Establishment-based Sex Workers Research Articles

Factors associated with establishment-based female sex workers accessing health care services in Shanghai

Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18–52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32–4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84–7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21–0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20–0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05–0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers.

STI Prevalence and Risk Behaviors among Establishment-based and Street-based Sex Workers in Jamaica

Background: Prevalence of sexually transmitted infections (STI) and risk behaviours among street and establishment-based sex workers (SW) were compared. Method: Between August and November 2008, face to face interviews and testing for sexually transmitted infections (STI) were conducted among Jamaican SW recruited by convenience and snowball sampling. Results: Forty-five street-based SW (SBSW) and 231 establishment-based SW (EBSW) were recruited. STI Prevalence was: HIV 4.9%, syphilis 6.2%, gonorrhea 12.7%, Chlamydia trachomatis 23.6%, and Trichomonas vaginalis 35.5%. 56.1% SW had at least one STI and STI prevalence was similar for both groups. Condom use with paying partners was >90% but lower with non-paying partners (33.3% SBSW and 20.8% EBSW, p = 0.166). Streetbased SW had more partners, initiated sex at an earlier age, operated in fewer parishes, and were more likely to have been exposed to prevention interventions. Daily alcohol, marijuana, and ecstasy use were higher among EBSW compared to SBSW (54.6 vs. 24.4%, p<0.001; 63.2% vs. 46.7%, p=0.029; 34.6% vs. 6.7%, p<0.001, respectively). Conclusion: Prevention programmes targeting key populations such as SW must address the different risk profiles of sub-populations. Inclusion of strategies to address substance use is critical for effective STI prevention among Jamaican SW.