Selling sex in unsafe spaces: sex work risk environments in Phnom Penh, Cambodia.
Selling sex in unsafe spaces: sex work risk environments in Phnom Penh, Cambodia.
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DOI：
10.1186/1477-7517-8-30
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发表时间：
2011-11-20
影响因子：
4.4
通讯作者：
Young Women's Health Study Collaborative
中科院分区：
文献类型：
--
作者：
Maher L;Mooney-Somers J;Phlong P;Couture MC;Stein E;Evans J;Cockroft M;Sansothy N;Nemoto T;Page K;Young Women's Health Study Collaborative
风险环境框架为了解女性性工作者对艾滋病毒和其他性传播感染的环境脆弱性提供了一个有价值但未得到充分利用的启发。事实证明，妓院比街头性工作更安全，坚持使用避孕套的比例更高，艾滋病毒感染率更低。虽然娱乐场所也被认为比街头性工作更安全，但很少有研究在这方面审查环境对易感染艾滋病毒的影响。作为青年妇女健康研究的一部分，我们对金边从事性工作的青年妇女（15-29岁）进行了一项前瞻性观察研究，我们进行了深入访谈（n = 33），以探讨易受艾滋病毒/性传播感染的脆弱性和相关危害。访谈由经过培训的访谈员用高棉语进行，并将其转录和翻译成英文，分析专题内容。柬埔寨加强了打击卖淫和贩卖人口的努力，增加了在娱乐场所和街头工作的妇女人数。我们的研究结果证实，街头性工作使妇女面临感染艾滋病毒/性传播疾病的风险，并确定了与娱乐性工作有关的重大环境风险，包括获得避孕套的机会有限和与酒精有关的中毒。我们的数据还表明，暴露于暴力和与警察的互动是由性交易的环境介导的。特别是，在诸如宾馆等环境中进行性交易，很少或根本没有同伴或管理人员的支持或保护形式的监督，可能会增加感染艾滋病毒/性传播感染的可能性。娱乐场所也可能为性工作提供高风险环境。我们的研究结果表明，旨在解决柬埔寨妓院性工作者艾滋病毒预防问题的战略并没有很好地转化为越来越多的妇女工作的街头和娱乐场所。迫切需要在法律的和政策改革的支持下采取有针对性的干预措施，旨在减少这些环境中性工作的环境风险。未来的研究应寻求调查性工作场所作为风险环境，探讨不同的商业模式在调解这些环境中的作用，并确定和量化暴露于不同的职业环境中的风险。
The risk environment framework provides a valuable but under-utilised heuristic for understanding environmental vulnerability to HIV and other sexually transmitted infections among female sex workers. Brothels have been shown to be safer than street-based sex work, with higher rates of consistent condom use and lower HIV prevalence. While entertainment venues are also assumed to be safer than street-based sex work, few studies have examined environmental influences on vulnerability to HIV in this context. As part of the Young Women's Health Study, a prospective observational study of young women (15-29 years) engaged in sex work in Phnom Penh, we conducted in-depth interviews (n = 33) to explore vulnerability to HIV/STI and related harms. Interviews were conducted in Khmer by trained interviewers, transcribed and translated into English and analysed for thematic content. The intensification of anti-prostitution and anti-trafficking efforts in Cambodia has increased the number of women working in entertainment venues and on the street. Our results confirm that street-based sex work places women at risk of HIV/STI infection and identify significant environmental risks related to entertainment-based sex work, including limited access to condoms and alcohol-related intoxication. Our data also indicate that exposure to violence and interactions with the police are mediated by the settings in which sex is sold. In particular, transacting sex in environments such as guest houses where there is little or no oversight in the form of peer or managerial support or protection, may increase vulnerability to HIV/STI. Entertainment venues may also provide a high risk environment for sex work. Our results indicate that strategies designed to address HIV prevention among brothel-based FSWs in Cambodia have not translated well to street and entertainment-based sex work venues in which increasing numbers of women are working. There is an urgent need for targeted interventions, supported by legal and policy reforms, designed to reduce the environmental risks of sex work in these settings. Future research should seek to investigate sex work venues as risk environments, explore the role of different business models in mediating these environments, and identify and quantify exposure to risk in different occupational settings.
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