Stoebenau Kirsten, Hindin Michelle J, Nathanson Constance A, Rakotoarison Paul Ghislain, Razafintsalama Violette
Institute for Population Health, University of Ottawa, 1 Stewart St, Ottawa, ON K1N 6N5 Canada.
Am J Public Health. 2009 May;99(5):811-9. doi: 10.2105/AJPH.2007.118422. Epub 2009 Mar 19.
Increasing evidence indicates that sex workers use condoms less consistently with regular (i.e., nonpaying) partners than with clients. Few studies have examined the extent to which these 2 categories are mutually exclusive. In an ethnographic study of women's sex work in Antananarivo, Madagascar, we examined how the meaning of women sex workers' sexual relationships could shift among 3 different forms of sex work. Condom use was less likely in forms in which the distinction between client and lover (sipa in Malagasy) was fluid. For many sex workers, therefore, relationships they understood to be intimate imparted the greatest health vulnerability. It is important to examine the influence of the meaning of sexual relationships on condom use for HIV prevention. Policy implications for HIV prevention work with sex workers are considered.
越来越多的证据表明，与嫖客相比，性工作者与固定（即非付费）伴侣使用避孕套的频率更低。很少有研究考察这两类伴侣在多大程度上相互排斥。在一项对马达加斯加塔那那利佛女性性工作的人种志研究中，我们考察了女性性工作者的性关系含义如何在三种不同形式的性工作中发生变化。在客户与情人（马达加斯加语为sipa）区分不明显的性工作形式中，使用避孕套的可能性较小。因此，对许多性工作者来说，她们认为是亲密关系的伴侣带来了最大的健康风险。考察性关系含义对预防艾滋病毒使用避孕套的影响很重要。文中还考虑了针对性工作者开展艾滋病毒预防工作的政策意义。
