Background The trafficking of women and girls for sexual exploitation is an internationally recognized form of gender-based violence, and is thought to confer unique sexual and reproductive health vulnerabilities. To date, little research has compared sexual risk or health outcomes among female sex workers (FSWs) based on experiences of sex trafficking. The current study sought to compare experiences of sexual risk and sexual and reproductive health outcomes among FSWs based on experiences of trafficking as an entry mechanism to FSW. Methods Data from a national sample of FSWs in Thailand (n=815) to was used to assess a) the prevalence of sex trafficking as an entry mechanism into FSW, and b) associations of sex trafficking with sexual risk and health outcomes. Results Approximately 10% of FSWs met criteria for trafficking as an entry mechanism to sex work. Compared with their non-trafficked counterparts, sex trafficked FSWs were more likely to have experienced sexual violence at initiation to sex work (ARR 2.29, 95% CI 1.11, 4.72), recent workplace violence or mistreatment (ARR 1.38, 95% CI 1.13, 1.67), recent condom failure (ARR 1.80, 95% CI 1.15, 2.80), condom non-use (ARR 3.35, 95% CI 1.49, 7.52), and abortion (ARR 2.83, 95% CI 1.48, 5.39). Discussion Both the prevalence of sex trafficking as an entry mechanism to FSW, coupled with the threats to sexual and reproductive health observed based on trafficking status, demonstrate the need for comprehensive efforts to identify and support this vulnerable population. Moreover, existing STI/HIV prevention programming may be stymied by the limited condom use capacity, and high levels of violence observed among those trafficked into FSW.

Background/objectives Commercial sex work is widely recognized as a primary context for heterosexual transmission of HIV/AIDS in many regions, including Southeast Asia. While violence victimization is considered to compromise women’s ability to protect against HIV and other sexually transmitted infections (STIs), with female sex workers (FSWs) uniquely affected, little research has investigated the role of violence as it relates to sexual risk and STI outcomes among FSWs. The current study sought to compare experiences of sexual risk and STI symptoms among FSWs based on their recent exposure to violence. Methods Data from a national sample of FSWs in Thailand (n=815) was used to assess a) the prevalence of experiencing recent physical or sexual violence within the context of sex work, and b) associations of such victimization with sexual risk (i.e., anal sex, condom non-use, condom failure, client condom refusal) and self-reported STI symptoms. Results Approximately 1 in 7 FSWs (14.6%) had experienced physical or sexual violence in the week prior to the survey. As compared with their non-victimized counterparts, FSWs exposed to recent violence were at greater risk for recent condom failure (19.6% vs. 12.3%, ARR 1.92, 95% CI 1.24, 2.95) and client condom refusal (85.7% vs. 69.0%, ARR 1.24, 95% CI 1.14, 1.35). In analyses adjusted for sexual risk, violence related to both STI symptoms collectively (ARR 1.11, 95% CI 1.02, 1.21) and genital lesions as an individual STI symptom (ARR 1.78, 95% CI 1.20, 2.66). Conclusion Physical and sexual violence against FSWs in Thailand appears to be a common experience, with victims of such violence demonstrating diminished capacity for STI/HIV harm reduction and greater prevalence of STI symptoms. Comprehensive efforts to reduce violence towards this vulnerable population must be prioritized, as a means of protecting the human rights of FSWs, and as a key component of STI/HIV prevention and control.

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Migration from one’s parents’ home and sexual debut are common features of the transition to adulthood. Although many studies have described both of these features independently, few have examined the relationship between migration and sexual debut in a systematic manner. In this study, we explore this link for young adults in Thailand. With relatively high rates of internal migration, rapid modernization, a moderate HIV epidemic, and a declining average age of sexual debut, Thailand presents an instructive environment in which to examine migration and sexual debut. We use two waves of a longitudinal data set (2005 and 2007) that includes a subsample of young adults who migrated to urban areas during that period. We identify characteristics and behaviors associated with sexual debut and examine the role of migration on debut. Our approach reduces several common sources of bias that hamper existing work on both migration and sexual debut: (1) the longitudinal nature of the data enables us to examine the effects of characteristics that predate both behaviors of interest; (2) the survey on sexual behavior employed a technique that reduces response bias; and (3) we examine differences in debut by marital status. We find that migrants have a higher likelihood of sexual debut than nonmigrants.

Adolescent sexual and reproductive health problems remain a public health concern in Indonesia. An increase of premarital sex as well as early sexual debut among adolescents without any protection leads to a high risk of adverse sexual and reproductive health consequences. This study aimed to assess condom use prevalence and identify its determinants among male adolescents who are sexually active in Indonesia. This was a cross-sectional study using secondary data from the Adolescent Reproductive Health component of the Indonesia Demographic and Health Survey (IDHS) 2012. The sample for this study was 1341 sexually active male adolescents aged 15–24 years old. Data were analyzed descriptively and using binary logistic regression for bivariate and multivariate analysis. This study found that condom use prevalence among male adolescents at first and last sex accounted for 25.0% and 27.4%, respectively. Determinants of condom use varied by time of sexual intercourse. Knowledge of sexual and reproductive health and obtaining information about condoms were consistently related to condom use at first and last sexual encounter. Meanwhile, residential type, age at first sex, and sexual partner were significant determinants of condom use at sexual debut whilst educational level was only associated with condom use at last sex. As the level of protected sex among male adolescents was very low, providing comprehensive sexuality education (CSE) is suggested in order to develop the capacity among adolescents in making informed decisions and preventing unsafe sex.