Social and Structural Factors Associated with HIV Infection among Female Sex Workers Who Inject Drugs in the Mexico-US Border Region

Abstract Background The Yunnan province is located near the “Golden Triangle” border region between China, Myanmar and Thailand, which has the highest HIV/AIDS prevalence in China. Female sex workers (FSWs) in the Yunnan province are highly vulnerable to HIV infection. The objective of this study was to examine the experiences of FSWs in the Yunnan to better understand the risk of infection and the potential for transmission of HIV. Methods Semi-structured interviews were conducted between May 2018 and June 2018 with 20 FSWs recruited in Hekou County, Yunnan Province, China. Thematic analysis was conducted to identify themes that highlighted increased exposure of FSWs to the risk of HIV infection and transmission. Results The findings showed that FSWs’ primary source for HIV information was gynecologists, with few visiting the local HIV charity Red Ribbon. FSWs reported infrequent visits for check-ups with some seeing a gynecologist once a year. FSWs felt that the onus was on them to prevent STI/HIV infection by using a condom during sex, regardless of their ability to negotiate use. FSWs were also reluctant to see a gynecologists for treatment. Instead, they resorted to douching as a way of preventing HIV/STIs and treating vaginal health problems, such as leucorrhea. Most FSWs worked without the influence of alcohol and drugs. A small number of FSWs reported heroin addiction and injecting drug use. Conclusion The findings suggest a need for innovative HIV prevention strategies among FSWs and their clients in the Chinese border region. Governmental agencies should continue to implement practical strategies in terms of HIV prevention education and condom use through tailored interventions that are localized. Such strategies should include localized tailored interventions that dispel myths about douching as a method of HIV/STI prevention and incorporate a mobile outreach approach, similar to the ‘roadside restaurant’ outreach that has been successful in rural China.

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HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China

International Journal of STD & AIDS ◽

10.1177/0956462417730258 ◽

2017 ◽

Vol 29 (5) ◽

pp. 424-434 ◽

Cited By ~ 10

Author(s):

Jing Zhu ◽

Rui Yuan ◽

Dan Hu ◽

Zhibin Zhu ◽

Ning Wang ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Sex Workers ◽

Female Sex Workers ◽

Yunnan Province ◽

Border Region ◽

High Risk Population ◽

Risk Population ◽

Female Sex ◽

Male Clients

Female sex workers (FSWs) and their male clients are vulnerable to HIV infection and serve as a bridge in HIV transmission from the high-risk population to the general, low-risk population. To examine the factors of FSWs and male clients that correlate with the prevalence of HIV infection in the Chinese–Vietnamese border region, a cross-sectional survey was conducted in 2014 in the Hekou county of the Yunnan province of China. We performed a questionnaire survey to collect data on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections and drug use. We found that the prevalence of HIV infection among FSWs was 2.74%, and 15 male clients (2.62%) were HIV-positive. Multivariate logistic regression analysis revealed that herpes simplex virus type 2 infection was a risk factor for HIV infection in FSWs and male clients, suggesting the increased role of sexual transmission in the HIV epidemic in the Chinese–Vietnamese border region. Positive urinalysis result for amphetamine-type stimulants was observed in FSWs with HIV infection. History of drug use was correlated with HIV infection, which increased the HIV infection risk of male clients, confirming that drug use is an important target in future interventions for HIV prevention.

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Structural factors associated with methamphetamine smoking among female sex workers in Tijuana, Mexico

Drug and Alcohol Review ◽

10.1111/dar.12633 ◽

2017 ◽

Vol 37 ◽

pp. S294-S302

Author(s):

Erin E. Conners ◽

Tommi L. Gaines ◽

Steffanie A. Strathdee ◽

Carlos Magis-Rodriguez ◽

Kimberly C. Brouwer

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Structural Factors ◽

Factors Associated ◽

Female Sex

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Cross-sectional study of female sex workers in Soweto, South Africa: Factors associated with HIV infection

PLoS ONE ◽

10.1371/journal.pone.0184775 ◽

2017 ◽

Vol 12 (10) ◽

pp. e0184775 ◽

Cited By ~ 9

Author(s):

Jenny Coetzee ◽

Rachel Jewkes ◽

Glenda E. Gray

Keyword(s):

South Africa ◽

Hiv Infection ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Female Sex

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FACTORS ASSOCIATED WITH THE LIKELIHOOD OF FURTHER MOVEMENT AMONG MOBILE FEMALE SEX WORKERS IN INDIA: A MULTINOMIAL LOGIT APPROACH

Journal of Biosocial Science ◽

10.1017/s0021932015000267 ◽

2015 ◽

Vol 48 (4) ◽

pp. 539-556 ◽

Cited By ~ 2

Author(s):

Dipak Suryawanshi ◽

Varun Sharma ◽

Niranjan Saggurti ◽

Shalini Bharat

Keyword(s):

Sex Work ◽

Sex Workers ◽

Perceived Risk ◽

Sexual Coercion ◽

Female Sex Workers ◽

Multinomial Logit ◽

Consistent Condom ◽

Cross Sectional Survey ◽

Factors Associated ◽

Female Sex

SummaryFemale sex workers (FSWs) are vulnerable to HIV infection. Their socioeconomic and behavioural vulnerabilities are crucial push factors for movement for sex work. This paper assesses the factors associated with the likelihood of movement of sex workers from their current place of work. Data were derived from a cross-sectional survey conducted among 5498 mobile FSWs in 22 districts of high in-migration across four states in southern India. A multinomial logit model was constructed to predict the likelihood of FSWs moving from their current place of work. Ten per cent of the sampled mobile FSWs were planning to move from their current place of sex work. Educational attainment, marital status, income at current place of work, debt, sexual coercion, experience of violence and having tested for HIV and collected the results were found to be significant predictors of the likelihood of movement from the current place of work. Consistent condom use with different clients was significantly low among those planning to move. Likewise, the likelihood of movement was significantly higher among those who had any STI symptom in the last six months and those who had a high self-perceived risk of HIV. The findings highlight the need to address factors associated with movement among mobile FSWs as part of HIV prevention and access to care interventions.

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