Understanding the Hierarchical Relationships in Female Sex Workers' Social Networks Based on Knowledge, Attitude, and Practice.

Dong Dong,Hu Hu,Yang Yang,Sun Sun,Wang Wang

doi:10.3390/ijerph16203841

Abstract

Female sex workers (FSWs) represent a high-risk population for HIV infection and transmission. In general, their fellow FSWs (peers) also play a role in their level of susceptibility to HIV/AIDS. This paper draws from interview data of 93 FSWs to construct a multi-layer FSW social network model based on their knowledge, attitude, and practice (KAP). Statistical analyses of the correlation among the three dimensions of KAP as well as their social interactions indicated that FSWs had basic knowledge of HIV/AIDS prevention but demonstrated little enthusiasm in acquiring relevant information. Their knowledge, attitude, and practice were highly positively correlated. Their attitude was more likely to be negatively influenced by their companions, while their practice was more likely to be positively affected. Besides, FSWs exhibited high homophily in KAP with their neighbors. Thus, during HIV/AIDS interventions, FSWs should receive individualized education based on their specific KAP. Considering the high level of homophily among FSWs, their propensity to be positive or negative in their KAP are significantly influenced by their companions. Making full use of peer education and social interaction-based interventions may help prevent and control the spread of HIV/AIDS.

Highlights

In China, heterosexual behavior is one of the main modes of human immunodeficiency virus (HIV) transmission [1]
We found that most female sex workers (FSWs) have a passive attitude toward HIV/AIDS prevention they have a certain understanding of HIV/AIDS
Female sex workers have drawn a lot of attention in the context of HIV/AIDS prevention

Summary

Introduction

In China, heterosexual behavior is one of the main modes of human immunodeficiency virus (HIV) transmission [1]. In 2007, it was the cause of only 36.1% of cases [2], while in 2017 (as of 31 October), that figure reached 68.50% [3] This large increase may be somewhat attributed to the behaviors of female sex workers (FSWs)—women who make a living by providing paid sexual services. They are a high-risk population for HIV infection and transmission because they have multiple sexual partners and engage in risky sexual behaviors (such as low rates of condom use during commercial sex) and, represent a key link in the spread of HIV from high-risk groups to the general population [3,4].

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