The prevalence and correlates of oral sex among low-tier female sex workers in Zhejiang province, China

Abstract

Objectives Oral sex and its associated factors among low-tier female sex workers (FSWs) have not been documented in the Chinese literature. Here, we report this perspective in this group. Methods The data were derived from a large cross-sectional study conducted among low-tier FSWs using a structured questionnaire in 21 counties in Zhejiang province, China. The prevalence of oral sex and its associated factors among 2645 low-tier FSWs were analyzed using bivariate and multivariate analysis. Results Of all participants, 579 (21.9%) had performed oral sex with clients over the previous month. Multivariate analysis revealed that oral sex is related to being unmarried, low income, early initiation of commercial sex, having conducted commercial sex in more counties, longer duration of commercial sex, larger number of clients, ever having engaged in anal sex, less use of condoms and oral contraceptives during the previous month, low rate of adoption for contraception at the present time, and STI-related symptoms during the previous half year. Conclusion Oral sex practitioners among low-tier FSWs in China are at a higher risk of STI, HIV, and unwanted pregnancy compared to those who did not engage in oral sex. Behavioral interventions carried out among low-tier FSWs should specifically target low-tier FSWs who practice oral sex, should carefully take into account the characteristics of these FSWs, provide risk awareness education and training for condom use negotiation, and promote the availability of condom and reproductive health care, timely diagnosis, and treatment of STIs.

Social and structural determinants associated with the prevalence of sexually transmitted infections among female commercial sex workers in Dhaka City, Bangladesh

“…Young (<30 years) sex worker was 43%-72% less likely to be afflicted with STIs (P = .031) than aged one, which may be due to unprotected sex by older FCSWs or protected encounters by younger [ 17 , 20 , 47 ]. However, risky sex by under-aged/unmarried FCSWs is also reported [ 12 , 48 ]. Years in the sex trade, a micro-physical factor positively associated with STIs (P<0.001) is also reflected in other studies [ 20 , 49 ], while dissonance exists [ 16 ].…”

“…Despite consistent condom use being the only effective strategy in preventing STI/HIV [ 6 , 14 , 39 , 47 ], the highest reported condom use by FCSWs was with new/one-time clients, and the lowest use with non-commercial/intimate sex partners [ 31 , 40 , 49 ]. Sex workers poorly understand the mechanism behind ‘consistent condom use’ and lack perceived knowledge [ 28 , 48 ]. Interviewing and analyzing the data of this study regarding consistent condom use/CCU, the authors noticed that the ’perception of consistent condom use’ was very poorly understood by the FCSWs of this study (69.4% of them had no schooling).…”

“…‘Commercial sex’ performed on roads/parks/shrines/markets had a 2.6-times probability of being infected with STIs than in hotels (P = 0.030). It might be the lower hierarchal status of on-street FCSWs reported worldwide [ 2 , 4 , 5 , 9 , 16 , 19 , 20 , 47 , 48 ]. On-street or floating FCSWs are reported to have a lower price per sexual encounter [ 2 , 4 , 16 , 48 ], have longer exposure times, use condoms inconsistently, exhibit riskier sexual behaviors [ 33 , 48 ], and may face more violence/abuse for being illiterate and destitute [ 15 , 16 , 42 , 47 , 48 ].…”

Understanding Women’s Knowledge, Awareness, and Perceptions of STIs/STDs in Asia: A Scoping Review

“…Migrant workers [50] Transgender [39,[54][55][56][57] FSW */inmates [42,47,52,[58][59][60][61][62][63] Homeless community [36] Women [64] Multiple sex partners Transgender [39,44,57] FSW * [42,59,65] Married community [66] Women [67,68] Social Fear of rejection, discrimination, and stigmatization FSW * [58] Migrant workers [50] Lacking awareness and knowledge Transgender [22,39] FSW * [52,60,69] Adolescents [24] Married community [24,37] Homeless community [36] Women (married/pregnant) [25,[27][28][29]67] Personal Personality behaviour: impulsivity FSW */inmates [6,51] Occupation-related risk FSW * [48,52,70,…”