title: A profile of HIV risk factors in the context of sex work environments among migrant female sex workers in Beijing, China.
abstract: Migrant female sex workers (FSWs) are one of the most at-risk populations for HIV in China. This study demonstrates how multiple risk factors are situated and vary by types of sex work environments in a sample of 348 migrant FSWs in Beijing. Participants reported high rates of clients' refusal to use condoms (76%), unsafe sex with both clients (32%), non-paid regular partners (e.g. boyfriend or husband) (76%), and a sexually transmitted infection symptom (79%) last year. Only 22% of FSWs had been tested for HIV. Risk factors were compared by three types of sex work environments: (1) entertainment establishments, (2) personal services sectors, and (3) street-based venues, including roadside brothels. Street-based FSWs, compared to the other FSWs, were more likely to be older, married with children, migrate from rural areas, and be arrested by police, and less likely to be educated, have contact with prevention services, be knowledgeable about HIV, and be tested for HIV. The FSWs in entertainment establishments were more likely than street-based FSWs to have reported being physically, verbally, and/or sexually abused by clients. Multiple discriminant analysis distinguished a profile of two different groups of risk factors: (1) police arrest, lack of protection from violence, access to prevention and health care, and HIV knowledge, and (2) verbal and physical abuse and clients' refusal of condom use. In the massive internal migration in China, disadvantages in economic sectors drive women to become involved in sex work. HIV prevention strategies must target socio-structural factors embedded in sex work environments.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA. hy2227@columbia.ed
authors.forename: Huso
authors.initials: H
authors.lastname: Yi
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mantell
authors.forename: Rongrong
authors.initials: R
authors.lastname: Wu
authors.forename: Zhao
authors.initials: Z
authors.lastname: Lu
authors.forename: Jing
authors.initials: J
authors.lastname: Zeng
authors.forename: Yanhai
authors.initials: Y
authors.lastname: Wan
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D002681:China; D017280:Condoms; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D012307:Risk Factors; D011477:Sex Work / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D012931:Social Environment; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000523:psychology* / Q000706:statistics & numerical data*; D047568:Unsafe Sex / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
references.citation: AIDS Care. 2009 Feb;21(2):212-20
references.pmid: 19229691
references.citation: AIDS Care. 2007 Feb;19(2):282-8
references.pmid: 17364411
references.citation: Sex Transm Infect. 2009 Aug;85(4):290-5
references.pmid: 19158150
references.citation: Stud Fam Plann. 2006 Dec;37(4):241-50
references.pmid: 17209282
references.citation: AIDS. 2003 Feb 14;17(3):415-23
references.pmid: 12556696
references.citation: Sex Transm Dis. 2007 Sep;34(9):695-703
references.pmid: 17507838
references.citation: Soc Sci Med. 2009 Feb;68(3):473-8
references.pmid: 19026478
references.citation: AIDS Care. 1998 Apr;10(2):213-20
references.pmid: 9625904
references.citation: Int J Drug Policy. 2008 Apr;19(2):140-7
references.pmid: 18207725
references.citation: BMJ. 2008 Jul 30;337:a811
references.pmid: 18667468
references.citation: Sex Transm Dis. 2000 Mar;27(3):138-42
references.pmid: 10726645
references.citation: Am J Public Health. 2009 Apr;99(4):659-65
references.pmid: 19197086
references.citation: Lancet. 2007 Feb 24;369(9562):679-90
references.pmid: 17321313
references.citation: Lancet. 2005 Dec 17;366(9503):2123-34
references.pmid: 16360791
references.citation: Health Care Women Int. 2007 Sep;28(8):680-99
references.pmid: 17729127
references.citation: Psychol Bull. 2002 Nov;128(6):851-885
references.pmid: 12405135
references.citation: AIDS Care. 1997 Oct;9(5):539-47
references.pmid: 9404396
references.citation: Sex Transm Infect. 2008 Feb;84(1):34-5; discussion 36
references.pmid: 18212187
references.citation: Health Soc Work. 2008 Nov;33(4):275-85
references.pmid: 19070275
references.citation: Soc Sci Med. 1996 Jan;42(1):141-52
references.pmid: 8745115
references.citation: AIDS Care. 2009 Oct;21(10):1335-42
references.pmid: 19370470
references.citation: Lancet. 2008 Aug 30;372(9640):764-75
references.pmid: 18687460
references.citation: Health Care Women Int. 2005 Feb;26(2):134-48
references.pmid: 15804913
references.citation: AIDS Educ Prev. 2003 Apr;15(2):109-21
references.pmid: 12739788
references.citation: BMJ. 2001 Mar 3;322(7285):524-5
references.pmid: 11230067
references.citation: AIDS. 2000 Jun;14 Suppl 1:S11-21
references.pmid: 10981470
references.citation: Sex Transm Dis. 2005 Sep;32(9):572-80
references.pmid: 16118607
references.citation: AIDS Care. 1998 Feb;10(1):69-79
references.pmid: 9536203
references.citation: Sex Transm Dis. 2004 Nov;31(11):695-700
references.pmid: 15502679
references.citation: AIDS. 2007 Dec;21 Suppl 8:S95-101
references.pmid: 18172399
references.citation: Sex Transm Infect. 2005 Dec;81(6):442-7
references.pmid: 16326842
references.citation: Lancet. 2007 Jan 13;369(9556):132-8
references.pmid: 17223476
references.citation: Sex Transm Infect. 2005 Jun;81(3):201-6
references.pmid: 15923285
references.citation: AIDS Behav. 2008 Jul;12(4):623-36
references.pmid: 17694431
references.citation: Health Educ Behav. 2002 Aug;29(4):461-72
references.pmid: 12137239
references.citation: Health Psychol. 2006 Sep;25(5):595-603
references.pmid: 17014277
references.citation: World Health Popul. 2007 Jan;9(1):46-64
references.pmid: 18270499
references.citation: AIDS Educ Prev. 2004 Dec;16(6):538-56
references.pmid: 15585430
references.citation: AIDS Behav. 2006 Jul;10(4):421-30
references.pmid: 16421651
references.citation: AIDS Patient Care STDS. 2005 Jan;19(1):49-57
references.pmid: 15665635
references.citation: Cult Health Sex. 2007 Sep-Oct;9(5):489-503
references.pmid: 17687674
references.citation: Sex Transm Dis. 2003 Nov;30(11):803-8
references.pmid: 14603085
references.citation: Sex Transm Dis. 2005 May;32(5):270-80
references.pmid: 15849527
references.citation: AIDS Educ Prev. 2005 Apr;17(2):143-56
references.pmid: 15899752
references.citation: Trop Med Int Health. 2009 Jun;14(6):673-87
references.pmid: 19392742
references.citation: AIDS Care. 2007 Oct;19(9):1166-70
references.pmid: 18058401
references.citation: AIDS Educ Prev. 2002 Jun;14(3):217-27
references.pmid: 12092924
references.citation: AIDS Care. 2003 Apr;15(2):177-85
references.pmid: 12856339