Dataset Information

Clients of sex workers in different regions of the world: hard to count.

ABSTRACT:

Objectives

To estimate the proportion of the male population that reports having paid for sex in different regions.

Methods

Clients of sex workers were identified from representative samples of men asked in face-to-face interviews whether they had had sex in exchange for money or whether they had paid for sex, in the last 12 months. A total of 78 national household surveys and nine city based surveys were selected for inclusion. Where such surveys were not available, results of behavioural surveillance surveys and of research studies were also used. Using national estimates, a median percentage of men who reported paying for sex was calculated for each region.

Results

The median percentage of men who exchanged sex for money in the last 12 months in all regions was around 9-10%, with estimates from 13% to 15% in Central African region, 10 to 11% in Eastern and southern Africa, and 5-7% in Asia and Latin America. Estimates for men who paid sex were much lower at around 2-3% with ranges from 7% in the South African region to 1% in Asia and West Africa.

Conclusions

Although errors of measurement and critical issues of definitions and interpretation exist, this compilation represents a first attempt to obtain reasonably coherent estimates of the proportion of men who were clients of sex workers at regional level. Large discrepancies between regions were found. Further improvements in national estimates will be critical to monitor coverage of HIV prevention programmes for sex workers and clients, and to improve estimates of national HIV infection prevalence levels in low and concentrated HIV epidemics.

SUBMITTER: Carael M

PROVIDER: S-EPMC2576731 | biostudies-literature | 2006 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Clients of sex workers in different regions of the world: hard to count.

Carael M M Slaymaker E E Lyerla R R Sarkar S S

Sexually transmitted infections 20060601

<h4>Objectives</h4>To estimate the proportion of the male population that reports having paid for sex in different regions.<h4>Methods</h4>Clients of sex workers were identified from representative samples of men asked in face-to-face interviews whether they had had sex in exchange for money or whether they had paid for sex, in the last 12 months. A total of 78 national household surveys and nine city based surveys were selected for inclusion. Where such surveys were not available, results of be ...[more]

PMID: 16735289

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Project description:OBJECTIVES:To assess the prevalence of human immunodeficiency virus (HIV) infection and the correlated risk factors among male clients of female sex workers (FSWs) in a Chinese-Vietnamese border region in Yunnan Province, China. METHODS:A cross-sectional survey was conducted between 2014 and 2015 in Hekou County, Yunnan Province, China. Convenience sampling and snowball sampling methods were used to recruit male clients for a questionnaire survey to collect information on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections (STIs) and drug use. Multivariate logistic regression was used to examine factors correlated with HIV infection. RESULTS:Of 776 respondents who participated in the study, 721 (92.91%) were Chinese and 55 (7.09%) were Vietnamese. Overall HIV prevalence in male clients of FSWs was 2.06%, 128 (16.49%) were infected with HSV-2, and five (0.64%) tested syphilis-positive. Two-thirds (68.81%) of respondents reported always using condoms with FSWs, and 89.05% reported condom use in the last episode of commercial sex. Male clients from Vietnam were significantly more likely to take morphine (9.09%) compared with Chinese male clients of FSWs. Age ?50 years (OR: 8.11, 95%CI: 1.26-52.16) and morphine positivity (OR: 7.35, 95%CI: 1.42-38.06) were associated with HIV infection in the multivariate logistic regression model. CONCLUSION:The relatively high proportion of male clients of FSWs who have numerous sexual partners and use condoms less frequently make them serve as important bridges for HIV transmission from FSWs to the low-risk general population. The positive association between morphine positivity and HIV infection confirmed illegal drug use as another important route for acquiring HIV infection in addition to sexual transmission, indicating that innovative interventions addressing both drug use and risky sexual behaviors are greatly required for male clients. Respondents aged ?50 years have a higher risk of HIV infection, which emphasizes that older male clients of FSWs should be focused in future HIV prevention interventions in the border regions of China.

Project description:BackgroundStudies have demonstrated the significance of commercial sex work in the ongoing transmission of HIV and other sexually transmitted infections (STIs) in India. Clients of female sex workers (FSWs) are thought to be an important bridging population for HIV/STIs. However, there is a lack of information on basic characteristics of sex work clients. This study sought to describe the prevalence of HIV and other STIs, as well as examine the determinants of these pathogens among a sample of clients in south India.MethodsData were from a cross-sectional biological and behavioural survey of FSW clients from six districts in Karnataka State, India. The prevalence of HIV, syphilis, herpes simplex virus type 2 (HSV-2), chlamydia (CT) and gonorrhoea (NG) among clients was examined. Multivariable logistic regression models were used to analyse the socio-demographic, sexual behaviour and sex-work related characteristics related to the prevalence of each pathogen. Sampling weights and appropriate survey methods were utilized in regression models to account for complex sampling design.ResultsThe total sample size was 2,745. The average age of clients was 30.4 (SE:0.3). Across the total sample, the prevalence of HIV, HSV-2, syphilis and CT/NG was 5.6%, 28.4%, 3.6% and 2.2%, respectively. The prevalence of HIV/STIs varied substantially across districts, reaching statistical significance for HIV (p<.0001) and CT/NG (p=.005). In multivariable models, duration of paying for commercial sex was associated with increased risk for HIV and HSV-2 (AOR: 1.1; 95%CI: 1.0-1.1, p<.0001). Clients with brothels as a main FSW solicitation site were associated with increased risk of HIV (AOR: 2.4; 95%CI: 1.2-4.7, p=.001), while those frequenting lodges were at increased risk for CT/NG (AOR: 6.3; 95%CI: 1.9-20.6, p=.03). Examining co-infections, clients with HSV-2 infections were at substantially higher risk of being HIV-positive (AOR: 10.4; 95%CI: 6.1-17.7, p<.0001).ConclusionsThis study fills in important gaps in knowledge regarding clients in southern India. The strong association between HIV and HSV-2 infections highlights the complications in designing effective prevention, intervention and management programs of this well-hidden population.

Project description:ObjectivesTo explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers' working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs).DesignQualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics.SettingVancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers' safety over arrest, while continuing to target clients.Participants26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30?days in Vancouver.Outcome measuresThematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers' working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January-November 2013).ResultsSex workers' narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants' accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex.ConclusionsThese findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally.

Dataset Information

Clients of sex workers in different regions of the world: hard to count.

Objectives

Methods

Results

Conclusions

Publications

Clients of sex workers in different regions of the world: hard to count.

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