HIV Risk Behaviors Among Three Classes of Female Sex Workers in Vietnam

Increases in the rate of HIV infection in Vietnam among female sex workers and their clients require more effective preventive interventions based on a better understanding of this population and important subgroups within it. Because little was known about women in the hospitality sex industry, this study compared demographic and work characteristics, history of sexually transmitted infections (STIs), and condom use among a sample of 310 female sex workers in low-, middle-, and high-class hospitality businesses in Ho Chi Minh City (mean age = 26.77 years, SD = 6.17). Data were collected through individual, face-to-face, semistructured interviews. Logistic regression models were used to identify demographic predictors of the incidence of STIs and reported condom use. Low occupational status was most strongly associated with a history of STIs, and use of condoms with new and regular clients also differed by occupational class. Implications are discussed.     

Opportunities for woman-initiated HIV prevention methods among female sex workers in southern China

Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women's knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China.     

HIV Infections Among Older Male Clients of Low-Cost Commercial Sex Venues in Southern China

This study aimed to identify the association of unsafe sex behaviors with HIV infection among the male clients who purchase commercial sex in low-cost sex venues. A cross-sectional study was conduct in a southern province of China among male, low-cost commercial sex clients, who were over 50 years old. Participants were interviewed using a structured questionnaire and had completed HIV testing. Among the 3,485 participants, the prevalence of HIV was 2.96% (95% confidence interval: 2.40–3.52%). The associated risk factors studied for HIV infection included (1) not currently married; (2) use of counterfeit TCMs with sildenafil; (3) noncondom use during commercial purchased sex; and (4) recent engagement of commercial sex within past week. Given the high prevalence of HIV infection among the study group, more political policy intervention and health education should be considered for the identified subpopulation (over 50-year-old men in low-cost commercial venues, counterfeit TCMs with sildenafil and noncondom use).     

Group Work Practice with Transgendered Male to Female Sex Workers

Abstract

Group work is frequently the method of choice for working with adolescents. This paper focuses on group work with transgend-ered youth who engage in sex work. Utilizing case examples, this paper provides an overview of the role that sex work plays in the lives of some transgendered youth and offers guidance for those interested in utilizing group work approaches with transgendered adolescents.     

Sexual Behavior With Noncommercial Partners: A Concurrent Partnership Study Among Middle-Aged Female Sex Workers in China

Female sex workers (FSWs) often engage in concurrent partnerships, meaning they have multiple sexual relationships at the same time. The objective of this study was to investigate sexual concurrency and its associations with condom use and syphilitic infections among FSWs over age 35. Respondent-driven sampling was used to recruit 1,245 FSWs in Nanning, Hefei, and Qingdao, China. FSWs were asked to report whether they had concurrent partners in the past six months. Concurrency was defined as engagement in sex with commercial clients and (1) husbands and boyfriends (n = 167); (2) husbands only (n = 301); or (3) boyfriends only (n = 469). FSWs with only commercial clients were used as the comparison group (n = 308). Across all groups, the percentage of FSWs with prevalent and active syphilis ranged from 19.6% to 25.6% and 9.1% to 11.5%, respectively. Condom use was low with noncommercial sexual partners and was more likely to be used when FSWs’ boyfriends had other partners. Three components of the theory of planned behavior were significantly associated with consistent condom use. Concurrent relationships may lead to increased transmission of syphilis at the workplace and family levels. Effective interventions should target concurrency with both commercial and noncommercial partners.     

Predicting the Job Satisfaction of Female Sex Workers in Queensland,Australia

ABSTRACT. This study used a cross-sectional survey to examine job satisfaction and its correlates among 247 female sex workers working as private service providers, in licensed brothels, and in illegal sectors of the industry (mainly street-based workers). Overall, most sex workers reported positive job satisfaction. Satisfaction was higher in women working legally and was comparable with women from the general population. Multivariate analyses revealed that job satisfaction was significantly linked to women's reasons for initially entering the industry. Sex workers’ age, education, marital status, length of time in the industry, and current working conditions were apparently less important for satisfaction.     

Female Sex Trade Workers,Condoms, and the Public-Private Divide

Abstract

This qualitative study explored the ways in which social relations within the public (work) as opposed to the private (home) contexts shape variable condom use among female sex trade workers. Semi-structured interviews were conducted with 68 female sex workers working in various settings in an urban center in Eastern Canada. The findings suggest that work-related social relations, and the meanings associated with condoms at work, create a strong confidence in condom use. Within the private setting, such confidence was also evident but most women reported either not using condoms or only using “sometimes.” Nevertheless, many women do engage in risk management within the private setting, and take active steps to decrease their risks of Human Immunodeficiency Syndrome (HIV)/Sexually Transmitted Infections (STIs).     

Female Tourists, Casual Sex, and HIV Risk in Costa Rica

This paper describes the involvement of young female tourists who visit rural Costa Rica with gringueros (i.e., local men who actively seek relationships with foreign women), and explores the implications of these relations, which gringueros see as outlets for sexual adventure, for sexual behaviors that could contribute to the spread of HIV/AIDS. The findings highlight the need to use tourism-related locales to implement HIV/AIDS awareness strategies targeted at women tourists, gringueros, and other local youth.

Sexual Identity Disclosure and Awareness of HIV Prevention Methods Among Black Men Who Have Sex With Men

Black men who have sex with men (BMSM) are disproportionately affected by the human immunodeficiency virus (HIV) epidemic, yet we know little about how HIV-negative BMSM of different sexual orientations access HIV prevention strategies. Identity development, minority stress, and disclosure theories suggest that for people of different sexual orientations, disclosure of sexual identity may be related to health behaviors. We performed a latent class analysis on a sample of 650 BMSM (M_age = 33.78, SD = 11.44) from Atlanta, Georgia, to explore whether sexual orientation, disclosure of sexual identity, and relationship status were related to HIV prevention strategies, including awareness of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) and frequency of HIV testing. We found three distinct BMSM classes referred to as (1) closeted bisexuals, (2) sexual identity managers, and (3) gay, out, and open; all classes primarily engaged in casual sex. Classes differed in their awareness and access to HIV prevention strategies. The closeted bisexual class was least aware of and least likely to access HIV prevention. Findings have important implications for future research, namely the consideration of sexual identity and disclosure among BMSM. With this knowledge, we may be able to engage BMSM in HIV/sexually transmitted infection (STI) prevention services.     

Risk and Protective Factors Associated with Personal Mastery Among Sexual Minority African-American Female Sex Workers

Research among sexual minorities has traditionally examined problems such as substance use, HIV risk, mental health problems, and victimization. Among sexual minority street-based female sex workers, these vulnerabilities can be magnified. Grounded in theories of resilience, this study examines risk and protective factors associated with a high level of personal mastery among a vulnerable population of women. Data are drawn from baseline interviews from street-based African-American female sex workers enrolled in a randomized intervention trial in Miami, Florida. We compare sexual minority (N = 197) and heterosexual (N = 365) women on measures of risk and protective factors; among sexual minority women we present logistic regression analyses which reveal that severe mental distress and HIV transmission risk are associated with low levels of personal mastery, while protective factors of transportation access and social support are associated with high levels of personal mastery. These findings suggest that these protective factors may potentially facilitate the development of personal mastery and represent beneficial avenues for intervention efforts.     

Family Network,Workplace Network,and Their Influence on Condom Use: A Qualitative Study Among Older Female Sex Workers in China

The objective of this study was to qualitatively explore the components of social networks and their influence on condom use among female sex workers (FSWs) aged 35 years and older in China. In-depth interviews with 63 older FSWs and 6 focus group interviews with pimps and owners of roadside salons and hotels were conducted in 3 Chinese cities. The mean age of participants was 42.6 years old (SD = 6.9 years) and the mean age of starting sex work was 38.6 years old (SD = 6.6 years). Two types of networks that influenced condom use were identified: family networks (relationship with children and husbands) and workplace networks (relationship with peers, clients, pimps, and owners). Relationships between older FSWs and their children negatively influenced condom use. Low levels of network support and norms regarding condom use were observed in the relationship between older FSWs and their clients, whereas positive social support and norms were prevalent among older FSWs who had frequent contact with peers. Norms for condom use existed among pimps and owners but were counterbalanced by monetary gains. Future human immunodeficiency virus (HIV) interventions for older FSWs should take the different features of social network components into consideration.     

Economic Opportunities and the Division of Labor among Japanese Immigrant Couples in Southern California*

Based on 36 in‐depth interviews conducted with 18 Japanese couples who live in Southern California, this study examines the impact of differential economic opportunities on the division of labor among Japanese immigrant couples. Three main factors facilitate Japanese professional and businessmen’s mobility to and settlement in Southern California: (1) the gender‐based stratification of the workplace in Japan; (2) U.S. immigration policies that favor foreign nationals with strong corporate ties and business experience; and (3) the strong presence of Japanese corporations in Southern California. Whereas these conditions enable men to maintain their earning power, they do not benefit women in employment opportunities. The difference in economic opportunities encourages Japanese couples to preserve a breadwinner and homemaker division of labor, and women continue to do a bulk of housework and childcare even when women reenter the labor force later in their lives.     

Young Clients of Hotel-Based Sex Workers in Bangladesh: Vulnerability to HIV,Risk Perceptions,and Expressed Needs for Interventions

ABSTRACT

A qualitative study was conducted among key informants and 53 young clients (15 to 24 years of age) of commercial sex workers from nine hotels in Dhaka, Bangladesh. Respondents reported first sexual encounter before 18 years of age, and reasons for purchasing sex were to prove masculinity or to reduce wet dreams and masturbation, thought to be detrimental to health. Limited knowledge of HIV and sexually transmitted infections was linked to high-risk sexual practices. Condom use was related to perceptions of cleanliness, status, and trust in the sex worker.

A hotel-based, confidential intervention program promoting safe sex practices among clients of sex workers is warranted.     

Hypersexual Behavior and HIV Sex Risk among Young Gay and Bisexual Men

Hypersexual behavior has been identified as a sexual risk correlate among gay and bisexual men (GBM). The Hypersexual Behavior Inventory (HBI) has been shown to be a reliable and valid measure of hypersexual behavior in clinical populations, yet it has not been used to assess hypersexual behavior in nonclinical samples. We examined the psychometric properties of the HBI with survey data recorded between December 2009 and March 2010 in a sample of young men (N = 366, M = 21.46 years old, SD = 1.95) who self-identified as gay (89%) or bisexual (11%) and assessed its association with unprotected receptive anal intercourse (URAI) partners and occasions. Using cross-sectional data of single, sexually active young GBM (YGBM), we used confirmatory factor analyses to test the HBI's three-factor structure. Using negative binomial regressions, we then tested the association between the HBI subscales and sexual risk. After accounting for covariates, we found that sexual control was a risk factor for URAI partners and occasions, and coping was found to be a protective factor for URAI occasions. In light of our findings, we discuss the importance of reexamining the theoretical assumptions of hypersexual behavior and propose HIV prevention strategies that may reduce young GBM's vulnerability to HIV infection.     

HIV Voluntary Testing among Portuguese Women Attending Family Planning Clinics: Implications for HIV Prevention Education and Testing

ABSTRACT

Objectives: The aim of this article is to analyze the factors associated with HIV testing among 767 sexually active women. Methods: Participants were administered several self-report questionnaires that assessed behavioral and psychosocial measures. Results: Overall, 59.8% of the participants reported ever having tested for HIV. Results show that higher levels of education, being pregnant or having been pregnant, concern about AIDS, AIDS knowledge, self-efficacy in condom negotiation and perception of no risk in partner significantly predicted the likelihood of testing among women. Attending the mass was negatively associated with HIV testing. Conclusions: These findings provide information that can be used in the development of a focused gender sensitive HIV prevention program to increase HIV testing.     

Policing Chinese Migrant Sex Workers in Hong Kong

This article examines the nature of control of Chinese unwanted migrants. In contrast to much existing research work on the patterns and control of Chinese unauthorised migration to the West, the focus here is on the regulation of immigration violators who routinely move back and forth across the border between the People's Republic of China and the Special Administrative Region of Hong Kong. Through an examination of official statistics, relevant documents and pilot interviews with police officers, immigration officials and prison officers, this article aims to provide some critical insights into the operationalization of the migratory control regime in Hong Kong. In particular, the use of police crackdowns and imprisonment as a migration management instrument raises important questions about their efficacy and the differential impact on particular social groups, especially for women who overstay and are ostensibly engaged in migratory sexual labour.     

Migrant Workers and HIV Vulnerability in Korea

Despite a rapid increase of both migrant workers and incidence of HIV infection in Korea, little is known about the relation between the two. This paper examines the vulnerability to HIV infection of migrant workers in Korea, highlighting socio-cultural, political and economic contexts. Major information sources include articles, government reports, archives in migrant-support and AIDS-prevention organizations and in-depth interviews with government officials, NGO representatives and migrant workers. The study reveals migrant workers in Korea face an environment of discrimination and isolation because of their status as foreigners from less developed countries and with jobs characterised by low pay and status. Encountering stress and loneliness and without family support, migrant workers – especially single males, those undocumented and females in the sex industry – engage in risky sexual behaviours such as commercial and casual sex, leaving them vulnerable to HIV infection. Little knowledge of STD/HIV, few STD/HIV prevention programs and easy access to commercial sex compound migrant workers' vulnerability to HIV infection. The situation is worsening and current government policy, including lack of education, largely contributes to the problem.     

Challenges and Opportunities for Research on Same‐Sex Relationships

Research on same‐sex relationships has informed policy debates and legal decisions that greatly affect American families, yet the data and methods available to scholars studying same‐sex relationships have been limited. In this article the authors review current approaches to studying same‐sex relationships and significant challenges for this research. After exploring how researchers have dealt with these challenges in prior studies, the authors discuss promising strategies and methods to advance future research on same‐sex relationships, with particular attention given to gendered contexts and dyadic research designs, quasi‐experimental designs, and a relationship biography approach. Innovation and advances in the study of same‐sex relationships will further theoretical and empirical knowledge in family studies more broadly and increase understanding of different‐sex as well as same‐sex relationships.