Substance use and HIV risk behaviors among Thai female sex workers in Thailand

Background: Despite attempts to reduce the HIV incidences among female sex workers (FSWs) in Thailand, high HIV risk behaviors among FSWs were recently reported. Methods: Structured survey interviews asking about substance use, sexual behaviors, and psychosocial factors were conducted with 205 FSWs in Bangkok. Results: The study participants were young (M = 28 years old), and worked 10 hours a day, 6 days a week. They earned relatively high incomes ($702-$1,170 per month). Although 95% of participants had received HIV information and/or prevention supplies in the past 12 months, they had low scores on the HIV knowledge questions (73% answered correctly 5 or fewer of the 10 questions) and 86% reported that they might not use a condom to earn more money. In the previous 12 months, 91% of participants had been infected with Chlamydia and 83% with Vaginal Candidiasis. Among those who had ever been pregnant, 54% had had at least one abortion (range: 1-5). Substance use in the past 12 months was common: 94% had used alcohol, 32% had used marijuana, and 11% had used Ecstasy. In the past six months, the majority of participants (86%) had engaged in sex with customers under the influence of substances, such as alcohol (98%) and marijuana (20%). Conclusion: High HIV risk behaviors were found in our sample of Thai FSWs in Bangkok. Further studies are needed to investigate social and cultural factors which influence their HIV risk behaviors and to develop culturally appropriate intervention programs for Thai FSWs.