Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2012;7(12):e52858. doi: 10.1371/journal.pone.0052858. Epub 2012 Dec 28.
Context-specific typologies of female sex workers (FSWs) are essential for the design of HIV intervention programming. This study develops a novel FSW typology for the analysis of transactional sex risk in rural and urban settings in Indonesia. Mixed methods include a survey of rural and urban FSWs (n=310), in-depth interviews (n=11), key informant interviews (n=5) and ethnographic assessments. Thematic analysis categorises FSWs into 5 distinct groups based on geographical location of their sex work settings, place of solicitation, and whether sex work is their primary occupation. Multiple regression analysis shows that the likelihood of consistent condom use was higher among urban venue-based FSWs for whom sex work is not the only source of income than for any of the other rural and urban FSW groups. This effect was explained by the significantly lower likelihood of consistent condom use by rural venue-based FSWs (adjusted OR: 0.34 95% CI 0.13-0.90, p=0.029). The FSW typology and differences in organisational features and social dynamics are more closely related to the risk of unprotected transactional sex, than levels of condom awareness and availability. Interventions need context-specific strategies to reach the different FSWs identified by this study's typology.
针对女性性工作者（FSW）的特定情境分类对于设计艾滋病干预规划至关重要。本研究为印度尼西亚农村和城市地区的交易性性行为风险分析制定了一种新的 FSW 分类方法。混合方法包括对农村和城市 FSW（n=310）的调查、深入访谈（n=11）、关键知情人访谈（n=5）和民族志评估。基于性工作场所的地理位置、招揽地点以及性工作是否为主要职业，主题分析将 FSW 分为 5 个不同群体。多元回归分析表明，对于那些性工作不是唯一收入来源的城市场所型 FSW，与其他任何农村和城市 FSW 群体相比，她们更有可能始终如一地使用安全套。农村场所型 FSW 始终如一地使用安全套的可能性较低（调整后的 OR：0.34 95% CI 0.13-0.90，p=0.029），这一结果解释了这一效应。FSW 分类以及组织特征和社会动态方面的差异与无保护的交易性性行为风险更为密切相关，而不是安全套意识和可获得性的水平。干预措施需要有针对性的具体策略来接触到本研究分类中确定的不同 FSW。
