The price of sex: condom use and the determinants of the price of sex among female sex workers in eastern Zimbabwe.

The price of sex: condom use and the determinants of the price of sex among female sex workers in eastern Zimbabwe.
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DOI:
10.1093/infdis/jiu493
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发表时间:
2014-12-01
期刊:
The Journal of infectious diseases
影响因子:
--
通讯作者:
Gregson S
Gregson S
中科院分区:
其他
文献类型:
--
作者:
Elmes J;Nhongo K;Ward H;Hallett T;Nyamukapa C;White PJ;Gregson S

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背景。 无保护性行为的价格上涨威胁到安全套的高使用率,而安全套的使用率导致了津巴布韦人体免疫缺陷病毒(HIV)流行率的下降。为了加深对与安全性行为竞争的经济压力的理解,我们探讨了与津巴布韦东部农村地区商业性行为价格相关的因素。方法。 我们收集并分析了 2010 年 10 月至 12 月期间招募的 311 名女性的横截面数据,她们报告称,她们在过去一年中最近或第二次发生的性行为获得了报酬。具有针对女性性工作者 (FSW) 的稳健标准误的零膨胀负二项式模型被用来探索价格的社会和行为决定因素。结果。 性行为的中位价格为每晚 10 美元(四分位距 [IQR],5-20 美元),每次行为 10 美元(IQR,5-15 美元)。以现金和商品支付的金额没有显着差异。在最近的一次性行为中,受过更多教育的 FSW 获得的报酬要高出 30%–74%。客户对使用安全套的要求显着预测了受保护的性行为 (P < .01),但客户为无保护的性行为平均支付了 42.9% 的费用。结论。 在客户偏好决定安全套使用的工作环境中,FSW 有效地利用其个人资本来谈判安全套使用条款。加强性工作者对保护性行为的偏好有助于维持安全套的高使用率。
Background. Higher prices for unprotected sex threaten the high levels of condom use that contributed to the decline in Zimbabwe's human immunodeficiency virus (HIV) epidemic. To improve understanding of financial pressures competing against safer sex, we explore factors associated with the price of commercial sex in rural eastern Zimbabwe. Methods. We collected and analyzed cross-sectional data on 311 women, recruited during October–December 2010, who reported that they received payment for their most-recent or second-most-recent sex acts in the past year. Zero-inflated negative binomial models with robust standard errors clustered on female sex worker (FSW) were used to explore social and behavioral determinants of price. Results. The median price of sex was $10 (interquartile range [IQR], $5–$20) per night and $10 (IQR, $5–$15) per act. Amounts paid in cash and commodities did not differ significantly. At the most-recent sex act, more-educated FSWs received 30%–74% higher payments. Client requests for condom use significantly predicted protected sex (P < .01), but clients paid on average 42.9% more for unprotected sex. Conclusions. Within a work environment where clients' preferences determine condom use, FSWs effectively use their individual capital to negotiate the terms of condom use. Strengthening FSWs' preferences for protected sex could help maintain high levels of condom use.
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