Associations between drug use and risk behaviours for HIV and sexually transmitted infections among female sex workers in Yunnan, China

Abstract

This is a cross-sectional study of 399 subjects conducted to explore the association between drug use and risk behaviour for HIV and sexually transmitted infections (STIs) among female sex workers (FSWs), and also to study the prevalence of HIV/STIs among drug-using FSWs (DUFSWs) and non-DUFSWs in Yunnan province of China. Demographic information, mobility, sexual and drug-using behaviours were collected and subjects were tested for HIV/STIs. Mean age was 27 years (SD = ±7.8) and 94 (23.6%) tested positive for recent opiate use. Compared with non-DUFSWs, DUFSWs had a significantly higher prevalence of HIV (38% versus 4%, P ≤ 0.001), herpes simplex virus type 2 (HSV-2; 92% versus 60%, P ≤ 0.001) and STIs (95.7% versus 69.2%, P ≤ 0.001). DUFSWs had a significantly longer duration of commercial sex work compared with non-DUFSWs (median 5 versus 1 years, P ≤ 0.001), and had at least two clients in the last working day. DUFSWs were also more likely to work in low-end commercial sex venues and frequented a greater number of work locations than non-DUFSWs. Compared with non-DUFSWs, DUFSWs were more likely to exhibit riskier sexual behaviours and greater workplace mobility. Interventions targeting drug-related behavioural changes are needed urgently in this population in order to reduce rates of HIV and STIs.

A systematic review and meta-analysis of the prevalence, trends, and geographical distribution of HIV among Chinese female sex workers (2000–2011): implications for preventing sexually transmitted HIV

“…The frequency and intensity of drug use are associated with engagement in commercial sex, mostly due to addiction-related financial needs. 60 Drug-using FSWs are more likely to work in low-end sex venues, serve more clients, have a longer history of commercial sex work, and demonstrate riskier sexual behaviours. 15,23,60 A high proportion of FSWs have sexual partners who use drugs.…”

“…60 Drug-using FSWs are more likely to work in low-end sex venues, serve more clients, have a longer history of commercial sex work, and demonstrate riskier sexual behaviours. 15,23,60 A high proportion of FSWs have sexual partners who use drugs. 23 STIs are reportedly common in FSWs who use drugs and may facilitate the transmission of HIV.…”

HIV-related behavioral risk factors among older female sex workers in Guangxi, China

“…Therefore, high prevalence of HIV infection among FSW coupled with prevailing commercial sex transactions fuels a rapid increase of the heterosexual transmission of HIV in China (Chen, Peeling, Yin, & Mabey, 2011; Cohen, Ping, Fox, & Henderson, 2000). Existing studies have documented unprotected sex (Zhang, Li, Hong, Zhou, et al, 2012), injection drug use (Yao et al, 2012), partner violence (Zhang, Li, Hong, Chen, et al, 2012), infections of other STD (Parish et al, 2003), and no HIV testing (Hong et al, 2012) as risk factors for HIV infection and transmission among this at-risk population.…”

Understanding Sociocultural Factors Contributing to HIV Risk Among Ayoreo Bolivian Sex Workers

“…Other studies have shown that drug-using sex workers were about half as likely to use condoms as those who did not use drugs (MAP, 2005). Strong relationships between sex work and drug abuse have been found, with an increased risk of contracting HIV and other STIs (Yao et al, 2012), and even with being victims of sexual and physical abuse (Ulibarri, Strathdee &, Patterson, 2010). There is a need to put culturally-appropriate interventions in place, which take advantage of the existing health-related resources and infrastructures.…”