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Client Demands for Unsafe Sex: The Socioeconomic Risk Environment for HIV Among Street and Off-Street Sex Workers

Journal of acquired immune deficiency syndromes (1999), 2013-08, Vol.63 (4), p.522-531 [Peer Reviewed Journal]

2013 Lippincott Williams & Wilkins, Inc. ;2014 INIST-CNRS ;Copyright Lippincott Williams & Wilkins Aug 1, 2013 ;ISSN: 1525-4135 ;EISSN: 1944-7884 ;DOI: 10.1097/QAI.0b013e3182968d39 ;PMID: 23614990 ;CODEN: JDSRET

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Title:
Client Demands for Unsafe Sex: The Socioeconomic Risk Environment for HIV Among Street and Off-Street Sex Workers
Author: Deering, Kathleen N ; Lyons, Tara ; Feng, Cindy X ; Nosyk, Bohdan ; Strathdee, Steffanie A ; Montaner, Julio S.G ; Shannon, Kate
Subjects: Adolescent ; Adult ; Amphetamine-Related Disorders - psychology ; Biological and medical sciences ; Canada ; Condoms ; Condoms - utilization ; Confidence Intervals ; Cross-Sectional Studies ; Female ; Fundamental and applied biological sciences. Psychology ; HIV ; HIV Infections - transmission ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Medical sciences ; Methamphetamine ; Microbiology ; Miscellaneous ; Multivariate Analysis ; Odds Ratio ; Regression analysis ; Risk assessment ; Risk Factors ; Sex industry ; Sex Work - psychology ; Sex Work - statistics & numerical data ; Sex Workers - psychology ; Sexual behavior ; Social Environment ; Socioeconomic Factors ; Surveys and Questionnaires ; Unsafe Sex - psychology ; Unsafe Sex - statistics & numerical data ; Viral diseases ; Virology ; Young Adult
Is Part Of: Journal of acquired immune deficiency syndromes (1999), 2013-08, Vol.63 (4), p.522-531
Description: OBJECTIVE:Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural, and client-related factors associated with being offered and accepting more money after clients’ demand for sex without a condom. DESIGN:Cross-sectional study using baseline (February 2010 to October 2011) data from a longitudinal cohort of 510 SWs. METHODS:A 2-part multivariable regression model was used to identify factors associated with 2 separate outcomes(1) being offered more money for sex without a condom in the last 6 months; and (2) accepting more money, among those who had been offered more money. RESULTS:The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms, and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine less than daily (versus none) and less likely for SWs who solicited mainly indoors for clients (versus outdoor/public places). CONCLUSIONS:These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor workspaces are urgently required.
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins, Inc
Language: English
Identifier: ISSN: 1525-4135
EISSN: 1944-7884
DOI: 10.1097/QAI.0b013e3182968d39
PMID: 23614990
CODEN: JDSRET
Source: MEDLINE
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Client Demands for Unsafe Sex: The Socioeconomic Risk Environment for HIV Among Street and Off-Street Sex Workers

2013 Lippincott Williams & Wilkins, Inc. ;2014 INIST-CNRS ;Copyright Lippincott Williams & Wilkins Aug 1, 2013 ;ISSN: 1525-4135 ;EISSN: 1944-7884 ;DOI: 10.1097/QAI.0b013e3182968d39 ;PMID: 23614990 ;CODEN: JDSRET

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