上海市闸北区暗娼安全套使用及其影响因素研究

目的了解上海市闸北区暗娼安全套使用率及影响安全套使用的因素,为相关部门开展干预提供科学依据。方法采用立意抽样方法对闸北区部分娱乐场所的167名暗娼进行安全套使用情况调查。结果暗娼第一次提供商业性服务的平均年龄为(24.77±5.34)岁;在167名应答的调查对象中,过去一个月暗娼每次性行为都使用安全套的比例为68.9%,过去一周的比例为75.6%,最近一次使用的比例为92.7%,且差异有显著性(χ2=62.161,P=0.000);与顾客每次都使用安全套的比例高于她们与固定性伴(主要是男朋友或丈夫)的比例,差异有显著性(χ2=53.513,P=0.000);月收入高低、有否其他非顾客男性性伴是安全套使用的影响因素。结论暗娼安全套使用率随周期延长有下降趋势,且安全套使用在不同性伴间存在差异,应进一步采取有效干预措施,提高安全套坚持使用率。     

Predicting Health Care Utilization in Marginalized Populations: Black,Female, Street-Based Sex Workers

BackgroundPatterns of social and structural factors experienced by vulnerable populations may negatively affect willingness and ability to seek out health care services, and ultimately, their health.MethodsThe outcome variable was utilization of health care services in the previous 12 months. Using Andersen's Behavioral Model for Vulnerable Populations, we examined self-reported data on utilization of health care services among a sample of 546 Black, street-based, female sex workers in Miami, Florida. To evaluate the impact of each domain of the model on predicting health care utilization, domains were included in the logistic regression analysis by blocks using the traditional variables first and then adding the vulnerable domain variables.FindingsThe most consistent variables predicting health care utilization were having a regular source of care and self-rated health. The model that included only enabling variables was the most efficient model in predicting health care utilization.ConclusionsAny type of resource, link, or connection to or with an institution, or any consistent point of care, contributes significantly to health care utilization behaviors. A consistent and reliable source for health care may increase health care utilization and subsequently decrease health disparities among vulnerable and marginalized populations, as well as contribute to public health efforts that encourage preventive health.     

Predictors of Consistent Condom Use Among Chinese Female Sex Workers: An Application of the Protection Motivation Theory

We utilized Protection Motivation Theory to assess predictors of intention and behavior of consistent condom use among Chinese female sex workers (FSWs). A self-administered questionnaire was used in a cross-sectional survey among 700 FSWs in Guangxi, China. Multivariate logistic regression analysis indicated that extrinsic and intrinsic rewards, self-efficacy, and response costs predicted consistent condom use intention and behavior among FSWs. Sexually transmitted infection/ HIV prevention programs need to reduce FSWs’ perceptions of positive extrinsic rewards and intrinsic rewards for engaging in consistent condom use, reduce FSWs’ perception of response costs for using a condom, and increase condom use self-efficacy among FSWs.     

Social Support and Condom Use Among Female Sex Workers in China

While the relationship between social support and psychological well-being has been well established, limited studies have explored how social support might affect condom use among female sex workers (FSWs). Using cross-sectional data from 1,022 FSWs in Guangxi, China, we examined how different forms of support from diverse sources may influence condom use among FSWs. Friends, coworkers, and stable partners were FSWs’ main sources of social support. Social support from diverse sources differently impacts FSWs’ condom use. Policymakers need to consider the complicated profile of social support received by FSWs and create supportive environment for FSWs to protect themselves from HIV risks.     

Contraception and Condom Use Among Bolivian Female Sex Workers: Relationship-Specific Associations Between Disease Prevention and Family Planning Behaviors

We examined data from a clinic-based survey of 1,222 Bolivian female sex workers (FSWs) to assess whether use of nonbarrier modern contraception is associated with less consistent condom use with clients and noncommercial partners. Women who were using nonbarrier modern contraception were less likely than nonusers to consistently use condoms with noncommercial partners (AOR 0.393, 95% CI 0.203–0.759, p = .005). With clients, this inverse association did not hold. Public health professionals must consider both disease prevention and pregnancy prevention needs in this vulnerable population, and messages should be tailored to encourage dual method use with all partners.     

健康信念对低档场所女性性工作者安全套使用行为的影响

目的探讨健康信念如何影响低档场所女性性工作者安全套使用行为.方法以健康信念模式为理论基础设计问卷,采用方便抽样对随州市和武汉市低档场所女性性工作者进行调查,应用结构方程模型对调查结果进行分析.结果整个健康信念模式对安全套使用行为的确定系数为0.470 1;易感性认知、严重性认知、行为效益认知、行为障碍认知、自我效能对低档场所女性性工作者安全套使用行为的总体影响系数分别为0.14,0.18,0.37,0.58和0.10.结论应用健康信念模式,可以解释低档场所女性性工作者安全套使用行为的47%;影响女性性工作者安全套使用的因素从大到小依次为:行为障碍认知、行为效益认知、严重性认知、易感性认知和自我效能.     

在福州市服务小姐中推广使用安全套的研究

由于种种原因 ,娱乐场所的服务小姐在与他人发生性关系时 ,安全套使用率依然很低。而无保护的性关系是传播性病艾滋病的重要渠道。提高服务小姐安全套使用率是控制性病艾滋病通过性传播的关键。从 1 999年开始 ,福建省健康教育所应用卫生部招标的项目经费持续对福州市部分娱乐场所的服务小姐进行综合干预 ,并在干预前后对娱乐场所的服务小姐进行艾滋病性病防治知识和安全套使用情况的调查 ,现报告如下。对象与方法1 对象　在福州市 1 0家娱乐场所中包括 :夜总会、发廊、桑拿浴所服务小姐为干预对象。2 方法　在干预开始前 ,项目工作人员首…     

2006～2008年山东省部分女性性工作者安全套使用及其影响因素分析

[目的]了解女性性工作者安全套使用及其影响因素,为制定防治对策和干预措施提供依据。[方法]2006～2008年每年的7～9月,分层整群抽取青岛、烟台及德州3个市娱乐场所的女性性工作者,进行问卷调查。[结果]合计调查3 460人,75.17%的人<25岁,未婚者占75.87%,初中文化者占71.27%;最近1个月发生商业性行为时坚持使用安全套率为45.10%,与固定性伴这一比例为24.25%;11.20%的调查对象承认有吸毒史;31.42%最近1年做过HIV检测;不同场所、年龄、婚姻状况、文化程度、民族、艾滋病知识得分以及是否接受过干预服务之间安全套使用率有统计学意义(P<0.01或0.05)。[结论]山东省部分女性性工作者最近1个月与商业性伴及固定性伴安全套使用率呈上升趋势。     

2006-2008年山东省部分女性性工作者安全套使用及其影响因素分析

[目的]了解女性性工作者安全套使用及其影响因素,为制定防治对策和干预措施提供依据。[方法]2006～2008年每年的7～9月,分层整群抽取青岛、烟台及德州3个市娱乐场所的女性性工作者,进行问卷调查。[结果]合计调查3460人,75．17％的人〈25岁,未婚者占75．87％,初中文化者占71．27％;最近1个月发生商业性行为时坚持使用安全套率为45．10％,与固定性伴这一比例为24．25％;11．20％的调查对象承认有吸毒史;31．42％最近1年做过HIV检测;不同场所、年龄、婚姻状况、文化程度、民族、艾滋病知识得分以及是否接受过干预服务之间安全套使用率有统计学意义（P〈0．01或0．05）。[结论]山东省部分女性性工作者最近1个月与商业性伴及固定性伴安全套使用率呈上升趋势。     

商业性性服务工作者艾滋病相关知识、行为及安全套使用情况调查分析

目的:了解安徽省芜湖市商业性性服务小姐对艾滋病(AIDS)知识的掌握、行为特征及其安全套使用情况,为艾滋病健康教育和加强防控提供参考.方法:采用分层方便抽样方法对安徽省芜湖市市区75家中低档娱乐场所有女性商业性工作者使用自行设计的调查问卷,就预防艾滋病相关知识、行为特征及安全套使用情况进行调查.结果:共调查女性商业性工作者500人,其中本省267人占53.40%,外省233人,占46.60%;中档场所432人,占84.60%,低档场所68人,占13.60%;不同省份、不同档次场所的女性商业性工作者基本上了解艾滋病预防相关知识(正确知晓率为74.68%);女性商业性工作者安全套使用情况,最近一次使用率为82.20%(但省内略高于省外),最近一个月每次均使用率为53.00%(但中档场所明显高于低档场所).仍与配偶或同居男友发生性关系的277人中,最近一次性关系安全套使用率33.90%,最近一个月性关系每次都使用安全套的比率为19.10%.结论:不同省份、档次娱乐场所的女性商业性工作者虽基本上了解艾滋病预防相关知识及安全套正确使用知识,但每次性行为均使用安全套比率较低,加强商业性工作者安全套使用知识的宣传教育,提高其安全套的全程正确使用率,应作为今后干预工作的重点.     

Correlates of Self-Efficacy for Condom Use Among Male Clients of Female Sex Workers in Tijuana,Mexico

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.     

Associations of Physical and Sexual Health with Suicide Attempts Among Female Sex Workers in South Korea

This study investigated suicidal behavior prevalence and its association with physical and sexual health, and behavior-related factors among female sex workers in South Korea. Using time location sampling, we recruited 1,083 sex workers for an interviewer-administered questionnaire regarding sexual behavior, sociodemographics, and self-rated health (SRH) status. Participants were also tested for sexually transmitted diseases (STDs). We used binary logistic regression analysis to define suicide attempt factors. Around 28 % of sex workers in the sample reported that they had attempted suicide in the past year. Suicide attempts were independently associated with drinking alcohol almost every day, not using condom regularly, STD infection experience, and unfavorable SRH status. Higher suicide attempt likelihood was associated with poor sexual and physical health, but there was no significant association with the number of customers per week. We thus need to revive STD screening programs provided by the government and to support mental health programs.     

Condom Use with Female Sex Workers among Male Clients in Sichuan Province,China: The Role of Interpersonal and Venue-Level Factors

Commercial sex work has re-emerged as a widespread industry since China started economic reforms in the 1980s. This study examined the role of interpersonal and venue-level factors in commercial sex male clients' (CSMCs) condom use with female sex workers (FSWs) in China. Given the heterogeneity of commercial sex industry in China, this study also aimed to explore how these factors function differently by social ranks of commercial sex work frequented by CSMCs. A cross-sectional survey was conducted with 601 CSMCs in Sichuan province, China. Human immunodeficiency virus (HIV) prevalence in this sample was 1.7%. In addition to the individual characteristics, interpersonal factor was measured by the frequency of FSWs taking the initiative in condom use and providing condoms. Venue-level factor was assessed by the frequency of the managers of commercial sex venues communicating condom use policies and the frequency of condom availability in commercial sex venues. The primary behavioral outcome was consistent condom use with FSWs. Multivariate logistic regression models revealed that consistent condom use with FSWs was significantly associated with interpersonal (adjusted odds ratio (AOR), 1.62; 95% confidence interval (CI), 1.38, 1.90) and venue-level factors (AOR, 1.98; 95% CI, 1.40, 2.80). Moreover, the associations between interpersonal and venue-level factors and consistent condom use were moderated by social ranks of commercial sex work frequented by the male clients. The present study findings underscore the need for comprehensive HIV prevention approaches that integrate individual, interpersonal, and venue-level factors to reduce HIV risk behaviors among CSMCs in China.     

Client Retention and Health Among Sex Workers in Nairobi, Kenya

It is still a small body of research that directly addresses female sex workers’ relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi’s FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers’ practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer.     

Migration Status, Work Conditions and Health Utilization of Female Sex Workers in Three South African Cities

Intersections between migration and sex work are underexplored in southern Africa, a region with high internal and cross-border population mobility, and HIV prevalence. Sex work often constitutes an important livelihood activity for migrant women. In 2010, sex workers trained as interviewers conducted cross-sectional surveys with 1,653 female sex workers in Johannesburg (Hillbrow and Sandton), Rustenburg and Cape Town. Most (85.3 %) sex workers were migrants (1396/1636): 39.0 % (638/1636) internal and 46.3 % (758/1636) cross-border. Cross-border migrants had higher education levels, predominately worked part-time, mainly at indoor venues, and earned more per client than other groups. They, however, had 41 % lower health service contact (adjusted odds ratio = 0.59; 95 % confidence interval = 0.40–0.86) and less frequent condom use than non-migrants. Police interaction was similar. Cross-border migrants appear more tenacious in certain aspects of sex work, but require increased health service contact. Migrant-sensitive, sex work-specific health care and health education are needed.     

Variations in Condom Use by Locale: A Comparison of Mobile Chinese Female Sex Workers in Hong Kong and Mainland China

The present study investigated the prevalence of HIV and HIV-related behaviors and perceptions among 336 female sex workers (FSW) traveling from mainland China to work in Hong Kong. None of the participants tested HIV positive. Of the participants, 13.2% and 26.8%, respectively, would have unprotected sex with a client in Hong Kong or in mainland China if they liked the client; 16.7% and 21.7%, respectively, would have unprotected sex with a client in Hong Kong and in mainland China if he paid more. Of the participants, 98.5% used condoms in the last episode of sex work in Hong Kong and 78.1% were consistent condom users in Hong Kong in the last month. Yet, among those who previously worked as FSW in mainland China (n = 141), only 28.6% used condoms consistently in mainland China in the last year; 60% of those who used condoms inconsistently while in mainland China became consistent condom users in Hong Kong. Among those who did not use condoms in mainland China, willingness to have unprotected sex with a client who was liked by the FSW was a strong predictor for consistent condom use in Hong Kong (OR = 18.67, p < .001). Among those who were consistent condom users in Hong Kong, the same variable predicted inconsistent condom use while in mainland China (OR = 14.02, p < .05). Condom use behaviors change when FSW are working in different social contexts and behavioral changes are possible. Education programs should take socio-contextual factors into account.     

安全套使用项目对降低我国艾滋病性病传播的作用及其可行性研究

目的探索在中国实施娱乐场所100％安全套使用项目的有效性和可行性。方法采用非概率抽样法选择武汉市黄陂区木兰镇和前川镇，对性服务娱乐场所中所有女性性工作者实施现场干预流行病学研究，分干预前和干预后第3、6、9个月共4次，进行包括安全套使用情况等内容的面对面问卷访谈和艾滋病、衣原体血清学检验。结果共352人次接受本次调查，未发现艾滋病毒阳性感染者。研究对象安全套坚持使用率由干预前的32．86％逐步上升至干预后的第3、6、9个月分别为50．00％、63．22％和69．09％，干预前后差异有统计学意义（x^2=5．558，P〈0．05）。坚持使用安全套与未坚持和从不使用安全套的研究对象，其衣原体感染率差异有统计学意义（x^2=248．72，P〈0．01），从不使用安全套感染衣原体的危险性是坚持使用者的10．91倍。使用安全套预防性传播疾病的总有效性为85．82％。结论坚持正确使用安全套能有效减少性传播疾病的发病率；通过有效的政策倡导，在我国现行的法律政策范围内可以开展娱乐场所100％安全套使用项目。     

Stages of Consistent Condom Use,Partner Intimacy,Condom Use Attitude,and Self-Efficacy in African-American Crack Cocaine Users

This study examined how condom use attitude, self-efficacy, and partner intimacy related to five stages of consistent condom use. Interview data were collected from sexually active, heterosexual, African-American crack cocaine smokers (N = 366). Dependent measures assessed both the participants’ own responses and their perceptions about their last sex partner’s own personal condom use attitude and participants’ condom use self-efficacy expectations. Partner intimacy was assessed both as a continuous attitudinal and as a discrete relationship measure. Less than 10% were classified as consistent condom users. Two thirds of inconsistent users were in the Precontemplation (PC) stage. The contemplation (C) and preparation (P) stages were equal among the remainder of the inconsistent condom users. Higher partner intimacy reduced modestly readiness for consistent condom use. The stage but not the intimacy group was related to the condom use attitudes and self-efficacy measures. Last partners’ perceived own negative attitudes were significantly related to the stages of consistent condom use and was especially low in the action (A) and maintenance (M) stages. Participants’ own negative attitudes were unrelated to the stages. Of the self-efficacy measures, both participants’ performance and situational condom use self-efficacies increased significantly after the PC stage and were highest in the P, A, and M stages. However, situational self-efficacy accounted for most of performance self-efficacy variance. In sum, consistent condom use was rare. A partner’s attitudes and the participants’ own situational self-efficacy expectations, rather than intimacy, determined the readiness to adopt consistent condom use.     

Alcohol and Other Drug Use,Partner Violence,and Mental Health Problems Among Female Sex Workers in Southwest China

In this study we investigated the association between mental health problems and negative experiences among female sex workers (FSWs) in China. A total of 1,022 FSWs completed a self-administered survey on their demographic characteristics, mental health status, substance use behaviors, and experiences of partner violence. We found that alcohol use was independently predictive of mental health problems when both partner violence and illicit drug use were accounted for in the multivariate logistic regression models. The findings underscore the urgent need for effective alcohol reduction interventions and mental health promotion programs among FSWs in China and other developing countries.