Document Type : Original Article

Authors

1 Assistant Professor, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran / Assistant Professor, Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Public Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran

3 Department of Epidemiology and Biostatistics, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

4 Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

5 Infectious Diseases Specialist of Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background and aims: Female sex workers (FSWs) play an essential role in the transmission of HIV and are considered critical groups compared to the public groups of society and their customers. Therefore, this study was conducted to investigate the status of sexual intercourse among prostitutes in Shiraz in 2015-2016.
 
Methods: This is a cross-sectional study conducted on 162 prostitutes referred to Shiraz transitional damage reduction centers and the information was gathered through a checklist.
 
Results: The results showed that the mean age at the first vaginal intercourse was 16.57±3.65. In 62.3% of people, the main reason for prostitution was the need for money to help the family. It was also found that 39.5% of prostitutes had anal sex, and more than 95% of them did not use condoms during sex. There was also a statistically significant relationship (P<0.01) between the age of sexual intercourse and education level.
 
Conclusion: The results of this study demonstrated that prostitutes initiated the first sexual intercourse at a very young age, and increase in the education level postponed the first sexual intercourse. Otherwise stated, the first sexual intercourse can be delayed by increasing the level of education.

Keywords

1. Collins SP, Goldenberg SM, Burke NJ, Bojorquez-Chapela I, Silverman JG, Strathdee SA. Situating HIV risk in the lives of formerly trafficked female sex workers on the Mexico-US border. AIDS Care. 2013;25(4):459-65. doi: 10.1080/09540121.2012.720361. 
2. Afsar Kazeroni P, Khazaei Z, Mousavi M, Khazaei S, Sohrabivafa M, Dehghani SL, et al. Prevalence of human immunodeficiency virus and tuberculosis among homeless individuals. Immunopathol Persa. 2018;4(1):e06. doi: 10.15171/ipp.2018.06. 
3. Afsar Kazerooni P, Mousavi M, Khazaei Z, Vali Esfahani M, Mohseni S, Nejat M, et al. The prevalence of HIV among female head of household in Shiraz in 2015. Immunopathol Persa. 2018;4(2):e29. doi: 10.15171/ipp.2018.29. 
4. Goldenberg SM, Rangel G, Vera A, Patterson TL, Abramovitz D, Silverman JG, et al. Exploring the impact of underage sex work among female sex workers in two Mexico-US border cities. AIDS Behav. 2012;16(4):969-81. doi: 10.1007/s10461- 011-0063-3. 
5. Goldenberg SM, Engstrom D, Rolon ML, Silverman JG, Strathdee SA. Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico. PLoS One. 2013;8(8):e72982. doi: 10.1371/journal. pone.0072982. 
6. Estébanez P, Fitch K, Nájera R. HIV and female sex workers. Bull World Health Organ. 1993;71(3-4):397-412. 
7. Tran BX, Nguyen TV, Pham QD, Nguyen PD, Khuu NV, Nguyen NP, et al. HIV infection, risk factors, and preventive services utilization among female sex workers in the Mekong Delta Region of Vietnam. PLoS One. 2014;9(1):e86267. doi: 10.1371/journal.pone.0086267.
8. World Health Organization (WHO). The Global Health Sector Strategy on HIV/AIDS 2011-2015: An Interim Review of Progress: Abridged Report, May 2014. Geneva: WHO; 2014.
9. Devine A, Bowen K, Dzuvichu B, Rungsung R, Kermode M. Pathways to sex-work in Nagaland, India: implications for HIV prevention and community mobilisation. AIDS Care. 2010;22(2):228-37. doi: 10.1080/09540120903039869. 
10. Silverman JG, Decker MR, Gupta J, Maheshwari A, Willis BM, Raj A. HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women. JAMA. 2007;298(5):536- 42. doi: 10.1001/jama.298.5.536. 
11. 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(4):334- 9. doi: 10.1136/jech.2009.096834. 
12. Kimani J, McKinnon LR, Wachihi C, Kusimba J, Gakii G, Birir S, et al. Enumeration of sex workers in the central business district of Nairobi, Kenya. PLoS One. 2013;8(1):e54354. doi: 10.1371/journal.pone.0054354. 
13. Mousavi M, Fararouei M, Afsar Kazerooni P, Nasirian M, Ghaem H. Population based estimation of point and period prevalence of sexully transmitted infections based the Iranian symptoms surveillance system. Amazonia Investiga. 2019;8(18):29-42. 
14. Prüss-Ustün A, Wolf J, Driscoll T, Degenhardt L, Neira M, Calleja JM. HIV due to female sex work: regional and global estimates. PLoS One. 2013;8(5):e63476. doi: 10.1371/journal. pone.0063476. 
15. Karami M, Khazaei S, Poorolajal J, Soltanian A, Sajadipoor M. Estimating the population size of female sex worker population in Tehran, Iran: application of direct capture-recapture method. AIDS Behav. 2017;21(8):2394-400. doi: 10.1007/s10461-017- 1803-9. 
16. Vandepitte J, Lyerla R, Dallabetta G, Crabbé F, Alary M, Buvé A. Estimates of the number of female sex workers in different regions of the world. Sex Transm Infect. 2006;82 Suppl 3:iii18- 25. doi: 10.1136/sti.2006.020081. 
17. Atkinson R, Flint J. Accessing hidden and hard-to-reach populations: snowball research strategies. Social Research Update. 2001;33(1):1-4. 
18. Alizade M. The Relationship Between Health Belief Model Structures with HIV/AIDS Prevention Behaviors in Women with High Risk Sexual Behavior, Tabriz 2018 [dissertation]. Tabriz University of Medical Sciences, School of Nursing and Midwifery; 2020. [Persian]. 
19. Dandona R, Dandona L, Kumar GA, Gutierrez JP, McPherson S, Samuels F, et al. Demography and sex work characteristics of female sex workers in India. BMC Int Health Hum Rights. 2006;6:5. doi: 10.1186/1472-698x-6-5. 
20. Schissel B, Fedec K. The selling of innocence: the gestalt of danger in the lives of youth prostitutes. Can J Criminol. 1999;41(1):33-56. 
21. Kuhns JB, 3rd, Heide KM, Silverman I. Substance use/misuse among female prostitutes and female arrestees. Int J Addict. 1992;27(11):1283-92. doi: 10.3109/10826089209047350. 
22. Badrimanesh A, Moeedfar S, Habibzadeh MJ, Shakeri Golpaiegany T. Structural Analysis of gender justice in punishment of ta’zir crime. Journal of Criminal Law. 2020;10(2):7-28. doi: 10.22124/jol.2019.10554.1532. [Persian]. 
23. Movahed M, Moaven Z, Shahbazi N. Explore the meaning of prostitution in the prostitutes lived experience: a qualitative study. Quarterly Journal of Women and Society. 2020;11(42):279-306. [Persian]. 
24. Shampoor VZ, Alvandi NA. Effective Factors on Women’s Prostitution in Tabriz Central Prison. East police Azarbaijan science. 2011;1(1):37-57. 
25. Dandona R, Dandona L, Gutierrez JP, Kumar AG, McPherson S, Samuels F, et al. High risk of HIV in non-brothel based female sex workers in India. BMC Public Health. 2005;5:87. doi: 10.1186/1471-2458-5-87. 
26. Tucker S, Krishna R, Prabhakar P, Panyam S, Anand P. Exploring dynamics of anal sex among female sex workers in Andhra Pradesh. Indian J Sex Transm Dis AIDS. 2012;33(1):9-15. doi: 10.4103/0253-7184.93787. 
27. Mondal S, Ramesh B, Blanchard JF, Moses S. Condom use and experience of violence: evidence from polling booth surveys among female sex workers in Karnataka, India. In: XVI International AIDS Conference2006. 
28. Shetty A, Bradley J, James A, Lowndes C, Alary M. HIV risk and vulnerability in female sex workers in Mumbai: reflections from the field. CHARME Working Paper Karnataka, India: The CHARME Project; 2010. 
29. Beattie T, Shetty A, Devi Vanta U, Lowndes CM, Alary M, Bradley JE. The evolution of female sex work in Guntur, Andhra Pradesh: a qualitative study of HIV-related issues. Bangalore, India: CHARME Working Paper. 2009. 
30. Tian LH, Peterman TA, Tao G, Brooks LC, Metcalf C, Malotte CK, et al. Heterosexual anal sex activity in the year after an STD clinic visit. Sex Transm Dis. 2008;35(11):905-9. doi: 10.1097/OLQ.0b013e318181294b. 
31. Jooste S, Simbayi L, Kalichman S, Cain D. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. In: XVIII International AIDS Conference. Human Sciences Research Council (HSRC); 2010. 
32. Skoler-Karpoff S, Ramjee G, Ahmed K, Altini L, Plagianos MG, Friedland B, et al. Efficacy of Carraguard for prevention of HIV infection in women in South Africa: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372(9654):1977- 87. doi: 10.1016/s0140-6736(08)61842-5. 
33. Lane T, Pettifor A, Pascoe S, Fiamma A, Rees H. Heterosexual anal intercourse increases risk of HIV infection among young South African men. AIDS. 2006;20(1):123-5. doi: 10.1097/01. aids.0000198083.55078.02. 
34. Voeller B. AIDS and heterosexual anal intercourse. Arch Sex Behav. 1991;20(3):233-76. doi: 10.1007/bf01541846. 
35. Brody S, Potterat JJ. Assessing the role of anal intercourse in the epidemiology of AIDS in Africa. Int J STD AIDS. 2003;14(7):431-6. doi: 10.1258/095646203322025704. 
36. Ndinda C, Chimbwete C, McGrath N, Pool R. Perceptions of anal sex in rural South Africa. Cult Health Sex. 2008;10(2):205- 12. doi: 10.1080/13691050600988416. 
37. Ferguson A, Morris C. Assessing the role of anal intercourse in the epidemiology of AIDS in Africa. Int J STD AIDS. 2003;14(12):856. doi: 10.1258/095646203322556228. 
38. Halperin DT. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I. AIDS Patient Care STDS. 1999;13(12):717-30. doi: 10.1089/ apc.1999.13.717. 
39. Mosher WD, Chandra A, Jones J. Sexual Behavior and Selected Health Measures: Men and Women 15-44 Years of Age, United States, 2002. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2005. 
40. Billy JO, Tanfer K, Grady WR, Klepinger DH. The sexual behavior of men in the United States. Fam Plann Perspect. 1993;25(2):52-60. 
41. Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social Organization of Sexuality: Sexual Practices in the United States. University of Chicago Press; 2000. 
42. Lau JT, Mui LW, Tsui HY, Wong E, Ho SP. Prevalence of induced abortion and associated factors among Chinese female sex workers in Hong Kong. J Sex Marital Ther. 2007;33(1):19-29. doi: 10.1080/00926230600998441. 
43. Rahmati Najarkolaei F, Niknami S, Amin Shokravi F, Ahmadi F. Perception and behaviors of HIV/AIDS patients: a qualitative study. J Kermanshah Univ Med Sci. 2009;13(3):220-34. [Persian]. 
44. Tamang A, Nepal B, Puri M, Shrestha D. Sexual behaviour and risk perceptions among young men in border towns of Nepal. Asia Pac Popul J. 2001;16(2):195-210. doi: 10.18356/82fbb881-en. 
45. Thomsen S, Stalker M, Toroitich-Ruto C. Fifty ways to leave your rubber: how men in Mombasa rationalise unsafe sex. Sex Transm Infect. 2004;80(6):430-4. doi: 10.1136/ sti.2004.010421. 
46. Farrington EM, Bell DC, DiBacco AE. Reasons people give for using (or not using) condoms. AIDS Behav. 2016;20(12):2850- 62. doi: 10.1007/s10461-016-1352-7. 
47. Gogna ML, Pecheny MM, Ibarlucía I, Manzelli H, López SB. The reproductive needs and rights of people living with HIV in Argentina: health service users’ and providers’ perspectives. Soc Sci Med. 2009;69(6):813-20. doi: 10.1016/j. socscimed.2009.06.002. 
48. Bedimo AL, Bennett M, Kissinger P, Clark RA. Understanding barriers to condom usage among HIV-infected African American women. J Assoc Nurses AIDS Care. 1998;9(3):48- 58. doi: 10.1016/s1055-3290(98)80019-8. 
49. Muñoz FA, Pollini RA, Zúñiga ML, Strathdee SA, Lozada R, Martínez GA, et al. Condom access: associations with consistent condom use among female sex workers in two northern border cities of Mexico. AIDS Educ Prev. 2010;22(5):455-65. doi: 10.1521/aeap.2010.22.5.455. 
50. Shahmanesh M, Patel V, Mabey D, Cowan F. Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review. Trop Med Int Health. 2008;13(5):659-79. doi: 10.1111/j.1365-3156.2008.02040.x.