Violence victimisation, sexual risk and sexually transmitted infection symptoms among female sex workers in Thailand

• Published in: Sexually transmitted infections Vol. 86; no. 3; pp. 236 - 240
• Main Authors: Decker, Michele R, McCauley, Heather L, Phuengsamran, Dusita, Janyam, Surang, Seage, George R, Silverman, Jay G
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.06.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Biological and medical sciences; Condoms; Crime Victims - statistics & numerical data; Data collection; Disease prevention; Epidemiology. Vaccinations; Estimates; Female; General aspects; HIV; Human immunodeficiency virus; Human infectious diseases. Experimental studies and models; Human subjects; Humans; Infections; Infectious diseases; Medical sciences; Population; Prevalence; Prevention and actions; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex industry; sex work; Sex Work - statistics & numerical data; sexual assault; sexual risk; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Social research; STD; STI symptoms; Thailand; Unsafe Sex - statistics & numerical data; Vagina; Victimization; Violence; Violence - statistics & numerical data; Young Adult; Thailand; Asia; Southeast Asia; Bangkok Thailand; Infection; Prostitution; Symptomatology; Sexually transmitted disease; Violence; Sexual behavior; Female
• ISSN: 1368-4973; 1472-3263; 1472-3263
• DOI: 10.1136/sti.2009.037846

Background/ObjectivesCommercial sex work is a primary context for heterosexual HIV/AIDS transmission. Violence victimisation is considered to compromise women's ability to protect against HIV and other sexually transmitted infections (STI); little research has investigated violence as it relates to sexual risk and STI among female sex workers (FSW). This study sought to compare sexual risk and STI symptoms among FSW based on recent violence exposure.MethodsData from 815 FSW in Thailand were used to assess the prevalence of physical or sexual violence within the context of sex work, and associations of victimisation with sexual risk and STI symptoms.ResultsApproximately one in seven FSW (14.6%) had experienced violence in the week before the survey. Compared with their unexposed counterparts, FSW exposed to violence demonstrated a greater risk of condom failure (19.6% vs 12.3%, ARR 1.92, 95% CI 1.24 to 2.95) and client condom refusal (85.7% vs 69.0%, ARR 1.24, 95% CI 1.14 to 1.35). In analyses adjusted for sexual risk, violence related to STI symptoms collectively (ARR 1.11, 95% CI 1.02 to 1.21) and genital lesions as an individual STI symptom (ARR 1.78, 95% CI 1.20 to 2.66).ConclusionPhysical and sexual violence against FSW in Thailand appears to be common, with women experiencing such violence demonstrating diminished capacity for STI/HIV harm reduction and greater prevalence of STI symptoms. Efforts to reduce violence towards this vulnerable population must be prioritised, as a means of protecting the health and wellbeing of FSW, and as a key component of STI/HIV prevention and control.