Online Program

Fear of low-paying female sex workers and its implications in HIV prevention

Tuesday, November 5, 2013

Shan Qiao, PhD, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, Detroit, MI
Chen Zhang, PhD, Institute of Global Health, Vanderbilt University, Nashville, TN
Xiaoming Li, PhD, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, Detroit, MI
Yuejiao Zhou, MD, Center for Disease Control and Prevention,Guangxi Autonomous Region, China., Nanning, China
Wei Liu, MD, Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China
Bonita Stanton, MD, Wayne State University School of Medicine, Detroit, MI
Background: Commercial sex plays a critical role in rapidly increasing heterosexual transmission of HIV in China. Low-paying FSWs are especially vulnerable to HIV/AIDS. This study aims to describe the fear of low-paying FSWs and explore how different fears may influence their HIV-related behaviors. Methods: A cross-sectional study was conducted among 794 FSWs recruited from low-paying commercial sex venues in Guangxi, China. FSWs completed a self-administered questionnaire on their demographic information, fear of engaging in commercial sex as well as knowledge, attitudes and behaviors related to HIV/AIDS. Results: Most of the FSWs feared being infected by HIV (70%) or other STDs (54%). About 46% of them feared being arrested by the police. The FSWs were also worried that their involvement in commercial sex would become known to their families (49%) or to familiar people (21%). Fear of HIV infection was significantly associated with consistent condom use with clients (aOR=2.12, 95% CI=1.47, 3.06) after controlling demographic characteristics and other covariates. However, fear of being exposed to their families significantly prevented the FSWs from taking HIV testing (aOR=.60, 95% CI=.43, .83). Fear of being arrested by the police was negatively associated with accessing HIV prevention interventions (aOR=.51, 95% CI=.34,.77) . Discussion: Fear of HIV infection and other STDs may promote safer sexual behaviors among low-paying FSWs, while fear of families and police may prevent them from utilizing HIV prevention services. Our findings are consistent with Social Cognitive Theory, indicating the importance of examining emotional context of FSWs' behaviors in HIV prevention interventions.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the characteristics of fears of low-paying FSWs in China. Analyze associations between fears of this vulnerable population and their HIV-related behaviors. Demonstrate the importance of understating emotional contexts of low-paying FSWs in HIV prevention among this population.

Keyword(s): HIV/AIDS, Women and HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am involved closely in the data analysis and interpretation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.