Alcohol use, HIV risk behavior and experience of sexually transmitted infections among female sex workers of Nepal

Abstract

BackgroundAlcohol use is a pervasive phenomenon among female sex workers and their clients. It affects their physical health and promotes high-risk behavior and consequently, sexually transmitted infections (STIs). Hence, we designed a study to find the factors associated with alcohol use among the female sex workers of Eastern Nepal. The prevalence of HIV high-risk behavior and STIs among sex workers was also recorded. MethodsA cross sectional study was conducted in three commercial districts namely Sunsari, Morang and Jhapa of Eastern Nepal. All the FSWs who had been involved in commercial sex activity in the past six months were included in the study. Face-to-face interviews with 168-restaurant based and 42-street based female sex workers, who were identified through snowball sampling. Bivariate analyses were conducted using Chi–Square tests for categorical variables. Multivariate models were used to identify significant factors associated with alcohol use in the sex trade. ResultsLogistic regression analyses revealed that sex with intravenous drug user (IDUs) (AOR 2.275, 95% CI 1.266, 16.898), oral sex (AOR 3.261, 95% CI 1.166–9.121) and pregnancy (AOR 5.826, 95% CI 2.009, 16.898) were strongly associated with sexual encounter after consumption of alcohol. More than three fourths of the women were involved in at least one HIV high-risk behavior and more than 80% females had suffered from symptoms (past and present) of STIs. ConclusionHIV prevention efforts should focus on alcohol abuse, which can make the FSWs vulnerable to oral sex, accidental pregnancies, sexual encounters with IDUs.