Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand

Abstract

Background The trafficking of women and girls for sexual exploitation is an internationally recognized form of gender-based violence, and is thought to confer unique sexual and reproductive health vulnerabilities. To date, little research has compared sexual risk or health outcomes among female sex workers (FSWs) based on experiences of sex trafficking. The current study sought to compare experiences of sexual risk and sexual and reproductive health outcomes among FSWs based on experiences of trafficking as an entry mechanism to FSW. Methods Data from a national sample of FSWs in Thailand (n=815) to was used to assess a) the prevalence of sex trafficking as an entry mechanism into FSW, and b) associations of sex trafficking with sexual risk and health outcomes. Results Approximately 10% of FSWs met criteria for trafficking as an entry mechanism to sex work. Compared with their non-trafficked counterparts, sex trafficked FSWs were more likely to have experienced sexual violence at initiation to sex work (ARR 2.29, 95% CI 1.11, 4.72), recent workplace violence or mistreatment (ARR 1.38, 95% CI 1.13, 1.67), recent condom failure (ARR 1.80, 95% CI 1.15, 2.80), condom non-use (ARR 3.35, 95% CI 1.49, 7.52), and abortion (ARR 2.83, 95% CI 1.48, 5.39). Discussion Both the prevalence of sex trafficking as an entry mechanism to FSW, coupled with the threats to sexual and reproductive health observed based on trafficking status, demonstrate the need for comprehensive efforts to identify and support this vulnerable population. Moreover, existing STI/HIV prevention programming may be stymied by the limited condom use capacity, and high levels of violence observed among those trafficked into FSW.

Low Condom Use Among Adolescent Female Sex Workers in Thailand

“…This finding supports previous reports of condom failure and condom non-use among adolescent FSWs in Thailand (Decker et al, 2011;Limpakarnjanarat et al, 1999) and emphasizes the dramatic imbalance of power in the complex interrelationship between adolescent FSWs, their clients, intimate partners/husbands, club/brothel owners, and community.…”

“…In the context of FSWs, these culturally and religiously contrived demands create a situation in which gender power disparities are highly significant. Recognition of this context is essential in seeking to understand why it may be particularly difficult for adolescent FSWs to negotiate with older, male customers who are disinclined to use condoms (Limpakarnjanarat et al, 1999;Decker et al, 2011).…”

Characteristics of child commercial sexual exploitation and sex trafficking victims presenting for medical care in the United States

“…Much of the available data on CSEC is qualitative (Baldwin, Eisenman, Sayles, Ryan, & Chuang, 2011;Raphael, Reichert, & Powers, 2010;Raymond & Hughes, 2001), involving interviews of survivors or professionals who work with them. Many studies include victims of different forms of trafficking (Baldwin et al, 2011) (labor and sexual) or victims with very diverse geographic backgrounds (Decker, McCauley, Phuengsamran, Janyam, & Silverman, 2011;Sarka et al, 2008;Silverman et al, 2007). A number of risk factors have been associated with CSEC, although studies documenting these have important limitations.…”

Global Human Trafficking and Child Victimization

“…In many studies on human trafficking, researchers have included aggregate results for adults and children, 68 -70 boys and girls, 30 or individuals from multiple countries of origin. 71,72 Some researchers also combine victims of differing forms of trafficking. 44 Lacking disaggregated data, it is difficult to identify findings that may be specific to children or to subpopulations of child victims.…”