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Social and Structural Factors Associated with Consistent Condom Use Among Female Entertainment Workers Trading Sex in the Philippines

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Abstract

This paper examined socio-structural factors of consistent condom use among female entertainment workers at high risk for acquiring HIV in Metro Manila, Quezon City, Philippines. Entertainers, aged 18 and over, from 25 establishments (spa/saunas, night clubs, karaoke bars), who traded sex during the previous 6 months, underwent cross-sectional surveys. The 143 entertainers (42% not always using condoms, 58% always using condoms) had median age (23), duration in sex work (7 months), education (9 years), and 29% were married/had live-in boyfriends. In a logistic multiple regression model, social-structural vs. individual factors were associated with inconsistent condom use: being forced/deceived into sex work, less manager contact, less STI/HIV prevention knowledge acquired from medical personnel/professionals, not following a co-workers’ condom use advice, and an interaction between establishment type and alcohol use with establishment guests. Interventions should consider the effects of physical (force/deception into work), social (peer, manager influence), and policy (STI/HIV prevention knowledge acquired from medical personnel/professionals) environments on consistent condom use.

Resumen

Este artículo examina los factores socio-estructurales de uso constante de condones entre las trabajadoras sexuales con alto riesgo de contraer el VIH en Metro Manila, Quezon City, Filipinas. Las trabajadoras, mayores de 18 años, de 25 establecimientos (spa/saunas, clubes nocturnos, bares de karaoke), quienes negociaron el sexo durante los últimos 6 meses, se sometieron a los estudios transversales. Los 143 trabajadores (el 42% no siempre utilizó condones, el 58% siempre utilizó condones) tenían una edad mediana (23), una duración en el trabajo sexual (7 meses), educación (9 años), y el 29% estaban casados/cohabitaba con novios. En un modelo de regresión logística múltiple, los factores socio-estructural en comparación con factores individuales fueron asociados con el uso inconsistente del condón: el estar obligado/engañado al trabajo sexual, menos contacto con el gerente, menos conocimiento de la prevención de ITS/VIH adquirido por el personal médico, no seguir el consejo de una compañera sobre el uso de condones, y una interacción entre el tipo de establecimiento y el consumo de alcohol de los clientes. Las intervenciones deben considerar los efectos físicas (forzada a hacer/el engaño en el trabajo), sociales (entre compañeras, la influencia del gerente), y contextos de política (conocimiento de la prevención de ITS/VIH adquirido por el personal médico) de uso consistente del condón.

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References

  1. Philippines Department of Health. Be responsible, know your risks, get tested for HIV. Press release. 2009. http://portal.doh.gov.ph/node/2515. Accessed 21 Sept 2011.

  2. UNAIDS Joint United Nations Programme on HIV/AIDS and the World Health Organization. AIDS epidemic update. 2007. http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf. Accessed 21 Sept 2011.

  3. Program for Appropriate Technology in Health (PATH). Best practices in HIV and AIDS prevention education: the AIDS Surveillance and Education Project experience in the Philippines, 2003.

  4. Trinidad A. Child pornography in the Philippines. UP Center for Integrative and Development Studies and UNICEF Manila: Psychosocial Trauma and Human Rights Program; 2005. p. 14.

    Google Scholar 

  5. Program for Appropriate Technology in Health (PATH). Community outreach and peer education for HIV and AIDS prevention: the AIDS Surveillance and Education Project experience in the Philippines. 2003. http://www.pfpi.org/pdf/hiv-aids/FINAL%20COPE.pdf. Accessed 21 Sept 2011.

  6. US Department of State, Office of the Under Secretary for Global Affairs. Trafficking in persons report—June 2004. 2011. http://www.state.gov/g/tip/rls/tiprpt/2010/index.htm. Accessed 21 Sept 2011.

  7. Beyrer C. Shan women and girls and the sex industry in Southeast Asia: political causes and human rights implications. Soc Sci Med. 2001;53:543–50.

    Article  PubMed  CAS  Google Scholar 

  8. Rhodes T. Risk environments and drug harms: a social science for harm reduction approach. Int J Drug Policy. 2009;20:193–201.

    Article  PubMed  Google Scholar 

  9. Rhodes T, Simic M. Transition and the HIV risk environment. Br Med J. 2005;331:220–3.

    Article  Google Scholar 

  10. Des Jarlais DC. Structural interventions to reduce HIV transmission among injecting drug users. AIDS. 2000;14:S41–6.

    Article  PubMed  Google Scholar 

  11. Latkin CA, Knowlton AR. Micro-social structural approaches to HIV prevention: a social ecological perspective. AIDS Care. 2005;17(Suppl 1):S102–13.

    Article  PubMed  Google Scholar 

  12. Sumartojo E. Structural factors in HIV prevention: concepts, examples, and implications for research. AIDS. 2000;14(Suppl 1):S3–10.

    Article  PubMed  Google Scholar 

  13. Gupta GR, Parkhurst JO, Ogden JA, Aggleton P, Mahal A. Structural approaches to HIV prevention. Lancet. 2008;30:764–75.

    Article  Google Scholar 

  14. Morisky DE, Stein J, Chiao C, Ksobiech K, Malow R. Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: a multilevel analysis. Health Psychol. 2006;25:595–603.

    Article  PubMed  Google Scholar 

  15. Kerrigan D, Moreno L, Rosario S, et al. Environmental-structural interventions to reduce HIV/STI risk among female sex workers in the Dominican Republic. Am J Public Health. 2006;96:120–5.

    Article  PubMed  Google Scholar 

  16. Strathdee SA, Lozada R, Martinez G, et al. Social and structural factors associated with HIV infection among female sex workers who inject drugs in the Mexico–US border region. PLoS One. 2011;6:1–8.

    Article  Google Scholar 

  17. Dandona R, Dandona L, Gutierrez JP, et al. High risk of HIV in non-brothel based female sex workers in India. BMC Public Health. 2005;20:5–87.

    Google Scholar 

  18. Nishimura YH, Ono-Kihara M, Mohith JC, et al. Sexual behaviors and their correlates among young people in Mauritius: a cross-sectional study. BMC Int Health Hum Rights. 2007;7(8):1–11.

    Google Scholar 

  19. Philippines National AIDS Council. Follow-up to the declaration of commitment on HIV and AIDS United Nations general assembly special session (UNGASS): country report of the Philippines, January 2006 to December 2007 (with support from the UN Theme Group on HIV and AIDS). 2008. http://data.unaids.org/pub/Report/2008/philippines_2008_country_progress_report_en.pdf. Accessed 21 Sept 2011.

  20. Philippines National AIDS Council. Follow-up to the declaration of commitment on HIV and AIDS United Nations general assembly Special Session (UNGASS): country report of the Philippines, January 2008 to December 2009 (with support from the UN Theme Group on HIV and AIDS). 2010. http://data.unaids.org/pub/Report/2010/philippines_2010_country_progress_report_en.pdf. Accessed 21 Sept 2011.

  21. Philippines Department of Health, National Epidemiology Center. HIV/AIDS Registry Report. 2010. http://www2.doh.gov.ph/nec/HIV.htm. Accessed 14 Mar 2009.

  22. Human Rights Watch. Philippines: Unprotected: Sex, Condoms and the Human Right to Health, 2004, C1606. http://www.unhcr.org/refworld/docid/412ef1a74.html. Accessed 21 Sept 2011.

  23. Malig J. Ayala Alabang requires prescription for condoms. ABS-CBN News, 2011. http://www.abs-cbnnews.com/nation/metro-manila/02/24/11/ayala-alabang-requires-prescription-condoms. Accessed 21 Sept 2011.

  24. Program for Appropriate Technology in Health (PATH). Policy and advocacy efforts for HIV and AIDS Prevention: the AIDS Surveillance and Education Project experience in the Philippines, 2003. http://www.pfpi.org/pdf/hiv-aids/FINAL%20Policy%20Advocacy.pdf. Accessed 21 Sept 2011.

  25. Country Reports on Human Rights Practices—2003. Embassy of the United States in Manila. February 25, 2004. Archived from the original on March 31, 2008. http://web.archive.org/web/20080331110812/http://manila.usembassy.gov/wwwhrep4.html. Accessed 26 Apr 2008.

  26. Morisky DE, Lyu S, Urada L. The role of non-formal education in combating the HIV epidemic in the Philippines and Taiwan. Prospects. 2010;3(4):335–57.

    Google Scholar 

  27. Morisky DE, Ang A, Sneed C. Validating the effects of social desirability on self reported condom use. AIDS Educ Prev. 2002;14:351–60.

    Article  PubMed  Google Scholar 

  28. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.

    Article  Google Scholar 

  29. Golub ET, Latka M, Hagan H, et al. Screening for depressive symptoms among HCV-infected injection drug users: examination of the utility of the CES-D and the Beck depression inventory. J Urban Health. 2004;81:278–90.

    Article  PubMed  Google Scholar 

  30. Morisky DE, Peña M, Tiglao TV, Liu KY. The impact of the work environment on condom use among female bar workers in the Philippines. Health Educ Behav. 2002;29:461–72.

    Article  PubMed  Google Scholar 

  31. Norbeck JS, Lindsey AM, Carrieri VL. The development of an instrument to measure social support. Nurs Res. 1981;30:264–9.

    PubMed  CAS  Google Scholar 

  32. Norbeck JS, Lindsey AM, Carrieri VL. Further development of the Norbeck social support questionnaire: normative data and validity testing. Nurs Res. 1983;32:4–9.

    Article  PubMed  CAS  Google Scholar 

  33. Decker MR, McCauley HL, Phuengsamran D, Janyam S, Silverman JG. Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand. J Epidemiol Community Health. 2011;65:334–9.

    Article  PubMed  Google Scholar 

  34. Sarkar K, Bal B, Mukherjee R, et al. Sex-trafficking, violence, negotiating skill, and HIV infection in brothel-based sex workers of Eastern India, adjoining Nepal, Bhutan, and Bangladesh. J Health Popul Nutr. 2008;26:223–31.

    PubMed  Google Scholar 

  35. Shannon K, Strathdee SA, Shoveller J, Rusch M, Kerr T, Tyndall MW. Structural and environmental barriers to condom use negotiation with clients among female sex workers: implications for HIV-prevention strategies and policy. Am J Public Health. 2009;99:659–65.

    Article  PubMed  Google Scholar 

  36. Krishnan AK, Hendriksen E, Vallabhaneni S, Johnson SL, Raminani S, Kumarasamy N, et al. Sexual behaviors of individuals with HIV living in South India: a qualitative study. AIDS Educ Prev. 2007;19:334–45.

    Article  Google Scholar 

  37. United Nations Treaty Collection. Penal matters, chapter 12a. Protocol to prevent, suppress and punish trafficking in persons, especially women and children, supplementing the United Nations convention against transnational organized crime. New York: United Nations; 2000.

  38. Yang X, Xia G, Li X, Latkin C, Celentano D. Social influence and individual risk factors of HIV unsafe sex among female entertainment workers in China. AIDS Educ Prev. 2010;22:69–86.

    Article  PubMed  Google Scholar 

  39. Swendeman D, Basu I, Das S, Jana S, Rotheram-Borus MJ. Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases. Soc Sci Med. 2009;69:1157–66.

    Article  PubMed  Google Scholar 

  40. Hong Y, Fang X, Li X, Liu Y, Li M. Environmental support and HIV prevention behaviors among female sex workers in China. Sex Transm Dis. 2008;35:662–7.

    Article  PubMed  Google Scholar 

  41. Morisky DE, Tiglao TV. Educational and structural interventions and their impact on condom use and STI/HIV prevention for Filipina women and male customers. Asia Pac J Public Health. 2010;22(Suppl 3):151S–8S.

    Article  PubMed  Google Scholar 

  42. Morisky DE, Chiao C, Stein JA, Malow R. Impact of social and structural influence interventions on condom use and sexually transmitted infections among establishment-based female bar workers in the Philippines. J Psychol Human Sex. 2005;17:45–63.

    Article  PubMed  Google Scholar 

  43. Morisky D, Urada L. Organizational policy recommendations for control of STI/HIV among female sex workers in China: regular examination of workers in social hygiene clinics. AIDS Care. 2011;23(Suppl 1):83–95.

    Article  PubMed  Google Scholar 

  44. DKT International. Philippines: 2810161 CYPs in 2010. http://dktinternational.org/index.php?section=37. Accessed 21 Sept 2011.

  45. Tran TT, Le CL, Nguyen TL. Factors associated with inconsistent condom use among female sex workers in Nha Trang, Vietnam. Asia Pac J Public Health. 2008;20:370–8.

    Article  PubMed  Google Scholar 

  46. Pickering H, Okongo M, Nnalusiba B, Bwanika K, Whitworth J. Sexual networks in Uganda: casual and commercial sex in a trading town. AIDS Care. 1997;9:199–207.

    Article  PubMed  CAS  Google Scholar 

  47. Miller GA, Mendoza W, Krone MR, Meza R, Caceres CF, Coates TJ, Klausner JD. Clients of female sex workers in Lima, Peru: a bridge population for sexually transmitted disease/HIV transmission? Sex Transm Dis. 2004;31:337–42.

    Article  PubMed  Google Scholar 

  48. Chiao C, Morisky DE, Rosenberg R, Ksobiech K, Malow R. The relationship between HIV/sexually transmitted infection risk and alcohol use during commercial sex episodes: results from the study of female commercial sex workers in the Philippines. Subst Use Misuse. 2006;41:1509–33.

    Article  PubMed  Google Scholar 

  49. Witte SS, Batsukh A, Chang M. Sexual risk behaviors, alcohol abuse, and intimate partner violence among sex workers in Mongolia: implications for HIV prevention intervention development. J Prev Interv Community. 2010;38:89–103.

    Article  PubMed  Google Scholar 

  50. Larios SE, Lozada R, Strathdee SA, et al. An exploration of contextual factors that influence HIV risk in female sex workers in Mexico: the social ecological model applied to HIV risk behaviors. AIDS Care. 2009;21:1335–42.

    Article  PubMed  Google Scholar 

  51. Ko NY, Lee HC, Hung CC, et al. Effects of structural intervention on increasing condom availability and reducing risky sexual behaviours in gay bathhouse attendees. AIDS Care. 2009;21:1499–507.

    Article  PubMed  Google Scholar 

  52. UNAIDS. Report on the global AIDS epidemic. 2008. http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/globalreport/2008/jc1510_2008globalreport_en.pdf. Accessed 21 Sept 2011.

  53. Morrison-Beedy D, Carey MP, Tu X. Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS Behav. 2006;10:541–52.

    Article  PubMed  Google Scholar 

  54. Macalino E, Celentano DD, Latkin C, Strathdee SA, Vlahov D. Risk behaviors by audio computer-assisted self-interviews among HIV-seropositive and HIV-seronegative injection drug users. AIDS Educ Prev. 2002;14:367–78.

    Article  PubMed  Google Scholar 

  55. Wechsberg WM, Luseno WK, Lam WK, Parry CD, Morojele NK. Substance use, sexual risk, and violence: HIV prevention intervention with sex workers in Pretoria. AIDS Behav. 2006;10:131–7.

    Article  PubMed  Google Scholar 

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Acknowledgments

Support for this project was provided by the University of California Office of the President Pacific Rim Research Program, the UCLA International Institute, the UCLA Graduate Division to the Community Health Science Department’s Pre-doctoral Training Program in the Social and Behavioral Determinants of HIV/AIDS Prevention, and a training grant from the National Institutes of Drug Abuse (T32 DA023356). We extend appreciation to Benilda de Guia and the Philippine Rural Reconstruction Movement, Inc. team, Dr. Nymia Pimentel-Simbulan at the University of the Philippines Manila, and Dr. Irene Grafil of the Quezon City Health Department.

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Authors and Affiliations

  1. Division of Global Public Health, Department of Medicine, San Diego School of Medicine, University of California, 9500 Gilman Drive, MC 0507, La Jolla, San Diego, CA, 92093-0507, USA

    Lianne A. Urada & Steffanie A. Strathdee

  2. Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, USA

    Donald E. Morisky

  3. Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines, Manila, Philippines

    Laufred I. Hernandez

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  1. Lianne A. Urada
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  2. Donald E. Morisky
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  4. Steffanie A. Strathdee
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Correspondence to Lianne A. Urada.

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Urada, L.A., Morisky, D.E., Hernandez, L.I. et al. Social and Structural Factors Associated with Consistent Condom Use Among Female Entertainment Workers Trading Sex in the Philippines. AIDS Behav 17, 523–535 (2013). https://doi.org/10.1007/s10461-011-0113-x

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