McClair Tracy L, Hossain Tarik, Sultana Nargis, Burnett-Zieman Brady, Yam Eileen A, Hossain Sharif, Yasmin Reena, Sadiq Najmus, Decker Michele R, Ahmed Saifuddin
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Population Council, Dhaka, Bangladesh.
J Adolesc Health. 2017 Feb;60(2S2):S29-S34. doi: 10.1016/j.jadohealth.2016.09.024.
Dhaka City is home to thousands of migrants from Bangladesh's rural areas who often live in the streets. Prior studies examine street youth's practice of selling sex as a survival mechanism. We assess their less-studied practice of paying for sex and its association with sexual risk behaviors and outcomes.
As part of the global Link Up project, trained interviewers recruited 447 young men who live on the streets, ages 15-24, from seven Dhaka City "hotspots" to participate in a survey about sexual health. Among those who ever had sex, we examined frequencies and conducted bivariate analyses of sociodemographic characteristics by paying for sex status. We then conducted bivariate and multivariate logistic regression analyses of paying for sex in the last 12 months and sexual health behaviors and outcomes.
Median participant age was 18 years. Among those who ever had sex (N = 321), 80% reported paying for sex in the last 12 months and 15% reported selling sex in the last 12 months. In multivariate analyses, those who paid for sex had significantly increased odds of reporting sexually transmitted infection-related symptoms in the last six months (adjusted odds ratio = 1.76, 95% confidence interval [CI] = 1.17-2.64) and engaging in unprotected last sex with a nonprimary partner (adjusted odds ratio = 2.19, CI = 1.58-3.03).
The adverse factors associated with paying for sex among young men who live on the streets in Dhaka City highlight the need for programs to educate on HIV/sexually transmitted infection prevention and promote condom use, STI screening/treatment, and HIV testing in this population.
达卡市居住着成千上万来自孟加拉国农村地区的移民，他们常常露宿街头。先前的研究探讨了街头青年通过出卖性服务作为一种生存手段的行为。我们评估了他们较少被研究的购买性服务行为及其与性风险行为和后果的关联。
作为全球“联系起来”项目的一部分，经过培训的访谈员从达卡市的七个“热点地区”招募了447名年龄在15至24岁之间露宿街头的年轻男性，参与一项关于性健康的调查。在那些曾经有过性行为的人中，我们按是否购买性服务状况检查了频率，并对社会人口学特征进行了双变量分析。然后，我们对过去12个月内购买性服务情况以及性健康行为和后果进行了双变量和多变量逻辑回归分析。
参与者的年龄中位数为18岁。在那些曾经有过性行为的人（N = 321）中，80%报告在过去12个月内有过购买性服务行为，15%报告在过去12个月内有过出卖性服务行为。在多变量分析中，那些购买性服务的人在过去六个月内报告有性传播感染相关症状的几率显著增加（调整后的优势比 = 1.76，95%置信区间[CI] = 1.17 - 2.64），并且与非主要性伴侣进行无保护最后一次性行为的几率也显著增加（调整后的优势比 = 2.19，CI = 1.58 - 3.03）。
达卡市露宿街头的年轻男性中与购买性服务相关的不利因素凸显了针对该人群开展艾滋病毒/性传播感染预防教育、推广避孕套使用、性传播感染筛查/治疗以及艾滋病毒检测项目的必要性。
