International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Belgium.
S Afr Med J. 2013 Feb 19;103(4):246-51. doi: 10.7196/samj.6170.
In South Africa, information on sex workers' characteristics, sexual behaviour and health needs is limited. Current social, legal and institutional factors impede a safe working environment for sex workers and their clients.
To describe characteristics and sexual behaviour of female, male and transgender sex workers, and assess their risk factors for unprotected sex.
Repeat cross-sectional surveys among sex workers were conducted in Hillbrow, Sandton, Rustenburg and Cape Town in 2010. Sex workers were interviewed once; any re-interviews were excluded from analysis. Unprotected sex was defined as any unprotected penetrative vaginal or anal sex with last two clients.
Trained sex workers interviewed 1 799 sex workers. Sex work was a full-time profession for most participants. About 8% (126/1 594) of women, 33% (22/75) of men, and 25% (12/50) of transgender people had unprotected sex. A quarter of anal sex was unprotected. Unprotected sex was 2.1 times (adjusted odds ratio (AOR), 95% CI 1.2 - 3.7; p=0.011) more likely in participants reporting daily or weekly binge drinking than non-binge drinkers. Male sex workers were 2.9 times (AOR, 95%CI 1.6 - 5.3; p<0.001) more likely, and transgender people 2.4 times (AOR, 95% CI 1.1 - 4.9; p=0.021) more likely, than females to have unprotected sex. Sex workers in Hillbrow, where the only sex work-specific clinic was operational, were less likely to have unprotected sex than those in other sites.
Tailored sex work interventions should explicitly include male and transgender sex workers, sex work-specific clinics, focus on the risks of unprotected anal sex, and include interventions to reduce alcohol harm.
在南非，有关性工作者特征、性行为和健康需求的信息有限。当前的社会、法律和体制因素阻碍了性工作者及其客户的安全工作环境。
描述女性、男性和跨性别性工作者的特征和性行为，并评估他们无保护性行为的风险因素。
2010 年在希尔布劳、桑顿、勒斯滕堡和开普敦对性工作者进行了重复的横断面调查。性工作者接受了一次访谈；任何重访均被排除在分析之外。无保护性行为被定义为与最后两个客户进行的任何无保护的阴道或肛门性交。
经过培训的性工作者采访了 1799 名性工作者。对大多数参与者来说，性工作是一种全职职业。约 8%（126/1594）的女性、33%（22/75）的男性和 25%（12/50）的跨性别者发生了无保护性行为。四分之一的肛交是无保护的。与非狂饮者相比，报告每日或每周狂饮的参与者发生无保护性行为的可能性高 2.1 倍（调整后的优势比（AOR），95%置信区间 1.2-3.7；p=0.011）。男性性工作者的可能性高 2.9 倍（AOR，95%CI 1.6-5.3；p<0.001），跨性别者的可能性高 2.4 倍（AOR，95%CI 1.1-4.9；p=0.021），比女性更容易发生无保护性行为。在唯一运营的性工作者特定诊所所在的希尔布劳，性工作者发生无保护性行为的可能性低于其他地点。
专门针对性工作者的干预措施应明确包括男性和跨性别性工作者、性工作者特定诊所、关注无保护肛交的风险，并包括减少酒精危害的干预措施。
