Female Sex Workers In Thailand Research Articles

Prevalence and Genotypic Diversity of Human Papillomavirus Infection Among Male and Female Sex Workers in Thailand.

Human papillomavirus (HPV) is associated with cancer. Female sex workers (FSWs) are known to be at risk for HPV, but little is known about male sex workers (MSWs). We examined HPV prevalence and associated risk factors in both populations. During 2022, HPV testing using vaginal or penile samples, HIV testing, and interviews were performed among 100 MSWs and 100 FSWs in Chiang Mai, Thailand. The prevalence of all HPV types was 63.5% (66% in MSW, 61% in FSW), HPV-16 prevalence was 14%, HPV-52 was 13%, and HPV-18 was 4%. There was no difference between MSW and FSW for these subtypes. The prevalence of HPV-16 or HPV-18 was 17%, and for HPV-16, HPV-18, or HPV-52, it was 26%. HIV-positive participants had a higher prevalence of all HPV types (94% vs. 60%, P = 0.004), HPV-16 or HPV-18 (39% vs. 15%, P = 0.018), and HPV-16, HPV-18, or HPV-52 (50% vs. 23%, P = 0.017). We demonstrated an equally high HPV prevalence across the sexes. Further studies are needed to determine if this indicates an equal risk for cancer. Increased HPV awareness, screening, and vaccination should be considered, regardless of gender.

Low Condom Use Among Adolescent Female Sex Workers in Thailand

In Thailand, it is estimated that there are nearly 2 million female sex workers (FSWs), of whom 800,000 (40%) are under the age of 18 years. Studies examining condom use among adolescent FSWs in Thailand have been limited. Therefore, a survey was administered to a cross-sectional, nonrandomized sample of convenience among 130 adolescent, brothel-based FSWs in four geographic areas of Thailand. A condom utilization gap was evident in the present study, since on average adolescent FSWs used 3.8 condoms per day, while seeing 7.4 patrons per day. This is especially troubling since generalized condom utilization campaigns in the past have overlooked adolescent FSWs. Consequently, future public health efforts in Thailand need to recognize the existence and identify the unique healthcare needs of this vulnerable population, if they are to successfully decrease their sexually transmitted infection/HIV incidence rates.

Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand

BackgroundThe trafficking of women and girls for sexual exploitation is an internationally recognised form of gender-based violence, and is thought to confer unique sexual and reproductive health vulnerabilities. To date,...

Violence victimisation, sexual risk and sexually transmitted infection symptoms among female sex workers in Thailand

Background/ObjectivesCommercial sex work is a primary context for heterosexual HIV/AIDS transmission. Violence victimisation is considered to compromise women's ability to protect against HIV and other sexually transmitted infections (STI); little...

Knowledge, awareness, and attitudes of female sex workers toward HPV infection, cervical cancer, and cervical smears in Thailand

Objective To determine the knowledge, attitudes, and awareness of female sex workers (FSWs) regarding cervical cancer and its prevention in Thailand. Method From August through November 2008, 402 consecutive FSWs were recruited for interviews. Results The mean knowledge score was 4.9 (maximum possible, 15; range, 0–14). Approximately 60% of the FSWs had knowledge scores less than 5. Low education and a lack of health insurance were significant independent predictors of low knowledge scores (adjusted odds ratios, 3.17 and 1.97, respectively). More than half of the FSWs were unaware of being at higher risk for HPV infection or of the possible consequences of HPV infection. The negative attitude regarding cervical screening was caused by the fear of abnormal results (27.9%), experiencing pain (18.4%), and embarrassment (14.7%). Conclusion The knowledge and awareness of HPV infection, cervical cancer, and utility of cervical smears is low among FSWs in Thailand. Designing and implementing effective interventions is crucial and merits attention in future research.

Condoms in concentrated and generalised HIV epidemics

The promotion of male condoms is fundamental for programmes for prevention of HIV. Interventions resulting in consistent use of condoms by clients of female sex workers in Thailand, together with a reduction in the number of men who have sex with sex workers, show the effectiveness of condoms in curbing the incidence of HIV. 1 Nelson KE Celentano DD Eiumtrakoi S et al. Changes in sexual behavior and a decline of HIV infection among young men in Thailand. N Engl J Med. 1996; 335: 297-303 Crossref PubMed Scopus (321) Google Scholar However, for condoms to be effective, they must be used consistently and properly.

Factors associated with condom use among brothel-based female sex workers in Thailand

This study sought to determine the actual levels of condom use by female sex workers (FSW) in Thailand brothels. Specifically, it examined the influence that the country of origin of the FSW patrons exerted on usage of a condom, and it assessed the relevancy of constructs from the Health Belief Model in predicting FSW requesting condom usage by their clients. A survey was administered to a cross-sectional non-randomized convenience sample of 150 FSW in four geographic locations in Thailand, which included: Bangkok, Chang Mai, Mae Hong Son and Other (comprised mainly of brothels in small villages). Statistical interpretation of the data indicated that Thai FSW requested condom use in 63% of the cases, while the overall mean of condom use was only 51%. Condom use by patrons’ country of origin was as follows: westerners 76%, foreign Asians 52% and native Thai men 27%. These results fall considerably short of the Ministry of Health's goal of 100% condom use in Thai brothels. Furthermore, public health education initiatives need to effectively target the native Thai FSW patrons since they represent the clients least likely to use a condom (27%).

Condom Utilization Among Female Sex Workers in Thailand

Objective: To perform a small-scale rapid assessment of condom utilization rates among female sex workers (FSW) in various communities in Thailand, to distinguish condom utilization among FSW patrons by country of origin, and to assess the relevancy of constructs from the Health Belief Model in predicting FSW requesting condom utilization by their patrons. Methods: A convenience sampling approached was used among FSW in four cities of Thailand. Survey interviews were conducted in person by native speaking Thai graduate students from Mahidol University of Bangkok. Results: Approximately 70% of the FSW approached participated in the study, resulting in a sample size of 150. FSW requested condom use 63% of the time, while the overall mean proportion of condom use was 51%. Condom use by patrons by country of origin was as follows: Foreign Asian averaged 52%, Western averaged 76%, and local Thai averaged 27%. High levels of perceived fear of infection transmission from a patron, significantly predicted requesting patrons use a condom (Odd Ratio= 11.57, CI95% 4.37 to 30.63). Conclusion: This study found overall condom utilization was 51% among FSW, which is far below the 100% Condom Use goal advocated by the Thailand Ministry of Public Health imitative. Educational efforts need to be focused on the local Thai FSW patron who exhibited the lowest level of condom use. Educational messages may consider including elements of perceived susceptibility to sexbased infections since these perceptions had significant predictive utility in increasing condom use requests by the FSW.

Prevalence of sexually transmitted infections among clients of female commercial sex workers in Thailand.

Clients of commercial sex workers are considered at high risk for the acquisition and transmission of sexually transmitted diseases (STDs). Identification and treatment of infections in this group could help to reduce the transmission of STDs. To ascertain the prevalence of sexually transmitted organisms in male clients of female sex workers in Thailand by analysis of seminal fluid collected after intercourse. Used condoms were collected from 291 male clients attending a brothel in Hat Yai, Thailand during a 7-day period. Nucleic acid was extracted from seminal fluid and tested by polymerase chain reaction for the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus (HSV) and HIV sequences. Overall, 17 (6%), 47 (16%), and 2 (1%) of specimens were positive for C trachomatis, N gonorrhoeae and T vaginalis respectively. HSV sequences were found in 24 (8%) of the specimens: 14 specimens (5%) with HSV type 1, and 11 specimens (4%) with HSV type 2. HIV RNA was detected in two samples (1%). Overall, 75 specimens (26%) were positive for one or more infections, and more than one pathogen was detected in 16 specimens (5%). This study reports a high rate of STDs among clients of female sex workers in Thailand. Consequently, this population is a significant risk for transmitting STDs to commercial sex workers and to other noncommercial partners. Strategies that target this population of men are needed to reduce STD and HIV transmission.

Disease progression and survival with human immunodeficiency virus type 1 subtype E infection among female sex workers in Thailand.

This study describes rates and correlates of disease progression and survival among 194 female sex workers in northern Thailand who were infected with human immunodeficiency virus type 1 (HIV-1; 96% with subtype E). The median rate of CD4 T lymphocyte decline (3.9 cells/microL/month), median time from infection to <200 CD4 T lymphocytes/microL (6.9 years), and time to 25% mortality (6.0 years) were similar to those found in studies performed in Western countries before highly active antiretroviral therapy was available to populations infected with HIV-1 subtype B. Mortality rates among women with >100,000 HIV-1 RNA copies/mL were 15.4 times higher (95% confidence interval, 5.2-45.2) than among women with <10,000 copies. Initial CD4 T lymphocyte counts and serum virus load were independently strong predictors of survival. These results can help in assessing the effects of the epidemic in Thailand and in determining the prognoses for individual patients.

Narrative explorations and self-esteem: research, intervention and policy for HIV prevention in the sex industry in Thailand

Findings are presented from an integrated programme of research involving psychosocial analysis and programme design, implementation and evaluation, to promote consistent condom use by female sex workers in Thailand. The context is outlined with respect to Thai sexual culture, the HIV/AIDS epidemic and the changing structure of the sex industry. Essentially the programme seeks to contribute to the effective functioning of the Thai Government's policy of ‘100% condom use in the sex industry’. Following Phase I, which involved detailed psychosocial investigation, the programme sought to address the knowledge, attitudinal, motivational and self-esteem factors found to influence condom use. The design of this multifaceted intervention is discussed. The key element in the programme entailed the design and use of dramatic narrative scenarios on video to depict the dilemmas and concerns faced by sex workers, as a basis for open discussion and personal exploration. The programme was implemented in high-income and low-income sex establishments in Central Thailand. It was evaluated using a pre-test/post-test, intervention and control, quasi-experimental design. Findings are presented for the more crucial low-income settings to indicate the effects on cognition and behaviour. Most critically, the consistency of condom use over a one-month period increased from 66% pre-test to 86% in the post-test period in the intervention settings, but showed no change among the control sex workers. We consider the implications of the findings for HIV prevention in the Thai sex industry. Copyright © 1999 John Wiley & Sons, Ltd.

Narrative explorations and self-esteem: research, intervention and policy for HIV prevention in the sex industry in Thailand.

This paper reports on a project that integrates basic behavioral and need assessment research with program design, implementation and evaluation to promote consistent condom use in the sex industry of Thailand. The project structure consisted of Phase I, which provided a detailed psychosocial investigation into the factors influencing condom use by female sex workers in Thailand. Phase II translated the research findings of Phase I into an operational intervention. This involved an integrated series of stages including pre-program needs assessment, intervention design, implementation, evaluation, and finally dissemination and policy integration. As a basis for open discussion and personal exploration the use of dramatic narrative scenarios on video were used to depict the problems experienced by sex workers. This program was implemented in high and low-income establishments in central Thailand; evaluation was performed through pre/post-test, intervention and control, and quasi-experimental design. Findings demonstrated an increase in the consistency of condom use over a period of 1 month among the low-income intervention group, from 66% (pre-test) to 86% (post-test), while there was no significant change observed among the sex workers in the control group.

Can prostitutes marry? Thai attitudes toward female sex workers

This study explores popular attitudes towards female sex workers in Thailand by examining the general public's perceptions of a prostitute's ability to marry based on focus group data. The tentative conclusion emerging from our findings that the general public believes sex workers can marry is that a relative lack of severe or lasting social stigma is an important part of a Thai context that facilitates recruitment into prostitution and permits it to persist on a widespread scale. We interpret this conclusion in terms of the broader value system in Thai society. Although our findings are implicitly comparative in nature, a lack of comparable information from other countries on how those who provide commercial sex are viewed by the general population prevents a more definitive conclusion. There is an obvious need for research on this topic as well as on how sex workers view themselves, and how this translates into actual behavior. Data set used: focus group transcripts from the project “Theinfluence of primary female partners and male peers on male extramarital sexual behavior in Thailand”.

Medication use by female sex workers for treatment and prevention of sexually transmitted diseases, Chiang Rai, Thailand.

Female sex workers (FSWs) in Thailand are at high risk for sexually transmitted diseases (STDs). Although regular attendance at public STD clinics is required, FSWs may frequently use medications obtained in the community for STDs. To determine the frequency of use of medications for STDs from sources other than public STD clinics among FSWs in Thailand and to describe factors associated with such medication use. A cross-sectional survey of FSWs attending the public STD clinic in Chiang Rai, Thailand, was performed. Of the 200 FSWs interviewed, 55% had ever used medications to treat or prevent STDs from a source other than a public STD Clinic, and 36% had done so in the prior year. Most use (79%) was to treat STD symptoms, and medication was most frequently obtained directly from a pharmacy (54%). This use of community medication for STDs was associated with younger age, non-Thai ethnicity, seeking STD treatment during the current clinic visit, and brothel-based sex work. Use of medications from various sources in the community was common among these FSWs. Further research is needed to determine the appropriateness of this treatment. Innovative methods to ensure adequate quality STD care by community providers and to improve the health-care-seeking behaviors of these high-risk women are needed.