Wawer M J, Podhisita C, Kanungsukkasem U, Pramualratana A, McNamara R
Center for Population and Family Health, Columbia University, New York, NY 10032, USA.
Soc Sci Med. 1996 Feb;42(3):453-62. doi: 10.1016/0277-9536(95)00150-6.
This paper examines the social origins and working conditions of selected female commercial sex workers in Thailand. Quantitative data gathered from 678 commercial sex workers (CSWs) in low-price brothels, tea houses and other work sites in three urban centers were supplemented by focus group discussions and in-depth interviews. The commercial sex establishments were selected from lists provided by local health officials. Social factors associated with entry into commercial sex work and condom use for sexual intercourse were investigated as they operate on contextual, intermediate and proximate levels. Women from the North region of Thailand predominated (68%) and they tended to be younger than the 27% from the Northeast. The majority of all women maintained financial ties to the home by sending income to parents, siblings and other relatives but this pattern is stronger among Northern women. Qualitative data suggest that women were systematically recruited into prostitution from villages in the North and their work enabled them to comply with traditional family support roles. Women from the Northeast revealed a more complex pattern of entry with intrafamily strife, divorce, efforts to find other employment, and entry into sex work at a later age than the women from the North. Northeastern women were more than twice as likely as Northern women to have had a husband as their first sex partner (55% vs 22%). The lives of CSWs were found to be tightly controlled by brothel owners and managers, although 8% were living with a husband or partner, and non-commercial sexual relationships in the month prior to interview were reported by up to 23%. Data indicate need for even more intensive education on HIV transmission, especially with respect to risk of transmission in the absence of AIDS symptoms. Appearance and a trusting relationship were the common reasons given for not using condoms. With the most recent client, 92% reported use if the client was not known and 70% reported use if the client had visited the same CSW three or more times. Education on HIV must take these attitudes and motivations into account as well as sanctions for brothel owners who do not enforce condom use. The proportion of Thai men who visit brothels in addition to other sexual partners, high rates of HIV among CSWs, and inconsistent use of condoms create a complex web that accelerates the spread of the HIV epidemic in Thailand.
本文研究了泰国部分女性商业性工作者的社会出身和工作条件。通过对三个城市中心低价妓院、茶馆及其他工作场所的678名商业性工作者（CSW）收集的定量数据，辅以焦点小组讨论和深度访谈。商业性场所是从当地卫生官员提供的名单中选取的。研究了与从事商业性工作及性交时使用避孕套相关的社会因素，这些因素在背景、中间和直接层面发挥作用。来自泰国北部地区的女性占主导（68%），她们往往比来自东北部的27%的女性更年轻。所有女性中的大多数通过给父母、兄弟姐妹和其他亲属寄钱与家庭保持经济联系，但这种模式在北部女性中更为明显。定性数据表明，女性是从北部村庄被有组织地招募到卖淫行业的，她们的工作使她们能够履行传统的家庭供养角色。来自东北部的女性进入这一行业的模式更为复杂，存在家庭内部冲突、离婚、寻找其他工作的努力，且比北部女性进入性工作的年龄更晚。东北部女性有丈夫作为其首个性伴侣的可能性是北部女性的两倍多（55%对22%）。尽管8%的商业性工作者与丈夫或伴侣生活在一起，且在访谈前一个月有高达23%的人报告有非商业性关系，但研究发现她们的生活受到妓院老板和经理的严格控制。数据表明，需要对艾滋病毒传播进行更深入的教育，特别是关于在没有艾滋病症状时的传播风险。外表和信任关系是不使用避孕套的常见原因。对于最近的客户，如果客户不认识，92%的人报告使用了避孕套；如果客户曾三次或更多次光顾同一名商业性工作者，70%的人报告使用了避孕套。关于艾滋病毒的教育必须考虑到这些态度和动机，以及对不强制使用避孕套的妓院老板的制裁。除了其他性伴侣外还光顾妓院的泰国男性比例、商业性工作者中艾滋病毒的高感染率以及避孕套使用的不一致，构成了一个复杂的网络，加速了艾滋病毒在泰国的传播。
