Depressive symptoms and condom use with clients among female sex workers in China

Abstract

This study examines the association between depressive symptoms and condom use with clients among 278 female sex workers (FSW) in Guangxi, China. About 62% of these FSW had a high level of depressive symptoms (CES-D total score ≥ 16). Multiple logistic regression analyses indicated that FSW with high level of depressive symptoms were less likely to use condoms consistently (aOR = 0.50, 95% CI: 0.28-0.89) or use condoms properly (aOR = 0.44, 95% CI: 0.20-0.99). The findings suggested that HIV prevention programs targeted at FSW should take into consideration the level of depression they experience.

Mental Health and Interpersonal Factors Associated with HIV-Related Risk Behaviors Among Non-Institutionalized Female Injection Drug Users Who Are Also Sex Workers in China

“…Consistent with previous studies, a significant proportion of FSWs and drug users reported mental health problems, such as hopelessness or depressive symptoms; and IDUFSWs were more likely than the general female IDUs to report hopelessness and depressive symptoms (Silbert, Pines, & Lynch, 1982;Miller, Mahler, & Gold, 1991;Paone et al, 1999;Burns et al, 2004;Hong et al, 2007).…”

“…Studies suggest that women with such negative affects are ill-equipped to deal with the additional stress of insisting on condom use during sex work (O'Leary, 1995). Depression has been associated with inconsistent condom use with sex work clients (Hong et al, 2007;Stevenson & Petrak, 2007), while hopelessness and pessimism have been associated with high risk sexual behaviors among FSWs (Silbert, Pines, & Lynch, 1982;Paone et al, 1999). FSWs with poor interpersonal or social support are also less likely than others to be consistent condom users during sex work (Dandona et al, 2005;Campbell, 2000).…”

Factors Associated with Sexually Transmitted Infection Underreporting Among Female Sex Workers in China

“…The underreporting in the current study might be largely due to low 28 Another major deterrent to STI testing was the strong stigma associated with commercial sex, as previous studies suggested that self-perceived stigma has led to increased sexual risks, including delayed testing or treatment. 29 Therefore, interventions aimed at reducing the STI epidemic in FSWs should not only focus on reducing sexual risks among FSWs and their clients but also increase their awareness and motivation to access STI=HIV testing. Structural interventions at a society level are needed to reduce the stigma against FSWs and create a positive environment for them to seek preventive care and treatment.…”

Prevalence of depressive symptoms and associated factors among people who inject drugs in China

“…The validated Chinese version showed good internal reliability (Cheung and Bagley, 1998;Chi and Boey, 1993;Song et al, 2008) and has been used in studies targeting key populations such as female sex workers (Hong et al, 2007) in China. Participants rated how often they have experienced depressive symptomatology in the past 7 days, on a four-point Likert scale ['rarely or none of the time (less than 1 day)' to 'almost or all of the time (5-7 days)'].…”