Sou Julie, Shannon Kate, Li Jane, Nguyen Paul, Strathdee Steffanie A, Shoveller Jean, Goldenberg Shira M
From the *Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada; †School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; ‡Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada; and §University of California San Diego School of Medicine, San Diego, CA.
Sex Transm Dis. 2015 Jun;42(6):312-6. doi: 10.1097/OLQ.0000000000000276.
Migrant women in sex work experience unique risks and protective factors related to their sexual health. Given the dearth of knowledge in high-income countries, we explored factors associated with inconsistent condom use by clients among migrant female sex workers over time in Vancouver, BC.
Questionnaire and HIV/sexually transmitted infection testing data from a longitudinal cohort, An Evaluation of Sex Workers Health Access, were collected from 2010 to 2013. Logistic regression using generalized estimating equations was used to model correlates of inconsistent condom use by clients among international migrant sex workers over a 3-year study period.
Of 685 participants, analyses were restricted to 182 (27%) international migrants who primarily originated from China. In multivariate generalized estimating equations analyses, difficulty accessing condoms (adjusted odds ratio [AOR], 3.76; 95% confidence interval [CI], 1.13-12.47) independently correlated with increased odds of inconsistent condom use by clients. Servicing clients in indoor sex work establishments (e.g., massage parlors) (AOR, 0.34; 95% CI, 0.15-0.77), and high school attainment (AOR, 0.22; 95% CI, 0.09-0.50) had independent protective effects on the odds of inconsistent condom use by clients.
Findings of this longitudinal study highlight the persistent challenges faced by migrant sex workers in terms of accessing and using condoms. Migrant sex workers who experienced difficulty in accessing condoms were more than 3 times as likely to report inconsistent condom use by clients. Laws, policies, and programs promoting access to safer, decriminalized indoor work environments remain urgently needed to promote health, safety, and human rights for migrant workers in the sex industry.
从事性工作的移民女性在性健康方面面临独特的风险和保护因素。鉴于高收入国家这方面的知识匮乏，我们探讨了不列颠哥伦比亚省温哥华市从事性工作的移民女性随时间推移客户使用避孕套不一致的相关因素。
从2010年至2013年收集了来自纵向队列“性工作者健康获取评估”的问卷和艾滋病毒/性传播感染检测数据。使用广义估计方程的逻辑回归对为期3年的研究期间国际移民性工作者中客户使用避孕套不一致的相关因素进行建模。
在685名参与者中，分析仅限于182名（27%）主要来自中国的国际移民。在多变量广义估计方程分析中，获取避孕套困难（调整后的优势比[AOR]，3.76；95%置信区间[CI]，1.13 - 12.47）与客户使用避孕套不一致的几率增加独立相关。在室内性工作场所（如按摩院）接待客户（AOR，0.34；95% CI，0.15 - 0.77）以及高中学历（AOR，0.22；95% CI，0.09 - 0.50）对客户使用避孕套不一致的几率有独立的保护作用。
这项纵向研究的结果凸显了移民性工作者在获取和使用避孕套方面持续面临的挑战。获取避孕套有困难的移民性工作者报告客户使用避孕套不一致的可能性是其他人的3倍多。迫切需要法律、政策和项目来促进获得更安全、非刑事化的室内工作环境，以促进性产业中移民工人的健康、安全和人权。
