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

A qualitative study using in-depth interviews explored the perceptions and views of brothel leaders and HIV program experts on the acceptability and adoptability of using gatekeepers in interventions aimed at improving Female Sex Workers’ (FSWs) condom use in Nigeria. Brothel leaders are an influential group within the FSWs’ social and physical environment and their attitudes, beliefs and actions can influence the immediate brothel environment and the adoption of interventions within the brothel. HIV prevention experts make key decisions on the content and strategies adopted for HIV prevention efforts and also influence the design and implementation of HIV prevention strategies within programs. Four themes illustrating the benefits and barriers of the inclusion of gatekeepers within the immediate environment of the FSW were identified. Results show that brothel leadership inclusion in HIV prevention efforts could exert potential positive influence on the immediate brothel environment. Brothel leaders can support the institution of establishment policies supporting consistent condom use by the FSWs, promotion of HIV awareness, resolution of conflicts and harassments, support to new entrants into sex work and the reinforcement of protective behaviors among the FSWs. The decriminalization of sex work and the inclusion of gatekeepers support into country HIV program guidelines may contribute to mitigating prevalent sociocultural factors limiting FSWs’ rights as well as their access to health services. The present study provides insights into the potential positive roles of brothel leaders in improving condom use and other HIV/AIDs related interventions for brothel based FSWs in Abuja, Nigeria from the perspective of brothel leaders and HIV prevention experts.

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Stigma, Social Support, and Sexual Behavior Among Female Sex Workers at Risk for HIV in Malawi

AIDS Education and Prevention ◽

10.1521/aeap.2021.33.4.290 ◽

2021 ◽

Vol 33 (4) ◽

pp. 290-302

Author(s):

Laura M. Ruegsegger ◽

Melissa Stockton ◽

Vivian F. Go ◽

Hannah Piscalko ◽

Dylane Davis ◽

...

Keyword(s):

Social Support ◽

Substance Use ◽

Hiv Prevention ◽

Condom Use ◽

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Inconsistent Condom ◽

Female Sex ◽

Inconsistent Condom Use

Lack of social support and sex work stigma may hinder STI/HIV prevention for female sex workers (FSW). We explored the associations between sex work stigma and social support with sexual behaviors in Malawi. In 2017, 150 HIV-negative, venue-based FSW completed a behavioral survey containing sex work stigma items and social support. Linear binomial regression models were used to estimate prevalence differences of inconsistent condom use and substance use before sex by social support and stigma. A majority (93%) reported sex work–related internalized stigma. About 50% reported family or friend isolation. Social support was high (mean index: 86.53). Inconsistent condom use and substance use before sex had little to no association with stigma and social support. Malawian FSW largely internalize stigma and experience isolation from family and friends yet have high levels of social support. Large-scale evaluations should investigate the role of stigma and social support in STI/HIV prevention for FSW.

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Programmatic Mapping: Providing Evidence for High Impact HIV Prevention Programs for Female Sex Workers (Preprint)

10.2196/preprints.12636 ◽

2018 ◽

Author(s):

Faran Emmanuel ◽

Navindra Persaud ◽

Sharon S Weir ◽

Parinita Bhattacharjee ◽

Shajy Isac

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Hot Spot ◽

Prevention Programs ◽

Lessons Learned ◽

Specific Information ◽

Performance Targets ◽

Female Sex ◽

Treatment Services

UNSTRUCTURED Programmatic mapping (PM) is a rapid and efficient mechanism to develop size estimates of key populations including female sex workers (FSWs) and geolocate them at physical locations in a systematic and scientific manner. At the macro level, this information forms the basis for allocating program resources, setting performance targets, and assess coverage. At a micro level, PM data provide specific information on hot spots, estimates of FSWs at those spots, and hot spot typology and days and times of operation, all of which provides targeted service delivery strategies. This information can provide a reliable platform to plan HIV prevention and treatment services to considerable scale and intensity. Above all, the entire PM process requires deep involvement of FSWs, which increases community ownership of the data and can lead to an increased uptake of services. Despite a few limitations, the approach is versatile and can be used in varied country contexts to generate important information about sex work and its dynamics. In this paper, we describe experiences and lessons learned from using evidence generated from PM of FSWs in multiple countries to develop HIV prevention programs at scale.

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A Short History of HIV Prevention Programs for Female Sex Workers in Ghana

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000000446 ◽

2015 ◽

Vol 68 ◽

pp. S138-S145 ◽

Cited By ~ 6

Author(s):

Peter Wondergem ◽

Kimberly Green ◽

Samuel Wambugu ◽

Comfort Asamoah-Adu ◽

Nana Fosua Clement ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Prevention Programs ◽

Short History ◽

Female Sex ◽

History Of

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The Mental and Physical Health of Female Sex Workers: A Comparative Study

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2001.00857.x ◽

2001 ◽

Vol 35 (1) ◽

pp. 75-80 ◽

Cited By ~ 45

Author(s):

Sarah E. Romans ◽

Kathleen Potter ◽

Judy Martin ◽

Peter Herbison

Keyword(s):

Social Networks ◽

Physical Health ◽

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

General Health Questionnaire ◽

Psychiatric Morbidity ◽

Convenience Sample ◽

Female Sex ◽

Mental And Physical Health

Objectives: The objective of this study was to compare the mental and physical health, adult abuse experiences and social networks of female sex workers with data previously collected from two large community samples of age-matched women. Method: A convenience sample of sex workers were interviewed and completed two wellestablished questionnaires, the General Health Questionnaire (GHQ-28) and the Intimate Bond Measure (IBM). Sex workers were invited to reflect on their experiences of their work. Results: There were no differences in mental health on the GHQ-28 or in self-esteem (measured by an item on the Present State Examination) between the two groups. Neither were there any differences in their assessment of their physical health or the quality of their social networks. Sex workers were less likely to be married and had been exposed to more adult physical and sexual abuse than the comparison group. They were more likely to smoke and to drink heavily when they drank. One-third said that their general practitioner was not aware of their work. A subgroup not working with regular clients or in a massage parlour had higher GHQ-28 scores and may be an at-risk group. Narrative information about the work, particularly its intermittent nature, is presented. Conclusions: No evidence was found that sex work and increased adult psychiatric morbidity are inevitably associated, although there may be subgroups of workers with particular problems. The illegal and stigmatized nature of sex work are likely to make usual public health strategies more difficult to apply, considerations which should give concern from a preventive health standpoint.

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The Female Sex Work Industry in a District of India in the Context of HIV Prevention

AIDS Research and Treatment ◽

10.1155/2012/371482 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Raluca Buzdugan ◽

Shiva S. Halli ◽

Jyoti M. Hiremath ◽

Krishnamurthy Jayanna ◽

T. Raghavendra ◽

...

Keyword(s):

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Work Setting ◽

Vulnerability Factors ◽

Modes Of Operation ◽

Sex Worker ◽

Work Settings ◽

Female Sex ◽

Female Sex Work

HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified. In addition to previously documented brothel, lodge, street,dhaba(highway restaurant), and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges,dhabas, and on highways describe factors that put them at high HIV risk. Of these,dhabaand highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme.

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From Violence to Sex Work: Agency, Escaping Violence, and HIV Risk Among Establishment-Based Female Sex Workers in Tijuana, Mexico

Global Perspectives on Women's Sexual and Reproductive Health Across the Lifecourse ◽

10.1007/978-3-319-60417-6_12 ◽

2017 ◽

pp. 191-212

Author(s):

Shonali M. Choudhury ◽

Debbie Anglade ◽

Kyuwon Park

Keyword(s):

Sex Work ◽

Hiv Risk ◽

Sex Workers ◽

Female Sex Workers ◽

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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