A study of HIV/AIDS related knowledge, attitude and behaviors among female sex workers in Shanghai China

Abstract

BackgroundChina is currently facing a rapid and widespread increase in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The activities of female sex workers (FSWs) have contributed to the mounting epidemic of HIV/AIDS and other sexually transmitted diseases (STDs). Therefore, this study aimed to assess the HIV/AIDS-related knowledge, attitude and risk behaviors among FSWs operating in Shanghai China.MethodsA cross-sectional study was conducted in five districts of Shanghai, including three suburbs and two downtown locales. We adopted a cluster randomized sampling method to obtain ten geographic sites which consisted of one or more communities/villages proximal to a location where FSWs were accessible. A total of 324 FSWs from 109 Xitou Fang, massage parlors and hair salons who explicitly provided sexual services were enrolled in the study. Each participant completed a questionnaire survey and interview aimed to collect information on the individual's knowledge, attitude, and behaviors associated with risk for HIV/AIDs.ResultsThe overall correct answer rate of HIV/AIDS-related knowledge was 60.8%, and the knowledge of FSWs from downtown areas was significantly higher than those from suburban areas (P < 0.05). The percentage of FSWs who reported having experiences in commercial sexual services without the use of condoms was 33.6%. Condom slippage or breakage was reported as having occurred at least once by 51.2% of the FSWs. FSWs from suburban areas were found to more often engage in high-risk behaviors, including oral and anal sex, than those from downtown areas (P < 0.001). Many of the FSWs (65.7%) reported having non-client sexual partners (most were identified as boyfriends or husbands); however, condom usage with these partners were lower (34.3%).ConclusionsBased on the findings from our survey, we advise that promotion of HIV/AIDS-related knowledge be targeted towards FSWs in Shanghai, especially those operating in the suburbs. HIV prevention efforts, such as urging constant condom usage with both clients and steady partners, should be sustained and reinforced among the female sex workers population.

Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China

“…Also, the majority (67.3%) had no more than 9 years of formal schooling. These data were consistent with Cai and colleagues’ (2010) study, which stated that FSWs in China were young women who migrated from poor rural areas to urban cities with limited education. In addition, China’s urbanization has accelerated with a very fast pace due to the economic reform, and more than half of the population became urban dwellers for the first time in 2011 (Liang, Lu, & Wu, 2014).…”

“…Therefore, FSWs were considered as bridging groups and drivers of the epidemic (China Ministry of Health, 2012). Previous research has demonstrated a pervasive lack of awareness and knowledge of HIV/AIDS among FSWs in China because most of them are young women who migrated from poor rural areas to urban cities with limited education (Cai et al, 2010). In addition, inconsistent condom use is very common during commercial sex among Chinese FSWs (Gu et al, 2008).…”

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

“…In 1949 when the Communist Party took over China, sex work was banned and reportedly eliminated (Boittin, 2013). During the 1980s, China's open door policy and economic reforms have been attributed to a remarkable resurgence in commercial sex (Cai et al, 2010). Most Chinese FSWs are rural-to-urban migrants (Kaufman, 2011).…”

Social, psychological, and environmental-structural factors determine consistent condom use among rural-to-urban migrant female sex workers in Shanghai China

“…By conducting a detailed review of the literature and performing a small scale pre-survey with a limited portion of the FSWs of the itinerant population in Shanghai, we found that risky behaviors, such as unprotected sexual intercourse, were practiced by 34%-40% of FSWs [17]. By taking a cross-sectional sample size estimation approach, the error was calculated as follows: ϵ  = 0.15 P ; P = 37%; Q = 1-P =63%; and α  = 0.05 Z α  = 1.96.…”