted from 1997 to 2000, was a condom promotion campaign conducted\\u000a through outreach to sex workers. Four serial cross-sectional surveys were carried out before and after the intervention. Over\\u000a a period of 2�years, reported condom use
Su-Su Liao; Qi-Ya He; Kyung-Hee Choi; Esther S. Hudes; Jin-Fang Liao; Xiao-Chun Wang; Min Liu; Wen-Li Pan; Jeffrey S. Mandel
Biomarker validation of recent unprotected sexual intercourse in a prospective study of young women engaged in sex work in Phnom Penh, Cambodia
Summary A study of female sex workers in Phnom Penh, Cambodia found self-reported condom use to be of questionable validity, particularly among amphetamine-type stimulant (ATS) users and those with multiple partners. Background Accurate measurement of unprotected sex is essential in HIV prevention research. Since 2001, the 100% Condom Use Program targeting female sex workers (FSW) has been a central element of the Cambodian National HIV/AIDS Strategy. We sought to assess the validity of self-reported condom use using the rapid prostate-specific antigen (PSA) test among Cambodian FSW. Methods From 2009 to 2010 we enrolled 183 FSW in Phnom Penh in a prospective study of HIV risk behavior. PSA test results from the OneStep ABAcard� were compared to self-reported condom use in the past 48 hours at quarterly follow-up visits. Results Among women positive for seminal fluid at the first follow-up visit, 42% reported only protected sex or no sex in the detection period. Discordant results were more likely among brothel and street-based FSW vs. entertainment (56% vs. 17%), recent (last 3 months) ATS users (53% vs. 20%), and those with >5 partners in the past month (58% vs. 13%). In multivariable regression models, positive PSA results were associated with recent ATS use (Adjusted Risk Ratio (ARR) = 1.5; 95% confidence interval (CI):1.1 � 2.2), having a non-paying last sex partner (ARR=1.7; CI:1.2 � 2.5), and sex work venue (ARR=3.0; CI:1.4 � 6.5). Correspondingly, women with a non-paying last sex partner were more likely to report unprotected sex (ARR=1.5; CI:1.1 � 2.2), but no associations were found with sex work venue or ATS use. Conclusions Results confirm the questionable validity of self-reported condom use among FSW. The PSA biomarker assay is an important monitoring tool in HIV/STI research including prevention trials.
Evans, Jennifer L.; Couture, Marie-Claude; Stein, Ellen S.; Sansothy, Neth; Maher, Lisa; Page, Kimberly
More Women Than Men: Implications of the Changing Sex Ratio.
ERIC Educational Resources Information Center
Texas, like the rest of the nation, is undergoing a shift toward an excess of females. Review of the changing balance of the sexes reveals that there were only 95.9 males per 100 females in 1970 with a projected drop to 93.8 by 1980. In 1950 Texas had an excess of 15,000 males, but by 1960 females outnumbered males by 90,000 and by 234,000 in�
Skrabanek, R. L.
A serosurvey of Haemophilus ducreyi, syphilis, and herpes simplex virus type 2 and their association with human immunodeficiency virus among female sex workers in Lagos, Nigeria.
Cross-sectional standard serologic assays were used to determine the prevalence of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus type 2 (HSV-2) antibodies among 796 female commercial sex workers from Lagos, Nigeria, and their association with HIV antibody status. The seroprevalence rates were 86% for anti-H. ducreyi IgG and 69% for anti-H. ducreyi IgA, 4% for rapid plasma reagin and Treponema palladium hemagglutination assay confirmed syphilis, 59% for HSV-2, 12% for HIV-1, and 2% for HIV-2. Lower-class sex workers were significantly more likely than upper-class sex workers to be H. ducreyi-positive and to have current or past syphilis infection. The presence of syphilis increased significantly with older age. Non-Nigerian sex workers had significantly higher reactivity to chancroid and borderline reactivity to syphilis. A history of sex with non-Nigerian Africans was significantly associated with chancroid reactivity and borderline significant with syphilis serostatus. H. ducreyi seropositivity was significantly more likely in female sex workers with HSV-2 and syphilis. Chancroid and HSV-2 antibodies were also more common in HIV-infected sex workers. The high prevalence of H. ducreyi antibodies detected in this study underscores the importance of an effective program to control genital ulcerative disease as part of the strategy to prevent the spread of HIV in Nigeria. PMID:9587174
Dada, A J; Ajayi, A O; Diamondstone, L; Quinn, T C; Blattner, W A; Biggar, R J
Contentious issues in research on trafficked women working in the sex industry: Study design, ethics, and methodology
The trafficking of women and children for work in the globalized sex industry is a global social problem. Quality data is needed to provide a basis for legislation, policy, and programs, but first, numerous research design, ethical, and methodological problems must be addressed. Research design issues in studying women trafficked for sex work (WTSW) include how to (a) develop coalitions
Julie Cwikel; Elizabeth Hoban
The Absent Brother: The Effect of Sex of Siblings on Aspirations and Parental Encouragement of Young Women.
ERIC Educational Resources Information Center
This research project focuses on the socialization of young women, and whether that socialization is affected by the sex of the siblings with whom a girl is reared. Specifically, it is argued that sex role differentiation will be stronger when the family includes both male and female children. Subjects were 939 women, 14 to 24 years of age, who�
Lin, Sheila Seubold; Oliver, Pamela
Sibling Sex Ratio and Sexual Orientation in Men and Women: New Tests in Two National Probability Samples
One line of research on the etiology of sexual orientation has examined sibling sex ratio, the ratio of brothers to sisters collectively reported by a group of individuals, but this research has only used clinical and\\/or convenience samples. In the present study, homosexual men and women�s sibling sex ratio was examined in two national probability samples. Results indicated that homosexual
Anthony F. Bogaert
Factor Structure of the Dutch Version of the Childhood Trauma Questionnaire-SF among Female Sex Workers in the Netherlands
In this study, the factor structure of the Childhood Trauma Questionnaire short form (CTQ-SF) in a group of 123 female sex workers in the Netherlands was examined. Structural equation modeling was used to perform the confirmatory factor analysis. The fit between the five-factor model of Bernstein and Fink and the observed empirical model was good. We found a five-factor solution
Stefan Bogaerts; Annelies L. Daalder; Marinus Spreen; Leontien M. Van der Knaap; Jens Henrichs
Correlates of amphetamine-type stimulants use and associations with HIV-related risks among young women engaged in sex work in Phnom Penh, Cambodia
Background Amphetamine-type stimulant (ATS) use has increased in Cambodia and emerged as a significant problem among female sex workers (FSWs), potentially contributing to increased risk of HIV. We examined the prevalence of ATS use and its effect on sexual risk behaviors, and sexually transmitted infections (STI) among FSWs in Phnom Penh, Cambodia. Methods A one-year prospective study among young women engaged in sex work in brothels, entertainment establishments and on a freelance basis. Socio-demographics, sexual risks, and recent ATS use were assessed by self-report. Blood and urine samples were collected to detect HIV, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Bivariate and multivariate longitudinal analyses were conducted to assess the effects of ATS use on number of sex partners, inconsistent condom use with paying partners and incident STI. Results ATS use was higher among women working freelance (35.6%) and in brothels (34.8%) compared to women working in entertainment establishments (17.7%) or in multiple venues (14.8%). ATS users reported more sex partners and days drunk in the previous month. In multivariate longitudinal analysis, ATS use was associated with having a higher number of sex partners (Adjusted Risk Ratio 1.49; 95% CI: 1.00�2.21) and incident STI (Adjusted Odds Ratio 5.41; 95% CI: 1.15�25.48), but not inconsistent condom use with paying partner. Conclusion ATS users had more sex partners, high level of alcohol use, and were at increased risk of STI. Our findings underscore ATS use as an important emerging risk exposure that should be integrated into HIV prevention interventions targeting this population.
Couture, Marie-Claude; Evans, Jennifer L.; Sothy, Neth San; Stein, Ellen S.; Sichan, Keo; Maher, Lisa; Page, Kimberly
Men and Women on the Tube: Sex and Sex-Stereotypes on Television.
National Technical Information Service (NTIS)
Televised sexuality is examined in the context of gender stereotypes for three recent, 'new adult' programs which have been billed as departures from traditional treatments of sex roles and/or sexuality: 'All That Glitters,' 'Soap,' and 'We've Got Each Ot...
S. Hesselbart
Ego development and sex attitudes in heterosexual and homosexual men and women
A comparison was made of heterosexual and homosexual men and women utilizing Loevinger's concept of ego development and focusing on the relationships among ego levels and attitudes toward homosexuality and on personal sex guilt and other sociosexual variables. Previous comparative studies were critically analyzed with respect to the adequacy of definition and description of sampling procedures, and the appropriateness of
Charles B. Weis; Robert N. Dain
Comparison of Daily and Retrospective Reports of Vaginal Sex in Heterosexual Men and Women
This study examined the agreement between daily and retrospective reports of vaginal sex over a two-month period in a sample of 376 heterosexually active men and women. We also examined whether gender, age, or method of daily data collection (self-administered vs. interviewer administered) were related to agreement between daily and retrospective reports. Both counts and categorical measures of frequency of
Mary Rogers Gillmore; Barbara C. Leigh; Marilyn J. Hoppe; Diane M. Morrison
Invisible Victims: Same-Sex IPV in the National Violence Against Women Survey
With intimate partner violence (IPV) among same-sex couples largely ignored by policy makers and researchers alike, accurately estimating the size of the problem is important in determining whether this minimal response is justified. As such, the present study is a secondary data analysis of the National Violence Against Women Survey and represents the first multiple variable regression analysis of U.S.
Adam M. Messinger
Sex Education and Cultural Values: Experiences and Attitudes of Latina Immigrant Women
ERIC Educational Resources Information Center
The paper aims to further explore the role that culture plays in the provision and assimilation of sex education among Latina immigrants in the USA. To accomplish this, researchers conducted focus groups and interviews with 30 women from Central and South America who have lived in the USA for at least five years. Participants were asked to reflect�
Villar, Maria Elena; Concha, Maritza
Invisible Victims: Same-Sex IPV in the National Violence against Women Survey
ERIC Educational Resources Information Center
With intimate partner violence (IPV) among same-sex couples largely ignored by policy makers and researchers alike, accurately estimating the size of the problem is important in determining whether this minimal response is justified. As such, the present study is a secondary data analysis of the National Violence Against Women Survey and�
Messinger, Adam M.
Sex education and cultural values: experiences and attitudes of Latina immigrant women
The paper aims to further explore the role that culture plays in the provision and assimilation of sex education among Latina immigrants in the USA. To accomplish this, researchers conducted focus groups and interviews with 30 women from Central and South America who have lived in the USA for at least five years. Participants were asked to reflect on their
Maria Elena Villar; Maritza Concha
Sexuality and Sex in Mentoring and Tutoring: Implications for Women's Opportunities and Achievement.
ERIC Educational Resources Information Center
It appears that among the three dyadic relationships examined in this article (i.e. grooming mentoring, networking mentoring, and tutoring), grooming mentoring has considerable potential to embrace sexuality and sex in ways that have negative implications for opportunities and achievement, particularly for women. A research agenda is proposed.�
Haring-Hidore, Marilyn; Paludi, Michele A.
Comparative views of the public, sex workers, businesses and residents on establishing managed zones for prostitution: analysis of a consultation in Liverpool.
Drug addiction, violence and anti-social behaviour are characteristics of street prostitution. An alternative approach to zero tolerance is establishing a managed zone where sex workers operate according to regulations and can access health services. Using a consultation with sex workers (n=50), businesses (n=51), residents (n=179) and the public (n=789) we examined where a zone might be established in a UK city (Liverpool) and characteristics of the zone required by these stakeholders. All groups believed a zone would improve sex workers' safety and reduce prostitution elsewhere. Sex workers (96%) agreed to work in a zone. Location criteria from all groups were used to identify two potential business areas to host a zone but businesses in or near these areas rejected plans through fear for staff safety and reduced business. We discuss the consultation process, difficulties in locating services for marginalised groups in cities and the implications for health and judicial policy relating to prostitution. PMID:17029923
Bellis, Mark A; Watson, Fay L D; Hughes, Sara; Cook, Penny A; Downing, Jennifer; Clark, Peter; Thomson, Rod
Development of pulmonary arterial hypertension in women: interplay of sex hormones and pulmonary vascular disease
Pulmonary arterial hypertension (PAH) is a progressive disease of the pulmonary vasculature, ultimately resulting in right heart failure and death. This disease is strongly predominant in females, although little is known regarding how sex influences disease development. Recent developments highlighting the importance of estrogen metabolites in both animal models and human disease have substantially increased our understanding of PAH in women. This review will focus on general knowledge of PAH, translational and basic science data regarding sex hormones in the pulmonary vasculature and on clinical issues that are particular to women with PAH. Future directions for study include the influence of sex hormones on right ventricular responses, improving the understanding of the influence of estrogen exposure in human disease and the study of dehydroepiandrosterone in basic science and human disease.
Pugh, Meredith E; Hemnes, Anna R
Understanding the diversity of male clients of sex workers in China and the implications for HIV prevention programmes.
Male clients of sex workers have been overlooked in China's HIV prevention efforts. This study aims to examine men's practices and attitudes toward extramarital sexual relationships, motivations for visiting female sex workers (FSWs), perceptions of sexually transmitted infection (STI)/HIV risk and risk prevention strategies used. One hundred and eighty-six clients of FSWs with varying socio-economic statuses were interviewed in different sex work settings. Men described no conflict between their role as a client and a responsible family provider. They described social pressure from peers and business partners to visit FSWs, sexual pleasure and companionship as motivators to seek commercial sex. While some men reported no risks associated with visiting FSWs, others identified risks such as being arrested by the police, robbed by gangs and threatening the health of their families by contracting a STI. This study underscores the diversity of FSW clients and the need to understand the beliefs and behaviours of different client types to develop appropriate HIV prevention programmes. It also demonstrates the feasibility of recruiting different types of male clients, a hard-to-reach population for Chinese HIV prevention efforts. PMID:22313090
Huang, Yingying; Maman, Suzanne; Pan, Suiming
Correlates of self-efficacy for condom use among male clients of female sex workers in tijuana, Mexico.
Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior. PMID:23842786
Volkmann, Tyson; Wagner, Karla D; Strathdee, Steffanie A; Semple, Shirley J; Ompad, Danielle C; Chavarin, Claudia V; Patterson, Thomas L
HIV Prevalence and Risk Behaviors Among African American Women Who Trade Sex for Drugs Versus Economic Resources.
Trading sex for money, drugs, goods, services, or a place to stay is prevalent among women who use drugs and has been associated with women's risk of HIV acquisition. There is evidence that trading sex for drugs only may be associated with elevated risk of HIV compared with trading sex for money. The purpose of this study was to assess whether�HIV risk behaviors and HIV prevalence differ among African American drug using women (N�=�92) who traded sex for drugs only, traded sex for economic resources (defined as money, shelter, or other resources) only, or traded sex for both economic resources and drugs. In this study, lower rates of condom use and higher rates of HIV were found among women who traded sex for drugs only compared to women who traded sex for economic resources or for economic resources and drugs. These findings suggest that African American women who trade sex for drugs only�represent an understudied yet highly vulnerable group. PMID:24496649
Dunne, Eugene M; Dyer, Typhanye Penniman; Khan, Maria R; Cavanaugh, Courtenay E; Melnikov, Alex; Latimer, William W
Risk factors associated with Chlamydia and gonorrhea infection among female sex workers in two Mexico-U.S. border cities
Female sex workers (FSWs) aged ?18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent interviews and testing for Chlamydia and gonorrhea using nucleic acid amplification. Correlates of each infection were identified with logistic regression. Among 798 FSWs, prevalence of Chlamydia and gonorrhea was 13.0% and 6.4%. Factors independently associated with Chlamydia were being younger, working in Tijuana versus Ciudad Juarez, and recent methamphetamine injection. Factors independently associated with gonorrhea were working in Tijuana versus Ciudad Juarez, using illegal drugs before or during sex, and having a recent male partner who injects drugs. Chlamydia and gonorrhea infection were more closely associated with FSWs� drug use behaviors and that of their sexual partners than with sexual behaviors. Prevention should focus on subgroups of FSWs and their partners who use methamphetamine and who inject drugs.
Loza, Oralia; Strathdee, Steffanie A.; Martinez, Gustavo A.; Lozada, Remedios; Ojeda, Victoria D.; Staines-Orozco, Hugo; Patterson, Thomas L.
Papua New Guinea: an innovative strategy to raise self-esteem of sex workers in Port Moresby, Papua New Guinea, and to promote safer sex practices with clients.
This paper describes an innovative strategy implemented by the TRANSEX Plus Project (TPP) in Papua New Guinea. TPP was created as a response by the government to the rapid increase of HIV-infected individuals throughout the country as reported by the ethnographic study that was conducted in 1994. Since TPP is an intervention research project, it utilized the peer education approach to educate transport workers and sex workers to become peer educators in HIV/AIDS and sexually transmitted disease prevention. Also, the peer education approach helps sustain any positive behavior change by providing the information to maintain the change. The activities carried out by the program, proved to be successful as indicated by the behavioral change that took place among the target groups by the increased condom use and increased visits to the project center. PMID:12295872
Elly, J; Aisa, M; Ananag, J; Janet, P; Rabia, M
Sex differences in soleus strength may predispose middle age women to falls.
This study investigated middle age healthy adults to elucidate if plantar flexion (PF) strength differences exist because of the triceps surae or the soleus when comparing between sexes. A random population sample was stratified by sex and included 25 healthy (12 women and 13 men) subjects who volunteered for participation. Dorsiflexion range of motion was measured using a biplane goniometer. Self-reported function was assessed using the Foot and Ankle Ability Measure. Ankle PF strength was assessed using the Biodex System 3. To determine triceps surae vs. soleus strength, testing positions included (1) full ankle dorsiflexion with the knee in full extension and (2) full ankle dorsiflexion with 90� of knee flexion. Results indicated that women were significantly weaker than men in absolute PF strength for both triceps surae and soleus testing positions. Furthermore, even with normalizing PF strength to body mass PF strength deficits persisted. Additionally, when the contribution of the soleus was accounted for in the full knee extended position (triceps surae), normalized strength differences no longer existed between sexes. Therefore, these results indicate that what appeared as triceps surae complex strength deficits in middle age women compared with men was actually soleus weakness. This may suggest that middle age women are predisposed to increased falls at an early age than previously reported. Additionally, this may indicate that the soleus muscle should be a focus of strength training for women during middle age. PMID:23222092
Chimera, Nicole J; Manal, Kurt T
The Neural Correlates of Neuroticism Differ by Sex and Prospectively Mediate Depressive Symptoms Among Older Women
Background Mood disorders in old age increase the risk of morbidity and mortality for individuals and healthcare costs for society. Trait Neuroticism, a strong risk factor for such disorders into old age, shares common genetic variance with depression, but the more proximal biological mechanisms that mediate this connection are not well understood. Further, whether sex differences in the neural correlates of Neuroticism mirror sex differences in behavioral measures is unknown. The present research identifies sex differences in the stable neural activity associated with Neuroticism and tests whether this activity prospectively mediates Neuroticism and subsequent depressive symptoms. Methods A total of 100 (46 female) older participants (>55 years) underwent a resting-state PET scan twice, approximately two years apart, and completed measures of Neuroticism and depressive symptoms twice. Results Replicating at both time points, Neuroticism correlated positively with resting-state regional cerebral blood-flow activity in the hippocampus and midbrain in women and the middle temporal gyrus in men. For women, hippocampal activity mediated the association between Neuroticism at baseline and depressive symptoms at follow-up. The reverse mediational model was not significant. Conclusions Neuroticism was associated with stable neural activity in regions implicated in emotional processing and regulation for women but not men. Among women, Neuroticism prospectively predicted depressive symptoms through greater activity in the right hippocampus, suggesting one neural mechanism between Neuroticism and depression for women. Identifying responsible mechanisms for the association between Neuroticism and psychiatric disorders may help guide research on pharmacological interventions for such disorders across the lifespan.
Sutin, Angelina R.; Beason-Held, Lori L.; Dotson, Vonetta M.; Resnick, Susan M.; Costa, Paul T.
Association between alcohol use and sexually transmitted infection incidence among kenyan women engaged in transactional sex.
Few prospective studies have evaluated the association between alcohol use and STI acquisition among African women. We examined the association between baseline drinking frequency and STIs in a cohort of Kenyan women reporting transactional sex. The association between alcohol use and STI differed significantly by HIV status. Among 139 HIV-positive women, STI acquisition was significantly associated with consuming 1-7 drinks/week and marginally associated with ?8 drinks/week in unadjusted analyses. However, no association between alcohol use and STIs was observed among 335 HIV-negative women. Addressing alcohol use within comprehensive HIV care may also reduce the burden of STIs among high-risk women. PMID:24179037
Wilson, Kate S; Odem-Davis, Katherine; Shafi, Juma; Kashonga, Francis; Wanje, George; Masese, Linnet; Mandaliya, Kishor; Jaoko, Walter; McClelland, R Scott
HIV, STI prevalence and risk behaviours among women selling sex in Lahore, Pakistan
Background More than 340 million cases of curable sexually transmitted infections (STIs) were estimated to have occurred worldwide in 1995. Previous studies have shown that the presence of other concomitant STIs increases the likelihood of HIV transmission. The first national study of STIs conducted in Pakistan in 2004 revealed a high burden of STIs among women selling sex. The HIV epidemic in Pakistan has thus far followed the "Asian epidemic model". Earlier studies among women selling sex have shown a low prevalence of HIV coupled with a low level of knowledge about AIDS. The aim of our study was to estimate the prevalence of HIV and STIs, and assess knowledge and risk behaviours related to HIV/STI, among women selling sex in Lahore, Pakistan. Methods A total of 730 participants were recruited through respondent-driven sampling. The participants were women selling sex in three areas (referred to as "A", "B", and "C") of Lahore. A structured questionnaire addressing demographic information, sexual life history, sexual contacts, and knowledge and practices related to HIV/STI prevention was administered by face-to-face interview. Biological samples were obtained from all participants and tested for HIV, Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. Pearson's chi-square and multivariable logistic regression analysis were performed to test associations between potential risk factors and specified diagnosed infections. Results The prevalence of HIV infection was 0.7%, T pallidum 4.5%, N gonorrhoeae 7.5%, C trachomatis 7.7% and T vaginalis 5.1%. The participants had been selling sex for a median period of seven years and had a median of three clients per day. Sixty five percent of the participants reported that they "Always use condom". The median fee per sexual contact was Rs. 250 (3 Euro). Compared to Areas A and C, women selling sex in Area B had a significantly higher risk of chlamydial infection, gonorrhoea and trichomoniasis. Among the participants, 37% had correct knowledge about HIV/AIDS transmission and its prevention. Conclusions The prevalence of HIV was <1%, and of any other STI 18.5% among participating women selling sex in Lahore, Pakistan. A reasonably high condom use, a relatively low number of sexual partners, and a relatively low prevalence of STIs might have contributed to the low HIV prevalence.
Community Health Worker Hepatitis B Education for Cambodian American Men and Women
Background Cambodian Americans have high rates of chronic hepatitis B virus (HBV) infection and liver cancer. There is very limited information about the utility of community health worker (CHW) approaches to cancer education for Asian American men. We have previously reported our positive findings from a trial of CHW education about HBV for Cambodian Americans who had never been tested for HBV. This report describes similarities and differences between the outcomes of our CHW HBV educational intervention among Cambodian American men and women. Methods The study group for this analysis included 87 individuals (39 men and 48 women) who were randomized to the experimental (HBV education) arm of our trial, participated in the CHW educational intervention, and provided follow-up data six months post-intervention. We examined HBV testing rates at follow-up, changes in HBV-related knowledge between baseline and follow-up, and barriers to HBV testing (that were reported to CHWs) by gender. Results At follow-up, 15% of men and 31% of women reported they had received a HBV test (p=0.09). HBV-related knowledge levels increased significantly among both men and women. With respect to HBV testing barriers, women were more likely than men to cite knowledge deficits, and men were more likely than women to cite logistic issues. Discussion Our study findings indicate that CHW interventions can positively impact knowledge among Cambodian American men, as well as women. They also suggest CHW interventions may be less effective in promoting the use of preventive procedures by Cambodian American men than women. Future CHW research initiatives should consider contextual factors that may differ by gender and, therefore, potentially influence the relative effectiveness of CHW interventions for men versus women.
Taylor, Victoria M.; Burke, Nancy J.; Sos, Channdara; Do, H. Hoai; Liu, Qi; Yasui, Yutaka
Tricks of the trade: sexual health behaviors, the context of HIV risk, and potential prevention intervention strategies for male sex workers.
Sex work is a significant risk for HIV and sexually transmitted infection (STI) among men who have sex with men (MSM); however, there is a dearth of knowledge about how to reduce risk in this group. MSM sex workers (N = 32) completed a semistructured qualitative interview and a close-ended quantitative assessment. Analyses focused on themes relevant to intervention development. Participants reported an average of 46 male sex partners in the prior 12 months; 31% of participants were HIV-infected. Male sex workers frequently used substances during sex and had elevated levels of psychological distress. Qualitative findings suggest that trauma-informed mental health and substance abuse treatment, ready access to HIV/STI testing and treatment and condoms/informational materials, support groups to address isolation/loneliness, skill-building for risk reduction with sex partners, and paid incentives as add-ons to effective behavior change interventions may be valuable intervention components. Targeting consumers of paid/exchanged sex may assist with changing community norms regarding the practice of transactional sex. Multipronged interventions to decrease sexual risk taking among male sex workers would also benefit from addressing the unique socioeconomic and legal needs of this population. PMID:19928046
Reisner, Sari L; Mimiaga, Matthew J; Mayer, Kenneth H; Tinsley, Jake P; Safren, Steven A
HIV, HSV2 and Syphilis Prevalence in Female Sex Workers in Kerman, South-East Iran; Using Respondent-Driven Sampling
Background We estimated the prevalence of HIV, sexually transmitted infections (STIs), and risky behaviors among female sex workers (FSW) in Kerman City, Iran. Methods: Women, 18 years or older, who reported selling sex for at least 6 months during their lifetime and had at least one sexual contact with