Indigenous HIV Prevention Beliefs and Practices Among Low-Earning Chinese Sex Workers as Context for Introducing Female Condoms and Other Novel Prevention Options

Qual Health Res. 2017 Jul;27(9):1302-1315. doi: 10.1177/1049732316673980. Epub 2016 Nov 2.

Abstract

New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women's existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women's HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available.

Keywords: China; HIV/STI; female condoms; female sex workers; heterosexual transmission; prevention; qualitative method of research.

MeSH terms

  • Adult
  • Anthropology, Cultural
  • Anti-Bacterial Agents / administration & dosage
  • China / epidemiology
  • Condoms, Female / statistics & numerical data*
  • Consumer Health Information / methods
  • Female
  • HIV Infections / ethnology
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Medicine, Chinese Traditional / statistics & numerical data
  • Middle Aged
  • Poverty*
  • Qualitative Research
  • Risk Assessment
  • Risk Factors
  • Sex Workers / psychology*
  • Sexually Transmitted Diseases / prevention & control
  • Socioeconomic Factors
  • Substance Abuse, Intravenous / epidemiology
  • Vaginal Douching / statistics & numerical data

Substances

  • Anti-Bacterial Agents