Depression and HIV Risk Behaviors among Female Sex Workers in Guangdong, China: A Multicenter Cross-Sectional Study

Abstract

Background. Our study aimed to assess the burden of depression and evaluate factors associated with depression and status of HIV risk behaviors among female sex workers (FSWs) in Guangdong, China. Method. We recruited FSWs from massage parlors, saunas, restaurants, hotels, hair salons, and streets in Guangdong, China, in 2014. Information on demographic characteristics, HIV testing history, and sexual behaviors was collected using a questionnaire. A blood sample was collected to test for HIV, syphilis, and HCV. A participant was defined as being depressed if she obtained 6 points or above using the 12-item General Health Questionnaire. Results. Among the 653 participants, 41.7% were 21–30 years old and 43.6% married. Overall, 52.4% were found to be depressed. FSWs who had correct syphilis related knowledge [aOR = 1.45; 95% CI: 1.04–2.03] and had primary sex partner (1.63, 1.14–2.33) were more likely to be depressed. FSWs who did not use a condom during their last sex with the primary sex partner were less likely to be depressed (0.47, 0.31–0.71). Conclusion. Our study observed high level of depression and HIV risk behaviors among Chinese FSWs. Future interventions should integrate mental health services in comprehensive interventions to prevent depression among Chinese FSWs.

Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

“…Nine studies reported on mental health problems and condom use with clients and regular partners [ 24 , 53 , 56 , 60 , 62 , 68 , 71 , 80 , 84 ]. Condom use measurement varied with studies either reporting frequency of condom use (always versus not always) or condom use at last sex (yes/no).…”

“…Eight studies reported on HIV/STI and mental health problems [ 36 , 44 , 47 – 49 , 60 , 69 , 73 ]. One study [ 48 ] was excluded from the meta-analyses because it did not use a validated tool to measure depression, and one study was excluded because it only sampled HIV-negative women [ 44 ].…”

“…The pooled unadjusted OR for depression and HIV is 1.4 (1.1-1.8), p = 0.005 (n = 4 studies from 5 countries) and for suicidal ideation and HIV is 1.4 (1.1-1.8), p = 0.04 (n = 2 studies from 3 countries) (S4 Fig). One study reported associations between depression and current syphilis infection; the unadjusted OR was 0.6 (0.3-1.2), p = 0.1 [60].…”

Psychiatric Morbidities among Female Sex Workers in Bangladesh: an Observational Study

“…Also, their work is strongly forbidden by religious laws with certain extreme punishments. For this reason, female sex workers conceal their real identity while interacting with their clients and living in society [1][2][3]. Combination of many factors like cultural and legal barriers, female sex workers are a deprived part of communities [4] and it is very difficult to gather information 5 and perform a psychiatric study on female sex workers in Bangladesh although various non-governmental organization (NGO), such as BWHC (Bangladesh Woman's Health Coalition), DNS (Durjoy Nari Shangha) and Light House are the STI/RTI treatment centres in Bangladesh play a significant role in helping female sex workers with their sexual health.…”

“…Combination of many factors like cultural and legal barriers, female sex workers are a deprived part of communities [4] and it is very difficult to gather information 5 and perform a psychiatric study on female sex workers in Bangladesh although various non-governmental organization (NGO), such as BWHC (Bangladesh Woman's Health Coalition), DNS (Durjoy Nari Shangha) and Light House are the STI/RTI treatment centres in Bangladesh play a significant role in helping female sex workers with their sexual health. Sex workers are vulnerable population who are prone to many health conditions including medical diseases such as sexually transmitted diseases (STDs) as well as psychiatric disorders [1][2][3]. The psychosocial vulnerabilities and mental stressor including, childhood sexual abuse, exposure to childhood physical abuse, poverty, illiteracy, low socioeconomic status various interpersonal violence that is unfavourable to family conditions [6][7][8] such as conflicts with own family, make these vulnerable patients more susceptible to psychiatric disorders.…”