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2013 ; 25
(5
): 613-8
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Social and cultural contexts of HIV risk behaviors among Thai female sex workers
in Bangkok, Thailand
#MMPMID23082928
Nemoto T
; Iwamoto M
; Sakata M
; Perngparn U
; Areesantichai C
AIDS Care
2013[]; 25
(5
): 613-8
PMID23082928
show ga
Recently, the number of indirect female sex workers (FSWs) who work at bars/clubs
and massage parlors is substantially increasing in Thailand; however, there are
huge gaps in knowledge about HIV risk behaviors among indirect FSWs. This study
aimed to describe and understand HIV risk behaviors among Thai FSWs in Bangkok in
relation to sociocultural factors and work environment (e.g., bars/clubs, massage
parlors, brothels, and street). Based on venue-based purposive sampling methods,
Thai FSWs were recruited for qualitative interviews (n=50) and survey interviews
(n=205). Based on mixed methods, the study revealed that HIV risk and substance
use behaviors among FSWs significantly differed depending on work venues,
although there were no significant differences between work venues on some key
risk behaviors (e.g., inconsistent condom use with primary partners and
customers; willingness to engage in unsafe sex with customers). A multiple linear
regression analysis revealed that FSWs who had used illicit drugs, were young,
had low levels of self-esteem, or reported STIs had frequently engaged in
unprotected vaginal sex with customers. Also, FSWs who worked at bars/clubs, were
young, had higher income, or reported STIs had frequently engaged in sex with
customers under the influence of alcohol. Qualitative interviews illustrated
FSWs' alcohol and drug use due to their stressful life (e.g., long working hours
and a large number of customers) and easy access to alcohol and drugs. FSWs had
shown inaccurate knowledge about HIV prevention methods and engaged in risky
behaviors, such as washing vagina with water or toothpaste after having had sex
with customers. The HIV prevention strategies in Thailand need to be
re-structured through implementing evidence-based HIV prevention intervention
programs for FSWs, which must address sociocultural factors (e.g., self-esteem)
and alcohol and drug use specific to work venues.
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