Sex Workers In Bangladesh Research Articles

Prevalence and Associated Factors of Severity of Gender-Based Violence Among Street-Based Female Sex Workers in Bangladesh

Prevalence and Associated Factors of Severity of Gender-Based Violence Among Street-Based Female Sex Workers in Bangladesh

Violence against Women Working in Sex Trade: A Study in Bangladesh

The study explores the nature of violence against sex workers in Bangladesh and their challenges. The study was conducted in Tangail Brothel, which is the largest brothel in Bangladesh. This is a primary study, and a quantitative method was employed to find out the real facts from sex workers at Tangail brothel. The findings of the study show that women face multiple acts of violence including physical, verbal, and sexual abuse. Furthermore, pressures for minimum earnings, lack of legal and medical support, and discards of social movements are the main challenges of sex workers. The study recommends that governments, authorities, human rights organizations, and law enforcement agencies should pay more attention to preventing such violence and establishing their human rights.

Intimacy, trust, and exploitation: Sex workers' relationship with their intimate partners in a Bangladeshi brothel

Being pushed to the margins of society, brothel-based sex workers in Bangladesh develop relations with their intimate partners, referred to as babus . This study, based on fieldwork in a Bangladeshi brothel, documents how sex workers' relations with intimate partners are shaped by intimacy and exploitation and the ways meanings of such relations are rooted in cultural norms. This paper shows that sex workers' intimate relations involve trust, dependency, and emotional attachment, which extend to choices of condom use. This paper argues that sex workers' relations with their intimate partners derive meaning from the broader culture of Bangladesh, in which femininity and domesticity play a dominant role. Understanding sex workers' intimate relations in the Bangladeshi context is important because it sheds light on the nature of the private life of the sex workers from a culture-specific point of view.

The Organisation of Sex Work in Bangladesh

This paper problematises the dominance of the Northern gaze on sex work. Because the organisation of sex work takes place under different modes in Bangladesh, sex work premises have a unique structure which sets them apart from sex work in the Global Northern contexts. In particular, the dichotomy between private and public life, which has influenced the structure and organisation of sex work in many Northern contexts, as well as the regulation of sex work, is less pronounced in the Bangladeshi context. By documenting the culturally distinct and varied experiences of regional sex workers in Bangladesh, this paper emphasises the diversity among sex workers and argues that ignoring the culturally-specific conditions of the organisation of sex work risks universalising sex workers as perpetual victims. This paper highlights the importance of acknowledging the cultural variability of sex work to understand the diversity of sex workers’ experiences.

Sexual exploitation of trafficked children: Survey evidence from child sex workers in Bangladesh

Human trafficking is a serious humanitarian problem. Using a nationally representative survey of Bangladeshi child sex workers and an instrumental variable model, we examine the working conditions of trafficked child sex workers and how they differ from those of nontrafficked child sex workers. We find that the victims trade sex with 190 percent more clients at a 67.8 percent lower wage and are more exposed to violence, leading to sickness, such as fever and headache. However, the differences in the prevalence of STDs and injury are insignificant presumably because the owners have an incentive to protect the victims from STDs. These findings suggest that evaluating sex workers’ working conditions by the prevalence of STDs alone may underestimate the severity of the exploitation of victims. Furthermore, conducting an empirical analysis without distinguishing between trafficked and nontrafficked workers, as performed in previous studies, leads to misunderstandings regarding the sex industry. We also contribute to the literature concerning the worst form of child labor by providing the first rigorous evidence of the working conditions of child sex workers. Finally, four implications for practitioners are discussed.

Condom use, symptoms of suggestive sexually transmitted infections, and health care seeking among female sex workers in Bangladesh.

This article presents a mixed-method cross-sectional study reporting condom use, sexually transmitted infection (STI) symptoms, and care seeking of female sex workers (FSWs) in Dhaka, Bangladesh. A survey of 1228 FSWs, in-depth interviews (n = 24), and key informants' interviews (n = 26) were used for data collection. Among the 1228 FSWs included in this study, 50% of them were illiterate and 39.3% were married, and their mean age was 27.1years. The consistent use of condoms was reported by 75.6% of the FSWs, 88.7% reported having STI symptoms in the last 6 months, while 91.8% visited one of the drop-in centers for services. FSWs without formal education had lower odds of using condoms consistently (AOR: 0.72; 95% CI: 0.55-0.95), and those working elsewhere than in the streets showed higher odds (AOR: 1.63; 95% CI: 1.23-2.15) to use condoms. Stigma to access health care services, poor knowledge about STI/HIV, and low perceived risk were mentioned as causes of having STI symptoms in the survey as well as in qualitative in-depth interviews. Self-reported condom use, STI symptoms, and care-seeking practices were found to be high among the FSWs. Inconsistent condom use and a high number of sex partners could be the reasons for high levels of STI symptoms. Innovative objectively verifiable approaches should be tested to collect condom use data.

Impact of Testing on Sexually Transmitted Infections among Female Brothel Sex Workers in Bangladesh: A Randomized Controlled Trial.

Past studies that have designed interventions to reduce the prevalence of sexually transmitted infections (STIs) have typically provided onsite treatment to sex workers who tested positive, which were expensive and difficult to implement. The purpose of this study was to examine the effect of an intervention which tested for STIs and provided information on the closest treatment facility on reducing the prevalence of STIs among female brothel-based sex workers (BSWs) in Bangladesh. The study adopted a pre-post interventional design as well as a randomized controlled study design. A baseline sample and follow-up urine sample were collected to evaluate the prevalence of STIs among participants in the treatment, but not control group. A baseline survey and interviews were also conducted for both the groups. The study found a nonsignificant reduction from baseline to follow-up in STI prevalence among intervention participants (adjusted odds ratio [aOR]: 0.74; 95% CI: 0.38, 1.45). However, the participants in the intervention group were significantly more likely to have a repeat client (aOR: 1.60; 95% CI: 1.12, 2.29) and nonsignificantly less likely to engage with a client suspected of having an STI (aOR: 0.62; 95% CI: 0.39, 1.00) than participants in the control group. The intervention testing of STIs and providing information to the positive cases about nearest treatment facilities were not effective in reducing the prevalence of STIs among BSWs. Further study of the clinical and behavioral impacts of such efforts to reduce STIs among BSWs is warranted.

Experiences of a 'screen and treat' cervical cancer prevention programme among brothel-based female sex workers in Bangladesh: A qualitative interview study.

Objectives:Little is known about sex workers’ experiences of cervical cryotherapy. We sought to understand sex workers’ perspectives of ‘screen and treat’ programmes and their management of the World Health Organization post-treatment guidance to abstain from sex or use condoms consistently for 4 weeks. We explored contraceptive preferences and use of menstrual regulation services.Methods:We conducted semi-structured interviews with 16 sex workers and six brothel leaders in an urban brothel complex in Bangladesh between October and November 2018. All had undergone cryotherapy. We conducted a thematic analysis using deductive coding, informed by a priori themes, and inductive data-driven coding.Results:Most sex workers could not abstain from sex during the healing period. Consistent condom use was challenging due to economic incentives attached to condomless sex and coercive behaviours of clients. The implications of non-adherence among high-risk groups such as sex workers are not known. Use of short-acting methods of contraception was common, and discontinuation was high due to side effects and other perceived health concerns. The majority of sex workers and brothel leaders had utilized menstrual regulation services. Barriers to accessing timely menstrual regulation and other sexual and reproductive health services included limited mobility, economic costs, and discriminatory attitudes of health care workers.Conclusion:Service innovations are required to enable sex workers to abstain or use condoms consistently in the post-cryotherapy healing phase and to address sex workers’ broader sexual and reproductive health needs. Further research is required to assess the risk of HIV and other sexually transmitted infection transmission following cryotherapy among high-risk groups.

Psychiatric Morbidities among Female Sex Workers in Bangladesh: an Observational Study

Psychiatric Morbidities among Female Sex Workers in Bangladesh: an Observational Study

Survey measures versus incentivized measures of risk preferences: Evidence from sex workers' risky sexual transactions

Survey measures of risk attitudes are primarily used in the health literature, although incentivized measures of risk preferences are being increasingly used in other fields. We exploit the unique setting of commercial female sex workers in Bangladesh to investigate whether incentivized measures of risk preferences, or non-incentivized survey measures of risk preferences, best identify the risky commercial sex decisions that they make. The study uses survey data collected during February–April 2016, and October–November 2016 from eight brothels in Bangladesh. Wave 1 includes 1,332 female sex workers, Wave 2 includes 1,185 female sex workers. Our findings suggest that researchers can reliably use survey measures to elicit risk preferences on health.

High-risk behavior of HIV/AIDS among females sex workers in Bangladesh: survey in Rajshahi City.

Female sex workers (FSWs) and their clients are one of the major sources of spread of HIV/AIDS in Bangladesh. The purpose of this study was to determine the rate of unprotected sex among FSWs in Rajshahi City, Bangladesh. A total of 200 FSWs were randomly selected for the survey from February to September 2012. The age range of FSWs was 16-41 years (average age, 24.52 ± 6.26 years), and the majority of these women (84.4%) were married. More than 88% of FSWs reported practicing unprotected sex because of clients' insistence. Further analysis showed a significantly higher rate of protected sex among unmarried FSWs (P < 0.01). Approximately 32% of FSWs did not undergo voluntary counseling and testing (VCT) for HIV, and this factor was significantly associated with the education level (P < 0.01), age (P < 0.01), and economic status (P < 0.05). Furthermore, 89.5% respondents did not ask their new clients about VCT/HIV status, and this factor was associated with the resident area (P < 0.05), age (P < 0.05), and economic status (P < 0.01) of FSWs. Authorities in this country should focus their HIV/AIDS prevention efforts on illiterate FSWs, married FSWs, and FSWs aged below 21 years or above 30 years.

Safer Sex Negotiation and Its Association With Condom Use Among Clients of Female Sex Workers in Bangladesh

This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients.

Factors associated with condom use negotiation by female sex workers in Bangladesh

Negotiation for condom use by female sex workers with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 female sex workers; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the 7 days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street-based female sex workers, respectively. Overall, 28.1% of female sex workers negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2-2.0) and self-perceived risk of human immunodeficiency virus infection (AOR, 1.8 95% CI, 1.6-2.1) were positive predictors for condom negotiation. Compared to the hotel-based female sex workers, street (AOR, 0.6; 95% CI, 0.4-0.9) and brothel-based female sex workers (AOR, 0.7; 95% CI, 0.5-0.9) were less likely to negotiate for condom use. Female sex workers in Bangladesh are at high risk for sexually transmitted infection / human immunodeficiency virus infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by female sex workers, and should be strengthened in commercial sex venues.

The health and social well-being of female sex workers’ children in Bangladesh: A qualitative study from Dhaka, Chittagong, and Sylhet

Numerous studies have documented the health problems of sex workers; however, there has been limited research documenting the well-being of children of sex workers. Threats to the health and welfare of these children span their lives. Problems among infants may be more difficult to observe, but field observations by staff at NGOs, who operate drop-in-centers for sex workers in Bangladesh, suggest that older children of sex workers experience significant risks to their health and safety.This qualitative study explored the threats to the health and welfare of children of sex workers through focus group discussions with sex workers and brothel madams in Bangladesh, all of whom were mothers. Risks to their children were explored from the time of pregnancy through adolescence.Findings indicate that stigmatization of and discrimination against these children and their mothers are underlying conditions that compromise their access to safe housing, childcare, health care, education, and the protection of law enforcement. The threats they face may exceed those of other children in Bangladesh and include sexual exploitation, exploitive labor, trafficking for adoption, and forced entry into crime. In addition, many children of sex workers have reportedly been traumatized after witnessing police brutality against their mothers. While both sons and daughters of sex workers face similar barriers in altering their life trajectories, gender-specific challenges were also identified.Additional research documenting trends among children of sex workers and their mothers is needed; however, much can be done immediately to mitigate potential harm by targeting family-based support to these mothers and children to meet basic needs and ensure their basic rights. Our recommendations are to strengthen health, social welfare, and other services to address protection and prevention needs; ensure access to basic services; and provide interventions that address the marginalization resulting from stigma and discrimination.

Access to Education for the Children of Sex Workers in Bangladesh: Opportunities and Challenges

The children of sex workers in Bangladesh are denied even the most basic human rights. This article is based on recent research focused on the children of sex workers in the context of their everyday lives. The study focused on access to education and how education could be a vehicle for them to break the vicious cycle of exploitation. This was a mixed method interpretative study which employed qualitative and quantitative approaches, but in this paper only qualitative data which was generated through in-depth interviews and focus group discussions is used. Data was collected from sex workers, their children, teachers and NGO workers who participated in the study. Information has been collected for analysing the expectation of the children of sex workers and hope for the future, and the opportunities available to them during their schooling. Thematic analysis technique was used to understand the challenges and barriers faced by the children of sex workers in fulfilling their educational aspirations. The lives of the children of sex workers are marginalised by the mainstream society. Though it is very difficult to break the vicious cycle of exploitation, this research finds that education may be a stepping stone for them to create a better future. However, it is argued that the children of sex workers need income generating vocational and technical education to enable them to earn and support their family. Policy recommendations have been made in order to achieve Education For All targets and Millennium Development Goals, and to provide a second chance for these vulnerable young people to have a better life.

Prevention and control of sexually transmissible infections among hotel-based female sex workers in Dhaka, Bangladesh

Hotel-based sex workers in Bangladesh have high rates of sexually transmissible infections (STIs), high client turnover and low condom use. Two monthly clinic-based strategies were compared: periodic presumptive treatment (PPT) and enhanced syndromic management (ESM) - one round of presumptive treatment followed by treatment based on assessment and laboratory tests. A randomised controlled trial compared PPT and ESM by prevalence and incidence, behaviour, retention, cost and STI incidence and prevalence. Demographic, behavioural and clinical data were collected from women at two clinics in Dhaka. All women received presumptive treatment and were randomised to receive PPT or ESM at nine monthly visits. In total, 549 women (median age: <20 years) were enrolled. At baseline, the prevalence of chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) was 41% (ESM: 41%; PPT: 42%). After 9 months, chlamydia and gonorrhoea decreased to 7% overall, (ESM: 7.4%; PPT: 6.8%). At each visit, 98% of women receiving ESM met the therapy criteria and were treated. Retention was low (50%). Total costs were 50% lower per visit for each woman for PPT (ESM: $11.62 v. PPT: $5.80). The number of sex work sessions was reduced from 3.3 to 2.5 (P<0.001), but income did not change. Coercion was reduced but condom use at last sex did not change significantly. Monthly PPT and ESM were effective approaches for STI control. PPT offered a feasible, low-cost alternative to ESM. Educational aspects led to a reduction in coercion and fewer sessions. Implementation studies are needed to improve condom use and retention.

Symptoms of Sexually Transmitted Infections and Care-Seeking Behaviors of Male Clients of Female Sex Workers in Bangladesh

In Bangladesh, male clients (MCs) of female sex workers (FSWs) represent diverse occupational categories from different socioeconomic strata, and they are considered a bridging group to transmit sexually transmitted infections (STIs) to their spousal and nonspousal female partners. This study aimed to better understand sexual behaviors, STI symptoms, and care-seeking behaviors among MCs of FSWs in Bangladesh. A cross-sectional study was conducted among MCs from November 2005 to July 2006 in 3 types of sex trade settings in Bangladesh. Of 1565 MCs included in this study, 531 were from brothels, 515 from hotels, and 519 from street-based settings. Among the MCs, 32.2% reported having had STI symptoms within the last 1 year before the interview and 81.5% sought care for those symptoms. Among those who reported symptoms, 44.5% received treatment from pharmacies, 37.4% received treatment from qualified medical professionals, 8.6%, received treatment from nongovernment organization clinics, and 7.8% went to herbal providers. Male clients who had only 1 to 4 years of schooling were 2.4 times more likely to have STI symptoms (adjusted odds ratio [OR], 2.4; 95% confidence interval [CI], 1.5-3.8) compared with the MCs having 10 or more years of schooling. The MCs who had sex with more than 3 nonmarital sexual partners in the last month were 2 times more likely to have STI symptoms (adjusted OR, 2.0; 95% CI, 1.4-2.8). The MCs who used condoms consistently in their non-marital sexual contacts were significantly less likely (adjusted OR, 0.4; 95% CI, 0.3-0.6) to have STI symptoms. Reported risk behaviors, STI symptoms and care-seeking behavior suggest that MCs are a potential risk group for transmission of HIV and STIs. The study findings underscore the need to target HIV/STI prevention intervention for MCs, which are predominantly geared toward FSWs.

Young Clients of Hotel-Based Sex Workers in Bangladesh: Vulnerability to HIV, Risk Perceptions, and Expressed Needs for Interventions

ABSTRACT A qualitative study was conducted among key informants and 53 young clients (15 to 24 years of age) of commercial sex workers from nine hotels in Dhaka, Bangladesh. Respondents reported first sexual encounter before 18 years of age, and reasons for purchasing sex were to prove masculinity or to reduce wet dreams and masturbation, thought to be detrimental to health. Limited knowledge of HIV and sexually transmitted infections was linked to high-risk sexual practices. Condom use was related to perceptions of cleanliness, status, and trust in the sex worker. A hotel-based, confidential intervention program promoting safe sex practices among clients of sex workers is warranted.

‘My Body, My Talk’: Empowerment and Disempowerment Trajectories of Sex Workers in Bangladesh

‘My Body, My Talk’: Empowerment and Disempowerment Trajectories of Sex Workers in Bangladesh

Sexually Transmitted Infections Among Brothel-Based Sex Workers in Bangladesh: High Prevalence of Asymptomatic Infection

OBJECTIVE AND GOAL: The goal of this study was to study the prevalence of sexually transmitted infections (STIs)/reproductive tract infections (RTIs) among brothel-based sex workers (SWs) in Bangladesh. A cross-sectional study was conducted among SWs in 4 randomly selected brothels. A sociodemographic and behavioral survey and pelvic examination was conducted. Specimens including endocervical swab, high vaginal swab, and blood were collected and were examined for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, bacterial vaginosis candidiasis, and syphilis. A total of 439 SWs were enrolled and 49.6% had genital symptoms. Among all SWs, 17.5% were positive for N. gonorrhoeae; 15.5% for C. trachomatis; 7.5% for T. vaginalis, and 6.6% had active syphilis. A total of 67.4% SWs were positive for at least 1 cervical and/or vaginal infection. The prevalence of STIs/RTIs among SWs in brothels in Bangladesh is high. An intervention strategy addressing both symptomatic and asymptomatic infections and periodic screening of SWs for RTIs/STIs is essential for successful HIV and STIs prevention programs.