Female streetwalkers' perspectives on migration and HIV/STI risks in a changing economic and social environment: a qualitative study in Shanghai, China

Abstract

China's 30-year economic boom has created a unique social and economic market for commercial sex, as well as for a workforce of migrant women from rural China. This qualitative study explores the impact of the rapidly changing social and economic environment on migration patterns, sexually transmitted infection (STI) knowledge, STI risk behaviours, and health beliefs among female streetwalkers in Shanghai. Qualitative data were collected in 2010 through semi-structured in-depth interviews with 16 streetwalkers to characterise their migration passages, sexual health and behaviours, and peer networks. Many streetwalkers reported histories of childhood impoverishment, of family or partner violence or trauma, of migration consistent with the timeline and routes of economic development, and of a scarcity in health, social, or economic support. Their knowledge of the prevention and treatment of HIV and STIs was limited. They had little bargaining power on condom use, and the majority resorted to vaginal douching and self-management with antibiotics as preventative measures. The study identifies streetwalkers’ perspectives on the changing environment, their options and actions, and finally HIV/STI risks that were unique to this hidden population.

Intimate-Partner and Client-Initiated Violence among Female Street-Based Sex Workers in China: Does a Support Network Help?

“…We focus on Chinese SBSW since much of the research on violence against sex workers has been carried out in developed Western countries such as the United States, England, and Canada [ 3 , 6 , 60 , 61 ]. Additionally, the recent expansion of commercial sex markets in developing countries, such as Thailand, India, and China, has incentivized researchers to shift their study settings [ 40 , 41 , 62 – 67 ]. China, in particular, has experienced a considerable growth in the prostitution sector over the past three decades [ 40 , 41 , 67 ].…”

“…Additionally, the recent expansion of commercial sex markets in developing countries, such as Thailand, India, and China, has incentivized researchers to shift their study settings [ 40 , 41 , 62 – 67 ]. China, in particular, has experienced a considerable growth in the prostitution sector over the past three decades [ 40 , 41 , 67 ]. Hong and colleagues (2014) recently examined rates of both CIV and IPV among Chinese female sex workers and found high rates of both—nearly sixty percent had experienced IPV and forty-five percent reported CIV.…”

Bias in Self-Reported Condom Use: Association Between Over-Reported Condom Use and Syphilis in a Three-Site Study in China

“…The selection of 35 years to define mid-age FSWs was based on the findings from our qualitative studies conducted in the three sites [31] and from other reports [30, 36]. …”

Identifying Barriers to Condom Use Among Female Sex Workers: a Systematic Review and Meta-analysis

“…Furthermore, about 530 million people have genital herpes and 290 million women have human papillomavirus. On the other hand, about 110,000 deaths have been attributable to STIs in the world [5].…”

“…The studies showed that despite high risk of STIs among FSWs, rate of condom use is not high [11,12]. Several epidemiological studies have reported different factors which effect on the use of condoms among female sex workers [5,13,14]. However, the results reported by the studies are inconsistent.…”