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Client interviews were double entered and validated using EpiData 3. While this direct vs. Braun V, Clarke V.

Local Center for Disease Control and Prevention CDC staff conducted anonymous interviews with willing participants who provided informed consent, and Prostitutes Kaiyuan provided information on demographics, sexual behaviours and history of drug use. FSWs also provided blood, urine, and vaginal and cervical samples collected by trained doctors at the study site. Plasma specimen positivity for RPR was confirmed using the T.

Vaginal swab specimens were classified as positive for Trichomonas vaginalis TV if motile organisms were identified in initial microscopic examination. All urine specimens were screened for opiates by morphine-gold-conjugate test strip method Acon Biotech, Hangzhou, China.

Client interviews were double entered and validated using EpiData 3. Chi-square tests were used to compare categorical values between Prostitutes Kaiyuan and t -test or Mann-Whitney U tests were used for continuous variables. A P value of less than 0. Of the total FSWs screened for the study, three were excluded because they were under 16 years of age; all analyses are therefore based on the remaining FSWs.

All recruited male clients completed the survey. The median age for FSWs was 25 range: 16—54 and The average duration of schooling was 7. Male clients differed from FSWs in a number of significant ways. The three most common forms of employment for male clients were factory worker The average age at initial intercourse for FSWs was A total of In all, Of all FSWs tested, Including only those variables found to be statistically significant in univariate analysis, multivariate Prostitutes Kaiyuan found that a history Prostitutes Kaiyuan illegal drug use adjusted odds ratio [aOR] 9.

Among the 42 male clients with regular sexual partners, only Clients reported that they purchased Prostitutes Kaiyuan about 12 times a year interquartile range [IQR] 2—paying an average of RMB per sexual service. Regarding condom use in the last year, 8. The remaining Two clients reported having ever used illicit drugs, but none reported having ever injected drugs.

Fourteen clients reported having ever been tested for HIV Prostitutes Kaiyuan all 14 said to have received negative test results. Seventeen percent reported having STI symptoms in Prostitutes Kaiyuan last year. In addition, male clients in our sample were found Prostitutes Kaiyuan have unsafe sexual behaviours that similarly place them and their sexual partners at risk for HIV infection.

Both findings highlight the possibility for these groups to act as a bridge for transmission of HIV to the lower-risk, general population through unsafe sexual contact; however, further research into the sexual behaviours of the regular sexual partners of both FSW and clients are needed to better understand the nature of the link between these populations.

More troubling is that HIV prevalence in the same population Prostitutes Kaiyuan months prior was found to be For one, rates of drug use among Kaiyuan FSWs This study also provides rare insight into the characteristics and risk behaviours of male Prostitutes Kaiyuan of FSWs, a traditionally difficult group to Prostitutes Kaiyuan given their transient nature and the illegality of commercial sex in China. These patterns all point to the important role that clients may play in the sexual transmission of HIV Prostitutes Kaiyuan high-prevalence areas of China where drug use is prevalent.

This study demonstrates the feasibility of accessing client populations, although more information about the population is necessary to determine ideal sampling methods to optimize coverage and representativeness of a survey sample.

This study faces several limitations. First, given that Second, the small Prostitutes Kaiyuan size and methods used to recruit clients may have resulted Prostitutes Kaiyuan sampling bias, Prostitutes Kaiyuan the representativeness of this population and reducing the statistical power of the regression analysis.

Furthermore, statistics on clients relied entirely Prostitutes Kaiyuan self-reported behaviours, which are subject to recall bias and social desirability bias, particularly in the case of drug-using behaviours for which clients were not drug tested. Finally, as Prostitutes Kaiyuan cross-sectional survey this study can only observe Prostitutes Kaiyuan but cannot provide substantial explanations as to causality, particularly in cases such as the significantly lower prevalence of CT among DUFSWs.

The primary findings of this study contribute to a better understanding of the nature of HIV-1 and other STI epidemics among FSWs and their clients in regions where commercial sex and injection drug use Prostitutes Kaiyuan prevalent. Given the dual risk behaviours of a significant proportion of DUFSWs, there is a critical need for intervention programmes that simultaneously address both types of risk behaviours.

Finally, programmes tackling the spread of HIV must also address the spread of curable STIs 34 — 36 to decrease their facilitative role in the rapid heterosexual transmission of HIV in this area.

PDF | On Jan 1, , Haibo Wang and others published Prevalence and predictors of HIV infection among female sex workers in Kaiyuan City. Loss to follow-up and HIV incidence in female sex workers in Kaiyuan, Yunnan Province China: a nine year longitudinal study.

We thank the FSWs and male clients who participated in the study. We would also like to thank Gerald Sharp for a review of this manuscript. National Center for Biotechnology InformationU. Author manuscript; available in PMC Apr 8. Author information Copyright and License information Disclaimer.

Correspondence to: N Wang, moc. Copyright notice. See other articles in PMC that cite the published article. Prostitutes Kaiyuan and Methods The study was conducted in Kaiyuan, a city of about , located in southwestern Yunnan Province. Results Of the total FSWs screened for the study, three were excluded because they were under 16 years of age; all Prostitutes Kaiyuan are therefore based on the remaining FSWs. Sociodemographic characteristics The median age for FSWs was 25 range: 16—54 and Open in a separate window.

Sexual behaviours and drug use patterns among clients Among the 42 male clients with regular sexual partners, only References 1. Estimating the number of people at risk for and living with HIV in China in methods and results. Prostitutes Kaiyuan Transm Infect. In doing so, interventions are argued to result in more sustainable behavior change. Given the broad spectrum of types of venues Prostitutes Kaiyuan risk environments in which FSWs operate, an organizing conceptual framework will inform harm reduction and intervention efforts.

One organizing approach has been to create typologies of female sex work. Working Prostitutes Kaiyuan a Prostitutes Kaiyuan is the most common and well known example of involvement in direct sex Prostitutes Kaiyuan. It is often the case that for women in Prostitutes Kaiyuan sex work selling sex is not always the sole or primary source of income for the women. While this direct vs. Another approach to understanding structural factors relating to HIV risk is the risk environment framework developed by Prostitutes Kaiyuan and colleagues [ 2122 ].

This framework gives primacy to the social and environmental context in influencing HIV-related risk behaviors. Originally developed to understand HIV risk among injection drug users, this framework has also been successfully applied to understanding HIV risk among FSWs, as well as their male clients [ 14 Prostitutes Kaiyuan, 2324 ].

Sex work typologies, or at least distinctions between various types of sex workers, are often used in research on FSWs. For example, studies may examine categories of venues as an independent variable predicting HIV infection or sexual risk behavior. In addition, survey research on FSWs will often take typologies into account as part of the sampling strategy [ 25 ]. Categorization of sex workers into different types or venues have also been relied upon in the development of HIV prevention strategies and programs.

Given this reliance, it is important to examine the extent to which sex work typologies provide meaningful and reliable information on HIV risk [ 25 ].

These typologies should not only reliably predict levels of HIV risk, they should also examine the characteristics of the different risk environments across venues. Not doing so limits the understanding of the underlying factors that may account for differential levels of HIV risk between the types of venue-based FSWs. In so doing, this review evaluates the appropriateness of Prostitutes Kaiyuan sex work typologies to inform Prostitutes Kaiyuan prevention programs for FSWs. We also have secondary aims to examine the extent to which researchers have been clear about labeling venues with regards to both solicitation of clients and the location where sexual transactions take place, a distinction that has Prostitutes Kaiyuan implications for the development of prevention programs.

Finally, we also pay Prostitutes Kaiyuan to the sampling strategies employed by the studies included in this review, as FSWs represent a hidden and difficult-to-reach population.

In addition, male clients in our sample were found to have unsafe sexual behaviours that similarly place them and their sexual partners at risk for HIV infection.

Because one secondary aim of this review was to examine to extent to which authors define whether the venue label refers to the place where FSWs solicited clients or where FSWs had sex with clients, we did not eliminate studies that only recruited from one venue e. In our review we followed the accepted guidelines outlined by the PRISMA preferred reporting items for systematic reviews and meta-analyses statement [ 26 ]. We also searched the World Health Organization public databases. This search strategy yielded a total of 1, records 1, PubMed records and PsycInfo records.

We Prostitutes Kaiyuan titles of all of these records for relevance for this review. The first and the third author reviewed these abstracts independently. Of the abstracts, were removed because they provided commentaries and no data, or were randomized controlled trials, or alternate research designs. Another 56 qualitative studies, 29 Prostitutes Kaiyuan that examined male or transgender sex workers, and Prostitutes Kaiyuan that did not provide sufficient descriptions of the sample e.

This resulted in 87 full-text articles that were assessed for eligibility. From these 87, we removed 41 articles that reported behavioral data e. In the Prostitutes Kaiyuan, 37 studies were included Prostitutes Kaiyuan this review. We coded various study characteristics.

HIV/STI risk among venue-based female sex workers across the globe: A look back and the way forward

Prostitutes Kaiyuan The primary aim of this study was to assess the appropriateness of sex work typologies, or Prostitutes Kaiyuan categorization of types of FSWs in understanding HIV risk. A total of 37 studies spanning 2 decades — were included in this review Table 1. Eight Seventeen different countries were represented.

All but two of the studies Minh et al. Nine Various venues and types of FSWs were represented by the studies included in this review. Six Other venues that were examined across the studies included FSWs in hotels, hair salons, and entertainment establishments e. These included older as Prostitutes Kaiyuan as more recent papers i. Of the 37 studies, 14 Eleven Of the other 26 studies that identified different types of Prostitutes Kaiyuan in their study, 17 However, upon close examination of those 26 studies examining differences between venue-based FSWs, only 4 Three of those 4 studies measured client characteristics e.

Finally, of the 14 studies that compared brothel-based FSWs to some other group, 4 In light of the risk environment framework, an important distinction with regards to HIV risk among venue-based FSWs is the location in which FSWs solicit Prostitutes Kaiyuan versus the location in which the sexual transaction takes place.

For example, a sex worker may solicit a client on a street, and she may have sex with him on Prostitutes Kaiyuan street corner or in a motel. These different contexts may have substantially different influences on HIV risk e.

In another example, different levels Prostitutes Kaiyuan risk may result from soliciting and servicing a client in a brothel, compared to soliciting and servicing a client in a bar, where alcohol use may Prostitutes Kaiyuan safer sex negotiation. Of the 37 studies in this review, 16 One notable exception is Buzdugan et al. In doing this they were able to categorize FSWs by both e.

Of the 8 studies published in the last two years, We reviewed the literature on venue-based FSWs and HIV risk to examine the appropriateness of relying solely on categorization of types of FSWs as an independent variable predicting HIV and other sexually transmitted infections.

Comparisons between brothel-based FSWs Prostitutes Kaiyuan other types or venues did not yield consistent results, suggesting that categorizing FSWs by venue or type may not always be meaningful for understanding HIV risk, without also examining contextual factors that might explain venue differences.

The risk environment conceptual framework has been shown to be useful Prostitutes Kaiyuan understanding HIV Prostitutes Kaiyuan among high risk groups, including FSWs. Research that has systematically examined the risk environments of FSWs using quantitative methods has been conducted in Mexico and the Philippines [ 1423 ].

Strathdee and colleagues studied FSWs from Tijuana and Ciudad Juarez, Mexico who injected drugs and found that risk environment factors e. Qualitative research has also been conducted to characterize the risk environments of FSWs in Canada and Serbia [ 28 — 30 ].

In Serbia, Rhodes and colleagues Prostitutes Kaiyuan female and transvestite sex workers and found that the experience of violence from both clients and police was normative and was linked to unprotected sex, suggesting the need for legal protections for sex workers in this country [ 30 ]. For those particularly interested in studying venue-based FSWs, we put forth a conceptual framework for this type of research, Prostitutes Kaiyuan in Figure 2.

The model hypothesizes that HIV risk among FSWs is partly a function of venues or types of sex work, but also proposes that different structural characteristics explain such venue differences in HIV risk.

For example, in one study, brothel-based FSWs in Thailand were shown to Prostitutes Kaiyuan a lower prevalence of HIV than street-based FSWs [ 31 ]; this difference may have been explained by the condom policies instituted in brothels, but this hypothesis was not formally tested.

In another study, brothel-based FSWs in Cambodia had higher HIV prevalence than entertainment venue-based FSWs [ 32 ]; had it been assessed this difference may have Prostitutes Kaiyuan explained by the client-perpetrated violence that may be more likely to occur in the privacy of brothels. As these examples illustrate, risk environment Prostitutes Kaiyuan should be assessed in research on venue-based FSWs.

The Prostitutes Kaiyuan we put forth is akin Prostitutes Kaiyuan predicting a mediated process in which venue-level factors are proposed to account for venue differences in HIV risk. By going beyond categorizing FSWs by venue or type, the assessment of characteristics of the FSW risk environment would provide valuable information for the development of HIV prevention programs targeted for this population.

For example, collective power and community mobilization in India [ 1933 ], community solidarity and safer sex government policy in the Dominican Republic [ 18 ], social cohesion and mutual aid in the community of Rio de Janeiro, Brazil [ 34 ], and both residential Prostitutes Kaiyuan and parenting challenges in Andhra Pradesh, India [ 3536 ] have all been demonstrated as macro-level structural Prostitutes Kaiyuan influencing HIV risk among FSWs.

Proposed conceptual Prostitutes Kaiyuan for HIV prevention research on venue-based female sex workers whereby macro- and micro-level risk environment factors are systematically assessed and hypothesized to explain venue differences in HIV risk. The clandestine and often illegal nature of sex work results in FSWs being a hidden and difficult-to-reach population. Consequently, studies of FSWs must often rely on convenience sampling e.

Prostitutes Kaiyuan from this review suggest that these more advanced sampling methods have been utilized more in recent years.

While efforts should be taken to de-stigmatize sex work, other methods different from convenience sampling may be used, like time-location sampling. Unfortunately, police Prostitutes Kaiyuan and other logistical problems can complicate the ability to select venues at random [ Prostitutes Kaiyuan ]. Altogether, more research is necessary to provide more information and guidance on proper sampling strategies to increase access to FSWs. Overall, results suggest that without more meaningful and rich assessments of risk environments, the use of false dichotomies or categorizations of FSWs may mask associations by grouping together FSWs who have very different risk profiles.

In addition to information gleaned from quantitative methods, more qualitative and mixed method research is required to adequately describe the context of risk environments. The use of both quantitative and qualitative methods would also allow for detection of measurement bias from a given method [ 47 ], and the data gathered from one method may be used to complement and aid interpretation of findings from the other, painting a more comprehensive and rich picture of the risk factors at play.

Understanding the social, physical, economic, and physical factors surrounding and influencing risk behaviors among different FSWs around the world is essential for HIV prevention aims. Ultimately, the conceptual and methodological approach outlined here should aid the development of effective and sustainable tailored HIV prevention interventions targeting FSWs. National Center for Biotechnology InformationU. Author manuscript; available in PMC Prostitutes Kaiyuan 1.

Eileen V. PitpitanPh. KalichmanPh. EatonPh. StrathdeePh. PattersonPh. Seth C. Lisa A. Steffanie A. Thomas L. Author information Copyright and Prostitutes Kaiyuan information Disclaimer. Correspondence regarding this article should be addressed to: Eileen V. Copyright notice. See other articles in PMC that cite the published article. Search Strategy In our review we followed Prostitutes Kaiyuan accepted guidelines outlined by the PRISMA preferred reporting items for systematic reviews Prostitutes Kaiyuan meta-analyses statement [ 26 ].

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Study Characteristics We coded various study characteristics. Overview of Review The primary aim of this study was to assess the appropriateness of sex work typologies, or the categorization of types of FSWs in understanding HIV risk. Indirect i. Indirect e. Other e. Bar vs. Freelance i. Roamers i. Lower- class FSWs i. Street-based vs.

Low- end i. Home vs. Street vs. Phaseures homeless people living and working on the street vs. Other i. Establishment i. Lower risk venues saunas, karaoke, hotels, night clubs Undefined Entertainment vs. Prostitutes Kaiyuan agency vs. Flat vs. Sauna Solicited Assessment of Venue Differences Eleven Solicitation vs. Place of Prostitutes Kaiyuan In light of the risk environment framework, an important distinction with regards to HIV risk among venue-based FSWs is the location in which FSWs solicit clients versus the location in which the sexual transaction takes place.

Figure 2. References 1. Estimates of the number of female sex workers in different Prostitutes Kaiyuan of the world. Sex Transm Prostitutes Kaiyuan. Talbott JR. Rekart ML. Sex-work harm reduction.

The ecology of sex work and drug use Prostitutes Kaiyuan Saratov Oblast, Russia. Sex Transm Dis. Vanwesenbeeck I. Another decade of social scientific work on sex work: a review of research — Annu Rev Sex Res.

Violence by clients towards female prostitutes in different work settings: questionnaire survey.

HIV/STI risk among venue-based female sex workers across the globe: A look back and the way forward

Correlates of partner violence among female street-based sex workers: substance abuse, history of childhood abuse, and HIV risks.

Scambler G, Paoli F. Soc Sci Med. Occupational stigma as a primary barrier Prostitutes Kaiyuan health care for street-based sex Prostitutes Kaiyuan in Canada. Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis. Health Psychology.

Female sex workers (FSWs) continue to represent a high-risk population in need (), Kaiyuan City, China, FSWs in Kaiyuan City, Higher risk venues. Keywords: HIV, STI, IDU, female sex workers, male clients, prevalence, drug use, China The study was conducted in Kaiyuan, a city of about ,

Social and structural factors associated with HIV infection among female sex workers who inject drugs Prostitutes Kaiyuan the Prostitutes Kaiyuan border region. An example of research that uses quantitative methods to examine HIV risk factors exogenous to the individual among female sex workers using the risk environment framework.

Promoting HIV testing and condom use among Filipina commercial sex workers: findings from a quasi-experimental intervention study. AIDS Behav. Social influence Prostitutes Kaiyuan individual risk factors of HIV unsafe sex among female entertainment workers in China.

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HIV/STI risk among venue-based female sex workers across the globe: A look back and the way forward

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HIV/STI risk among venue-based female sex workers across the globe: A look back and the way forward

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