Vaginal washing and lubrication among female sex workers in the Mexico-US border region: implications for the development of vaginal PrEP for HIV prevention

Abstract Background The Yunnan province is located near the “Golden Triangle” border region between China, Myanmar and Thailand, which has the highest HIV/AIDS prevalence in China. Female sex workers (FSWs) in the Yunnan province are highly vulnerable to HIV infection. The objective of this study was to examine the experiences of FSWs in the Yunnan to better understand the risk of infection and the potential for transmission of HIV. Methods Semi-structured interviews were conducted between May 2018 and June 2018 with 20 FSWs recruited in Hekou County, Yunnan Province, China. Thematic analysis was conducted to identify themes that highlighted increased exposure of FSWs to the risk of HIV infection and transmission. Results The findings showed that FSWs’ primary source for HIV information was gynecologists, with few visiting the local HIV charity Red Ribbon. FSWs reported infrequent visits for check-ups with some seeing a gynecologist once a year. FSWs felt that the onus was on them to prevent STI/HIV infection by using a condom during sex, regardless of their ability to negotiate use. FSWs were also reluctant to see a gynecologists for treatment. Instead, they resorted to douching as a way of preventing HIV/STIs and treating vaginal health problems, such as leucorrhea. Most FSWs worked without the influence of alcohol and drugs. A small number of FSWs reported heroin addiction and injecting drug use. Conclusion The findings suggest a need for innovative HIV prevention strategies among FSWs and their clients in the Chinese border region. Governmental agencies should continue to implement practical strategies in terms of HIV prevention education and condom use through tailored interventions that are localized. Such strategies should include localized tailored interventions that dispel myths about douching as a method of HIV/STI prevention and incorporate a mobile outreach approach, similar to the ‘roadside restaurant’ outreach that has been successful in rural China.

Download Full-text

HIV Risk in Female Sex Workers in the Chinese Border Region

10.21203/rs.2.24518/v1 ◽

2020 ◽

Author(s):

Yuan Yuan Wang ◽

Amanda Wilson ◽

Rusen Chen ◽

Ping Cen ◽

Yuehui Wang ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Vulnerable Population ◽

Border Region ◽

Border Regions ◽

Golden Triangle ◽

Female Sex ◽

Hiv Virus ◽

Hiv Aids

Abstract Background: Female sex workers (FSWs) in Yunnan are a highly vulnerable population to HIV virus. The HIV positive FSWs can then pass onward the HIV transmission via commercial sex. Yunnan is located near the “Golden Triangle” border region, which has the highest HIV/AIDS prevalence rates in China. Method: In order to understanding of the HIV burden and risk in FSWs in the border region of China, semi-structured interviews were conducted between May 2018 and June 2018 with 20 FSWs recruited in Hekou County, Yunnan province, China. Results: Thematic analysis was applied for the data analysis. There were four themes that were actively interpreted from the data, including: Desire for Condom Use, Poor Gynaecological Service Access, Low HIV/AIDS Literacy, and Working Without the Influence. Conclusion: There is an urgent demand for HIV prevention among FSWs and their clients in the Chinese border regions. It is essential for governmental infrastructures to implement practical strategies in terms of HIV prevention for FSWs in China. Keywords human immunodeficiency virus (HIV), female sex workers (FSWs), “Golden Triangle”, China A Brief Summary of Findings Female sex workers (FSWs) in Yunnan are a highly vulnerable population to HIV virus. There is an urgent demand for HIV prevention among FSWs in the Chinese border regions.

Download Full-text

“The Drug Will Help Protect My Tomorrow”: Perceptions of Integrating PrEP into HIV Prevention Behaviors Among Female Sex Workers in Lilongwe, Malawi

AIDS Education and Prevention ◽

10.1521/aeap.2019.31.5.421 ◽

2019 ◽

Vol 31 (5) ◽

pp. 421-432

Author(s):

Jaclyn Shea ◽

Agatha Bula ◽

Wezzie Dunda ◽

Mina C. Hosseinipour ◽

Carol E. Golin ◽

...

Keyword(s):

Hiv Prevention ◽

Sexual Behaviors ◽

Sex Workers ◽

Female Sex Workers ◽

Economic Effects ◽

Sub Saharan Africa ◽

Prevention Strategies ◽

Female Sex ◽

Hiv Prevention Strategies ◽

Hiv Acquisition

Female sex workers (FSW) are disproportionately at risk for HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, yet approaches for incorporating PrEP within prevention strategies used by FSW are lacking. Semistructured focus group discussions were conducted with 44 HIV-negative FSW in Lilongwe, Malawi to explore perceptions of PrEP: acceptability, integration within HIV prevention behaviors, and barriers to use. Acceptability of PrEP was high. Motivation to use PrEP was rooted in love for one's life, anticipated negative economic effects associated with HIV acquisition. PrEP was viewed as complementary to existing norms for engaging in healthy sexual behaviors. Many felt PrEP may provide extra protection from HIV, along with condoms and frequent STI testing. Unpredictable daily lives, stigma, and side effects were barriers that could affect PrEP use. Leveraging existing HIV prevention strategies and social norms surrounding HIV prevention behaviors may positively impact PrEP uptake among FSW in Malawi and sub-Saharan Africa.

Download Full-text