title: Prevalence and correlates of sexual and gender-based violence against Chinese adolescent women who are involved in commercial sex: a cross-sectional study.
abstract: Despite the vast quantity of research among Chinese female sex workers (FSWs) to address concerns regarding HIV/sexually transmitted infection (STI) risk, there is a paucity of research on issues of sexual and gender-based violence (SGBV) and the missed opportunity for sexual and reproductive health (SRH) promotion among young FSWs. Our research aimed to assess the prevalence and correlates of SGBV among Chinese adolescent FSWs, and to explore SRH service utilisation.
  
  
  
  A cross-sectional study using a one-stage cluster sampling method was employed. A semistructured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine individual and structural correlates of SGBV.
  
  
  
  Between July and September 2012, 310 adolescent women aged 15-20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months were recruited and completed their interview in Kunming, Yunnan Province, China.
  
  
  
  Findings confirm the high prevalence of SGBV against adolescent FSWs in China, with 38% (118/310) of participants affected in the past year. Moreover, our study demonstrated the low uptake of public health services and high rates of prior unwanted pregnancy (52%; 61/118), abortion (53%; 63/118) and self-reported STI symptoms (84%; 99/118) in participants who were exposed to SGBV. Forced sexual debut was reported by nearly a quarter of FSWs (23%; 70/310) and was independently associated with having had a drug-using intimate partner and younger age (<17 years old) at first abortion. When controlling for potential confounders, having experienced SGBV was associated with frequent alcohol use, having self-reported symptoms of STI, having an intimate partner and having an intimate partner with illicit drug use.
  
  
  
  This study calls for effective and integrated interventions addressing adolescent FSWs' vulnerability to SGBV and broader SRH consequences.
authors.affiliation: Yunnan Research Centre for Hygiene and Health Management, School of Management and Economics, Kunming University of Science and Technology, Kunming, China.
authors.forename: Xu-Dong
authors.initials: XD
authors.lastname: Zhang
authors.affiliation: Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Sierra
authors.initials: S
authors.lastname: Myers
authors.affiliation: Yunnan Research Centre for Hygiene and Health Management, School of Management and Economics, Kunming University of Science and Technology, Kunming, China.
authors.forename: Hong-Juan
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: The Affiliated Hospital, Kunming University of Science and Technology, Kunming, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Kunming Maternal and Child Health Care Centre, Kunming, China.
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Li
authors.affiliation: Sexually Transmitted Disease Unit, Kunming Centre for Disease Control, Kunming, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.affiliation: Burnet Institute, Melbourne, Victoria, Australia.|Department of Obstetrics and Gynaecology, International Centre for Reproductive Health, Ghent University, Ghent, Belgium.|Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
authors.forename: Stanley
authors.initials: S
authors.lastname: Luchters
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D000074386:Gender-Based Violence / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D060386:Sex Workers / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D055815:Young Adult
keywords: PUBLIC HEALTH; SOCIAL MEDICINE