Sexually Transmitted Diseases
Volume 42, Issue 6, 2015, Pages 312-316

Structural determinants of inconsistent condom use with clients among migrant sex workers: Findings of longitudinal research in an urban canadian setting (Article)

Sou J. , Shannon K. , Li J. , Nguyen P. , Strathdee S.A. , Shoveller J. , Goldenberg S.M.*
  • a Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
  • b Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, Department of Medicine, University of British Columbia, St Paul's Hospital, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada
  • c Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada
  • d Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada
  • e University of California San Diego School of Medicine, San Diego, CA, United States
  • f School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
  • g Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, Department of Medicine, University of British Columbia, St Paul's Hospital, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada

Abstract

Background: Migrant women in sex work experience unique risks and protective factors related to their sexual health. Given the dearth of knowledge in high-income countries, we explored factors associated with inconsistent condom use by clients among migrant female sex workers over time in Vancouver, BC. Methods: Questionnaire and HIV/sexually transmitted infection testing data from a longitudinal cohort, An Evaluation of Sex Workers Health Access, were collected from 2010 to 2013. Logistic regression using generalized estimating equations was used to model correlates of inconsistent condom use by clients among international migrant sex workers over a 3-year study period. Results: Of 685 participants, analyses were restricted to 182 (27%) international migrants who primarily originated from China. In multivariate generalized estimating equations analyses, difficulty accessing condoms (adjusted odds ratio [AOR], 3.76; 95% confidence interval [CI], 1.13-12.47) independently correlated with increased odds of inconsistent condom use by clients. Servicing clients in indoor sex work establishments (e.g., massage parlors) (AOR, 0.34; 95% CI, 0.15-0.77), and high school attainment (AOR, 0.22; 95% CI, 0.09-0.50) had independent protective effects on the odds of inconsistent condom use by clients. Conclusions: Findings of this longitudinal study highlight the persistent challenges faced by migrant sex workers in terms of accessing and using condoms. Migrant sex workers who experienced difficulty in accessing condoms were more than 3 times as likely to report inconsistent condom use by clients. Laws, policies, and programs promoting access to safer, decriminalized indoor work environments remain urgently needed to promote health, safety, and human rights for migrant workers in the sex industry. Copyright © 2015 American Sexually Transmitted Diseases Association All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

urban population urban area prospective study longitudinal study health promotion Human immunodeficiency virus infection Prospective Studies human Longitudinal Studies statistics and numerical data condom Condoms Substance-Related Disorders sex worker sexually transmitted disease condom use Confidence interval Surveys and Questionnaires migrant worker Humans psychology Canada female Socioeconomic Factors Multivariate Analysis socioeconomics questionnaire prostitution Health Knowledge, Attitudes, Practice Article major clinical study adult health education migration utilization Sex Workers Transients and Migrants attitude to health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929873112&doi=10.1097%2fOLQ.0000000000000276&partnerID=40&md5=1a1d4f002c6830bfcaf9b5caff2280d0
DOI: 10.1097/OLQ.0000000000000276
ISSN: 01485717
Cited by: 8
Original Language: English