University of California, San Francisco, Center for AIDS Prevention Studies, San Francisco, CA 94105, USA.
Int J Drug Policy. 2012 Nov;23(6):498-504. doi: 10.1016/j.drugpo.2012.03.005. Epub 2012 May 18.
HIV transmission in India is primarily heterosexual and there is a concentrated HIV epidemic among female sex workers (FSWs). Earlier reports demonstrate that many FSWs consume alcohol regularly before sexual encounters. This qualitative study is part of a larger quantitative study designed to assess alcohol consumption patterns among female sex workers and their association with sexual risk taking. Here we investigate the environmental influence, reasons for and consequences of consuming alcohol in the FSW population.
Trained staff from two Non-Governmental Organizations in Andhra Pradesh and Kerala conducted semi-structured interviews with 63 FSWs in Chirala, Andhra Pradesh (n = 35) and Calicut, Kerala (n = 28) following extensive formative research, including social mapping and key informant interviews, to assess drinking patterns and sexual risk behaviors.
FSWs reported consuming alcohol in multiple contexts: sexual, social, mental health and self-medication. Alcohol consumption during sexual encounters with clients was usually forced, but some women drank voluntarily. Social drinking took place in public locations such as bars and in private locations including deserted buildings, roads and inside autorickshaws (motorcycle taxis). Consequences of alcohol consumption included failure to use condoms and to collect payments from clients, violence, legal problems, gastrointestinal side effects, economic loss and interference with family responsibilities.
FSWs consume alcohol in multilevel contexts. Alcohol consumption during transactional sex is often forced and can lead to failure to use condoms. Social drinkers consume alcohol with other trusted FSWs for entertainment and to help cope with psychosocial stressors. There are multiple reasons for and consequences of alcohol consumption in this population and future interventions should target each specific aspect of alcohol use.
印度的 HIV 传播主要是异性传播，女性性工作者（FSW）中存在集中的 HIV 流行。早期报告表明，许多 FSW 在性行为前经常饮酒。这项定性研究是一项更大的定量研究的一部分，旨在评估 FSW 中的饮酒模式及其与性冒险行为的关联。在这里，我们研究了 FSW 群体中饮酒的环境影响、原因和后果。
来自安得拉邦和喀拉拉邦的两个非政府组织的训练有素的工作人员在 Chirala（安得拉邦）（n = 35）和喀拉拉邦（n = 28）进行了半结构化访谈，在进行了广泛的形成性研究之后，包括社会绘图和关键知情人访谈，以评估饮酒模式和性风险行为。
FSW 报告在多种情况下饮酒：性、社交、心理健康和自我治疗。与客户进行性接触时饮酒通常是被迫的，但有些女性自愿饮酒。社交饮酒发生在酒吧等公共场所，也发生在废弃建筑物、道路和摩托车出租车等私人场所。饮酒的后果包括未能使用避孕套和向客户收取款项、暴力、法律问题、胃肠道副作用、经济损失和干扰家庭责任。
FSW 在多层次环境中饮酒。交易性性行为期间的饮酒通常是被迫的，可能导致避孕套使用失败。社交饮酒者与其他值得信赖的 FSW 一起饮酒，以娱乐和帮助应对心理社会压力源。该人群中存在多种饮酒原因和后果，未来的干预措施应针对酒精使用的每个特定方面。
