Injection drug use, sexual risk, violence and STI/HIV among Moscow female sex workers.

Abstract:

BACKGROUND/OBJECTIVES:The HIV prevalence in Eastern Europe and Central Asia continues to increase. While injection drug use (IDU) is leading factor, heterosexual transmission is on the rise. Little is known about female sex workers (FSWs) in the region despite the central role of commercial sex in heterosexual sexually transmitted infection (STI)/HIV transmission globally. The authors evaluated the prevalence of STI/HIV among Moscow-based FSWs and potential risk factors including IDU, sexual risks and violence victimisation. METHODS:Moscow-based FSWs (n=147) completed a clinic-based survey and STI/HIV testing over an 8-month period in 2005. RESULTS:HIV prevalence was 4.8%, and 31.3% were infected with at least one STI including HIV. Sexual behaviours significantly associated with STI/HIV included anal sex (adjusted odds ratio (AOR) 3.48), high client volume (three or more clients daily, AOR 2.71), recent subbotnik (sex demanded by police; AOR 2.50) and regularly being presented with more clients than initially agreed to (AOR 2.45). Past year experiences of physical violence from clients and threats of violence from pimps were associated with STI/HIV (AOR 3.14 and AOR 3.65, respectively). IDU was not significantly associated with STI/HIV. Anal sex and high client volume partially mediated the associations of abuse with STI/HIV. CONCLUSIONS:Findings illustrate substantial potential for heterosexual STI/HIV transmission in a setting better known for IDU-related risk. Many of the STI/HIV risks observed are not modifiable by FSWs alone. STI/HIV prevention efforts for this vulnerable population will benefit from reducing coercion and abuse perpetrated by pimps and clients.

journal_name

Sex Transm Infect

authors

Decker MR,Wirtz AL,Baral SD,Peryshkina A,Mogilnyi V,Weber RA,Stachowiak J,Go V,Beyrer C

doi

10.1136/sextrans-2011-050171

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

278-83

issue

4

eissn

1368-4973

issn

1472-3263

pii

sextrans-2011-050171

journal_volume

88

pub_type

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