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Condom negotiations among female sex workers in the Philippines: environmental influences.
PLoS One. 2012; 7(3):e33282.Plos

Abstract

BACKGROUND

Social and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.

METHODS

Female bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues.

RESULTS

Of 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment--trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34-49.90), economic environment--sex without a condom to make more money (AOR = 1.52, 95% CI 1.01-2.30), policy environment--sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49-4.48), and individual risk--substance use (AOR = 2.36, 95% CI = 1.28-4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons.

CONCLUSIONS

Factors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability.

Authors+Show Affiliations

Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, United States of America. lurada@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22448241

Citation

Urada, Lianne A., et al. "Condom Negotiations Among Female Sex Workers in the Philippines: Environmental Influences." PloS One, vol. 7, no. 3, 2012, pp. e33282.
Urada LA, Morisky DE, Pimentel-Simbulan N, et al. Condom negotiations among female sex workers in the Philippines: environmental influences. PLoS One. 2012;7(3):e33282.
Urada, L. A., Morisky, D. E., Pimentel-Simbulan, N., Silverman, J. G., & Strathdee, S. A. (2012). Condom negotiations among female sex workers in the Philippines: environmental influences. PloS One, 7(3), e33282. https://doi.org/10.1371/journal.pone.0033282
Urada LA, et al. Condom Negotiations Among Female Sex Workers in the Philippines: Environmental Influences. PLoS One. 2012;7(3):e33282. PubMed PMID: 22448241.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Condom negotiations among female sex workers in the Philippines: environmental influences. AU - Urada,Lianne A, AU - Morisky,Donald E, AU - Pimentel-Simbulan,Nymia, AU - Silverman,Jay G, AU - Strathdee,Steffanie A, Y1 - 2012/03/20/ PY - 2011/10/07/received PY - 2012/02/06/accepted PY - 2012/3/27/entrez PY - 2012/3/27/pubmed PY - 2012/8/21/medline SP - e33282 EP - e33282 JF - PloS one JO - PLoS One VL - 7 IS - 3 N2 - BACKGROUND: Social and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines. METHODS: Female bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues. RESULTS: Of 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment--trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34-49.90), economic environment--sex without a condom to make more money (AOR = 1.52, 95% CI 1.01-2.30), policy environment--sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49-4.48), and individual risk--substance use (AOR = 2.36, 95% CI = 1.28-4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons. CONCLUSIONS: Factors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22448241/Condom_negotiations_among_female_sex_workers_in_the_Philippines:_environmental_influences_ L2 - https://dx.plos.org/10.1371/journal.pone.0033282 DB - PRIME DP - Unbound Medicine ER -