Saw Swee Hock School of Public Health (MD 3), National University of Singapore, Singapore, Singapore.
J Urban Health. 2012 Dec;89(6):1031-44. doi: 10.1007/s11524-012-9723-5.
Globalization has led to a rapid influx of female workers from Asian countries with high prevalence of HIV to Singapore, with many entering the entertainment industry. We assessed the prevalence of sexual services, condom use, and self-initiated screening for sexually transmitted infections (STIs) and associated variables among foreign female entertainment workers in Singapore. A cross-sectional survey of 317 female entertainment workers, using mystery clients, was conducted on a two-stage proportional cluster sample of 93 entertainment establishments stratified by geographical zone in Singapore. We found a high prevalence (71 %) of sexual services in entertainment establishments with 53 % of the female entertainment workers reporting selling sex. Consistent condom use for sex with paying clients in a usual week in the past 3 months was low, ranging from 37.9 % for oral sex, 46.9 % for anal sex, to 51.9 % for vaginal sex. On multivariate logistic regression, consistent condom use for vaginal sex with clients showed a significant independent association with the entertainment worker's behavior of asking clients to use condoms and a borderline association with entertainment worker being a Chinese national. Less than half (48.9 %) of the sex workers had ever been screened for STIs either locally or in their home country. The only independent factor significantly associated with STI screening was having to support one's family. In summary, a high percentage of foreign female entertainment workers in Singapore reported selling sex. Condom use and STI screening were low among them. Access to STI screening, treatment, and education services should be enhanced for foreign female entertainment workers in Singapore.
全球化导致来自亚洲艾滋病毒高发国家的大量女性工人涌入新加坡，其中许多人进入娱乐行业。我们评估了新加坡外国娱乐女性工作者的性服务、 condom 使用和性传播感染（STI）自我筛查的流行率以及相关变量。使用神秘客户对 93 个娱乐场所进行了分层地理区域的两阶段比例聚类抽样，对 317 名外国娱乐女性工作者进行了横断面调查。我们发现娱乐场所的性服务发生率很高（71%），其中 53%的女性娱乐工作者报告卖淫。过去 3 个月中，在一个通常的一周内与付费客户进行性行为时， condom 使用的一致性很低，从口腔性行为的 37.9%，肛门性行为的 46.9%到阴道性行为的 51.9%。多元逻辑回归分析显示，与客户进行阴道性行为时 condom 使用的一致性与娱乐工作者要求客户使用 condom 的行为有显著的独立关联，与娱乐工作者是中国公民有关联。不到一半（48.9%）的性工作者曾在当地或原籍国进行过性传播感染筛查。唯一与 STI 筛查显著相关的独立因素是养家糊口。总之，新加坡大量的外国娱乐女性工作者报告卖淫。 condom 使用和 STI 筛查率较低。应加强新加坡外国娱乐女性工作者的 STI 筛查、治疗和教育服务。
