Changes in prostitution and the AIDS epidemic in Thailand

Hanenberg, Robert; Rojanapithayakorn, Wiwat

doi:10.1080/713612352

Cited by 71 publications

(46 citation statements)

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“…Thus, increasing proportions of female sex workers are now operating in such venues as beer gardens, bars, nightclubs, karaoke TV centers, massage parlors, or disco dance (Hanenberg & Rojanapithayakorn, 1998; WHO, 2001), where they have become known as indirect sex workers or as female bar workers (FBWs).…”

Section: Introductionmentioning

confidence: 99%

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Impact of Social and Structural Influence Interventions on Condom Use and Sexually Transmitted Infections Among Establishment-Based Female Bar Workers in the Philippines

Morisky

Chiao

Stein

et al. 2005

Journal of Psychology & Human Sexuality

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SUMMARYThis quasi-experimental study evaluated the influence of structural intervention components (e.g., changing organizational and social influence factors) in reducing biological sexually transmitted infections (STIs) and reports of unprotected sex among female bar workers (FBWs) in the Philippines (N = 369 at baseline). Recruited from four large southern Philippines cities, FBWs were exposed to a standard care, a manager influence, a peer influence, or a combined manager/ peer influence condition. After the two-year intervention period, FBWs in the combined peer and manager intervention condition showed greater reductions in STIs and unprotected sex relative to those in the standard care condition. FBWs in the combined and the manager only conditions also showed a decrease in STIs compared to those in the standard care condition. Managers in the standard care condition reported lower positive condom attitudes and lower attendance at HIV/ AIDS related training sessions compared to those in the combined condition. The combined effect of managers and peers had a positive, synergistic effect on condom use behavior and STI reduction compared to the standard care. This research provides empirical evidence that structural changes such as rules, regulations, and increased accessibility of condoms must be in combination with normative changes (individuals' attitudes, beliefs and normative expectancies) in order to achieve the greatest benefit in condom use behavior and STI reduction/prevention. KeywordsFemale bar workers; HIV/AIDS risk; structural intervention; STIs; condom useIn the Asian sex industry, commercial sex related activity has been transitioning outside of the brothel as legal pressures escalate and as customers perceive this pressure. Thus, increasing proportions of female sex workers are now operating in such venues as beer gardens, bars, nightclubs, karaoke TV centers, massage parlors, or disco dance (Hanenberg & Rojanapithayakorn, 1998; WHO, 2001), where they have become known as indirect sex workers or as female bar workers (FBWs).The FBWs' lifestyle tends to be particularly distinctive from that of brothel based sex workers who are commonly referred to as commercial sex workers (CSWs). This is especially true in the realm of heterosexual relationships (Bloom et al., 2002). Unlike brothel-based CSWs, FBWs predominantly host or entertain male customers within the confines of the establishment by serving drinks, conversing or other similar activities. FBWs receive only small salaries and/or commissions based on quantity of drinks and food items which they serve. FBWs generally negotiate sexual activities inside the work establishment, which typically take place off-premise. If the negotiated off-premise activities do occur during "working hours," the patron is generally expected to pay a "bar fine" to the establishment's manager for any of the FBWs "leave-time."The FBWs' compensation for this negotiated off-premise sex work tends to be much greater than the meager establishment wages and is perceived...

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Section: Introductionmentioning

confidence: 99%

“…establishments (Hanenberg & Rojanapithayakorn, 1998;WHO, 2001), where they have become known as indirect sex workers or as female bar workers (FBWs).…”

mentioning

confidence: 99%

Impact of Social and Structural Influence Interventions on Condom Use and Sexually Transmitted Infections Among Establishment-Based Female Bar Workers in the Philippines

Morisky

Chiao

Stein

et al. 2005

Journal of Psychology & Human Sexuality

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“…The Thai 100% Condom Program is a successful example of such an intervention. This initiative targeted all Thai brothel-based commercial sex workers on their consistent condom use (Hanenberg & Rojanapithayakorn, 1998). Other projects have also yielded great success in improving condom use among female sex workers (Hanenberg, Rojanapithayakorn, Kunasol, & Sokal, 1994).…”

mentioning

confidence: 99%

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

Morisky¹,

Stein²,

Chiao³

et al. 2006

Health Psychology

103

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The authors assessed the relative impact of structural and social influence interventions on reducing sexually transmitted infections (STIs) and HIV risk behavior among female sex workers in the Philippines (N = 897). Four conditions included manager influence, peer influence, combined manager-peer influence, and control. Intervention effects were assessed at the establishment level in multilevel models because of statistical dependencies among women employed within the same establishments. Control group membership predicted greater perceived risk, less condom use, less HIV/AIDS knowledge, and more negative condom attitudes. Combination participants reported more positive condom attitudes, more establishment policies favoring condom use, and fewer STIs. Manager-only participants reported fewer STIs, lower condom attitudes, less knowledge, and higher perceived risk than peer-only participants. Because interventions were implemented at the city level, baseline and follow-up city differences were analyzed to rule out intervention effects due to preexisting differences. Keywordsfemale commercial sex workers; HIV/AIDS risk; social influence intervention; STIs; condom use Female commercial sex workers (FCSWs) are at high risk of transmitting HIV and sexually transmitted infections (STIs). This is particularly true in Asian countries, such as the Philippines. For instance, a recent large survey showed an exceptionally high prevalence rate of chlamydiosis among Filipino FCSWs ranging from 27% to 36% (World Health Organization, 2002). According to the survey, the principal mode of transmission was heterosexual contact (World Health Organization, 2002 HIV prevention has traditionally focused on using cognitive-behavioral individually oriented approaches to induce beneficial changes in the individual's attitudes, knowledge, and behaviors regarding HIV, with little attention to important structural-environmental factors that also account for individual behaviors (O'Leary, Holtgrave, Wright-DeAguero, & Malow, 2003). However, individualized prevention strategies may be less than optimal in changing risky behaviors in such situations as those of commercial sex workers (Bandura, 1982(Bandura, , 1987Ford et al., 1996;O'Leary & Martins, 2000;Pleck, Sonenstein, & Ku, 1990). Social-structural factors, such as extreme poverty, which characterizes Filipino FCSWs, and a lack of support by employers as well as customers may impede safe sex practices; satisfying the customer's desire for sex without a condom may have become almost mandatory in maintaining one's livelihood and reducing conflicts with employers, despite the FCSW's personal perception of risk. Peers may also exert an influence on safe sex behaviors when FCSWs are based within establishments. Therefore, economic factors, peer influences, and employment-or employerrelated factors may have become a major barrier against consistent condom use ( Morisky et al., 1998;Outwater et al., 2000).In contrast, a perception of a supportive attitude by one's employer toward cond...

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“…Regular attendance for STI screening has been demonstrated to be one effective way to control STI and reduce HIV within the context of commercial sex at the national level (UNAIDS, 2003;Hanenberg & Rojanapithayakorn, 1998). But, there has been little systematic study of those who are most at risk (FSWs) in the context within which a FSW works, lives, and seeks health services.…”

Section: Discussionmentioning

confidence: 99%

Clinic appointment attendance for sexually transmitted infection screening among Filipina sex workers: A multilevel analysis

Chiao

Morisky

Ksobiech³

et al. 2007

AIDS Care

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This study evaluates putative individual-and contextual-level social risk factors that may influence the likelihood Filipina sex workers (FSWs) attend and utilize health services for STI screening. Face-to-face interviews were conducted with 1,004 FSWs and their 86 employers. Research staff also collected clinic appointment attendance data. Hierarchical linear modeling was used to estimate the simultaneous effects of individual-and workplace-level factors. Results showed that both individual-and contextual-level characteristics were associated with STI screening appointment attendance. Individual characteristics found to have significant effects on clinic attendance included occupation, income, length of work and commercial sex involvement. City of establishment was a workplace characteristic significantly associated with appointment attendance. In addition to cross-level interactions, the impact of individual-level occupation depended upon characteristics of the workplace. These findings suggest that individual health service utilization is contingent upon contextual-level risk factors in the workplace. Intervention implications aimed at increasing clinic attendance are discussed.

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Changes in prostitution and the AIDS epidemic in Thailand

Cited by 71 publications

References 10 publications

Impact of Social and Structural Influence Interventions on Condom Use and Sexually Transmitted Infections Among Establishment-Based Female Bar Workers in the Philippines

Impact of Social and Structural Influence Interventions on Condom Use and Sexually Transmitted Infections Among Establishment-Based Female Bar Workers in the Philippines

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

Clinic appointment attendance for sexually transmitted infection screening among Filipina sex workers: A multilevel analysis

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