It is important for people who exchange sex to get tested for HIV regularly and know their status. Even though sex work is at least partially legal in some countries, the law rarely protects sex workers. Many social and structural factors make it difficult to prevent and treat HIV among persons who exchange sex for money or nonmonetary items.
Other risk factors for this population include Multiple high-risk sex partners, e. The goal of the legalisation was to regulate voluntary prostitution, to decrease the amount of involuntary prostitution and to improve the social position of sex workers. Sexual Risk Factors Persons who exchange sex may not use condoms consistently. More insight into the characteristics of this population and the determinants associated with STI occurrence might help target STI control. People who trade sex for drugs tend to have more clients, use condoms less often, and are more likely to share needles and other drug works. More money for sex with partners known to be HIV positive. There is a potential for some of these clients to act as a bridging population for further spread of STI into the general population [ 13 — 15 ]. Concern that they may lose income if identified as being HIV-positive. Some persons who know their HIV status may be reluctant to seek or stay in care because of Mistrust of the health care system. Female, male and transgender adults and young people who receive money or goods in exchange for sexual services, either regularly or occasionally. Are uncomfortable sharing information about sexual and substance use histories as part of HIV testing protocol. Drug and Alcohol Use There is a strong link between exchange sex and drug and alcohol use. Sex tourism is fuelling the demand for sex workers in many countries, particularly in Asia and the Caribbean. Other than facing the criminalisation of sex work, they may also face surveillance, racial profiling, arrest, detention, deportation and other restrictions on mobility imposed by criminal, immigration and trafficking laws. For example, it is estimated that one in five people in the sex trade in Andrah Pradesh, India and one in 10 in Thailand have been trafficked. Migrant sex workers often become the targets of both police and immigration officers, especially those who cross borders both legally and illegally and do not have immigration status. In addition, little is known about the associated determinants for different STI. Even though sex work is at least partially legal in some countries, the law rarely protects sex workers. Therefore, the unit of analysis is a consultation. This forces them onto the street where control over condom and drug use is compromised and exposure to violence is heightened, all of which compounds their vulnerability to HIV. The variables STI symptoms and partner notification were reported since and the variable condom use at last sexual contact, and whether this contact was a steady or a casual partner were reported since We analysed all consultations of FSW between and Sex workers have told us that when they ask a client to use a condom, he offers double the price to have sex without the condom. Clients may refuse to pay for sex if they have to use a condom, and use intimidation or violence to force unprotected sex. Electronic supplementary material The online version of this article doi: Financial circumstances and other barriers e.
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