Behaviour Of Female Sex Workers Research Articles

Biobehavioral survey using time location sampling among female sex workers living in Ghana in 2020.

The HIV epidemic in Ghana is characterized as a mix of a low-level generalized epidemic with significant contributions from transmission among female sex workers (FSW) and their clients. This study seeks to identify and describe key characteristics and sexual behaviors of FSW and estimate the prevalence of HIV, syphilis, gonorrhea, chlamydia, and hepatitis B virus (HBV) among FSW in Ghana. A total of 7,000 FSW were recruited for the study using Time Location Sampling (TLS) approach with 5,990 (85.6%) participants completing both biological and the behavioral aspects of the study. A structured questionnaire was administered to respondents to assess several factors, such as background characteristics, sexual risk behaviors, condom usage, HIV/AIDS knowledge, opinions, and attitudes. Trained staff conducted face-to-face interviews using mobile data collection software (REDCap) after provision of specimens for HIV and STI testing. Descriptive statistics such as medians, ranges, charts, and percentages are performed and presented. Also included, are bivariate analyses to establish relationships between FSW type and other relevant characteristics of the study. Among the 7,000 (100%) FSW sampled from all regions, 6,773 took part in the behavioral and 6,217 the biological. There were 783 (11.2%) respondents who took part only in the behavioral and 227 (3.2%) only in the biological. Most were young, with a median age of 26 years, majority had never been married or were widowed/divorced and a quarter had no education or had only primary education. Majority (74.8%) of FSW first sold sex at age 25 years or less with a median age of 20 years. Most (84.8%) of the FSW indicated that they entered sex work for money, either for self or family and had an average of eleven (11) sexual partners per week. More than half (55.2%) of the FSW were new entrants who had been in sex work for less than 5 years before the study. Consistent condom use with paying clients was generally unsatisfactory (71%), and was however, very low (24%) with their intimate partners or boyfriends. Only about half (54.6%) of FSW have been exposed to HIV prevention services in the last three months preceding the survey, and this varies across regions. Overall, comprehensive knowledge about HIV and AIDS was low. Only 35% of FSW had comprehensive knowledge. HIV prevalence was 4.6% and was higher among seaters (brothel-based) and older FSW who had been sex work for a longer period. The HIV prevalence from the previous bio-behavioral survey (BBS) in 2015 and 2011 were estimated to be 6.9 and 11.1%, respectively. Compared to the results from the previous studies, the findings give an indication that Ghana is making significant progress in reducing the burden of HIV among FSW in the country. However, risky behaviors such as low consistent condom use, low coverage of HIV services across the regions, and low comprehensive knowledge could reverse the gains made so far. Immediate actions should be taken to expand coverage of HIV services to all locations. Efforts must be made to reach out to the new entrants while also addressing strongly held myths and misconceptions about HIV.

Information behavior and HIV/AIDS/STI awareness among Bangladeshi female sex workers: Do informational programs help?

Using de Certeau's concepts of “tactics” and “strategies,” this study explores the everyday information seeking behavior of female sex workers (FSWs) in Bangladesh. This study also examined the effectiveness of informational programs on HIV/AIDS and STI in empowering FSWs to negotiate condom use during sex. A mixed method research design was employed in this study, which included face-to-face surveys with 116 female sex workers (FSWs) and four focus group discussions (FGDs) with 23 street based FSWs. The study finds that Bangladeshi female sex workers use “tactics” in meeting their information needs. They reported rarely using formal information sources such as government agencies and indicated sometimes being harassed by law enforcement agencies because of their professional status, creating a distance between formal information agencies and their everyday life information seeking. Furthermore, FSWs reported having significant unmet information needs. The findings regarding the effectiveness of HIV/AIDS and STI informational programs indicated that simply providing ‘information’ may not be sufficient to empower FSWs to negotiate safer sexual practices with their clients.

Health-seeking behavior of female sex workers: a systematic review

Health-seeking behavior of female sex workers: a systematic review

Risk attitude, risky behaviour and price determination in the sex market: A case study of Yangon, Myanmar

AbstractCommercial sex is a prevalent but risky profession in many countries, including Myanmar. Although risk attitude is a potentially important factor in determining risky behaviour of female sex workers (FSWs), few studies have explicitly investigated the issue. This is one of the first studies to elicit the risk attitude of FSWs using a simple risk game. We conducted the risk game with FSWs in Yangon, Myanmar, where the average GDP per capita is very low, to study how risk attitude is related with observable characteristics and with risky behaviour related to the use of condoms in the commercial sex market. We found that risk attitude is relatively independent of observable characteristics and the decision to use a condom. However, transaction prices were directly associated with risk attitude.

Effect Of Cellular Phone SMS As Health Education Media About HIV And AIDS On Health Service Search Behavior Of Women Sex Workers

Abstract Human Immunodeficiency Virus (HIV) is a virus that attacks white blood cells (lymphocytes) that cause the decline of human immune. High risk groups such as Female Sex Workers (FSWs) tend not to access health services because of the decrimination they face in society. Health promotion is still an important strategy in increasing self-awareness of FSWs to perform Voluntary Counseling and Testing (VCT) examination, one of them is through the utilization of cellular phone technology. This study aims to determine the effect of cell phone Short Message Service (SMS) as a media health education about HIV and Acquired Immune Deficiency Syndrome (AIDS) to health seeking behavior of FSWs. Pre-experimental design one group pre-test pos-ttest design was conducted at 33 FSWs at Terminal Pesiapan, Tabanan District. The results of pre-test and post-test showed an influence on behavior (knowledge, attitude and action) after SMS based health promotion intervention (p <0,05), knowledge (p = 0,039), attitude (p = 0,003), and action (p = 0,000). After the intervention there was an increase in behavior that is on knowledge 30,3%, 36,4% attitude and 63,6% action. Mobile phone SMS media proves to be effective in conveying health information so as to raise awareness of FSWs in conducting HIV and Sexually Transmitted Infections (STIs). An innovative, short, easy-to-understand message on HIV and AIDS should be provided with simple language and regular use of cellular-based information technology by healthcare workers.
 Keywords: Behavior, FSWs, Health Education, Mobile Phone SMS

Determinants of safe sexual behavior of female sex workers in Tehran: the woman, her network, and the sexual partner

BackgroundDespite the steady growth of sexual transmission of HIV, there is little evidence about safe sexual behavior of FSWs, and social network effects on this behavior, in Iran. Our aim in this study was to determine the effect of social network characteristics on condom use among FSWs, considering individual characteristics of the FSWs and of their sexual partners, characteristics of their relationship, and the FSW’s personal network.MethodsA cross-sectional ego-centric network survey of 170 FSWs was carried out in Tehran between January and June 2017. A multilevel ordered logistic regression analysis was conducted to examine the effects of individual and relational characteristics simultaneously.ResultsCondom use in sexual relationships of the FSWs on average was rather low. Important determinants of safe sexual behavior were found both at the level of the individual FSW and at the level of the sexual partner. The main determinants at the level of the individual FSW were FSWs’ age and HIV knowledge. At the level of the sexual partner, age and education of sexual partners, as well as intimacy, duration of tie, frequency of contacts with a given partner, frequency of contact, perceived social support, and perceived safe sex norms were significantly associated with condom use.ConclusionsThe findings highlighted that considering only the individual characteristics of female sex workers is not sufficient for effectively promoting condom use. Factors at the network and dyadic level should also be considered, especially the role of sexual partners. Network-based interventions may be useful which modify social relationships to create a social environment that can facilitate changes in sexual behavior.

Sexual Risk Behaviors of Sex Workers for HIV / AIDS and STIs in the City of Bamako, Mali

Background: HIV / AIDS affects all social strata and including female sex workers who are a particularly vulnerable group at risk of HIV infection. Objective To assess the risky sexual behavior of female sex workers in Bamako, Mali. Methods This is a quantitative cross-sectional analytical study conducted among 288 female sex workers in the city of Bamako, Mali. This study used a questionnaire to collect information from January to April 2021. Results Out of 288 sex workers, 41% came from neighboring countries (Burkina Faso, Cote d'Ivoire, Mauritania). More than half of the participants had started working as sex workers before the age of 20. More than half of sex workers do not always use a condom. About 32% of female sex workers had previously had anal sex, 20% had experienced group sex, and less than a quarter smoked or drank alcohol before sex. A significant relationship was found between the behavior or practice of sex workers with the following variables: ethnicity (P = 0.04); marital status (P = 0.01); monthly income (P = 0.001), age at first sexual intercourse (P = 0.03); the presence of STDs in the past (P = 0.02), knowledge of HIV status (P = 0.04) and nationality (P = 0.03). Conclusions This study highlights negative risk behaviors of sex workers such as not using condoms consistently, anal sex, alcohol, and smoking. It is therefore important to develop education actions to improve the knowledge, attitude, and practice of sex workers related to HIV/ AIDS in Mali.

Sexual Behavior of Female Sex Workers in Makassar, Indonesia

Introduction: Sexual workers have been considered a core group for HIV and Sexual Transmission Diseases (STDs). Their risk is higher than women in the general population. As a developing country, Indonesia is no exception, where sexual transmission has become the main driver for the development of the epidemic in recent years. The survey result of Makassar's AIDS Eradication Commission in 2014 showed that the number of FSWs in Makassar increased. The high number of FSWs in Makassar affect the number of HIV/AIDS cases apparently. Method: This study used data from a rapid survey conducted by Makassar AIDS Eradication Commission in 2013. The survey was carried out to gain information about the sexual behaviour of FSWs in Makassar. The number of sample was 240 in which sampling was carried out using the C-Survey program system. A systematic questionnaire was used to gather data from FSWs, and data was analyzed by using STATA program. Result: Most of the FSWs in this study are aged between 36-40 years old (27.9%). For the last sexual intercourse, most of the FSWs offered a condom to their clients (85.0%). However, the number of clients who used a condom for intercourse was lower that is 77.5%. The main reason why clients refuse to use a condom is that they are uncomfortable. Conclusion: The awareness of FSWs to offer a condom is higher than the willingness of clients to use a condom consistently. Keywords: Sexual Behaviour; Condom Use; Female Sexual Workers; Makassar.

THE PHENOMENON OF DIMLY LIT STALLS ALONG THE NORTH COAST ROAD (CASE STUDY OF INDIRECT FEMALE SEX WORKERS) AGAINST THE SPREAD OF SEXUALLY TRANSMITTED DISEASES IN JENU SUBDISTRICT TUBAN

Introduction: Cases of STIs continue to soar, one of which is due to the practice of prostitution because women sex workers (WPS) are one of the high risk groups of contracting and transmitting STIs. The purpose of this study was to explore knowledge and explore the behaviour of women sex workers indirectly. Methods: The design of this research uses descriptive qualitative research method with phenomonology. The subject of this study was women indirect sex workers who sold sexual services in exchange for money located in the village stalls of Sugiwaras District Jenu Tuban District a number of five women sex workers. Data collection techniques used in this research are observation and structured interview techniques. Result: The results of this study showed that participants' knowledge of reproductive health was not good, as evidenced by the women sex workers were not immediately able to explain the definition, signs and symptoms and how to prevent the spread of sexually transmitted infections (STIs). In terms of applying behaviour, participants were classified as negative because all participants revealed to have had unless condomless sexual intercourse and economic difficulties. Conclution: The sexual behaviour of female sex workers indirectly in the stalls along the pantura was classified as negative because all participants revealed to have had sexual intercourse without condoms and economic difficulties. Female sex workers also have low knowledge of STI.

Participatory geographic mapping and activity space diaries: innovative data collection methods for understanding environmental risk exposures among female sex workers in a low-to middle-income country

BackgroundA common approach for measuring place-based exposure is to use geographically-defined administrative boundaries and to link neighborhood characteristics at this level. This approach, however, may not be feasible in low-to middle-income countries where neighborhood-level data are limited or unavailable, and administrative boundaries are often unstandardized and not proportional to population size. Furthermore, such traditional approaches may not be appropriate for marginalized populations whose environments can be more difficult to study. In this paper, we describe two innovative and feasible methods to generate geospatial data to characterize and assess the role of risk environments on drug use among female sex workers living with HIV in the Dominican Republic.MethodsParticipatory geographic mapping and daily activity space travel diaries were employed.ResultsThe methods presented in this study were feasible to implement, acceptable by study participants, and yielded rich geospatial data to analyze the impact of contextual factors on risk behaviors of female sex workers in a low-to middle-income country.ConclusionParticipatory geographic mapping and activity space diaries are two alternative methods for collecting geospatial data among hard-to-reach populations in resource constrained settings. Moreover, the methods are interactive and educational, allowing study participants to take an active role in the data collection process and potentially allowing for a deeper understanding of place-based effects on health and behavior.

HIV Testing and Receiving Test Results by the Female Sex Workers; Retrospective Study using Data from Sri Lanka National HIV Prevention Programme

<strong>Introduction: </strong>Improving HIV testing among Key Populations (populations at high risk) is the first step to achieve 90:90:90 treatment targets. Studying the time taken to HIV testing and subsequent clinic visits to uptake the test results provide important inputs for development of HIV prevention programmes. <strong> </strong> <strong>Objectives: </strong>This study aims to understand the pattern of HIV testing behavior of Female Sex Workers (FSWs) over the time and provide recommendations for development of HIV prevention programmes for FSWs <strong> </strong> <strong>Methods: </strong>HIV testing data of 5,667 FSWs registered with national HIV prevention programme in 10 Districts of Sri Lanka during 2016 and 2017 were analyzed using, survival data analysis techniques and extended Prentice, Williams &amp; Peterson (PWP) gap time model. <strong> </strong> <strong>Results: </strong>Time taken to acceptance of HIV test is more dependent on individual factors of FSWs whereas uptake of test result is less dependent on individual factors. Youth FSWs take more time to accept an HIV test. FSWs who are operating in Districts out of Colombo, use condoms, reported undergone HIV testing before join the programme, take more time for HIV testing and uptake test results. FSWs with high partner exchange rate (therefore at high risk) are less likely to complete both events and take more time for testing. Interaction between FSW typology and condom use was found with the use of PWP model. <strong> </strong> <strong>Conclusion: </strong>High risk FSWs are more reluctant for HIV testing and uptake of test results. Factors identified in the study as associated with time taken for both events can be taken into account in planning future HIV preventions programs among FSWs.

Perempuan dan IMS : Perilaku Menjaga Personal Hygiene Organ Reproduksi pada Pekerja Seks Langsung di Indonesia

Background: The localization of prostitution in Jember District has been closed permanently since 2007. It causes the hidden prostitution business that has been increasing in the street or as indirect sex work. This condition makes the limited access to provide information, condoms and STDs screening among female sex workers (FSWs). Besides using condom, washing reproductive organs are often conducted to prevent STDs. This study aims to explore the behavior of FSWs in washing and lubricating reproductive organs. Method: This is a qualitative research which involved 12 FSWs in three areas of ex-localization in South Jember, 5 pims and health staffs. Data were collected through indepth-interviews and observation of work areas. Thematic content analysis was employed to identify themes and patterns of data. Results: The behavior of genital hygiene among FSWs to keep healthy was relatively categorized not good. Beside low consistent in condom use, most of them wash their vagina using traditional herbs or soap. They also often drink traditional herbs to prevent STDs. Lack of knowledge and support from the pimps and health staffs to use condom during sex made them vulnerable from STDs. Changing panties routinely and avoid anal sex were practiced among FSWs to have safe sex.

Quality of care and HIV service utilization among key populations in Zambia: a qualitative comparative analysis among female sex workers, men who have sex with men and people who use drugs

ABSTRACTHIV epidemic control requires improving access and uptake of HIV services by key populations (KPs). In Zambia, the behaviors of female sex workers (FSWs), men who have sex with men (MSM), and people of who use drugs (PWUD) are criminalized, and little information exists about their HIV/STI service use. Using a quality of care (QOC) framework, we compared barriers to and opportunities for HIV/STI service access and uptake among the three KPs. We conducted in-depth interviews and focus group discussions with 314 KP members between July 2013 and September 2015 in eight districts. Poorer QOC was received at public health facilities compared to private, NGOs and traditional healers. Stigma and discrimination, confidentiality, and legal prosecution were barriers to service use and more salient among MSM than FSWs and PWUD. Invasive facility policies were barriers and more prominent among FSWs than MSM and PWUD. Service unavailability was of equally high salience among MSM and PWUD than FSWs. Comfort in the clinic and perceived treatment effectiveness were facilitators for all three KPs. The health care experiences of KPs are not monolithic; HIV/STI service improvement strategies should address the concerns and be tailored to the needs of each key population.

Community Savings Groups, Financial Security, and HIV Risk Among Female Sex Workers in Iringa, Tanzania.

This study assessed the association between community savings group participation and consistent condom use (CCU) among female sex workers (FSW) in Iringa, Tanzania. Using cross-sectional data from a survey of venue-based FSW (n=496), logistic regression was used to examine the associations between financial indicators including community savings group participation and CCU. Over one-third (35%) of the women participated in a savings group. Multivariable regression results indicated that participating in a savings group was significantly associated with nearly two times greater odds of CCU with new clients in the last 30days (aOR=1.77, 95% CI 1.10-2.86). Exploratory mediation analysis indicated that the relationship between savings group participation and CCU was partially mediated by financial security, as measured by monthly income. Findings indicate that community savings groups may play an important role in reducing sexual risk behaviors of FSW and hold promise as part of comprehensive, community-led HIV prevention strategies among FSW.

Sexually Transmitted Diseases Preventive Behavior Among Female Sex Workers

Introduction: Sex workers and their customers are the high-risk group population that potentially transmitting sexually transmitted diseases including Human Immunodeficiency Virus (HIV). This research aims to describe the preventive behaviour of female sex workers in preventing transmission of STDs and HIV in Gambilangu Semarang Localization. Methods: This research was qualitative study, The 5 participants of this study were female sex workers who still active in Localization within the period of 2016-2017. Results: The behavior of female sex workers on the prevention of STDs and HIV, were identified as: all participants always offered condoms to clients before sexual transactions, all the participants negotiated the clients to use condom before having sexual intercourse, all participants rejected firmly to have sex with the client suspected having STDs yet reluctant to use condoms, most participants washed the vagina using betel soap, consuming herbs and antibiotics without a medical prescription that they believed it could prevent STDs.

Influence of Profession as Risk of STIs in Intimate Partner Relationship in South Asian Countries

Mixing of sexual partners as part of the profession of female sex workers (FSWs) can be a risk in intimate partner relationship, which is primarily based on love and affection. Sexual relation with one partner provides emotional and psychological support. However, when it is a web of partners, it often results in unprotected sex, consequently creating a pathway for disease and increasing the vulnerability of FSWs to sexually transmitted infections (STIs). This paper analyses the subtleties of sexual behavior of FSWs and their vulnerability toward STIs in intimate partner relationship in South Asian countries. The basic data used in this paper have been taken from 3 countries, 1271 FSWs from Bangladesh, 1404 FSWs from Nepal, and 7399 FSWs from India. The data were collected through modified time location cluster sampling as a part of mapping and size estimation of most-at-risk populations (MARPs) in Nepal and key affected populations (KAPs) in Bangladesh during the period of 2010–2016. The data for India are taken from the integrated behavioral and biological assessment (IBBA), which assesses the prevalence of high risk population in India. The findings reveal that the majority of the FSWs were married, which reveals dynamics of sexual activity placing them at higher risk of STIs. About half of the FSWs had more than 15 coituses in the last 30 days in Nepal, which is a high risk factor. Unprotected sex is reported high across all three countries irrespective of all background characteristics. Condom use during intercourse in Bangladesh is less likely in older FSWs and more likely among educated FSWs who had coital frequency of 7 or more in the last 30 days. Interestingly, unmarried FSWs in Nepal are less likely to use condom in their last sex as against India where FSWs are more likely to use condom in their last sex. The prevalence of STI among uneducated FSWs is found higher in Bangladesh as compared to Nepal and India. The socio-demographic background characteristics showed a significant association with unprotected sex, coital frequency and prevalence of STI across all three countries.

Sexual and reproductive health behaviors of female sex workers in Dhaka, Bangladesh.

ObjectivesThe objective of this study was to document sexual and reproductive health (SRH) practices among female sex workers (FSWs) including abortion, pregnancy, use of maternal healthcare services and sexually transmitted infections (STIs) with the aim of developing recommendations for action.MethodsA total of 731 FSWs aged between 15 and 49 years were surveyed using a stratified sampling in Dhaka, Bangladesh. A workshop with 23 participants consisted of policy makers, researchers, program implementers was conducted to formulate recommendations.ResultsAbout 61.3% of 731 FSWs reported SRH-related experiences in the past one year, including abortion (15.5%), ongoing pregnancy (9.0%), childbirth (8.3%) or any symptoms of STIs (41.6%). Among FSWs who had an abortion (n = 113), the most common methods included menstrual regulation through manual vacuum aspiration (47.8%), followed by Dilation and Curettage procedure (31%) and oral medicine from pharmacies (35.4%). About 57.5% of 113 cases reported post abortion complications. Among FSWs with delivery in the past year (n = 61), 27.7% attended the recommended four or more antenatal care visits and more than half did not have any postnatal visit. Adopting sustainable and effective strategies to provide accessible and adequate SRH services for FSWs was prioritized by workshop participants.ConclusionThere was substantial unmet need for SRH care among FSWs in urban areas in Dhaka, Bangladesh. Therefore, it is important to integrate SRH services for FSWs in the formal healthcare system or integration of abortion and maternal healthcare services within existing HIV prevention services.

Correlates of HIV and Inconsistent Condom Use Among Female Sex Workers in Ukraine.

While female sex workers (FSWs) carry one of the highest risks of HIV transmission, little is known about predictors of HIV and risky behavior of FSWs in Ukraine. In this study of 4806 Ukrainian FSWs, the prevalence of HIV was 5.6%. FSWs had higher odds to be HIV infected if they had lower income, were older, injected drugs, experienced violence, and solicited clients on highways. Inconsistent condom use with clients was reported by 34.5% of FSWs. FSWs who solicited clients at railway stations, via media, through previous clients and other FSWs, and on highways reported lower consistency of condom use. Furthermore, inconsistent condom use was related to younger age, alcohol use, having fewer clients, not being covered with HIV prevention, and experiences of violence. The present study expands on the rather limited knowledge of correlates of the HIV and inconsistent condom use among FSWs in Ukraine.

Health-Seeking Behaviour of Brothel-Based Female Sex Workers in the Management of Sexually Transmitted Infections in Urban Communities of Ogun State, Nigeria

Objective: This study examined the the health-seeking behaviour of female sex workers (FSWs) in the management of STIs. Methods: One hundred and thirty-one FSWs were interviewed using semi-structured questionnaires in Ogun State, South-West Nigeria. Results: Most (87.8%) of respondents interviewed knew condom use as the most effective way STIs including HIV can be prevented. About 24.0% and 94.0% of respondents consistently used condom during each round of sex with their regular/trusted sex partners and clients that ranged from2 to 9 and an average of 5 daily. Low (16.0%) self-perceived risk of STIs/HIV was reported among the FSWs despite their high-risk sexual activity. More than half of the respondents had good knowledge of signs and symptoms of STIs. In contrast, none of them knew that STIs can be asymptomatic. About 23.0% of the respondents have had STIs with 30.0% of these being recurring infections. Good health seeking behaviour was exhibited by respondents as most sought diagnosis (43.3%) and treatment (66.7%) for past STIs from medical doctors although many self-medication before reporting at the hospital for treatment. Moreover, 80.9% of respondents reported that they subject themselves to periodical medical examination. Conclusion: Results suggest the need for more educational interventions targeting this group emphasizing their high susceptibility to STIs/HIV, the significance of correct and consistent use of condoms for the prevention of STIs/HIV and the consequences of self-diagnosis and medication for STIs reported by many of the respondents.

Knowledge of HIV and HPV Infection, and Acceptance of HPV Vaccination in Spanish Female Sex Worker

Objective: To examine the socioeconomic variables, lifestyles, and sexual behaviors of female sex workers; their knowledge about the risk of HIV and human papillomavirus (HPV) infection; the HPV vaccine, and their attitudes toward it. Methods: 168 female sex workers (18-49 years old) filled out a questionnaire consisting of 5 parts with a total of 19 items. Results: Knowledge of Pap smears was moderate; 47% of the participants had undergone at least one. Most respondents (52.4%) had never heard of HPV. Most (88%) recognized HIV as a virus that can be acquired sexually. For most women, recommendations from non governmental organizations (NGOs) (68.5%) were the major influences in deciding to be vaccinated and learning how to take care of their health. Conclusion: The cost-effectiveness ratios for HPV control and vaccination strategies would be more favorable if younger women are targeted and initial catch-up efforts are targeted to female sex workers by revising screening policies. Healthcare workers and volunteers in NGOs should be educated and trained about HIV, HPV infection, and HPV vaccination and its relationship with genital cancer.