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S Afr Med J. 2013 Feb 19;103(4):246-51. doi: 10.7196/samj.6170.

Characteristics, sexual behaviour and risk factors of female, male and transgender sex workers in South Africa.

Author information

1
International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Belgium. marlise.richter@gmail.com

Abstract

BACKGROUND:

In South Africa, information on sex workers' characteristics, sexual behaviour and health needs is limited. Current social, legal and institutional factors impede a safe working environment for sex workers and their clients.

OBJECTIVES:

To describe characteristics and sexual behaviour of female, male and transgender sex workers, and assess their risk factors for unprotected sex.

METHODS:

Repeat cross-sectional surveys among sex workers were conducted in Hillbrow, Sandton, Rustenburg and Cape Town in 2010. Sex workers were interviewed once; any re-interviews were excluded from analysis. Unprotected sex was defined as any unprotected penetrative vaginal or anal sex with last two clients.

RESULTS:

Trained sex workers interviewed 1 799 sex workers. Sex work was a full-time profession for most participants. About 8% (126/1 594) of women, 33% (22/75) of men, and 25% (12/50) of transgender people had unprotected sex. A quarter of anal sex was unprotected. Unprotected sex was 2.1 times (adjusted odds ratio (AOR), 95% CI 1.2 - 3.7; p=0.011) more likely in participants reporting daily or weekly binge drinking than non-binge drinkers. Male sex workers were 2.9 times (AOR, 95%CI 1.6 - 5.3; p<0.001) more likely, and transgender people 2.4 times (AOR, 95% CI 1.1 - 4.9; p=0.021) more likely, than females to have unprotected sex. Sex workers in Hillbrow, where the only sex work-specific clinic was operational, were less likely to have unprotected sex than those in other sites.

CONCLUSION:

Tailored sex work interventions should explicitly include male and transgender sex workers, sex work-specific clinics, focus on the risks of unprotected anal sex, and include interventions to reduce alcohol harm.

PMID:
23547701
[Indexed for MEDLINE]
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