Three types of partner violence and effects on HIV risks among female sex workers in China

OBJECTIVE: Global literature documents the prevalence and severity of partner violence against FSW and the strong relationship between partner violence and HIV risks. Most of existing studies, however, did not adequately depict the effects of different types of partner violence on HIV risks. The current study aims to examine how physical, emotional and sexual violence perpetrated by clients and stable partners affects the FSWs' HIV-related behaviors. METHODS: We conducted a cross-sectional survey among 1,022 FSWs recruited through community outreach from two southwest cities in China. Participants completed a self-administered survey including measures of three types of partner violence and HIV risks. RESULTS: 58% and 45% women ever experienced partner violence from stable partner and clients, respectively. Among them, 55.5% and 40% experienced emotional violence, 16.2% and 16.8% experienced sexual violence, and 20.1% and 17.1% experienced physical violence, correspondingly. Sexual violence perpetuated by both stable partners and clients was associated with STI history, no HIV testing and drug abuse (p<0.05). Inconsistent condom use was significantly associated with emotional, physical and sexual violence perpetuated by stable partners (p<.05), but such association was insignificant for the partner violence perpetuated by clients. CONCLUSION: The current study represents the one of the first efforts to investigate partner violence against FSW in China and how different types of partner violence affect FSW's HIV-related behaviors. Different types of partner violence had different impacts on FSW's HIV risks. We call for culturally appropriate interventions to reduce partner violence and related HIV risks for vulnerable FSWs in China.