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1
Harding-Davis, Erika Nikole. "Social and Structural Barriers to Safer Sex Among Heterosexual Female Sex Workers." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7010.
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Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers while controlling for age and sexual violence. This study was conducted using a quantitative research approach with a correlational method. Multiple linear regression statistical testing was performed using data from 534 participants from the National HIV Behavioral Surveillance study. Immigration status was not significantly associated with condom-less vaginal sex or multiple sex partners. However, homelessness and substance use were positively associated with condom-less vaginal sex and multiple sex partners. In addition, utilization of healthcare was negatively associated with condom-less vaginal sex. The results from this study can increase awareness and knowledge of challenges and barriers among female sex workers living in Illinois. In addition, the results of this study may contribute to establishing baseline epidemiology of this population and guidelines on addressing the factors associated with unsafe sexual behaviors that can potentially lead to HIV and other STIs.
2
Elliott, Nalishebo Kay Gaskell. "The health and wellbeing of female street sex workers." Thesis, University of Hertfordshire, 2017. http://hdl.handle.net/2299/19510.
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Previous research on female street sex workers (FSSWs) has primarily concentrated on the stigmatisation of women's involvement in the sex industry particularly with reference to the spread of HIV/AIDS. The response of the criminal justice system to the regulation of the illegal aspects of women's engagement in street sex work has also been criticised. However, the impact of street sex work on the health and wellbeing of these women requires further research. The aim of this study was to explore the perceptions and needs of female street sex workers in relation to their own health and wellbeing. The study used a qualitative mixed methods approach that included analysis of three sets of data: visual data, secondary data and primary data. There were 10 FSSWs recruited for the primary data sample. The epistemological position underpinning this study is social constructivism and a feminist paradigm has informed the conduct of the research process and data analysis. The theoretical application of Bourdieu's framework of habitus, capital and field has provided the lens through which to explore the socially constructed experiences of FSSWs health and wellbeing. Findings from this study revealed that FSSWs experienced poor physical, mental and social health and wellbeing. They faced limited life choices and often felt discriminated against by the agencies and institutions that should have offered support. The women spoke of their personal histories especially traumatic life events in childhood consisting of sexual abuse, neglect, loss, rejection as well as intimate partner violence in adult life. The loss of their children to social services, housing difficulties and addiction to alcohol and crack cocaine were also significant in contributing to social exclusion and their multiple positions of vulnerability. This study contributes to the body of work on women's health and wellbeing. In particular, it adds to our understanding of the lived experiences of women involved in street sex work. A key public health priority should be the development of policies and systems to provide quality services to support the health, safety and wellbeing of FSSWs.
3
Darbha, Subrahmanyam. "Reproductive Health Trends In Female Sex Workers In Madagascar." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1309360596.
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4
Woode, Owusu Melvina. "Male Clients of Female Sex Workers : An Exploratory Epidemiological Study." Thesis, University of Manchester, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532212.
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Sanders, Teela. "A risky business : how sex workers manage their clients, community and conscience." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270471.
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6
Leaney, Zelda. "Health care for female sex workers : need, risk, access & provision." Thesis, University of Bath, 2006. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428357.
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Sex workers are not only acted upon by medical, moral and legal discourses due to the risk they present to their own health but also due to the perceived risk they pose to the health of others. The diverse settings and different ways in which sex can be sold, combined with previous life experiences contribute to the wide variation in need and risk. This thesis investigates the differential understandings of need, risk, access to and provision of health care between sex workers and health care service providers. Simultaneously it offers an explanation for the continuation of need when health care provision exists. Four discursive themes directed the research: need, risk, access and provision. Data was obtained from semi-structured interviews with street and non-street sex workers and service providers. Discourse analysis was performed to ascertain the conditions, rules and authority under which statements in relation to the discursive themes are constructed. Thematic indexing enabled the analysis of the discursive themes within the empirical data, considering the inter-relationship with discursive constructs (i.e. stigma, safety, pollution, rights and power) identified within previous moral, medical and legal discourse. Sex workers and service providers identified need and risk as problematic drug use, damaged mental health, STIs and violence, but categorise and prioritise differently. Complex constructions were identified, suggesting underlying influences that direct them. Contradictions and tensions exist within the differential construction of the discursive themes, made more problematic by the chaotic lifestyle of many sex workers. The differential understandings must be recognised or the sex worker will continue to be 'maintained' within the complex and interlinked relationships of prostitution, damaged mental health and problematic drug use, the latter two made worse by prostitution but not solely a result of prostituting.
7
Yusuf, Abass Babatunde. "Adherence to ART among HIV Infected Female Sex Workers in Nigeria." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7524.
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A lack of adherence to antiretroviral therapy (ART) increases the risk of onward human immunodeficiency virus (HIV) transmission and mortality. The purpose of this cross-sectional study based on Andersen's conceptual framework was to test the associations between age, marital status, job/occupational status, education, membership in a peer support group, community, and facility ARV drug refill and alcohol and substance use, and adherence to ART among female sex workers (FSWs) who are 15 years and older in Rivers and Cross Rivers states Nigeria. Data were abstracted from existing program data collected between January 2015 and December 2017 by Heartland Alliance International, Nigeria. Results from chi-square statistics showed that age, job/employment, and marital status were not associated with adherence to ART. Binary logistic regression analyses showed that respondents with senior secondary education were 1.385 times more likely to adhere to ART than other education levels (OR = 1.385, 95% CI = 1.203, 1.593). Respondents who had ARV refill in the facility were 1.737 times more likely to adhere to ART than respondents who had community ARV refill (OR= 1.737, 95% CI: 1.297, 2.326). Also, respondents who were a member of a support group were 6.430 times more likely to adhere to ART compared to those not in a support group (OR= 6.430, 95% CI: 4.682, 8.831). Lastly, respondents who did not abuse alcohol or substance were 1.820 times likely to adhere to ART compared to those who did (OR= 1.820, 95%: CI: 1.356, 2.444). All-inclusive key population policies could aid in lessening the barriers the FSWs face in receiving comprehensive health services as well as endorsing interventions such as alcohol and drug rehabilitation, counseling, and incentives to join peer support groups that could benefit FSWs, their clients, and families.
8
Supawadee, Petrat Pimpawun Boonmongkon. "Human rights education as a tool for empowerment of female sex workers : a case study of one non-formal education program for female sex workers in Thailand /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd398/4537358.pdf.
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Nguyen, Tri. "Female Sex Workers and STI/HIV in Ba Ria – Vung Tau Province, Vietnam: Transmission, Knowledge, Attitudes and Sexual Behaviors." Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367150.
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Female sex workers (FSWs) have been identified as one of the high-risk population groups for HIV and STI infections; they play a potential bridging role in the spread of the STI/HIV epidemic from specific high-risk populations to the general population. A cross-sectional study using mixed methods (quantitative research combined with qualitative research) was conducted to determine the prevalence of STI/HIV infections and assess the levels of STI/HIV-related knowledge, and attitudes towards STIs/HIV and sexual behaviours among FSWs in Ba Ria – Vung Tau, Vietnam. Quantitative research methods were used for an epidemiological survey to recruit 420 FSWs in two cities and six districts of Ba Ria – Vung Tau province, Vietnam. The survey explored the STI/HIV prevalence, socio-demographic characteristics and risk factors affecting FSWs. The recruited participants were interviewed face-to-face, using a structured questionnaire, and then tested for HIV, Syphilis, Gonorrhoea, and Chlamydia. Qualitative research methods using in-depth interviews with a subsample of 45 FSWs supplemented the quantitative research findings, especially in relation to different perspectives of risk behaviours among FSWs.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Griffith Health
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10
Maloney, Emma. "Beyond survival sex: An exploratory study of the labour experiences of female street sex workers in Ottawa." Thesis, University of Ottawa (Canada), 2004. http://hdl.handle.net/10393/26707.
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This thesis develops a new theoretical framework outside the research that assumes women engaging in the street sex trade are 'victims' or 'workers', and instead examines the possibility that elements of both categories may be present in their reality. Street sex work is considered as labour, while leaving room for the possibility of the existence of survival sex. This qualitative research consists of an exploratory study of the viability, utility and limitations of a labour framework for understanding and analyzing the experiences of adult female street sex workers interviewed in the Ottawa area.
The findings reveal a number of characteristics unique to street sex work that challenge existing labour frameworks and direct us to rethink street sex work beyond employment. These characteristics are specifically related to the criminalized nature of the work and include, among other things, the reported violence perpetrated by police and clientele. Moreover, by deconstructing common stereotypes attributed to female street sex workers, we are able to normalize sex work and address issues of stigma. (Abstract shortened by UMI.)
11
Cheung, Nga. "Accounting for and managing risk in sex work : a study of female sex workers in Hong Kong." Thesis, Royal Holloway, University of London, 2012. http://repository.royalholloway.ac.uk/items/1f9e8dcf-7666-1fe1-5036-0f9fef15b9d0/9/.
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This thesis considers how in the course of their work female sex workers in Hong Kong experience risk. It concerns the indoor side of the sex market, an area which has so far been largely ignored in studies on commercial sex. The focus is on women working independently from flats. Focusing on women's own accounts of work-related risks, risky behaviour and coping strategies, this study investigates sex workers' reflexive understandings of prostitution and their occupational risk in late modern societies. The study emphasises the social, cultural, interactional and situational context, to understand the ways in which women involved in sex work conceptualise and respond to risk. There are three main themes emerge in sex workers' accounts. The first one is sexual health and diseases. In this empirical chapter, the main focus is on the flat-working women's accounts of themselves and their risk-taking (or risk-avoiding) behaviour in (potentially) risky situations, where, for example, unprotected sex has occurred. The findings suggest that, despite sex workers are being frequently seen as most susceptible to sexual health problems, the social norms which exist among sex workers and their clients play a crucial role in enabling sex workers to gain control over the sexual encounter and avoid risk behaviour. The next theme is violence against sex workers. Findings suggest that what violent crime symbolises in the context of sex work is that some women are beneath contempt because of their working identity. It is more “acceptable” to perpetrate violence against sex workers because this group is set apart from women in other service occupations. The last theme is concerned with sex workers' accounts of their emotional experiences at work, which mainly explores how social and cultural factors influence individuals' interpretation and accounts of their emotions. Accounts given by women demonstrate that many of them seemingly did not conceive their involvement in the sex business as “wrong”. Nevertheless, because sex work is still largely marginalised and stigmatised in Chinese societies, they might experience unpleasant emotions which were mostly related to the “whore” stigma.
12
Wong, William Chi Wai. "A study of female sex workers in Hong Kong : moving beyond sexual health." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/25333.
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International research from the early 90s has convincingly shown that sex work per se is not a major vector in the spread of HIV in developed regions. Instead self-determination, autonomy and control are crucially important when it comes to HIV risks as well as the general health and well-being of the female sex workers (FSWs). A 30-minute face-to-face interview was conducted in 89 women by direct approach and snowballing through a well- established non-government organisation (NGO), followed by a focus group discussion drawn from the participants of the questionnaire in 2003-4. In 2004, an outreach Well-women clinic was set up at another NGO and using the rate of abnormal PAP smears identified and follow-up rates we wanted to assess whether it was a feasible option for early detections of pre-invasive cervical cancer in FSWs in Hong Kong. The FSWs surveyed scored significantly lower in physical, psychological, and environmental health domains in WHOQOL-BREF (HK) questionnaire when compared to non-sex workers of the same age group and sex in Hong Kong. After controlling for background characteristics, a number of factors that were inherent to the sex industry were significantly associated with poor psychological health and suicidality. In the supplementary focus group discussion some sex workers described the experience of being abused at work but at the same they could not seek any protection from .the police. While these FSWs’ perception of personal health was good, a considerable proportion had suffered from illnesses. Many street workers experienced difficulty in utilising health service in Hong Kong. When they did, it was mainly for acute problems. Affordable access to public health services was excluded and many found private services unaffordable due to the high price charged. It was common for these women to self-medicate, delay -seeking help, or travel back to China for treatment. This project identifies problems and difficulties faced by FSWs in Hong Kong and we use these findings to design a service that may improve their health. An outreach Well-women clinic seems a feasible option and an effective way in the early detection of cervical cancer for some FSWs.
13
Gaynor, Andrea. "Contesting identity and status : a study of female commercial sex workers and citizenship." Thesis, University of Huddersfield, 2018. http://eprints.hud.ac.uk/id/eprint/34745/.
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The extant research concerning commercial-sexwork is extensive, covering a diverse range of issues, such as physical and psychological risks; with on-street work regarded as persistently perilous. CSWs are marginalised from mainstream society by their work identity and associated behaviours which are incongruous with societal mores and norms for ideal citizens. Yet, apart from research related to geographical space and citizenship rights, and a few studies relating to sexual citizenship; the relationship between citizenship status/identity and commercial-sexwork is overlooked or included as an ‘add on’ to other concerns. This is regarded as an omission as those who do not conform to citizenship ideals are offered a “hand-up” or experience increased monitoring by the state in the form of law and policy directives. Importantly, for CSWs historical and contemporary legal and policy discourses (such as nuisance, victim, abuser, exiting and criminal) impact negatively upon their relationship with citizenship status compounding their marginalisation. Thus the overarching aim within this thesis is that it explores the citizenship journeys of CSWs utilising Lister’s (2003a) differentiated universalism citizenship concept. To achieve this aim there are four research questions; ‘How do CSWs experience citizenship?’, ‘How do participants express their understandings of citizenship?’, ‘To what extent are values and ethics a component of commercial-sexwork?’ and ‘How does a citizenship identity relate to a commercial-sexwork identity?’. A thematic analysis of data from five semi-structured interviews and 123 online forum correspondents found three overarching themes: ‘Understanding citizenship: Civil rights and duties, and social rights’; ‘Enacting citizenship: active citizenship and intimate citizenship and commercial sex work’ and ‘Exiting commercial-sexwork: becoming ‘normal’ citizens’. The main findings were that CSWs understand the conditional nature of citizenship; they pursue the right to work and the duties to pay tax and national insurance; evidence active citizenship behaviours, a community of practice and there is support for the notion that the disembodied nature of commercial-sexwork corresponds to work within the public arena - challenging the public/private binary. Yet, the state has appropriated these CSWs citizenship contributions without the corresponding benefits of citizenship status or identity. Further, via the quasi-legal status of commercial-sex work, the state has ignored or misrecognised key citizenship attributes such as agency in terms of their right to choose to work in this arena; such omissions amount to an injustice. This is compounded by the state’s exiting process which does little to advance CSWs status and identity but rather leads to a disciplined citizenship status. This thesis concludes that for transformative recognition, a more differentiated citizenship concept which recognises the similarity between CSWs and other females in terms of claims to rights, agency and justice but acknowledges their diversity is a necessity. Additionally, policy and legal discourses are ineffective in reducing CSWs marginalisation which impacts on their citizenship status. The latter will continue unless law and policy makers explicitly recognise CSWs citizenship contributions whilst considering how legal and policy discourse negatively construct the citizenship status of those who conform (victims or those who exit) and those who do not (nuisances or criminals).
14
Bala, Shruti. "Assessment of Vulnerability of Female Sex Workers in Southeast Asia to HIV Infection." Thesis, The University of Arizona, 2010. http://hdl.handle.net/10150/146206.
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HIV/AIDS is more than a health issue. It can affect anyone -- men, women, and children. It is a fundamental threat to development and places the political stability and economic security of developing countries at risk. An analysis of the HIV situation in Southeast Asia among high risk population, specifically sex workers, highlights that political leadership, active health systems, resources, and community level ownership are key elements in the fight against HIV. Sex workers, both formal and informal, are vulnerable to HIV infection due to multiple partners and inconsistent condom use, injecting drug use, migration and mobility, and social and economic factors. In the past two decades, interventions such as the 100% Condom Policy and empowerment and capacity building programs have reduced the vulnerability of HIV infection among sex workers. The increasing movement of sex workers between the countries in Southeast Asia has raised concerns regarding the transmission of HIV. It is necessary to address HIV infection among sex workers from a regional perspective, taking into account the political, social, and economic situation of respective countries. HIV/AIDS is not an issue restricted to the health center alone -- it requires a multi-sectorial approach that combines policy, education, empowerment, health, and gender equity.
15
Seib, Charrlotte. "Health, well-being and sexual violence among female sex workers : a comparative study." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16398/1/Charlotte_Seib_Thesis.pdf.
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Background
- Prostitution has been documented in most societies, although the context in which it occurs may vary greatly. In Queensland, Australia, sex workers can operate from legal brothels or privately but all other sectors of the sex industry are prohibited. It is assumed that regulation of the sex industry through legalization leads to better health and social outcomes for sex workers and their clients. However, this assumption has rarely been subjected to empirical scrutiny.
Aims
- This research examined the occupational health and safety of female sex workers in Queensland and explored the relationship between legislative change, workplace violence, mental health and job satisfaction. Sex workers interviewed in 2003 (after legalisation) were compared to a prior study of this population conducted in 1991 (before official regulation of the sex industry). Further, in-depth analysis of the 2003 cohort compared sex workers employed in legal and illegal sectors, to assess violence, health status and job satisfaction.
Methods
- Cross-sectional, convenience sampling was used to collect data from female sex workers in 2003. This data was compared with data collected earlier (in 1991) and explored differences in the two samples using bivariate analysis. Similar recruitment strategies on both occasions were used to recruit women from all known sectors of the Queensland sex industry. The 1991 comparison sample (Boyle et al. 1997) included 200 women (aged between 16 and 46 years), and in 2003, 247 women (aged 18 to 57) participated. The 2003 sample included workers from legal brothels (n=102), private sole-operators (n=103) and illegal street-based sex workers (n=42). Using data collected in 2003, this study assessed the relationship between physical and mental health and job satisfaction and two main independent variables, i.e., current work sector and recent workplace violence. Bivariate analysis of physical health and independent variables showed no significant relationships and therefore further analysis was not undertaken. However, analysis of mental health and job satisfaction showed complex interactions between multiple variables and therefore linear modeling was performed to adjust for confounding.
Results
- Analysis of the 1991 and 2003 samples showed little apparent change over time in self-reported sexually transmitted infections (STIs). There were substantial changes over time in the types of sexual services being provided to clients, with the 2003 sample more likely to provide 'exotic' services. Violence experienced ever in their lifetime differed; in 1991, 29% reported having ever been raped compared with 42% in 2003 (p= <0.01). In 2003, 50% of illegal sex workers reported having ever been raped by a client compared with 12% of private sex workers and 3% of brothel-based sex workers (p=<0.01). Overall, the sex workers reported roughly equivalent job satisfaction to Australian women. A desire to leave the sex industry was most strongly correlated with reduced job satisfaction (p=<0.01). Satisfaction was also relatively low among those whose family was not aware of their sex work (p=<0.01). Similarly, the mental and physical health of this sample was comparable to age-matched women from the general population. Wanting to leave the sex industry was most strongly associated with poor mental health (p=<0.01), as was recent sexual or physical assault by a client (p=0.06) and the woman's main work sector (p=0.05). Illegal sex workers reported substantially lower mental health scores than their counterparts in legal sex work.
Conclusions
- Self-reported STI diagnosis was high in these samples but the prevalence appears not to have changed over time. Comparing 2003 to 1991, there were trends towards safer and more diverse sexual practices. It is likely the sex industry has 'professionalized' and now includes more sex workers providing specialist, 'exotic' services. This sample of female sex workers reported high rates of violence, with those working illegally at greatest risk. Analysis suggests a complex interaction between variables contributing to mental health and job satisfaction. In general, it appears that the majority of sex workers enjoyed at least as much job satisfaction as women working in other occupations. It also appears that this sample had equivalent mental health to women from the general population, although the sub-group of illegal workers generally had poorer health. Job satisfaction and the extent of workplace hazards (especially risk of violence) were also strongly associated with different sectors of the sex industry. It is probable that legalisation has benefited some (perhaps most) but there are health and safety concerns for those outside the legal framework. Legislative reform should focus on violence prevention, promoting reporting of violent events to police, and further exploration of the impact of legislation on the health of workers in the sex industry.
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Seib, Charrlotte. "Health, well-being and sexual violence among female sex workers : a comparative study." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16398/.
Full textAbstract:
Background: Prostitution has been documented in most societies, although the context in which it occurs may vary greatly. In Queensland, Australia, sex workers can operate from legal brothels or privately but all other sectors of the sex industry are prohibited. It is assumed that regulation of the sex industry through legalization leads to better health and social outcomes for sex workers and their clients. However, this assumption has rarely been subjected to empirical scrutiny. Aims: This research examined the occupational health and safety of female sex workers in Queensland and explored the relationship between legislative change, workplace violence, mental health and job satisfaction. Sex workers interviewed in 2003 (after legalisation) were compared to a prior study of this population conducted in 1991 (before official regulation of the sex industry). Further, in-depth analysis of the 2003 cohort compared sex workers employed in legal and illegal sectors, to assess violence, health status and job satisfaction. Methods: Cross-sectional, convenience sampling was used to collect data from female sex workers in 2003. This data was compared with data collected earlier (in 1991) and explored differences in the two samples using bivariate analysis. Similar recruitment strategies on both occasions were used to recruit women from all known sectors of the Queensland sex industry. The 1991 comparison sample (Boyle et al. 1997) included 200 women (aged between 16 and 46 years), and in 2003, 247 women (aged 18 to 57) participated. The 2003 sample included workers from legal brothels (n=102), private sole-operators (n=103) and illegal street-based sex workers (n=42). Using data collected in 2003, this study assessed the relationship between physical and mental health and job satisfaction and two main independent variables, i.e., current work sector and recent workplace violence. Bivariate analysis of physical health and independent variables showed no significant relationships and therefore further analysis was not undertaken. However, analysis of mental health and job satisfaction showed complex interactions between multiple variables and therefore linear modeling was performed to adjust for confounding. Results: Analysis of the 1991 and 2003 samples showed little apparent change over time in self-reported sexually transmitted infections (STIs). There were substantial changes over time in the types of sexual services being provided to clients, with the 2003 sample more likely to provide 'exotic' services. Violence experienced ever in their lifetime differed; in 1991, 29% reported having ever been raped compared with 42% in 2003 (p= <0.01). In 2003, 50% of illegal sex workers reported having ever been raped by a client compared with 12% of private sex workers and 3% of brothel-based sex workers (p=<0.01). Overall, the sex workers reported roughly equivalent job satisfaction to Australian women. A desire to leave the sex industry was most strongly correlated with reduced job satisfaction (p=<0.01). Satisfaction was also relatively low among those whose family was not aware of their sex work (p=<0.01). Similarly, the mental and physical health of this sample was comparable to age-matched women from the general population. Wanting to leave the sex industry was most strongly associated with poor mental health (p=<0.01), as was recent sexual or physical assault by a client (p=0.06) and the woman's main work sector (p=0.05). Illegal sex workers reported substantially lower mental health scores than their counterparts in legal sex work. Conclusions: Self-reported STI diagnosis was high in these samples but the prevalence appears not to have changed over time. Comparing 2003 to 1991, there were trends towards safer and more diverse sexual practices. It is likely the sex industry has 'professionalized' and now includes more sex workers providing specialist, 'exotic' services. This sample of female sex workers reported high rates of violence, with those working illegally at greatest risk. Analysis suggests a complex interaction between variables contributing to mental health and job satisfaction. In general, it appears that the majority of sex workers enjoyed at least as much job satisfaction as women working in other occupations. It also appears that this sample had equivalent mental health to women from the general population, although the sub-group of illegal workers generally had poorer health. Job satisfaction and the extent of workplace hazards (especially risk of violence) were also strongly associated with different sectors of the sex industry. It is probable that legalisation has benefited some (perhaps most) but there are health and safety concerns for those outside the legal framework. Legislative reform should focus on violence prevention, promoting reporting of violent events to police, and further exploration of the impact of legislation on the health of workers in the sex industry.
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Deering, Kathleen Nicole. "The structure of sex work : variability in the numbers and types of sex partners of female sex workers in southern India." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/33978.
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Background and objectives: There is limited knowledge of sexual structure (i.e., the numbers, types and distributions of sex partners and patterns of sexual contact) and its relationship with HIV infection and prevention among female sex workers (FSWs). The objectives of this study were therefore: to examine the social and environmental factors associated with the numbers of clients of FSWs; to characterize heterogeneity in sexual structure and assess how sexual structure influences HIV prevalence; and to examine the impact of an HIV intervention on condom use by different partners (clients, intimate partners), as reported by FSWs.
Methods: This study used data collected from FSWs and clients in Karnataka state, southern India as part of the Avahan AIDS Initiative, an ongoing large-scale HIV intervention. Bivariate and multivariable statistical techniques were used to examine the relationships between two outcomes (numbers of clients and condom use) and key social and environmental factors, including exposure to the Avahan intervention. A deterministic compartmental mathematical model was developed to understand how sexual structure influenced HIV prevalence on a population level.
Results: Sexual structure displayed substantial geographic variation across districts in Karnataka. The most common predictors of higher rates of clients were a reliance on sex work as sole income, younger age, and being single or cohabiting as compared to married. The effect of the solicitation environment (e.g., brothels, public places, homes) varied by district. Intervention exposure was associated with increased condom use by FSWs’ clients, but not their intimate partners. Mathematical modelling identified sexual structure parameters with the largest influence on increasing (numbers of clients of FSWs; numbers of visits to FSWs by clients; frequency of sex acts with repeat clients) and decreasing (duration of the repeat FSW-client partnership; fraction of repeat clients) HIV prevalence within and across districts.
Conclusions: Differences in the sexual structure of FSWs and their commercial clients have important implications for HIV transmission dynamics. In light of findings related to both differences in sexual structure across districts and the impact of an intervention on condom use by different partners of FSWs, HIV prevention planners need to tailor interventions to respond to local contexts.
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Escamilla, Loredo María Ixhel [Verfasser]. "Developing safer sex negotiation skills among Latin American female sex workers working in Germany / María Ixhel Escamilla Loredo." Bielefeld : Universitätsbibliothek Bielefeld, 2014. http://d-nb.info/1060824353/34.
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Yin, Zheng. "Determinants of consistent male condom use among female commercial sex workers in greater Manchester." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.511746.
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Evans, Catrin. "Commercial sex work and sexual health : an ethnographic study of HIV prevention among female commercial sex workers in Calcutta." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2000. http://researchonline.lshtm.ac.uk/682301/.
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This thesis presents the results of ethnographic research conducted from 1995 to 1997 among sex workers in two Calcutta redlight areas where a STD/HIV Intervention Project (SHIP) is being implemented. The thesis provides an in-depth study of sex workers' lives, their concepts of sexual health and their relationship to the SHIP. This material is used to critically consider a number of key concepts currently informing HIV prevention practice, specifically, sexual health, community participation, empowerment and behaviour change. Initial chapters set the background to the study and describe the complex world of the Calcutta sex trade and sex workers' struggle to construct a meaningful social identity. Subsequent chapters consider sex workers' and other actors' varying responses to, and interpretations of, the SHIP. These are related to an analysis of the process of project implementation, revealing the context-dependent, strategic, meaningful and contested nature of community, identity, participation and empowerment, and also highlighting the significance of different constructions of agency for the ways in which these concepts are expressed by different actors. The thesis goes on to examine sex workers' own (vis a vis biomedical) perceptions of sexual health and, drawing upon the SHIP as an example, analyses the representations, meanings and strategic uses of different kinds of knowledge and its perceived role in behaviour change. The next chapter looks at the varying meanings that sexual practices take on for sex workers in the context of their social and occupational position. It examines women's strategies around safer sex and uses this material to critique conventional theories of behaviour change, arguing for a perspective that acknowledges sex workers' agency yet recognizes the ways in which its expression is shaped and constrained by micro and macro level socio-cultural and economic forces. The thesis concludes by arguing that in-depth ethnographic research on sex workers' lives combined with a contextually embedded analysis of the processes and meanings of an intervention yields important insights for understanding, developing and replicating effective HIV prevention initiatives among this group.
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Leong, Sio-iok Jacqueline. "The consistency and correctness of condom use among Chinese female sex workers in Macau SAR." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36887432.
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Ghimire, Laxmi. "Health services utilisation for sexually transmitted infections including HIV by female sex workers in Nepal." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=158823.
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A total of 425 questionnaire-based interviews and 15 in-depth interviews with FSWs in Nepal including non-participant observation in the field were conducted in 2006. The age range of the FSWs participated was 15-46 years. FSWs (30.8%) reported having had STI symptoms in presences 12 month. The quantitative findings suggested that many reported having used condoms during their last sexual intercourse, but in-depth interviews suggested the opposite. One fifth (21%) had never visited health facilities. Of those who visited, 149 (50.3%) turned to a private clinic and pharmacy; 181 (61.1%) used Non-Governmental Organisation (NGO) clinics, 79 (26.6%) resorted to care in hospital and 30 (10.1%) treated themselves. The remainder 85 (28.7%) were found to seek help from primary health care centre, health posts, family planning clinic or other health institutions for treatment. The behaviour theories and models used in this study (i.e. health belief model, theory of reasoned action and planned behaviour) partly explain the decisions of FSW on use and non-use of available health services. The study identified that lack of confidentiality and privacy created distrust among FSWs and stopped them from accessing health services. Embarrassment, disregard by health care providers and poor communication with them, long waiting time and fear of exposure as a sex worker were major barriers to seeking health services. It is therefore necessary to provide specific training to service providers in all types of health care institutions in order to promote confidential and quality health services.
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Chang, Chun Oratai Rauyajin. "HIV/AIDS preventive behavior (Condom use) and its determinants among female commercial sex workers in Beijing, China /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-ChangC.pdf.
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Enkhbold, Sereenen, Sovd Tugsdelger, Satoshi Morita, Junichi Sakamoto, and Nobuyuki Hamajima. "HIV/AIDS Related Knowledge and Risk Behaviors Among Female Sex Workers in Two Major Cities of Mongolia." Nagoya University School of Medicine, 2007. http://hdl.handle.net/2237/9194.
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Guha, Mirna. "Negotiations with everyday power and violence : a study of female sex workers' experiences in eastern India." Thesis, University of East Anglia, 2017. https://ueaeprints.uea.ac.uk/66489/.
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Studies on sex work in India have tended to portray female sex workers as either victims or empowered agents. Over the last two decades, binaries of free and forced regarding participation in sex work have been reinforced by development discourses and interventions on HIV/AIDS and human trafficking which target the sex work community in India. This choice/compulsion binary, in turn, has elicited another binary of violent/non-violent social relations, thereby exceptionalising the nature of violence within sex work. This thesis argues against this exceptionalisation by locating an analysis of women’s participation in sex work, and their experiences of power and violence, within a context of everyday social relations in Eastern India. It presents qualitative data generated from eight months of fieldwork across two prominent red-light areas in Kolkata, a shelter home for rescued female sex workers in its southern suburb, Narendrapur, and villages in the South 24 Parganas district in West Bengal. Analysis shows that the research subjects’ experiences of power and violence in social relations with members of the household, community, market and state (Kabeer, 1994) and experiences of deviance (Becker, 1963) in these relationships, shape pathways into, lives within and pathways out of sex work. It highlights the cyclical nature of gender-based violence and power inequalities across the lives (Ellsberg and Heise, 2005) of women formerly and currently in sex work. Struggles with power and violence prior to entering sex work continue in different forms within sex work and persist even after women leave, often leading to a return to sex work. These findings problematize static readings of female sex workers’ victimhood and agency. Instead, they present a contextually nuanced analysis of their dynamic experiences and negotiations, rooted within an understanding of wider regional,social and cultural norms on women’s sexuality, mobility and labour force participation.
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Cesnulyte, Egle. "Limited agency in a neo-liberal world : the case of female sex workers in Mombasa, Kenya." Thesis, University of Leeds, 2013. http://etheses.whiterose.ac.uk/4974/.
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Neo-liberal practices based on economic theory and supported by appropriate discourses are explored in this thesis to show how these processes affect social, economic and patriarchal structures, and explore their gendered effects. The sex industries are analysed as an example to show how women who are in a disadvantaged position in society manoeuvre the socio-economic and patriarchal scene, ‘bargain with patriarchy’, and attempt to make a living or progress socially and economically through unconventional choices. This task is undertaken through the analysis of Mombasa self-identified sex workers’ life stories and narratives. Neo-liberal practice resulted in increased poverty and ruptures in social structures. Even though some women manage to manoeuvre the patriarchal and economic systems of Kenya to their own advantage through unorthodox choices (selling sex being one of them) and manage to change their initial disadvantaged position, many women are unsuccessful in this undertaking. An analysis of sex workers’ work strategies and plans for the future shows that women aim to capitalise on gender and economic inequalities that marginalise them in order to advance. In order to succeed in this endeavour, women have to find entrepreneurial ways to perform certain socially accepted gendered roles. Therefore, it will be argued that in a socio-economic system influenced by neo-liberalism that builds on gender inequality, the individuals who internalise neo-liberal logic can succeed in improving their initial disadvantaged position to some extent, but that such individual agency is limited because it fails to challenge socio-economic and patriarchal structures.
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Saiyed, Faiez K., Eddy R. Segura, Diane Tan, Jesse L. Clark, Jordan E. Lake, and Ian W. Holloway. "Social networks and condomless intercourse with female partners among male sex workers in the Dominican Republic." SAGE Publications Ltd, 2021. http://hdl.handle.net/10757/655587.
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Male sex workers (MSW) in the Dominican Republic (DR) have multiple sexual partners, including personal and client-relationships, and are disproportionately affected by human immunodeficiency virus (HIV). We examined the prevalence of condomless anal and/or vaginal intercourse (CI) among MSW in the DR as a function of social network factors. Self-report surveys and social network interviews were administered to MSW recruited through venue-based sampling (N = 220). A generalized linear model was used to complete a Poisson Regression model and identify variables significantly associated with the outcome of interest. CI was more common with female (28.3%) than with male partners (4.9%). Factors associated with CI with the last female partner included older age of MSW, CI with the last male partner, having a stable female partner (a consistent or main partner), and having ≥1 family member in the participants’ social network. Partner and social network characteristics associated with CI among MSW suggest the utility of dyadic and network interventions to reduce HIV risk.National Institute of Mental Health
Revisión por pares
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Vickerman, Shelley Ann. "The experiences of transgender female sex workers within their families, occupation and the health care system." University of the Western Cape, 2018. http://hdl.handle.net/11394/6868.
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Magister Artium (Psychology) - MA(Psych)There is a dearth of scholarly literature surrounding transgender female sex workers (TFSW) within South Africa. Their voices are often marginalised and not adequately heard in the literature and in a society that generally views gender as a fundamental element of the self, determining their subject positions against binaried heteronormative gender ideals. This process of the ‘othering’ of TFSW, is exacerbated by the moralistic judging of their occupation of sex work. This has left many TFSWs vulnerable to emotional abuse such as being socially stigmatised, discriminated against and socially isolated. The literature further echoes vulnerability to physical violence, such as hate crimes, rape, heightened HIV infection, homelessness, police brutality and murder. The current study aimed to explore the subjective experiences of TFSW within their families, occupations and the healthcare system within the Cape Town metropole, South Africa. The study was framed within an intersectional feminist epistemological position, highlighting intersecting identities that marginalise groups of people. Informant driven sampling was used in the case of this study where a total of eleven participants were individually interviewed using a semi-structed approach – interviews ranged from 35-90 minutes. The data collected was subsequently analysed using thematic analysis and the three themes that emerged were: transgender female (TGF), Sex work and HIV. Family rejection and abuse based on participants non-conforming gender identity was expressed by participants. Repressive home circumstances led to many opting to live on the street. Participants described being introduced to sex work through a network of other homeless TFSW, also described as ‘Sisters’ (who fulfil the role of family) as a means of survival. Sex work for TGFs is a particularly dangerous job, as sex workers run the risk of being exposed as TGFs, often resulting in severe physical harm for some. To cope with their severe realities of violence and homelessness, many reported turning to substances, such as alcohol and methamphetamine. A total of ten participants described being HIV positive and adherence was very poor among the group. This could be attributed to stigmatisation from health workers, substance use and homelessness. This group of women, though vulnerable and structurally oppressed, displayed exceptional resilience. It is suggested that further research should be conducted on this group in the South African context for a clearer understanding of their needs and improved policy, as well as interventions for TFSW.
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Loza, Oralia. "Factors associated with early initiation into sex work and sexually transmitted infections among female sex workers in two Mexico-U.S. border cities." Diss., [La Jolla] : [San Diego] : University of California, San Diego ; San Diego State University, 2009. http://wwwlib.umi.com/cr/ucsd/fullcit?p3372796.
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Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2009.Title from first page of PDF file (viewed October 13, 2009). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references.
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Mediatrice, Barengayabo. "A qualitative study assessing the general health problems of street-based female sex workers in Cape Town." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/11486.
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Includes bibliographical references.Generally, sex workers are a socially marginalized group with poor physical health. Within the hierarchy of sex workers, street-based sex workers are at the bottom. Street-based sex workers face different kinds of work experiences and exposure, with varying degrees of health problems. Their health problems are more severe and worse than the other classes of sex workers. Street-based sex workers are subjected to considerable risks of physical abuse, beatings and rape. These impact greatly on their health. This study explored the general health problems of street-based female sex workers. The study was carried out in Cape Town among street-based female sex workers aged 18 years and above. It was cross-sectional, conducted over a period of six months using fifteen (15) in-depth interviews and four (4) focus group discussions. The respondents were non-randomly recruited through the Embrace Dignity Project, whose activities involved sex workers. The study discovered that condom use was inconsistent as a result of financial incentives, condom breakage, violence, rape and non-payment from clients when insisting on condom use. But some respondents were not using condoms at all. The majority of respondents reported stigmatization and discrimination by community members and the police. Most of the respondents do not go for routine and other medical checks. Some respondents were not satisfied with health care provision due to discrimination by providers and long waiting times. Notwithstanding, respondents reported a long list of health problems including: flu, cough, HIV/AIDS, TB, headache, vaginal discharge, itchy vagina, sleeplessness, high blood pressure, fever, heart problems, diarrhoea, sweating at night, arthritis, diabetes, alcoholic problems, bad breath, sore throat, and mouth rash. Physical and psychological problems were also mentioned. Most respondents rated their health status as bad. The illegality of sex work in South Africa pushes sex workers to practice the trade in obscure places making them very vulnerable. Street-based female sex workers have numerous general health problems, but with limited access to health services. The law does not also help the course of street-based female sex workers. There is an urgent need to partially criminalize sex work. Reorientation and education of sex workers and providers is also required. All these will help promote the welfare of sex workers.
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Nankobe, Vitalis Mbah. "Human Trafficking and Migrant Prostitution in Europe: A Qualitative Study of Nigerian Female Sex Workers in Italy." Thesis, Malmö universitet, Fakulteten för kultur och samhälle (KS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-21856.
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Muldoon, Katherine Anne. "Exposure to work place and war time violence among female sex workers living in conflict-affected northern Uganda." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/55124.
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Background and objectives: Sex workers in sub-Saharan Africa are dually affected by HIV/STIs and violence. It is estimated that over one-third of commercial sex workers in sub-Saharan Africa are living with HIV; within Uganda, the site of the current study, 37.2% of female sex workers are reportedly living with HIV compared to 8.5% among the general Ugandan female population. There is limited information on the health and safety of sex workers living in environments affected by conflict despite the structural conditions that heighten risk of HIV infection and exposure to violence. This dissertation explores the prevalence and factors associated with exposure to violence among women currently involved in sex work in conflict-affected northern Uganda.
Methods: This dissertation drew on data from a community-based cross-sectional study of HIV prevention, treatment, and care among 400 sex workers living in northern Uganda. Analyses investigated exposure to violence from commercial sources (e.g., clients) and non-commercial sources (e.g., conflict-related violence, including abduction). Descriptive statistics were used to display the individual-level, sex work environment, and conflict related characteristics of study participants. Bivariable and multivariable logistic regression methods were used to examine demographic, conflict-related, and sex work-related factors associated with exposure to violence.
Results: 49.0% of sex workers had experienced sexual and physical violence in the previous six months, including physical assault, rape, and gang rape. Police harassment, inconsistent condom use, and managers/pimps that controlled sex workers’ negotiations were factors independently associated with increased odds of violence from clients. Exposure to historical conflict-related violence was common, as 32.3% of sex workers had been abducted into the Lord’s Resistance Army. From this sample, less than half reported accessing post-abduction reintegration programming.
Conclusion: Sex workers in this study were exposed to extreme levels of commercial and non-commercial violence while concurrently facing substantial barriers to care. Rights-based policies, programming, and protective services for sex workers are needed to improve access to care and social services to reduce the burden of violence and improve health and well-being outcomes.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Bwalya, Clement Mudala. "Retention in HIV care among female sex workers on antiretroviral treatment in Lusaka, Zambia: A retrospective cohort study." University of the Western Cape, 2020. http://hdl.handle.net/11394/8045.
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Master of Public Health - MPHBackground: HIV/AIDS remains a major public health issue that is affecting all population groups and communities in Zambia. Among the most affected groups are key populations (KPs) such as female sex workers. KPs are considered at high risk of contracting HIV but have limited access to HIV services and retention in care due to internalized stigma, discrimination, criminalization, and negative attitudes towards HIV treatment. Under the USAID Open Doors project in Zambia, KPs access comprehensive HIV prevention, care and treatment services. The test and treat strategy is implemented by the project in support of the UNAIDS 90-90-90 targets by 2020 to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load. Aim: This study aimed to determine retention in care among female sex workers (FSWs) in the first six months after ART initiation using the HIV care cascade. Methodology: A retrospective cohort study was conducted of all new HIV positive female sex workers (FSWs) initiated on ART between October 2018 and June 2019 (9 months period) based on the electronic records. Data were extracted from SmartCare, an electronic health record system used by the ART clinic. Microsoft Excel and Epi-Info 7 software were used for data entry and analysis. Kaplan–Meier survival analysis was conducted to examine differences in retention rates. Results: A total of 205 FSWs were initiated on ART, out of which 180 were active on ART (36 youths and 144 adults) and 25 were lost to follow-up (four youths and 21 adults) during the 9 months study period. Of the 180 FSWs active on ART, 36 were FSWs aged 18 – 24 years (youths) representing 90% retained in care while 144 were FSWs aged 25 – 42 years (adults) with 87% being retained on ART treatment. Retention in ART care was not significantly different in the survival curves between the age groups of FSW youths and FSW adults during the study period (p-value = 0.637). Retention in ART care was not statistically significant for education (p-value = 0.481), marital status (p-value = 0.545), and occupation (p-value = 0.169). Conclusion: Retention in ART care among FSWs was 88%. However, there were no significant differences by age group identified in this study. While this study shows 88% retention rate among FSWs, it will be used as a baseline in meeting the UNAIDS 90-90-90 goals.
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Nguyen, Thi Minh Tam Orapin Pitakmahaket. "Condom use related to HIV/AIDS prevention among female commercial sex workers (CSWs) in Quang Ninh province, Vietnam /." Abstract, 2004. http://mulinet3.li.mahidol.ac.th/thesis/2547/cd368/4638495.pdf.
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Lensu, Suvi. "Whore, mother, citizen? : The need for a re-definition of the citizenship of sex workers in Argentina." Thesis, Stockholms universitet, Latinamerikainstitutet, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-153484.
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In the subject of prostitution there has been a growing trend towards a sex work discourse, where the selling of sex and sexual services is regarded as a form of emotional and erotic labor. The discourse emerged in response to the self-organization of sex workers into labor unions and citizenship rights groups. In Argentina the first steps towards self-representation of sex workers’ interests were taken in the early 1990s. Gradually the sex workers’ social movement has grown into the labor union Ammar (La Asociación de Mujeres Meretrices de Argentina), which actively seeks recognition for sex workers’ economic rights, labor rights and social rights. Although the selling and buying of sexual services has been legal since the early 20th century prostitutes’ rights have been suppressed hitherto. In 2008 Argentina enacted the United Nation’s Convention to combat human trafficking, Palermo Protocol, as federal law 26.364. The law re-enforced the state’s abolitionist policies towards prostitution, which consequently further marginalized the sex workers’ plight. Connecting their services with human trafficking schemes heightened the social stigmatization of sex workers. To contest the institutional violence and social discrimination Ammar presented a law proposal in 2013. The reform asks the state of Argentina to recognize sex work as a legitimate form of labor, thus insuring the sex workers’ labor and social rights. This paper contributes to the aforementioned sex work discourse by analyzing the self-agency of Argentine sex workers. Based on qualitative fieldwork studies I conducted in 2014 in Argentina and employing a feminist methodology my object is to study how sex workers’ counter hegemonic movement redefines their citizenship. To construct a theoretical framework for the case study I will utilize Giorgio Agamben’s paradigm of ‘state of exception’ and compliment Agamben’s shortcomings by advancing feminist- and queer theories, which have radically revaluated the concept of citizenship. The conclusion is that, even though Argentinian sex workers’ requirement for equal rights may be embryonic, it addresses an urgent inclusion of different kinds of sexualities and gender balances to the citizenship discourse.En el tema de la prostitución, es cada vez más importante la tendencia hacia un discurso sobre el trabajo sexual, donde la venta de sexo y servicios sexuales se consiederan como una forma de trabajo erótico y emocional. El discurso emergió como consecuencia de la organización de las trabajadoras sexuales dentro de sindicatos y grupos de derechos ciudadanos. En Argentina, los primeros pasos hacia la representación de los intereses de las trabajadoras sexuales, fueron a principios de la década de los 90. Gradualmente, el movimiento social de las trabajadoras sexuales ha crecido dentro del sindicato Ammar (Asociación de Mujereres Meretrices de Argentina) que activamente busca reconocimiento por los derechos económicos, laborales y sociales de las trabajadoras. Aunque la compra-venta de servicios sexuales es legal desde principios del siglo XX, los derechos de las prostitutas han sido reprimidos hasta ahora. En 2010, Argentina promulgó el Protocolo Palermo, como ley federal 26.364, en la Convención de las Naciones Unidas, para combatir el tráfico de humanos. La ley reafirmó las políticas encaminadas a la abolición de la prostitución, que sistemáticamente marginalizó la mala situación del colectivo. Relacionar sus servicios con el contexto del tráfico humano ha agudizado la estigmatización social de las trabajadoras sexuales. Para luchar contra la violencia institucional y la discriminación social, Ammar presentó un proyecto de ley el 2013. La reforma pide al Estado de Argentina que reconozca el trabajo sexual como una forma legítima de trabajo, asegurando así, los derechos laborales y sociales de las trabajadoras sexuales. Esta tesis contribuye al discurso mencionado anteriormente sobre el trabajo sexual, analizando la agnecia de las trabajadoras sexuales argentinas. Basado en estudios de campo cualitativos, llevado a cabo en 2014 en Argentina y utilizando metodología cualitativa y feminista, mi objetivo es estudiar como el movimiento contra-cultural de las trabajadoras sexuales redefine su ciudadanía. Para construir un marco teórico para el caso de estudio, voy a utilizar el paradigma de Giorgio Agamben sobre el “estado de excepción” y complementar sus aportaciones con teoría feminista, que ha reevaluado radicalmente el concepto de ciudadanía. La conclusión es que, aunque los requerimientos de las trabajadoras sexuales argentinas para la igualdad de derechos pueden ser incipientes, reclaman la urgente inclusión de diferentes tipos de sexualidad y articulación de género al discurso de ciudadanía.
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Mayer, Jennifer L. "From "Living Hell" to "New Normal": Illuminating Self-Identity, Stigma Negotiation, and Mutual Support among Female Former Sex Workers." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc6079/.
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Women in the sex industry struggle with emotional turmoil, drug and alcohol addiction, poverty, and spiritual disillusionment. Their lived experiences as stigmatized individuals engender feelings of powerlessness, which inhibits their attempts to leave the sex industry. This study illuminates how personal narratives develop throughout the process of shedding stigmatized identities and how mutual support functions as a tool in life transformation. Social identity theory and feminist standpoint theory are used as theoretical frameworks of this research, with each theory adding nuanced understanding to life transformations of female former sex workers. Results indicate that women in the sex industry share common narratives that reveal experiences of a "Living Hell", transitional language, and ultimate alignment with traditional norms. Implications of SIT and FST reveal the role of feminist organizations as possible patriarchal entities and adherence to stereotypical masculine ideology as an anchoring factor in continued sex work.
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Mayer, Jennifer L. Richardson Brian K. "From "living hell" to "new normal" illuminating self-identity, stigma negotiation, and mutual support among female former sex workers /." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-6079.
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Li, Yan. "Prevalence of sexually transmitted infections and HIV and associated risk factors among female sex workers in Guangdong Providence, China." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1666117501&sid=11&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Fröberg, Emma. "FEMALE SEX WORKERS LIFE IN A TIME OF PANDEMIC : A QUALITATIVE STUDY ON THE CONSEQUENCES OF THE COVID-19 PANDEMIC IN SWEDEN." Thesis, Malmö universitet, Malmö högskola, Institutionen för kriminologi (KR), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-43171.
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In 2020, COVID-19 spread worldwide, and a state of pandemic was declared by the World Health Organization. Female sex workers are in many ways dependant on the social conditions of society and have, throughout time, been considered as a highly victimized group. This study aims to gain insight into the changes and consequences the COVID-19 pandemic has had on female sex workers in Sweden by conducting semi-structured interviews with individuals who, through their employment, have connections to female sex workers. The collected data were analyzed using thematic analysis. The results revealed four themes that describe the changes and consequences witnessed by the participants. The first theme entails the vulnerabilities and circumstances that female sex workers are conditioned by in society. The second theme demonstrates the economic consequences which the pandemic outbreak caused. Not only in relation to expenses and difficulties traveling but also in terms of an increased market due to unemployment and lockdowns in Central Europe. This theme also includes a subgroup of physical consequences as a result of the competition created by the increased market of female sex workers in Sweden. This has caused the women to have to take additional risks and abuse. The third theme includes the bureaucratic and social complications caused by the social restrictions enforced to hinder the spread of the COVID-19. The fourth and last theme presents the participants' post-pandemic predictions.
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Syvertsen, Jennifer L. "Love and Risk: Intimate Relationships among Female Sex Workers who Inject Drugs and their Non-Commercial Partners in Tijuana, Mexico." Scholar Commons, 2012. http://scholarcommons.usf.edu/etd/4235.
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This dissertation examines the influence of love and other emotions on sexual and drug-related HIV risk among female sex workers who inject drugs and their intimate, non-commercial partners in Tijuana, Mexico. My work on a public health study along the Mexico-U.S. border and independent ethnographic research in Tijuana suggests the importance of emotions in shaping sex workers' relationships and health risks.
Love is a universal human emotional experience embodied within broader cultural, social, and economic contexts. A growing body of cross-cultural research suggests that modern relationships have transformed to emphasize love and emotional intimacy over moral or kinship obligations. Particularly in contexts of risk and uncertainty, intimate relationships provide emotional security. Drug-using couples may engage in unprotected sex or even needle sharing to convey notions of love and trust and help sustain emotional unity, but such acts also place partners at heightened risk for HIV.
For female sex workers in Tijuana who endure poverty, marginality, and an increased risk of contracting HIV, establishing and maintaining emotional bonds with intimate partners may be of paramount importance. Yet little is known about how female sex workers' intimate male partners shape their HIV risk perceptions and practices. Moreover, male partners' perspectives are critically absent in HIV prevention strategies.
This dissertation is nested within Proyecto Parejas, a study of the social context and epidemiology of HIV among sex workers and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico. Through semi-structured and ethnographic interviews, photo elicitation interviews, and participant observation, I got to know seven of the couples in Tijuana who are enrolled in Parejas. I examine their relationships through the lens of critical phenomenology, which combines concern with experience, emotions, and subjectivity with political economy perspectives that argue sex work, drug use, and HIV/AIDS is not randomly distributed but historically and structurally produced.
My work suggests that female sex workers and their intimate partners experience their relationships in gradations of love and emotional content. These relationships hold significant meaning in both partners' lives for emotional and material reasons, and shape each partner's HIV risk within and outside of the relationships. Couples choose not to use condoms with each other, often to define themselves as a couple. Sex outside of the relationship occurs for economic and culturally conditioned reasons, but does not necessarily diminish the meaning of the primary relationship. Motivations and ability to use condoms with clients and outside partners are context dependent and, in order to preserve trust and unity, sexual risks are typically not discussed. Partners share drugs and syringes with each other as a sign of care within a context of scarce material resources. Emotionally close couples tend to confine their sharing within the relationship, whereas less close couples also share with friends and family in more social forms of drug use.
Given their vulnerability within a milieu of poverty, social marginalization, and discrimination, love alone cannot explain the HIV risk that female sex workers and their partners face. Nevertheless, emotions are significant factors in both risk taking and risk management. This study encourages researchers, practitioners, and policy makers to consider the affective dimensions of HIV risk within sex workers' intimate relationships as an integral part of a multi-level strategy to address each partner's health and wellbeing.
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Ghee, Annette Elizabeth. "Individual and workplace-level correlates of sexually transmitted infections, including HIV infection, among Central American female sex workers : a multilevel approach /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/10936.
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Shahmanesh, M. "HIV prevention while bulldozers roll : developing evidence based HIV prevention intervention for female sex workers following the demolition of Goa's redlight area." Thesis, University College London (University of London), 2010. http://discovery.ucl.ac.uk/19228/.
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Background: Interventions targeting female sex workers (FSWs) are pivotal to HIV prevention in India. Societal factors and legislation around sex-work are potential barriers to achieving this. In recent years several high profile closures of red-light areas and dance bars in India have occurred. In this thesis I describe the effects of the demolition of Goa’s red-light area on the organsiation of sex-work, HIV risk environment, and implications for evidence-based HIV prevention. Methods: The pre-demolition phase was a detailed ethnographic study. The early post-demolition phase included rapid ethnographic mapping of sex-work in the immediate aftermath. The late post-demolition phase was a cross-sectional survey supplemented by an in-depth qualitative study. 326 FSWs were recruited throughout Goa using respondent-driven-sampling, and completed interviewer-administered questionnaires. They were tested for sexually transmitted infections (STIs) and HIV. Results: The homogeneous brothel-based sex-work in Goa evolved into heterogeneous, clandestine and dispersed types of sex-work. The working environment was higher risk and less conducive to HIV prevention. Infections were common with 25.7% prevalence of HIV and 22.5% prevalence of curable STIs. Women who had never worked in Baina, young women, and those who had recently started sex-work were particularly likely to have curable STIs, a marker of recent sexual risk. STIs were independently associated with young age, lack of schooling, no financial autonomy, deliberate-self-harm, sexual-abuse, regular customers, streetbased sex-work, Goan ethnicity, and being asymptomatic. Having knowledge about HIV, access to free STI services, and having an intimate partner were associated with a lower likelihood of STIs. HIV was independently associated with being Hindu, recent migration to Goa, lodge or brothel-based sex work, and dysuria. Conclusions: Tackling structural and gender-based determinants of HIV are integral to HIV prevention strategies. Prohibition and any form of criminalisation of sex-work reduce the sex workers’ agency and create barriers to effective HIV prevention.
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Rossouw, Johannes. "Depression and HIV risk among female sex workers in Nelson Mandela Bay Municipality, South Africa: Results from a respondent-driven sampling study." Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31733.
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Sex workers have a higher risk of acquiring and transmitting HIV as a result of social, structural, biomedical and behavioural factors. Many recent studies have highlighted that sex workers and other key populations experience higher levels of depression compared to the general population. Evidence is also emerging that mental health issues such as depression are related to HIV risk behaviour as well as the social and structural factors that leave sex workers vulnerable to bio-behavioural risks. The study protocol is described in Part A of this mini-dissertation. The study from which these data were derived is discussed in detail. Particular attention is placed on the use of respondent-driven sampling as a probabilistic method to estimate population proportion for hidden populations. The primary outcome, depression, and how it is measured through the Patient Health Questionnaire 9, is discussed in detail. The objective of measuring the prevalence of depression and assessing how it relates to risk factors is noted. The protocol argues that most research on sex workers focuses only on social, structural and bio-behavioural risk factors and rarely includes intrapersonal factors such as mental health. Based on this gap, it is argued that this research will help elucidate how depression, as an intrapersonal factor, relates to HIV risk. The literature review in Part B expands the argument that mental health in general and depression in particular are not given the attention they deserve as there are very few studies that measure mental health variables and even fewer that attempt to make any link between mental health, bio-behavioural risk and social vulnerabilities. The journal article in Part C offers empirical evidence that depression is higher among female sex workers than the general population and that depression is strongly associated with bio-behavioural and social risk factors. The article argues for more integration of mental health in research and programme implementation among sex workers.
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Bartlett, Elretha. "“You whore; you are so dirty, bitch”: the justification of and resistance to violence in the intimate relationships of female sex workers." Thesis, Rhodes University, 2017. http://hdl.handle.net/10962/5082.
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The objective of the study is to examine discourses of gender and dimensions of social difference implicated in female sex workers’ (FSWs) justifications of, and resistances to, intimate partner violence (IPV). Individual narrative interviews were conducted with FSWs (n=11) who were affiliated with the Sex Workers Education and Advocacy Taskforce (SWEAT). The participants were mostly women of colour (n=10), with a low socio-economic status, and between 31 and 51 years of age. Intersectionality and features of Foucauldian discourse analysis, as described by Parker (1992), informed the analysis of the interview data. In personal interviews, participants interrogated aspects of their own and their partners’ lives that they viewed as playing a significant role in the aetiology and experience of IPV. They drew on a discourse of violent black masculinity, developmental discourses, and patriarchal ideology to justify and resist their partners’ violent behaviour. They also positioned themselves and their ‘spoiled’ identities as playing a role in the experience of violence. Participants pointed to the construction of sex work as ‘dirty work’ and the role that this played in legitimising the violence that was directed at them by intimate partners. In relation to this positioning and its consequences in terms of justifications for violence, my analysis highlights occasions in which gender ideology is re-appropriated for the purpose of challenging the legitimacy of these interpretative frames. While gender politics is central to my analytic observations, my analysis demonstrates how intersections with race and class shape the specificities of FSWs experiences of IPV. In doing so, this study aims to broaden current insights into the phenomenon of IPV, as it does not only focus on gender discrimination, but on the complex interaction between various systems of oppression.
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Manivone, Viengthong Luechai Sringernyuang. "Gender and sexuality, and their implications on sexual reproductive health including HIV/AIDS : a case study of young female factory workers in Vientiane, Laos /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd376/4637980.pdf.
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Escobar, Laura Maria. "Progressive care an examination of male to female transgender sex workers' experiences within the health care and social service systems in San Francisco, California : a project based upon an independent investigation /." Click here for text online. Smith College School for Social Work website, 2007. http://hdl.handle.net/10090/1032.
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Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2007Thesis submitted in partial fulfillment for the degree of Master of Social Work. Includes bibliographical references (leaves 87-90).
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Choudhury, Shonali Mona. "Sex work does not make me an indecent woman a grounded theory study of the process of forming a positive self image and negotiating health in the lives of establishment-based female sex workers in Tijuana /." Diss., Restricted to subscribing institutions, 2009. http://proquest.umi.com/pqdweb?did=1835552451&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Traore, Isidore Tiandiogo. "Prise en charge des travailleuses du sexe confrontées au VIH/sida au Burkina Faso : évaluation d’un paquet d’intervention offert aux jeunes travailleuses du sexe dans la ville de Ouagadougou." Thesis, Montpellier, 2015. http://www.theses.fr/2015MONTT036.
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Contexte: Les travailleuses du sexe (TS) sont un groupe à risque de l’infection à VIH, jouant un rôle majeur dans la dynamique de l’épidémie en Afrique de l’Ouest. Les interventions de prévention et de prise en charge du VIH ciblant ces femmes sont donc indispensables, mais leur contenu reste à définir. Nous avons conçu un paquet d’intervention qui combinait la prévention et les soins, et estimé son impact sur l’incidence du VIH. Méthodes: Entre septembre 2009 et septembre 2010, nous avons réalisé une étude transversale à Ouagadougou (Burkina Faso) suivie d’une étude de cohorte interventionnelle chez des jeunes TS âgées de 18 à 25 ans, avec un suivi trimestriel pendant 21 mois maximum. Le paquet d’intervention de la cohorte combinait des activités de prévention effectuées par des pairs (sessions de communication pour un changement de comportement) et de soins (IST, VIH, soins généraux, santé sexuelle et reproductive, soutien psychologique).A chaque visite, les comportements sexuels étaient collectés par un questionnaire ; des tests VIH, HSV-2 et de grossesses étaient réalisés. L’incidence de l’infection à VIH observée dans la cohorte a été comparée à l’incidence attendue en absence d’intervention. Cette dernière a été estimée grâce à un modèle mathématique de Bernouilli utilisant les données collectées chez les clients des TS, et des estimations de paramètres clés issus de la littérature.Durant le suivi, nous avons défini un comportement à risque comme le premier épisode d’un évènement biologique résultant d’un rapport sexuel non-protégé : grossesse non-désirée, primo-infection HSV-2 ou à T. vaginalis. Nous avons utilisé un modèle logistique à effet aléatoire pour identifier les déterminants de ces comportements à risque durant le suivi.Résultats: Parmi les 609 travailleuses du sexe pré-sélectionnées dont 188 (30,9%) professionnelles, la prévalence du VIH était de 10,3% chez les professionnelles et 6,5% chez les non-professionnelles l’âge médian était de 21 ans. Au total, 41,2% des professionnelles et 47,5% des non-professionnelles rapportaient une utilisation non systématique du préservatif, principalement avec leurs partenaires réguliers.Dans cette étude transversale, l’infection à VIH était associée à l’âge (aOR=1,44; IC95%: 1,22-1,71), la vie en couple (AOR=2,70; IC95%: 1,21-6,04), et l’infection à T. vaginalis (aOR=9,63; IC95%: 2,93-31,59), tandis que la réalisation antérieure d’un test VIH réduisait nettement ce risque (AOR=0,18; IC95%: 0,08-0,40). Les 321 TS non-infectées par le VIH incluses dans la cohorte ont effectué un suivi total de 409 personne-années (p-a). Aucune participante n’a fait une séroconversion au VIH durant le suivi (0/409 p-a) alors que l’incidence attendue modélisée était de 5,05/409 p-a (IC95%, 5,01-5,08) soit 1,23 infection/100 p-a (p=0,005). Cette incidence nulle était associée à une réduction du nombre de partenaires réguliers et de clients réguliers ainsi qu’à une augmentation du taux d’utilisation constante du préservatif avec les nouveaux clients (aOR =2,19; IC95%, 1,16-4,14) et avec les clients réguliers (aOR=2,18; IC95%, 1,26-3,76). Cependant, les comportements à risque restaient élevés durant l’intervention : 26,7/100 p-a (IC95%, 24,1-33,7). Ce risque résiduel était plus élevé chez les TS vivant en couple (aOR =7,47, IC95%, 1,70-30,80) et chez les non-professionnelles (AOR =5,53, IC95%, 1,75-16,84). Ces dernières avaient le plus tendance à ne pas déclarer les comportements à risque lors des interviews. Conclusions: Notre étude a démontré la nécessité de cibler les jeunes TS par des interventions adaptées.Notre paquet d’intervention combinant la prévention du VIH et les soins a permis de réduire l’incidence du VIH chez les jeunes travailleuses du sexe au Burkina Faso. Les interventions devront se focaliser sur le dépistage du VIH, les TS non-professionnelles et les partenaires réguliersBackground: In West Africa, interventions targeting female sex workers (FSW) are crucial to impact on the HIV dynamics. However, the contents and efficacy of these interventions are unclear, and identifying the most at risk FSW in order to adapt these interventions remain challenging, partly because of the limitations of self-reported sexual behaviours. We therefore designed a comprehensive dedicated intervention targeting young female sex workers, and assessed its impact on HIV incidence in Burkina Faso and the reliability of interview data. Methods: From September 2009 to September 2010 we conducted a cross sectional study in Ouagadougou, Burkina Faso. Then HIV-uninfected FSW aged 18-25 years were enrolled in a prospective interventional cohort. The participants were followed quarterly for a maximum of 21 months. The intervention group received a package which combined prevention and care within the same setting, and consisting of peer-led education sessions, psychological support, sexually transmitted infections and HIV care, general routine health care, and reproductive health services. At each visit, behavioural characteristics were collected and HIV, HSV-2 and pregnancy were tested. High-risk behaviour was defined as the first occurrence of any biological event resulting from unsafe sex, including unexpected pregnancy or HSV-2 or T. vaginalis infection. We used random logistic models to assess the relationship between socio-demographic characteristics and the residual high risk behaviours during the intervention.We compared the cohort HIV incidence with a Bernoulli modelled expected incidence in the absence of intervention, using data collected at the same time from FSW clients and key parameters from the litterature. Results: We screened 609 FSW including 188 (30.9%) professionals. Their median age was 21 years [IQR, 19-23], and the prevalence of HIV was 10.3% among professionals and 6.5% among non-professionals. Overall, 277 (45.6%) women reported high-risk behaviours (41.2% among professionals and 47.5% among non-professionals), which were driven mainly by non-consistent condom use with regular partners. In multivariable analysis, before the intervention, HIV infection was associated with older age (AOR=1.44; 95%CI: 1.22-1.71), with being married/cohabiting (AOR=2.70; 95%CI: 1.21-6.04), and with T. vaginalis infection (AOR=9.63; 95%CI: 2.93-31.59), while previous HIV testing was associated with a decreased risk (AOR=0.18; 95%CI: 0.08-0.40).The 321 HIV-uninfected FSW enrolled in the cohort completed 409 person-years of follow-up. No participant seroconverted for HIV during the study while the expected modelled number of HIV infections were 5.05 (95%CI, 5.01-5.08) during the same follow-up (409 person-years) or 1.23 infection per 100 person-years (p=0.005). This null incidence was related to a reduction in the number of regular partners and regular clients, and to an increase in consistent condom use with casual clients (AOR =2.19; 95%CI, 1.16-4.14, p=0.01) and with regular clients (AOR=2.18; 95%CI, 1.26-3.76, p=0.005). However, the incidence of residual risk was high, at 26.7/100 person-years (95% CI, 24.1-33.7). The residual risk was higher among FSW living in couple (adjusted odd ratio [AOR] =7.47, 95% CI, 1.70-30.80) and among those for whom sex work was not the main source of income (AOR =5.53, 95% CI, 1.75-16.84). The latter also tended not to report high-risk behaviours during face –to–face interview. Conclusions: This study highlights the need for targeted interventions among young FSW focusing particularly on non-professionals, sexual behaviours with regular partners and regular HIV testing. The ANRS 1222 study intervention package which combined peer-based prevention and care within the same setting markedly reduced HIV incidence among young female sex workers in Burkina Faso, through reduced risky behaviours
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Parriault, Marie-Claire. "Connaissances, attitudes et pratiques vis-à-vis du VIH et des IST parmi les travailleuses du sexe en Guyane et à Oiapoque, Brésil." Thesis, Guyane, 2015. http://www.theses.fr/2015YANE0006/document.
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L’épidémie de VIH en Guyane est souvent présentée comme généralisée. Cependant, certains groupes semblent plus particulièrement touchés. Parmi ces groupes vulnérables, les travailleuses du sexe tiennent une place particulière compte tenu de la fréquence des rapports transactionnels dans la région. Ces échanges économico‐sexuels dépassent les frontières puisque de nombreux clients venant de Guyane rencontrent des travailleuses du sexe à Oiapoque, ville brésilienne frontalière. Malgré l'importance potentielle de la prostitution dans la dynamique de l'épidémie VIH, peu de données existent sur le sujet dans la région.L’objectif principal de cette étude était de répondre à ce manque de données et de décrire les connaissances, attitudes et pratiques des travailleuses du sexe en Guyane et à Oiapoque afin de pouvoir ajuster au mieux les actions de prévention.Les résultats des enquêtes menées en Guyane et à Oiapoque en 2010 et 2011 ont mis en lumière un certain nombre de faits favorisant la progression de l’épidémie au sein des travailleuses du sexe, mais également favorisant la diffusion de l’épidémie en population générale. Ainsi l’utilisation du préservatif n’était pas toujours adéquate et bien qu’elle était constante avec les clients, elle l’était beaucoup moins avec les partenaires intimes, dans un contexte de multipartenariat fréquent. Le taux de dépistage à Oiapoque était particulièrement faible également. Au‐delà de l’aspect individuel, le cadre structurel impactait clairement la vulnérabilité des travailleuses du sexe. Ainsi, la non‐disponibilité des traitements à Oiapoque, la précarité dans laquelle se trouvent les personnes et le cadre législatif des deux pays représentent des obstacles majeurs à la prise en charge destravailleuses du sexe.Différents niveaux de lecture sont nécessaires pour essayer de percevoir la complexité des comportements face au risque de transmission du VIH parmi les travailleuses du sexe. C’est à chacun de ces niveaux qu’il faut envisager la prévention, et non plus au seul niveau individuel, pour qu’elle puisse être efficace. Cette prévention doit, elle‐même, être envisagée plus globalement pour apporter une réponse efficace à l’épidémie de VIH en combinant des éléments de prévention comportementale, biomédicale et structurelleThe HIV epidemic in French Guiana is often described as generalized. However, some vulnerable groups appear particularly affected. Among these groups, female sex workers hold a special place because of the frequency of transactional relationships in the region. These sexual‐economic exchanges go beyond the borders since many customers from French Guiana solicit female sex workers in Oiapoque, the Brazilian border town. Despite the potential importance of sex work in the HIV epidemic, there is scarce data on the subject in the area.The main objective of this study was to address this knowledge gap and to describe the knowledge, attitudes and practices among female sex workers in French Guiana and Oiapoque in order to optimize and subsequently evaluate prevention.The results of the survey conducted in French Guiana and Oiapoque in 2010 and 2011 highlighted a number of events promoting the spread of the epidemic among female sex workers, but also promoting the spread of the epidemic in the general population. Thus, condom use was not always adequate. Although it was consistent with the customers, it was much less with intimate partners, in a common multiple sexual partnerships context. The HIV screening rate was particularly low in Oiapoque as well. Beyond the individual aspect, the structural framework clearly impacted the vulnerability of female sex workers. Thus, the non‐availability of treatment in Oiapoque, the precariousness in which people live and the legislative framework of the two countries are major barriers to female sex workers’ support.Different levels of understanding are necessary to disentangle the complexity of behaviors facing the risk of transmission of HIV among female sex workers. Prevention must be considered at each level, not only at the individual level, to be effective. Furthermore, prevention must be considered more generally to provide an efficient response to the HIV epidemic by combining behavioral, biomedical and structural prevention elements
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Amaral, Rose Luce Gomes do. "O papel das duchas higiênicas vaginais sobre a prevalência das infecções genitais em mulheres profissionais do sexo." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311580.
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Orientadores: Paulo César Giraldo, Ana Katherine da Silveira GonçalvesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-16T20:57:25Z (GMT). No. of bitstreams: 1 Amaral_RoseLuceGomesdo_D.pdf: 1220448 bytes, checksum: d6f8f0907e1226cc41668603ab978683 (MD5) Previous issue date: 2010
Resumo: O uso de duchas vaginais é comum em diferentes povos e culturas. Entre as mulheres que a praticam, a maioria a faz após a menstruação, antes ou após a relação sexual, com a finalidade de evitar o odor desagradável ou para eliminar corrimentos, refrescar a genitália ou prevenir a gravidez. Não está claro na literatura se as duchas poderiam causar problemas às usuárias. Objetivo: Verificar se o uso habitual de duchas vaginais associa-se à infecção genital por Chlamydia trachomatis/ Neisseria gonorrhoeae e Papilomavírus humano (HPV) em mulheres profissionais do sexo. Sujeitos e Métodos: Estudo de corte transversal avaliou 200 mulheres - 111 profissionais do sexo (PS) e 89 não profissionais do sexo (NPS) - assistidas em uma Unidade Básica de Saúde de Campinas, São Paulo, Brasil. Todas as mulheres foram entrevistadas e examinadas por um único pesquisador. A anamnese abordou os antecedentes demográficos, higiênicos, sexuais e médicos, como idade, cor, paridade, escolaridade, tabagismo, estado civil, uso de duchas vaginais, idade da primeira relação sexual, número de parceiros sexuais, número de coitos por semana, práticas sexuais, uso de preservativo e lubrificante. Amostras de células cervicais foram coletadas para testes de captura híbrida objetivando Chlamydia trachomatis/Neisseria gonorrhoaea e HPV. Na análise estatística usou-se o teste exato de Fisher ou X2 para as variáveis discretas, e Mann-Whitney para as variáveis não-paramétricas. O estudo foi aprovado pelo Comitê de Ética em Pesquisa (no 902/2009) e contou com a colaboração da Secretaria de Saúde do Estado de São Paulo e Laboratório Digene. Resultado: Cerca de 40% das mulheres investigadas praticavam duchas vaginais três ou mais vezes por semana (61,7% das PS e somente 14,6% das NPS). A infecção por CT/NG foi positiva em 10,5% do total dos casos, 17 casos (15,3%) em PS e em quatro casos (4,5%) das NPS (p=0,01), porém não houve diferenças significativas entre usuárias de duchas vaginais (14,81%) e não usuárias (7,6%), (p=ns). As PS não usuárias de duchas vaginais tiveram quase o dobro de infecção CT/NG que as NPS usuárias de duchas vaginais (13,9% vs 7,7%). O HPV foi positivo em 40,5% dos casos, sendo 55,8% da PS e em 21,3% das NPS (p=0,001), contudo DNA-HPV não foi significativamente diferente (p=0,47) entre PS usuárias de duchas vaginais (54,4%) e em não usuárias (58,1%). HPV de alto risco foi positivo em 16,2% e 11,6% (p=ns) e o HPV de baixo risco em 23,5% e 30,2% (p=ns) em usuárias e não usuárias de duchas vaginais respectivamente. Os HPV de alto e baixo riscos foram encontrados simultaneamente em 14,7% e 16,2% das usuárias e não usuárias de duchas vaginais, respectivamente (p=ns). Conclusão: O uso de duchas vaginais não se associou às infecções genitais por CT/NG e HPV de alto ou baixo grau nas mulheres estudadas (profissionais do sexo e não profissionais do sexo)
Abstract: The use of vaginal douching (VD) is widespread around the world, and is more common than is to be expected. The majority of women douche after menses, before or after sexual intercourse to prevent odor, to alleviate vaginal symptoms, or to prevent pregnancy, however it is not clear in the literature if this habit can cause damages for women. Objective: Establish whether high frequency VD favors Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) and Papilomavírus humano (HPV) infection in female sex workers (SW). Subjects and Methods: A clinical cross-sectional study involving 200 women, 111 SW and 89 non-sex workers (NSW) in a Health Center in Brazil. The subjects were submitted to an interview and examined by a single researcher. A questionnaire was filled out with data that included, medical and demographic history (age, race, parity, education, smoking, marital status), hygiene (use of VD, frequency and the solution used) and sexual behaviour (first sexual relation, number of sexual partners, frequency, sexual practices, homosexual relationships, use of condom and lubricant). Cervical samples were collected for CT and NG testing by hybrid capture 2 assay. Statistical analysis used the Fisher's exact test or qui square for discrete variables and Mann-Whitney test for nonparametric variables. The study was approved by Committee the Ethics in Research (no 902/2009) and received the cooperation of São Paulo Secretariat of Health and Digene laboratory. Results: Approximately 40% of women practiced douche three or more times per week (61.7% of SW and only 14.6% of the NSW). Infection with CT / NG was positive in 10.5% of the total cases, 17 cases (15.3%) in SW and in four cases (4.5%) of the NSW (p = 0.01). However, It was in 14.81% of D and but in and 7.6% of ND (p = ns). SW douchers had almost double CT and NG infections than NSW douchers (13.9% vs 7.7%). HPV infection was detected in 40.5% of cases, 55.8% of SW and 21.3% of NSW of (p = 0.001), despite of DNA HPV was not different (p = 0.47) between SW douchers (54.4%) and non-douchers (58.1%). High-risk DNA-HPV was positive in 16.2% and 11.6% (p = ns) and low-risk DNA-HPV in 23.5% and 30.2% (p = ns) in douchers and non-douchers respectively. High and low risk DNA-HPV were found simultaneously in 14.7% and 16.2% of douchers and non-douchers respectively (p = ns). Conclusion: The use of VD is not a causal factor for cervical CT/NG and High-/low risk HPV infection in women studied (SW and NSW)
Doutorado
Tocoginecologia
Doutor em Tocoginecologia