Degree and correlates of sexual mixing in female sex workers in Karnataka, India

Abstract

Abstract. Background:The degree of sexual mixing plays an important role in understanding disparities in sexually transmissible infections and HIV across social groups. This study examines the degree of sexual age mixing, and explores its individual and partnership level correlates among female sex workers (FSWs) in Karnataka, India. Methods: Data were drawn from special behavioural surveys conducted in 2006-07 among 577 FSWs in two districts of Karnataka: Belgaum and Bangalore. Sexual mixing in age was assessed as the difference in age between FSWs and their sexual partners, and the degree of assortativeness in sexual mixing was assessed using Newman's assortativity coefficient. Results: A total of 577 FSWs were interviewed; 418 of whom reported two or more partnerships, resulting in 942 partnerships. In about half (52%) of these partnerships, the age difference between the FSW and her sexual partner was 5 years or more. The degree of assortativity in age mixing was 0.098, indicating minimally assortative mixing. The disassortativeness in age mixing was positively associated with young age and no formal education, and negatively with duration in sex work. Partnerships which were of a commercial nature were more likely to be disassortative than noncommercial partnerships. Conclusion: The minimally assortative age mixing indicates sexually transmissible infections can transfer from members of one age group to another. Efforts are required to limit the transmission of infection from one group to other by promoting safer sexual behaviour.

HIV infection among female sex workers in concentrated and high prevalence epidemics

“…In Kenya and Thailand, host immune factors (e.g., lower state of CD4+ T cell, mucosal immune system) have helped explain why populations of highly HIV exposed FSWs remain persistently HIV-seronegative [17,18]. At the behavioural level, individual factors such as early age of sex work initiation and duration of time in sex work have been shown to shape sexual networks and risk patterning [19,20]. Injection drug use among sex workers, their clients and nonpaying partners exacerbate risks through parenteral transmission of syringe sharing at the partner-level and increased biological risks for hepatitis C virus [21,22].…”

ART coverage and viral suppression among female sex workers living with HIV in eThekwini, South Africa: Baseline findings from the Siyaphambili study

“…In addition to individual-level factors [18][19][20][21][22][23][24], macrostructural-level factors have increasingly been recognized for their centrality in HIV care engagement and viral suppression [8,[25][26][27][28][29][30][31]. A third of Siyaphambili participants reported unstable housing and we found a lack of housing to be associated with lower viral suppression.…”

“…Further, in addition to known individual and inter-personal factors that have been quantitatively assessed [14,[18][19][20][21][22][23][24], the central role of structural determinants has been increasingly recognized, although less studied [25,26]. Structural determinants are external contextual factors that shape HIV acquisition and transmission among FSW [25], heterogeneously impacting FSW by mitigating or potentiating HIV risks and vulnerabilities [25,26].…”