Characteristics of low-tier female sex workers who engage in commercial sex with old male clients in Zhejiang province, China: a cross-sectional study

Abstract

ObjectivesTo characterise low-tier female sex workers (FSWs) who engage in commercial sex with old male clients (OMCs).DesignCross-sectional study.SettingTwenty-one counties in Zhejiang province, China.ParticipantsA total of 2647 low-tier FSWs who participated in our survey from September to November 2013, and responded to the question regarding whether they engaged in commercial sex with OMCs during the previous month.Main outcome measuresData on sociodemographic characteristics, sexual behaviours, risk perception of HIV/sexually transmitted infection (STI), ever exposure to an HIV prevention service and degree of self-efficacy regarding condom use were collected via a face-to-face questionnaire administered by trained interviewers.ResultsOf the 2647 participants, 1165 (44.0%) had engaged in commercial sex with OMCs in the previous month. Low-tier FSWs working out of roadside shops, those who had engaged in sex work for longer, those with a larger number of clients, those who had engaged in anal or oral sex during the previous month, those currently using contraception measures, those who had STI symptoms and those who had been exposed to HIV prevention services during the previous 6 months were more likely to engage in commercial sex with OMCs. FSWs with a high level of education; those working out of small venues other than streets, hair salons and roadside shops; those who charged more for commercial sex; those who had sex with young clients during the previous month and those who had seen a doctor during the previous 6 months were less likely to engage in commercial sex with OMCs.ConclusionsLow-tier FSWs who engaged in commercial sex with OMCs reported more risky behaviours than those who did not engage in this behaviour. Attention should be paid to these behaviours in future interventions targeting low-tier FSWs.

Combining molecular transmission network analysis and spatial epidemiology to reveal HIV-1 transmission pattern among the older people in Nanjing, China

“…Furthermore, our study illustrated that the risk of clustering among the older people infected HIV with heterosexual commercial transmission was more than two times higher than those infected HIV with homosexual transmission. Previous researches have demonstrated that commercial sexual behavior acted as a major risk factor for HIV infection in the elderly [14,25]. Due to lack of companionship and support from spouses or children, old people meet psychological and emotional ful llment through pursuing commercial sexual services [26].…”

“…The HIV−1 molecular transmission networks alone can't capture the spatial characteristics of HIV transmission, so combining the molecular networks and the spatial epidemiology is conducive to understanding the dynamic changes of HIV−1 genotype and clusters from a spatial perspective, and providing evidences for mapping out regional HIV prevention strategies and optimizing allocation of health resources. Currently, domestic and foreign studies among older people mainly focused on HIV high-risk behaviors, attitudes, and risk factors of HIV infection [13,14], but reports of HIV-related spatial analysis or transmission network were relatively few targeting the population. According to the HIV monitoring data in Nanjing, the proportion of HIV-infected persons aged ≥ 50 years in the newly reported cases increased from 10.6% in 2010 to 23.9% in 2023, which suggested it was crucial to analyze HIV transmission characteristics and its impact on different districts of Nanjing among older people.…”

Understanding Women’s Knowledge, Awareness, and Perceptions of STIs/STDs in Asia: A Scoping Review

“…Migrant workers [50] Transgender [39,[54][55][56][57] FSW */inmates [42,47,52,[58][59][60][61][62][63] Homeless community [36] Women [64] Multiple sex partners Transgender [39,44,57] FSW * [42,59,65] Married community [66] Women [67,68] Social Fear of rejection, discrimination, and stigmatization FSW * [58] Migrant workers [50] Lacking awareness and knowledge Transgender [22,39] FSW * [52,60,69] Adolescents [24] Married community [24,37] Homeless community [36] Women (married/pregnant) [25,[27][28][29]67] Personal Personality behaviour: impulsivity FSW */inmates [6,51] Occupation-related risk FSW * [48,52,70,…”

“…This is due to the lack of awareness amongst them when it comes to protection and information on contraception. Furthermore, in some parts of Asia, contraception may be difficult to access [45,59,75], expensive [39], and in some cases prove to be a taboo [7]. This can make it challenging for women to use protection consistently.…”

Prevalence of syphilis and chlamydia trachomatis infection among female sex workers in Jiangsu, China: Results from a multicenter cross-sectional and venue-based study

“…Syphilis infection was estimated at 1.7% among FSWs in China, which was 6.8 times higher than among general population women in 2017 ( 7 ). FSWs contribute significantly to STIs transmission networks through their engagement in frequent unprotected sexual activities, multiple commercial sex partners ( 8 – 10 ), and limited asymptomatic STIs awareness ( 11 ). An Ecuador study reported that 25.5% of FSWs had unprotected sexual activities at least once in the previous 3 months ( 12 ).…”