HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA.
Psychol Health Med. 2010 Mar;15(2):172-87. doi: 10.1080/13548501003623914.
Migrant female sex workers (FSWs) are one of the most at-risk populations for HIV in China. This study demonstrates how multiple risk factors are situated and vary by types of sex work environments in a sample of 348 migrant FSWs in Beijing. Participants reported high rates of clients' refusal to use condoms (76%), unsafe sex with both clients (32%), non-paid regular partners (e.g. boyfriend or husband) (76%), and a sexually transmitted infection symptom (79%) last year. Only 22% of FSWs had been tested for HIV. Risk factors were compared by three types of sex work environments: (1) entertainment establishments, (2) personal services sectors, and (3) street-based venues, including roadside brothels. Street-based FSWs, compared to the other FSWs, were more likely to be older, married with children, migrate from rural areas, and be arrested by police, and less likely to be educated, have contact with prevention services, be knowledgeable about HIV, and be tested for HIV. The FSWs in entertainment establishments were more likely than street-based FSWs to have reported being physically, verbally, and/or sexually abused by clients. Multiple discriminant analysis distinguished a profile of two different groups of risk factors: (1) police arrest, lack of protection from violence, access to prevention and health care, and HIV knowledge, and (2) verbal and physical abuse and clients' refusal of condom use. In the massive internal migration in China, disadvantages in economic sectors drive women to become involved in sex work. HIV prevention strategies must target socio-structural factors embedded in sex work environments.
流动女性性工作者(FSWs)是中国 HIV 高危人群之一。本研究在北京的 348 名流动 FSW 样本中,展示了多种风险因素如何因性工作环境的类型而有所不同。参与者报告称,客户拒绝使用安全套的比例很高(76%)、与客户发生不安全性行为的比例为 32%、无报酬的固定伴侣(如男朋友或丈夫)比例为 76%、去年有性传播感染症状的比例为 79%。只有 22%的 FSW 接受过 HIV 检测。风险因素按三种性工作环境进行比较:(1)娱乐场所,(2)个人服务部门,(3)街头场所,包括路边妓院。与其他 FSW 相比,街头 FSW 更有可能年龄较大、已婚有子女、来自农村地区、被警察逮捕,而受教育程度较低、与预防服务有联系、了解 HIV 知识和接受 HIV 检测的可能性较低。娱乐场所的 FSW 比街头 FSW 更有可能报告受到客户的身体、言语和/或性虐待。多元判别分析区分了两组不同风险因素的特征:(1)警察逮捕、缺乏暴力保护、获得预防和保健服务以及 HIV 知识,(2)言语和身体虐待以及客户拒绝使用安全套。在中国大规模的国内迁移中,经济部门的劣势促使女性从事性工作。艾滋病毒预防策略必须针对性工作环境中嵌入的社会结构因素。
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