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2015 ; 12
(ä): 34
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Sexual and reproductive health risks amongst female adolescents who use
amphetamine-type stimulants and sell sex: a qualitative inquiry in Yunnan, China
#MMPMID26472221
Zhang XD
; Kelly-Hanku A
; Chai JJ
; Luo J
; Temmerman M
; Luchters S
Harm Reduct J
2015[Oct]; 12
(ä): 34
PMID26472221
show ga
BACKGROUND: China, as other Southeast Asian countries, has witnessed an increased
use in amphetamine-type stimulants (ATS) amongst urban youth. Amongst female
adolescents who both sell sex and use ATS, risk behaviours are compounded
resulting in even poorer health outcomes. However, limited knowledge exists on
ATS use patterns and ATS-related risk behaviours, particularly in this context.
This research aimed to improve the understanding of these issues amongst female
adolescents who use ATS and sell sex, and to inform future programming. METHOD:
This study utilised monthly focus group discussions (four in total) with the same
study participants in Yunnan, China. From within a drug-treatment programme,
female adolescents who reported both a history of drug use and selling sex were
purposively enrolled in the study. RESULTS: Participating adolescent females were
aged 17-19 years and were all internal-migrants with low literacy. All reported
polydrug use (mainly methamphetamine and heroin, whereas ecstasy and ketamine
have been infrequently employed). Being less informed about risks of drug use and
lack of sexual and reproductive health knowledge seemed to contribute to
problematic drug use, rough and prolonged sexual intercourse, inconsistent condom
use and ineffective contraceptive practice. For their income, participants
largely relied on selling sex, which was frequently coupled with drug sharing
services to clients. However, despite the practices, women did not self-identify
as sex workers, and therefore did not think that existing intervention services
targeting female sex workers were relevant to them. Moreover, criminalization and
stigmatisation of drug use and selling sex impeded their access to care services.
CONCLUSION: Current harm reduction and HIV/sexually transmitted infection (STI)
prevention services are unlikely to address the demand of female adolescents
engaged in drug use and commercial sex. Our findings highlight that a
comprehensive and coordinated harm reduction and sexual and reproductive health
response should be conducted involving these most vulnerable adolescents.