Sexual risk variability among brothel-based sex workers has been shown to be influenced by fear of HIV transmission, and by culture-bound gender norms as well as economic need, yet the effect of sexual agency on impoverished Latina sex workers' risk behavior with their clients remains poorly characterized. We investigated perceived health beliefs regarding susceptibility to/severity of HIV/AIDS, and sexual agency regarding barriers to condom use, benefits of unprotected sex, and risk-reduction behavior with clients among a sample of 33 brothel workers in Belize. Although 77% of participants felt at risk for HIV, only 30% always use condoms and 43% did not refuse unprotected sex with clients. Participants' narrative explanations for unprotected sex emphasized that clients'preferences often overrode brothel workers fear of HIV, and that the health benefits of using condoms with clients were often weighed against the social benefits of unprotected sex. Implications for brothel-based condom promotion programs and further research are discussed.

[No Keywords available]

education Models, Psychological HIV Infections psychological model belize Human immunodeficiency virus infection psychological aspect nursing methodology research poverty human condom Condoms health service Risk Reduction Behavior ethnology Hispanic Americans Unsafe Sex Health Services Needs and Demand Humans Hispanic Adolescent female questionnaire verbal communication prostitution Narration Health Knowledge, Attitudes, Practice Article high risk behavior Risk-Taking Questionnaires adult migration Utilization Review Transients and Migrants risk reduction Fear attitude to health