From the National HIV, AIDS and STIs Control Program, Ministry of Health.
Institute of Health Partners (IHP).
Sex Transm Dis. 2021 Oct 1;48(10):754-760. doi: 10.1097/OLQ.0000000000001417.
Knowing the number of persons at risk for sexually transmitted diseases (STDs) and their risk behaviors are needed to allocate limited resources, set targets for prevention and care activities, gauge the reach of programs, and assess their impact. Female sex workers (FSWs) are a population at high risk for STD worldwide; little is known about FSW in Bhutan.
We conducted a community-based survey and population size exercise of FSW in Bhutan. The survey used a hybrid venue-based/peer-referral sampling method. Population size estimation methods were key informant mapping, census and enumeration, unique object multiplier, and capture-recapture.
Of 517 women surveyed, 67.5% provided sex for money in the last year. Compared with FSWs at venues, FSWs referred by peers were more likely to have sex with alcohol (80.1% vs. 51.5%, P < 0.001) and more paying partners (mean, 3.5 vs. 2.0; P = 0.001), and less likely to have tested for an STD (28.3% vs. 51.0%, P < 0.001) or have outreach worker contact (27.6% vs. 41.5%, P = 0.007). The estimated number of FSWs in the 9 districts was 353 (95% confidence interval, 345-362). Extrapolation to the whole country projected 597 (417-777) FSWs nationally.
Our estimate of the number of FSW in Bhutan corresponds to 0.71% of adult urban women, a figure in line with other countries in South and Southeast Asia. Our data highlight the need for outreach beyond venues where women are employed to reach FSW at higher risk for STD but who have less access to interventions.
了解性传播疾病（STD）高危人群的数量及其风险行为，对于分配有限的资源、为预防和保健活动设定目标、评估项目的覆盖范围以及衡量其影响至关重要。性工作者（FSW）是全球 STD 高危人群；然而，关于不丹的 FSW 情况却知之甚少。
我们在不丹开展了一项基于社区的 FSW 调查和人口规模研究。该调查采用了混合场所/同伴推荐抽样方法。人口规模估计方法包括关键知情人绘图、普查和计数、独特对象乘数和捕获-再捕获。
在接受调查的 517 名女性中，67.5%的人在过去一年中通过性交易获取金钱。与在场所工作的 FSW 相比，由同伴推荐的 FSW 更有可能与饮酒者发生性行为（80.1%比 51.5%，P < 0.001），且性伴侣更多（平均 3.5 比 2.0；P = 0.001），更不可能接受 STD 检测（28.3%比 51.0%，P < 0.001）或与外展工作人员接触（27.6%比 41.5%，P = 0.007）。9 个地区的 FSW 估计人数为 353 人（95%置信区间为 345-362）。全国范围内的外推预测全国有 597 名（417-777）FSW。
我们对不丹 FSW 数量的估计与南亚和东南亚其他国家的成人城市女性比例 0.71%相吻合。我们的数据突出表明，需要超越场所，向处于更高 STD 风险但获取干预措施机会较少的 FSW 提供外展服务。
