title: HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers.
abstract: Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs in China.
authors: School of Public Health and Management, Chongqing Medical University, Chongqing, China. zenghuan586@aliyun.com.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China. zenghuan586@aliyun.com.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China. zenghuan586@aliyun.com.
authors: Huan
authors: H
authors: Zeng
authors: School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
authors: Lei
authors: L
authors: Zhang
authors: School of Public Health and Management, Chongqing Medical University, Chongqing, China.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
authors: Yong
authors: Y
authors: Zhao
authors: Centre for Disease Control and Prevention, Yubei District, Chongqing, China.
authors: Hui
authors: H
authors: Liu
authors: Institute of Health Policy, College of Human Medicine, Michigan State University, Lansing, Michigan, USA.
authors: Hang
authors: H
authors: Guo
authors: School of Public Health and Management, Chongqing Medical University, Chongqing, China.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
authors: Yang
authors: Y
authors: Wang
authors: Centre for Disease Control and Prevention, Yuzhong District, Chongqing, China.
authors: Zhen
authors: Z
authors: Zhang
authors: Center for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
authors: Limin
authors: L
authors: Mao
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D060386:Sex Workers
keywords: 
  HIV
  ; China; barriers; rural-to-urban migration; street-based sex workers