Condom Use in Commercial Sex Workers and Clients Among Incarcerated Sexworkers and STD Clinic Attendees in Jinan, Shandong Province

Background: Commercial sex workers and clientsare important core populations in the transmission ofsexually transmitted diseases (STDs) and human im-munodeficiency virus (HIV) infection. Research on thefrequency and determinants of condom use in com-mercial sex workers and their clients is important inincreasing condom use and reduction of the STD/HIV.Burden. Objectives: To establish the frequency of and fac-tors related to intention to use condoms and actualcondom use in commercial sex contacts and to deter-mine the differences in condom use between sex work-ers and clients.Methods: Incarcerated commercial sex workers(ICSW) and male STD clinic attendees were recruitedinto a cross-sectional study to obtain data on the fre-quency and factors associated with intention to usecondoms and condom use in commercial sexual con-tacts with an interviewer-administered questionnaire.Consistent condom use in ICSWs and never usingcondoms in male STD clinic attendees were analyzedusing univariate and multivariate logistic regressionmodels. Results: The frequency of reported consistent in-tention to use condoms and reported actual condomuse was 62% and 50.6%, respectively among 158ICSWs. For male STD clinic attendees, the propor-tion of reported consistent intention to use condomsand reported actual condom use was 10% and 20.7%,respectively. The factors positively influencing theconsistent intention to use condoms were pregnancypreventing measures and the belief of condom efficacyin the prevention of STD/HIV, whereas the factor as-sociated with actually consistent condom use was preg-nancy-preventing measure in ICSWs. Factors associ-ated with no intention to use condoms were low income,low STD/HIV knowledge level and the frequency ofvisiting CSW. The latter factor was also associatedwith never using condoms in male STD clinicattendees. Conclusions: Consistent condom use during com-mercial sex contacts was low, especially in clients.Greater effort is needed in condom promotion programin order to raise the level of condom use in commer-cial sex contacts.

Differences of HIV/AIDS Related Knowledge,Attitudes and Practices Between Commercial Sex Workers and Their Clients

Objective: To compare the HIV/AIDS related knowledge,attitudes and pratices (KAP) among the commercial sex workers (CSWs) with that of their clients in Shenzhen. Methods: A total of 124 female CSWs and 155 men,detained for selling or purchasing sexual services, were interviewed using a structured questionnaire. Results: CSWs scored higher than their clients on AIDS/HIV knowledge scores, though the difference was not significant and both groups only scored near 50%. ""Almost always""condom use rates were significantly higher for CSWs. Most of the women but fewer men knew condom use could prevent HIV/AIDS infection. The main reason for not using condoms among the women was the unwillingness of their customers. A higher proportion of the CSWs (9.7%) than men (2.6%) had ever used illegal drugs. The mean age of first sexual intercourse (18.2±2.1) and first commercial sex (20.2±3.9)among the CSWs were lower than that of the men (22.2±0.3and 27.1 ± 0.6, respectively). Conclusion: New health education programs promoting condom use should be developed to raise awareness about HIV/AIDS, particularly among men. CSWs and clients are high-risk groups for HIV/AIDS infection and transmission.

HIV/AIDs Risk Perception and Sexual Behavior among Commercial Female Sex Worker in Thailand

Background: Commercial female sex workers (CFSWs) are considered a high-risk group for HIV/AIDs. The prevalence of HIV/AIDs trends to increase among those groups also in Thailand. An adequate perception of the degree to which one is at risk of having HIV is necessary for behavioral change and of safe behaviors. HIV/AIDs risk perception among CFSWs was needed to reduce HIV/AIDs infection. Methods: A cross-sectional study was conducted among 141 CFSWs in Bangkok, Thailand. Participants were selected using convenient and purposive sampling methods for January to October 2019. Self-access questionnaire was used for collecting data with the reliability testing of 0.82. Logistic regression employed to identify adjusted odd ratio between demographic data, sexual behaviors and HIV/AIDs risk perception, p-value less than 0.05 was considered statistically significant. Results: 51.77% of CFSWs perceived themselves at high risk for HIV/AIDs infection. Most CFSWs reported that they did not consistently use condom (57.45%), factors associated with perception risk of HIV/AIDs including education level (adjusted OR = 2.23, 95% CI = 1.07 - 4.54), knowledge of HIV and STDs (adjusted OR = 3.65 and 3.22. 95% CI = 1.89 - 3.91), Condom use (adjusted OR = 2.56, 95% CI = 1.05 - 2.90) years engaged in sex work, age of initiating in sex work, frequency of sex work in the last month and unplanned sex work were significant with risk perception of HIV/AIDs (adjusted OR = 3.33, 2.71, 2.67, 2.56 and 95% CI = 1.99 - 3.84, 1.72 - 3.32, 1.29 - 3.12, 1.05 - 2.78 respectively), and had HIV/STDs test (adjusted OR = 3.22, 95% CI = 2.11 - 3.95). Other used illicit drugs by injection, smoking and alcohol consumption had a strong association with the high perception of HIV/AIDs among CFSWs. Conclusion: Majority of CFSWs with risky sexual behaviors had a high HIV/AIDs risk perception. Effective educational programmes are necessary to enable CFSWs to correctly assess their own HIV/AIDs risk and change risk behaviors based on self-assessment of actual risk.