Melbourne Sexual Health Centre, School of Population Health, The University of Melbourne, VIC, Australia;
Int J Womens Health. 2011 Feb 15;3:53-61. doi: 10.2147/IJWH.S14669.
Sex workers are considered a high-risk group for sexually transmitted infections, including human immunodeficiency virus (HIV), and are often targeted by prevention interventions with safer sex messages. The purpose of this study was to explore the extent to which knowledge of HIV and perception of risk influence safer sex practices among female sex workers (FSWs) in Port Moresby, Papua New Guinea. FSWs (n = 174) were recruited from 19 sites to participate in the study. Qualitative data were collected using semistructured interviews with FSWs (n = 142) through focus group discussions and (n = 32) individual interviews. In addition, quantitative data were collected from all FSWs using a short structured, demographic questionnaire. Data were analyzed using recurring themes and calculations of confidence intervals. Despite some common misperceptions, overall, most FSWs were basically aware of the risks of HIV and informed about transmission and prevention modalities but used condoms inconsistently. Most reported using condoms 'sometimes', almost one-sixth 'never' used condoms, only a fraction used condoms 'always' with clients, and none used condoms 'always' with regular sexual partners (RSPs). Among these FSWs, being knowledgeable about the risks, transmission, and prevention of HIV did not translate into safe sex. The findings suggest that certain contextual barriers to safer sex practices exist. These barriers could heighten HIV vulnerability and possibly may be responsible for infection in FSWs. Specific interventions that focus on improving condom self-efficacy in FSWs and simultaneously target clients and RSPs with safer sex messages are recommended.
性工作者被认为是性传播感染（包括人类免疫缺陷病毒，即 HIV）的高风险群体，他们经常成为安全性行为信息预防干预措施的目标。本研究旨在探讨巴布亚新几内亚莫尔斯比港的女性性工作者（FSW）对 HIV 知识和风险认知对安全性行为的影响程度。从 19 个地点招募了 174 名 FSW 参加这项研究。通过焦点小组讨论（n = 142）和（n = 32）个别访谈，对 FSW 进行了半结构化访谈，收集了定性数据。此外，还使用简短的结构化人口统计问卷从所有 FSW 中收集了定量数据。使用反复出现的主题和置信区间计算来分析数据。尽管存在一些常见的误解，但总体而言，大多数 FSW 基本上都了解 HIV 的风险，并了解传播和预防方式，但使用避孕套的情况不一致。大多数人报告说“有时”使用避孕套，近六分之一的人“从不”使用避孕套，只有一小部分人在与客户发生性行为时“总是”使用避孕套，而且没有人与固定性伴侣（RSP）“总是”使用避孕套。在这些 FSW 中，对 HIV 风险、传播和预防的了解并没有转化为安全性行为。研究结果表明，存在某些阻碍安全性行为的具体障碍。这些障碍可能会增加 HIV 的脆弱性，并且可能是 FSW 感染的原因。建议采取具体措施，重点提高 FSW 使用避孕套的自我效能，并同时针对客户和 RSP 开展安全性行为信息宣传。
