A Comparative Study of Condom Use and Self-Reported Sexually Transmitted Infections Between Foreign Asian and Local Clients of Sex Workers in Singapore

Wong, Mee Lian; Chan, Roy; Koh, David; Barrett, Mark; Chew, Suok Kai; Wee, Sharon

doi:10.1097/01.olq.0000168279.05452.ad

Cited by 15 publications

(10 citation statements)

References 34 publications

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“…Further qualitative inquiry might capture other nuances of condom negotiation beyond what the FSW might do if a venue patron refused to use condoms. For example, in Singapore, FSWs initiated condom use, but highly educated clients were more difficult to persuade to use condoms than lower educated clients [2]. Familiarity with clients also posed barriers to condom negotiation in another FSW study conducted in China [48].…”

Section: Discussionmentioning

confidence: 99%

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

et al. 2012

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BackgroundSocial and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.MethodsFemale bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues.ResultsOf 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment - trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34–49.90), economic environment - sex without a condom to make more money (AOR = 1.52, 95% CI 1.01–2.30), policy environment - sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49–4.48), and individual risk - substance use (AOR = 2.36, 95% CI = 1.28–4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons.ConclusionsFactors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability.

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Section: Discussionmentioning

confidence: 99%

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

et al. 2012

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“…22 Earlier studies showed that some of these women engaged in selling sex. 23,24 In Singapore, FSWs exist in many forms. They either work from the streets, entertainment establishments, or registered brothels.…”

Section: Introductionmentioning

confidence: 99%

Sex Work and Risky Sexual Behaviors among Foreign Entertainment Workers in Urban Singapore: Findings from Mystery Client Survey

et al. 2012

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Globalization has led to a rapid influx of female workers from Asian countries with high prevalence of HIV to Singapore, with many entering the entertainment industry. We assessed the prevalence of sexual services, condom use, and self-initiated screening for sexually transmitted infections (STIs) and associated variables among foreign female entertainment workers in Singapore. A cross-sectional survey of 317 female entertainment workers, using mystery clients, was conducted on a two-stage proportional cluster sample of 93 entertainment establishments stratified by geographical zone in Singapore. We found a high prevalence (71 %) of sexual services in entertainment establishments with 53 % of the female entertainment workers reporting selling sex. Consistent condom use for sex with paying clients in a usual week in the past 3 months was low, ranging from 37.9 % for oral sex, 46.9 % for anal sex, to 51.9 % for vaginal sex. On multivariate logistic regression, consistent condom use for vaginal sex with clients showed a significant independent association with the entertainment worker's behavior of asking clients to use condoms and a borderline association with entertainment worker being a Chinese national. Less than half (48.9 %) of the sex workers had ever been screened for STIs either locally or in their home country. The only independent factor significantly associated with STI screening was having to support one's family. In summary, a high percentage of foreign female entertainment workers in Singapore reported selling sex. Condom use and STI screening were low among them. Access to STI screening, treatment, and education services should be enhanced for foreign female entertainment workers in Singapore.

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“…(7) If they are casual workers, the issues may be compounded by the limited access to screening provided for licensed workers, who may travel without the disease being detected. (8) To minimise the spread of the disease within Singapore and around the region, (9) it is critical that appropriate information reaches these women and that they have access to subsidised testing and resources for safe sex.…”

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confidence: 99%

Zika in Singapore: insights from One Health and social medicine

Lysaght

Lee

Watson

et al. 2016

smedj

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A Comparative Study of Condom Use and Self-Reported Sexually Transmitted Infections Between Foreign Asian and Local Clients of Sex Workers in Singapore

Abstract: There is a need to design separate condom-promotion programs for foreign Asian and local clients of sex workers in Singapore.

Cited by 15 publications

References 34 publications

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

Sex Work and Risky Sexual Behaviors among Foreign Entertainment Workers in Urban Singapore: Findings from Mystery Client Survey

Zika in Singapore: insights from One Health and social medicine

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