Prevalence of psychological problems and relationships with condom use and HIV prevention behaviors among Chinese female sex workers in Hong Kong

Abstract

The present study investigated the prevalence of psychological problems and their relationships with relevant HIV prevention behaviors among female sex workers (FSWs). An anonymous cross-sectional survey was conducted. With a mapping exercise, 293 Chinese FSWs were recruited from a red-light district in Hong Kong. Results showed high prevalence of psychological problems among FSWs: substance use (40.4%), probable depression (53.9%), self-harm tendencies (34-38%), poor self-esteem (48-52%), and pessimistic future outlook (46-47%). Inconsistent condom use was common (51% with clients, 23% with one-night-stand sex partner, and 73% with boyfriends). Over 70% had not used HIV-related prevention services in the last 6 months. Multivariate analyses indicated that psychological problems were significantly associated with inconsistent condom use and non-use of prevention services. The poor psychological well-beings of FSWs have important public health implications. Relevant professional services should be provided and integrated with HIV prevention efforts.

Mental Health and HIV-Related High-Risk Behaviors Among Female Sex Workers

“…In addition, FSWs with higher GSI scores and more psychological symptoms in all subscales (except for obsessive-compulsive, interpersonal sensitivity, and psychoticism) were less likely to use condoms during their most recent sexual intercourse. This finding is generally consistent with that of a study conducted in China (25). Another study in China that involved 234 FSWs who were also injection drug users showed that mental health problems were prevalent among this group, and a large number of these women experienced psychological problems such as depression, disappointment, and pessimism.…”

“Amar te Duele” (“Love Hurts”): Sexual Relationship Power, Intimate Partner Violence, Depression Symptoms and HIV Risk Among Female Sex Workers Who Use Drugs and Their Non-commercial, Steady Partners in Mexico

“…In 1998, Farley et al (39) suggested that psychological distress among sex workers should be treated as a health crisis just as important as the HIV epidemic. Recently, Surrat et al (36) found that serious mental illness mediated the relation between trauma and unprotected sex among FSWs in Miami, and Lau et al (35) found that psychological problems were significantly associated with inconsistent condom use among FSWs in Hong Kong. Despite these studies, there is little research examining depression specifically, and its relation to HIV risk.…”

“…“Psychological distress,” “serious mental illness,” and “psychological problems” are general terms usually comprised of any combination of anxiety, depression, and posttraumatic stress disorder symptoms making comparisons of mental health status across FSW studies difficult. This study examined depression symptoms specifically given the consistently high rates of depression symptoms documented among FSW populations (33, 35, 37, 40, 41). …”

Age group differences in HIV risk and mental health problems among female sex workers in Southwest China

“…Inconsistent or ineffective condom use, a history of STD, and lack of HIV testing have been widely considered key HIV risks (Hong et al, 2012; Li et al, 2010; Li et al, 2011; Rusch et al, 2010; Zermiani et al, 2012; Zhang et al, 2011). Even though condom use can effectively prevent HIV transmission and other sexually transmitted infections among FSWs, only a small proportion of FSWs consistently and properly use condoms with their clients (Zhang et al, 2011; Li et al, 2010; Li et al, 2011; Lau et al, 2010). Recent studies in China revealed that 47.1% of FSWs had consistently used condoms during the previous month (Zhang et al, 2011), 15% consistently had used condoms throughout their sex lives (Yang et al, 2005), and 60% of FSWs knew how to use condoms effectively (Li et al, 2011; Yang et al, 2005).…”