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

Objectives: The purpose of this paper is to review trends of HIV prevalence, condom use and associated risk factors among the female sex workers (FSW) in Denpasar, Bali. Methods: To analyze trends of HIV prevalence, surveillance data from 2000-2013 was used. Survey data from 2007 to 2013 was referenced for analysis of condom use trends. Data on associated risk factors was taken from 2012 integrated HIV and behavior survey. Results and conclusion: HIV prevalence among direct FSW in 2000 was as low as 1.6% (95%CI: 0.05-3.15) and continued to rise, reaching a prevalence peak of 22.5% (95%CI: 16.4-26.6) in 2010. HIV prevalence began to decline in 2011, 2012 and 2013. Analysis unearthed similar prevalence trends among indirect FSW albeit with a much lower prevalence of 0.25% in 2001, rising to 7.2% in 2010 and declining to 2.2% in 2013. The proportion of direct FSW reporting to always wear condoms in the last working week increased from 38% in 2007 (95%CI: 33.3-42.7) to 65% in 2013 (95%CI: 60.4-69.6). Multivariate analysis with logistic regression indicated that the significant risk factor with HIV prevalence was the specific grouping of FSW, in that low/mid-price are more at risk in comparison to high price with OR=4.37 (95%CI: 1.42-13.38). Risk factors associated with condom use was also the specific group of FSW, high price reported higher condom use with OR=4.04 (95%CI:2.03-8.04) and greater role of sex work site ‘pimps’ in encouraging their FSW to reject clients refusing to wear condoms with OR=2.06 (95%CI: 1.29-3.30). HIV prevalence among indirect and high-price direct FSW was much lower compared to prevalence in low/mid-price direct FSW. HIV prevalence and condom use among direct FSW population are significantly associated with group price range and the role of ‘pimps’.

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Condom Use with Female Sex Workers among Male Clients in Sichuan Province, China: The Role of Interpersonal and Venue-Level Factors

Journal of Urban Health ◽

10.1007/s11524-009-9431-y ◽

2010 ◽

Vol 87 (2) ◽

pp. 292-303 ◽

Cited By ~ 23

Author(s):

Cui Yang ◽

Carl Latkin ◽

Rongsheng Luan ◽

Kenrad Nelson

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Sichuan Province ◽

Female Sex ◽

Male Clients

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The Role of Relationship Intimacy in Consistent Condom Use Among Female Sex Workers and Their Regular Paying Partners in the Dominican Republic

AIDS and Behavior ◽

10.1007/s10461-006-9184-5 ◽

2006 ◽

Vol 11 (3) ◽

pp. 463-470 ◽

Cited By ~ 74

Author(s):

Laura Murray ◽

Luis Moreno ◽

Santo Rosario ◽

Jonathan Ellen ◽

Michael Sweat ◽

...

Keyword(s):

Dominican Republic ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Consistent Condom ◽

Consistent Condom Use ◽

Female Sex ◽

Relationship Intimacy

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The role of local business employees and community members in the HIV risk environment of female sex workers in an urban setting: associations between negative interactions and inconsistent condom use

BMC Public Health ◽

10.1186/s12889-021-12293-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Susan G. Sherman ◽

Catherine Tomko ◽

Bradley E. Silberzahn ◽

Rebecca Hamilton White ◽

Danielle Friedman Nestadt ◽

...

Keyword(s):

Condom Use ◽

Hiv Risk ◽

Sex Workers ◽

Female Sex Workers ◽

Risk Environment ◽

Community Members ◽

Inconsistent Condom ◽

Female Sex ◽

Inconsistent Condom Use

Abstract Background The role of business employees and community members in the HIV risk environment of female sex workers (FSW) is underexplored, despite sex work often located in commercial and residential urban areas. We explored the effect of negative interactions between business employees and community members on inconsistent condom use with clients of female sex workers. Methods This study uses baseline data from the EMERALD study, a community empowerment intervention with FSW. We recruited a sample of 361 FSW in Baltimore, Maryland using targeted sampling techniques in ten zones characterized by high rates of sex work, located throughout the city. Participants were recruited between September 2017 and January 2019 and completed a survey, HIV rapid testing, and self-administered gonorrhea and chlamydia testing. The outcome, inconsistent condom use, was defined as not reporting “always” using condoms with paying clients. Poisson regressions with robust variance were used to model the effect of business employee and/or community member interactions on inconsistent condom use. Results Over half (54%) the sample was between 18 and 40 years old, 44% Black or another race, and experienced a range of structural vulnerabilities such as housing instability and food insecurity. Forty-four percent of the sample reported inconsistent condom use with clients. FSW reported being reported to the police weekly or daily for selling drugs (14% by employees, 17% by community), for selling sex (19% by employees, 21% by community), and experiencing weekly or daily verbal or physical threats (18% by employees, 24% by community). In multivariable models, being reported to the police for selling sex weekly or daily by community members (vs. never, aRR = 1.42, 95% CI = 1.08, 1.86) and business owners (vs. never, aRR = 1.36, 95% CI = 1.05, 1.76) increased risk of inconsistent condom use, as did monthly verbal or physical threats by community members (vs. never, aRR = 1.43, 95% CI = 1.08, 1.91). Conclusions Results show that both actors play important roles in FSWs’ HIV risk environment. Businesses and community members are important targets for holistic HIV prevention interventions among FSW in communities where they coexist in close proximity.

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