Vietnamese Female Sex Workers Research Articles

The effects of social networks on HIV risk behaviors among Vietnamese female sex workers: a qualitative study

IntroductionFemale sex workers (FSWs) experience heightened vulnerability to HIV and other health harms, and cross-border FSWs face additional challenges due to language issues, higher mobility, and weaker negotiation skills. Given the critical role of social network factors in HIV transmission, it is imperative to explore the social network characteristics of Vietnamese cross-border FSWs in China to enhance AIDS prevention and control.MethodsWe conducted semi-structured interviews with 22 Vietnamese FSWs in Hekou County, Yunnan Province from May to July 2018. The samples were selected using a purposive sampling strategy and stopped when reached theoretical saturation. Data collection and analysis were conducted iteratively to identify themes within the data. Participants reported their social relationships and how these relationships affected their HIV risk behaviours. All the interviews were recorded, transcribed verbatim, and reviewed. Thematic analysis was used to analyse the data.ResultsAmong 22 Vietnamese FSWs, the median age was 23.5. Concerning social networks, interviews revealed that their social networks were composed of three components: Workplace networks (customer, boss, colleague), Hometown networks (spouse or boyfriend, family member, fellow villager), and Social institutions networks (Chinese social institutions network, Vietnamese social institutions network). None of these networks can simply support or hinder Vietnamese FSWs’ preventive high-risk HIV behaviours, and the impact is achieved through each network’s ways. Within the workplace network, the predominant influence is the ascendancy-submissiveness dynamic that exists among customers, bosses, and VFSWs. In the hometown network, familial responsibilities emerge as the principal factor impacting VFSWs. Meanwhile, within the social institution network, pivotal roles are played by the Chinese CDC and the Vietnamese government in the dissemination of HIV knowledge.ConclusionsThe social networks of Vietnamese female sex workers exert a dual impact on high-risk HIV behaviors. Interventions should be designed and tailored to address the specific contextual factors and challenges associated with social networks among cross-border FSWs in China and other similar settings.

A Confounding Discourse Analysis of Vietnamese Sex Workers' Talk in the City of Kaiyuan, China.

Vietnamese female sex workers (VFSWs) cross the border into Kaiyuan City, Yunnan Province yearly. However, very little is known about both the health and psychological issues VFSWs experience. The objectives of this study were to explore the dominant discourses that emerged from the VFSWs' talk. The interviews occurred between May 2018 and June 2018 with 20 VFSWs who worked in Kaiyuan City, China. The English translated transcripts were analyzed using an eclectic feminist method of discourse analysis. Two discourses emerged. First, "Agency when working in Karaoke Bars and other Indoor Venues", and second, "Negative Impacts on Psychological Well-being and Other Problems from Migration." As for Discourse 1, the VFSWs positioned themselves as having agency over choosing their clientele as well as agency over what they were willing to negotiate with their clients to establish boundaries of their bodies. As for the Discourse 2, while there was a discourse of agency in their work there was also a contrasting, confounding discourse around the negative impact on psychological well-being and reports of stress as a migrant worker. Discourse 1 and Discourse 2 are confounding. When analyzed together, the discourses suggest that the impacts on psychological well-being may be more related to the migrant status of the women, supporting the notion of systemically influenced agency.

Trends and associated factors in the uptake of HIV testing among female sex workers in Sino-Vietnam border areas in Guangxi, China: a cross-sectional study

BackgroundHIV testing is a primary prevention strategy against the HIV epidemic and an entry point for HIV/AIDS-related care, prevention and treatment. This study aimed to estimate the uptake of HIV testing among Sino-Vietnam female sex workers (FSWs) in Guangxi, China, from 2016 to 2018, and to identify the factors influencing HIV testing uptake.MethodsA cross-sectional survey was conducted among FSWs in two Sino-Vietnam border cities of Guangxi, China. The survey was conducted through face-to-face interview, the data were collected by a structured questionnaire, and HIV-1 infection was detected simultaneously. Logistic regression analysis was used to determine the factors associated with uptake of HIV testing.ResultsIn total, 4565 Chinese local FSWs (CL-FSWs) and 636 cross-border migrant Vietnamese FSWs (CMV-FSWs) were recruited into this study. HIV-1 prevalence in CL-FSWs and CMV-FSWs was 0.70% and 3.14%, respectively. The rate of self-reported uptake of HIV testing in CL-FSWs and CMV-FSWs was 54.56% and 45.44%, respectively. The rates of self-reported uptake of HIV testing declined in both groups from 2016 to 2018. Logistic regression analysis indicated that a number of factors, including socio-demographic characteristics (age < 35 years, higher education, location in Chongzuo City), behaviour factors (having received free AIDS education, condom distribution services and peer education services, high risk sexual behaviours such as inconsistent condom use, having regular commercial sexual partners, etc.), psychological factors (perception of vulnerability to HIV/STIs, perception of risk for HIV infection) were the factors significantly related to uptake of HIV testing.ConclusionIn recent years, the rate of HIV testing uptake among Sino-Vietnam border FSWs in Guangxi, China was low, which may be an important reason for the high HIV-1 prevalence among FSWs in the region. A number of factors were identified to be associated with HIV-1 testing uptake, suggesting that HIV testing prevention strategies in this region could include accelerating AIDS education training, raising personal awareness of HIV testing, and improving accessibility of HIV testing.

Migrant female sex workers working at the Sino-Vietnamese border for a short time have a higher risk of HIV transmission: a consecutive cross-sectional study

ObjectivesFor migrant female sex workers (FSWs) at the Sino-Vietnamese border, the impact of work time in their current location on the spread of HIV/AIDS is not clear.MethodsData were collected from the Sino-Vietnamese border cities of Guangxi, China. Migrant FSWs working in these cities were studied. FSWs who worked less than 6 months in their current location were assigned to the short-term work group (ST FSWs), and FSWs who worked equal to or longer than 6 months in their current location were assigned to the long-term work group (LT FSWs). Logistic regression was performed to examine the impact of work time in the current location and factors associated with HIV infection.ResultsAmong the 1667 migrant FSWs, 586 (35.2%) and 1081 (64.9%) were assigned to the ST FSW and LT FSW groups, respectively. Compared to LT FSWs, ST FSWs were more likely to be of Vietnamese nationality, be less than 18 years old when they first engaged in commercial sex work, and have a low-level of HIV-related knowledge and had higher odds of using condoms inconsistently, having more male clients, having no regular male clients, and having a history of male clients who used aphrodisiacs but lower odds of receiving free condoms distribution and education/HIV counselling and testing programme. The analysis of factors associated with HIV infection revealed that Vietnamese FSWs, less than 18 years old when they first engaged in commercial sex work, having no regular male clients, and having lower average charge per sex transaction were correlated with HIV infection.ConclusionFSWs with short-term work at the Sino-Vietnamese border had a higher risk of risky sex and were correlated with HIV risk factors. Vietnamese FSWs were at higher risk of HIV infection, and they were more likely to have short-term work. More targeted HIV prevention should be designed for new FSWs who recently began working in a locality to further control the spread of HIV, particularly cross-border FSWs.

Vietnamese female sex workers in rural cross-border areas of Guangxi, China: migration and HIV/STI risk behaviors

ABSTRACT China’s HIV/AIDS epidemic continues to grow in rural and less developed areas. This consecutive cross-sectional study examines demographic and behavioral factors associated with HIV/STI infection, Hepatitis C (HCV) and other sexually transmitted infections (STIs) among Vietnamese female sex workers (FSW), a vulnerable population who cross into Guangxi, China. This study is a secondary data analysis of 303 Vietnamese and 4,348 Chinese FSWs recruited over seven years from two Chinese counties that border Vietnam. Logistic regression models compared demographics, HIV/STI status, HIV/AIDS-related knowledge, attitudes, and risk behaviors between Vietnamese FSWs and Chinese FSWs. Compared with Chinese FSWs, Vietnamese FSWs were younger, had attained lower education levels, were highly mobile, more likely to report using drugs, and were more vulnerable to HIV/STIs. Younger age, less educational attainment, shorter time in their current working location, no voluntary HIV testing in the last year, greater drug use, and not using condoms for all commercial sex in the last month were associated with higher HIV/STIs. In conclusion, several factors were associated with HIV/STI risk in Vietnamese cross-border FSWs. There is a pressing need to improve support systems for Vietnamese cross-border FSW and health system cooperation across the Chinese/Vietnamese border.

High hepatitis C virus infection among female sex workers in Viet Nam: strong correlation with HIV and injection drug use.

ObjectiveThe World Health Organization’s guidelines on viral hepatitis testing and treatment recommend prioritizing high prevalence groups. Hepatitis C virus (HCV) infection disproportionately affects people who inject drugs and men who have sex with men, but data on female sex workers (FSW) are limited. The study aimed to determine active HCV infection and risk factors associated with HCV exposure among Vietnamese FSW.MethodsWe surveyed 1886 women aged ≥ 18 years from Haiphong, Hanoi and Ho Chi Minh City who had sold sex in the last month. We tested for HCV antibody and HCV core antigen as markers for exposure to HCV and active infection, respectively.ResultsAcross these provinces, high prevalence of HCV exposure (8.8–30.4%) and active infection (3.6–22.1%) were observed. Significant associations with HCV exposure were HIV infection (aOR = 23.7; 95% CI: 14.8–37.9), injection drug use (aOR = 23.3; 95% CI: 13.1–41.4), history of compulsory detention (aOR = 2.5; 95% CI: 1.4–4.2) and having more than 10 sex clients in the last month (aOR = 1.9; 95% CI: 1.2–3.2). Among FSW who reported never injecting drugs, HIV infection (aOR = 24.2; 95% CI: 14.8–39.4), a history of non-injection drug use (aOR = 3.3, CI: 1.8–5.7), compulsory detention (aOR = 2.2; 95% CI: 1.2–4.0) and having over 10 sex clients in the last month (aOR = 2.2, 95% CI: 1.3–3.7) were independently associated with HCV exposure.DiscussionFSW have elevated HCV risks through sex- and drug-related pathways. These findings highlight the need to offer FSW-targeted HCV interventions and ensure their access to HIV prevention and treatment.

HIV prevalence and correlated factors on male clients of female sex workers in Hekou Yao autonomous county of Yunnan province, 2014-2015

Objective: To assess the prevalence and related factors of HIV infection among male clients of the female sex workers in Hekou Yao autonomous county of Honghe Hani Yi autonomous prefecture (Hekou county) in Yunnan province in China, 2014-2015. Methods: Serial cross-sectional survey was conducted during June 2014 to November 2015. Convenience sampling methods were used to recruit the male clients for this study. Self-reported information on social-demographic characteristics, with sexual and drug behavior patterns, was gathered. Both blood and urine samples were collected for HIV, with for opiate testing. Multivariate logistic regression and Exhaustive CHAID method were used to determine the correlated factors associated with HIV infection. Statistical analysis was used by SPSS 22.0 software and Clementine 12.0 software. Results: The overall HIV prevalence of male clients was 2.06% (16/776). Male clients who keep using condom with female sex worker was estimated as 68.81% (534/776). The last commercial sexual partner of Vietnamese male clients was all Vietnamese female sex workers. Compared with Chinese male clients, Vietnamese male clients have a higher rate of morphine positive. Factors as: age ≥50 years vs. age <30 years (OR=8.11, 95%CI: 1.26-52.16) and testing for morphine positive vs. morphine negative (OR=7.35, 95%CI: 1.42-38.06) were significantly associated with HIV infection through multiple logistic regression analysis. Through Exhaustive CHAID, it confirmed that age was the primary factor that associated with HIV infection of male clients. Conclusions: Relationship between morphine and HIV infection indicated that HIV prevalence of male clients in Hekou county was influenced by the combined effect of both illegal drug use and commercial sexual behavior. Special attention should be paid to male clients over 50 years of age, on HIV intervention.

Consecutive cross-sectional survey of prevalence of HIV infection/STD and related factors in Vietnamese female sex workers at a China-Vietnam border area, 2014-2015

Objective: To investigate the prevalence of HIV infection/STD and related factors in Vietnamese female sex workers (FSWs). Methods: Consecutive cross-sectional surveys were conducted in June 2014, December 2014, May 2015 and November 2015 in Hekou, a county bordering Vietnam in Yunnan province. Convenience sampling were adopted to select 1 058 Vietnamese FSWs aged>16 years. Questionnaire interview were used to collect the information about their demographics, sexual behaviors and drug use. Serum and urine samples were collected for HIV infection/STD detection and drug use test. Trend χ(2) test was applied for HIV infection/STD and drug use trend analysis. Multivariate logistic regression model was used to identify the related factors. Results: The consecutive cross sectional surveys indicated that the prevalence of HIV infection in Vietnamese FSWs were 3.20%(7/219), 2.04%(5/245), 1.89%(5/265) and 1.82%(6/329) respectively; the HSV-2 positive rates were 57.08%(125/219), 58.37%(143/245), 38.11%(101/265) and 51.06% (168/329) respectively. In addition, the prevalence of syphilis were 0.91%, 1.51%, 0.75% and 1.22% respectively. HSV-2 infection prevalence showed a downward trend (χ(2)=4.823, P=0.028). By logistic regression analysis, the related factors for HIV infection in Vietnamese FSWs were being amphetamine type stimulants (ATS) positive (OR=10.18, 95%CI: 4.33-23.92) and being HSV-2 positive (OR=2.89, 95%CI: 1.09-7.88); Age (OR=1.88, 95%CI: 1.32-2.61), no-paid sexual partner (OR=1.59, 95%CI: 1.26-2.01) and being ATS positive (OR=2.48, 95%CI: 1.10-5.57) were related factors for HSV-2 infection. Conclusions: Compared with the results of previous studies, the HIV infection prevalence declined in Vietnamese FSWs, but the HSV-2 infection prevalence was still high. The association between ATS use and HIV infection/STD suggested the necessity of strengthening AIDS intervention in Vietnamese FSWs, including the control of new type drug and sexual transmission.

Demographic and behavioral correlates of HIV/STI among Vietnamese female sex workers in southwest China

ABSTRACTPrevious literature has suggested high rates of HIV/STIs among Chinese FSWs. However, limited data were available regarding HIV-related risks among Vietnamese FSWs – a rapidly increasing, vulnerable population in southwest China. The current study examined the demographic and behavioral factors associated with the infection rates of HIV, syphilis, and Hepatitis C (HCV) among Vietnamese FSWs in Guangxi, China. We conducted a secondary data analysis of a cumulative sample of 1026 Vietnamese FSWs (aged 14–66) recruited over five years (2010–2014) from 35 National Sentinel Surveillance sites in Guangxi. Analyses included Fisher’s exact chi-square test, t-test, and binary logistic regression. The overall prevalence of HIV, syphilis, and HCV infections among the cross-border women were 3.2%, 6.9%, and 2.6%, respectively. Multivariate analysis showed that greater lengths of sex work and low paying work venues were significant risk factors for HIV infection; for syphilis infection, older age, drug use experience, and forgoing condom use were significant risk factors; for HCV infection, drug use experience was the only significant risk factor. Our findings suggest that elevated HIV-related risks among the Vietnamese FSWs are closely related to their financial disadvantages and that drug use is a prominent risk factor for cross-border women in the sex trade. Furthermore, culturally tailored and linguistically accessible HIV prevention and intervention initiatives that target cross-border FSWs, with a close international collaboration between China and Vietnam, are urgently needed.

Human immunodeficiency virus, syphilis and hepatitis C virus prevalence trends among cross-border migrant Vietnamese female sex workers in Guangxi, China.

BackgroundGlobal literature indicates the burden of human immunodeficiency virus (HIV), syphilis and hepatitis C virus (HCV) has disproportionately affected cross-border migrant female sex workers (FSW). However, few studies reported the HIV risk among Vietnamese FSW at borderline areas in China. We examined five consecutive years of HIV, syphilis, and HCV prevalence and corresponding risk factors among this group in Guangxi Province of China in the current study.MethodDemographic and behavioral data as well as test results of blood samples for HIV/syphilis/HCV testing were collected from the annual National Sentinel Surveillance (NSS) from the year of 2010 to 2014. The prevalence trends were first examined by stratified demographic and behavioral status. Predictive models with logistic regression were further employed to identify risk predictors for HIV, syphilis and HCV combined with multiple imputation for missing data as well as restricted cubic splines for key continuous covariates. Moreover, weighted prevalence using the distribution of venue types among all FSW from the NSS survey as the standardized population was also reported.ResultsThe overall prevalence of HIV, syphilis and HCV across the five year period was 3.2 % (95 % CI = 2.1 %,4.3 %), 6.9 % (95 % CI = 5.3 %,8. %), and 2.6 % (95 % CI = 1.6 %,3.6 %), respectively. HIV prevalence changed from 8.2 % (95 % CI = 0.5 %,15.9 %) in 2010 to 1.7 % (95 % CI = 0.4 %,3.0 %) in 2014, and the prevalence decreased notably among FSW who were younger than 25 years old, stayed less than six months, and who participated in the HIV prevention services (P < 0.05). The syphilis prevalence also ranged from 8.2 % (95 % CI = 0.5 %,15.9 %) in 2010 to 3.9 % (95 % CI = 1.9 %,5.9 %) in 2014, and the prevalence remained relatively stable among FSW who reported inconsistent condom use with clients in the past month, those who did not participate in HIV prevention services, and had lower HIV knowledge (P > 0.05). HCV prevalence increased from 0 % in 2010 to 2.2 % (95 % CI = 0.7 %, 3.7 %) in 2014. Multivariable analyses revealed that infection with HCV increased the odds of HIV and syphilis infection. Drug use (aOR = 44.0, 95C % = 16.3,129.5) increased the odds of HCV infection.ConclusionsThe relatively higher HIV, syphilis and HCV prevalence among Vietnamese FSW compared to their Chinese counterparts sets a challenge for health officials at both sides. To curb the epidemic among the cross-border FSW, preventive action requires bilateral cooperation and action by health authorities of China and Vietnam. A national-level response system should be launched in order to tackle the urgently ever-increasing epidemic.

Intervention caused changes in high risk sex behaviors among female sex workers from Vietnam in Yunnan, 2009-2013

> To understand the prevalence of high risk sex behaviors and HIV infection status among the female sex workers (FSWs) from Vietnam in Yunnan province during a 5 year intervention project and provide evidence for the improvement of the behavior intervention among this population. The survey was conducted annually among Vietnamese FSWs sampled in a county near China-Vietnam border to collect the information about their demographic characteristics, high risk sex behaviors and HIV test results through questionnaire and in-depth interview by bilingual outreach team. The behavior intervention included peer advise, training, lectures, interactive games, free condom distribution. The database was set up with Excel 2003 and the results were analyzed with SPSS 16.0. The condom use rates among the Vietnamese FSWs at commercial sex in last month were 1.5%, 36.0%, 67.7%, 86.5% and 90.3% (P<0.05) respectively; and the condom use rates at the latest sex were 89.5%,44.8%, 86.6%,92.5% and 99.0% respectively (P<0.05) . The HIV antibody positive rates were 7.5%, 3.6%, 5.9%, 4.0% and 3.1% respectively (P>0.05). The condom use rate of Vietnamese FSWs at commercial sex increased by more than 90% after the 5 year intervention project. However, the HIV-infection rate was still high. It is necessary to promote condom use among FSWs from Vietnam and their regular sex partners and strengthen the health education among clients.

Analysis of HIV Correlated Factors in Chinese and Vietnamese Female Sex Workers in Hekou, Yunnan Province, a Chinese Border Region.

ObjectivesTo assess the prevalence and correlated factors of HIV-1 among Chinese and Vietnamese female sex workers (FSW) in the border county of Hekou, Yunnan province, China.MethodsA cross-sectional survey was conducted collecting information on demographics, sexual behavior, medical history, and drug use. Blood samples were obtained to test for HIV/STIs. Multivariate logistic regression model was used to examine associations between factors and HIV-1 infection.ResultsOf 345 FSWs who participated in this study, 112 (32.5%) were Chinese and 233 (67.5) were Vietnamese. Vietnamese FSWs were significantly more likely to be HIV-1 positive (7.7%) compared with Chinese FSWs (0.9%) (p = 0.009). In multivariate analysis, sexual debut at age≤16 (OR 3.8: 95% CI: 1.4, 10.6), last client’s payment <150 RMB ($22 USD) (OR: 5.2, 95% CI; 1.7, 16.6), and HSV-2 (OR: 12.3; 95% CI: 1.6, 94.8) were significant for HIV-1 infection.ConclusionsDifferences in HIV prevalence in Vietnamese and Chinese FSWs may be indicative of differential risk. It is important to characterize the nature of trans-border transmission in order to gain a better understanding of the potential impact on the international HIV epidemic. Understanding the correlated factors for HIV in Vietnamese and Chinese FSWs is important for designing interventions for this vulnerable population.

Inconsistent Condom Use and History of Trauma Among Vietnamese Female Sex Workers in a Chinese Border Region

Previous studies have indicated a potential association between trauma, such as physical violence, emotional violence and sexual violence, and high-risk sexual behavior. Female sex workers (FSWs) were interviewed to elicit history of traumatic events and sexual behaviors. Among 187 participants, 79 (42.2 %) inconsistently used condoms with clients in the past 30 days. Experiencing community violence (OR: 0.4; 95 % CI: 0.2, 0.8) was found to be significantly protective for inconsistent condom use. In this study, experiencing community violence was found to be protective for inconsistent condom use among FSWs, but none of the other trauma subgroups had significant associations with inconsistent condom use. Reasons for unprotected sex among FSW may be more related to economic or other contextual factors.

HIV and Associated Risk Factors Among Male Clients of Female Sex Workers in a Chinese Border Region

Male clients of female sex workers (FSWs) serve as a potential bridge of human immunodeficiency virus (HIV) to the general population. Little is known about the characteristics and risk factors for HIV infection among male clients patronizing FSWs in Hekou County, Yunnan Province in southern China bordering with Vietnam. Male clients were recruited through outreach of study staff, referrals by Vietnamese FSWs and their bosses, and snowball sampling. Each participant completed a questionnaire survey and donated a blood specimen to test for HIV, herpes simplex virus type 2 (HSV-2), and syphilis. Logistic regression models were fitted to identify factors associated with HIV infection. Among 306 participants, 28 (9.2%) were HIV positive, 81 (26.5%) were HSV-2 positive, and none was infected with syphilis. Approximately half (n = 149, 49.2%) reported always using condoms with sex workers in the past year; 36 (11.8%) reported a history of injection drug use (IDU). Compared with HIV-negative men, HIV-positive men were more likely to have a history of IDU (64.3% vs. 6.5%) and be coinfected with HSV-2 (50.0% vs. 24.1%). IDU was the most salient risk factor for HIV infection in this study, which suggests that male clients may acquire HIV from routes other than commercial sex, but the significance of HSV-2 infection indicates that sexual transmission is also of concern. HIV prevention intervention programs for this often ignored and hard-to-reach risk group should be two-pronged, addressing both drug use and commercial sex.

HIV–Related Risk Behaviors among Female Sex Workers in Ho Chi Minh City, Vietnam

This study quantitatively and qualitatively described HIV risk behaviors among Vietnamese female sex workers (FSWs) who work at three distinct venues in Ho Chi Minh City: street, massage parlors, and bars/clubs. Although 35% of the participants had never been tested for HIV, 18% of street and 7% of bar/club FSWs reported being positive. Almost all massage parlor FSWs had never used a condom for oral sex. Inconsistent condom use for vaginal sex with customers was more prevalent among bar/club FSWs (85%) than massage parlor (72%) and street FSWs (68%). Many participants reported difficulties in negotiating condom use with customers because of economic pressure, maintaining relationships, and lack of bargaining power. Bar/club FSWs revealed a difficult situation where drinking is part of their work. Thirty percent of street FSWs had injected drugs and reported addiction to heroin in relation to their helpless condition as FSWs. Street FSWs had the lowest levels of self-esteem and norms toward practicing safe sex and the highest levels of economic pressure. This study recommends future HIV prevention programs for FSWs in Vietnam that target their specific risk behaviors and work environments.

Factors Associated With Inconsistent Condom Use Among Female Sex Workers in Nha Trang, Vietnam

This study examined consistent condom use with clients, self-reported sexually transmitted infections (STIs), and associated factors among Vietnamese female sex workers (FSWs). Data were collected through a cross-sectional survey among 192 FSWs in Nha Trang city, in 2005. The rate of consistent condom use with casual clients, regular clients, and nonpaying partners were 59.3%, 38.3%, and 5.3%, respectively. About 5.7% of the FSWs admitted that they are intravenous drug users, and 66.7% of the sample had symptoms of STIs in the past 12 months. Indirect FSW, being drug users, having many clients per week, not watching television on a regular basis, those who thought that they themselves are at extremely high risk of having HIV, and those have never been tested for HIV have been found to be associated with inconsistent condom use. Our results suggest the need to improve STI control in FSWs, further promotion of condom use and information, education, and communication among FSWs.

Factors Associated with HIV Testing, Condom Use, and Sexually Transmitted Infections Among Female Sex Workers in Nha Trang, Vietnam

This study examined predictors of HIV testing, successful condom negotiation with clients, and self-reported sexually transmitted infections (STIs) among Vietnamese female sex workers (FSW). Data were collected by using face-to-face interviews from a community sample of 610 FSW from Nha Trang city during October-December, 2000. Having had an HIV test was associated with having spent time in a rehabilitation center. Consistently successful negotiation of condom use occurred most among FSW who had few clients, understood how HIV was not transmitted, and had not reported ever having any symptoms of STIs. Migration to Nha Trang for sex work was a risk factor for an STI diagnosis; successful negotiation of condom use had a protective effect. Our results suggest the need for voluntary HIV counseling and testing, further promotion of condom use among FSW populations, and better use of rehabilitation sites to promote HIV prevention.