Offer of financial incentives for unprotected sex in the context of sex work
Offer of financial incentives for unprotected sex in the context of sex work
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DOI：
10.1111/j.1465-3362.2009.00091.x
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发表时间：
2010-03-01
影响因子：
3.8
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
--
作者：
Johnston, Caitlin L.;Callon, Cody;Kerr, Thomas
介绍和目标。商业性工作者常常被描绘成疾病传播的媒介。然而，客户在性风险承担和相关决策中所扮演的角色尚未得到彻底的描述。设计和方法。参与者来自温哥华注射吸毒者研究，一个纵向队列。分析仅限于2001年6月至2005年12月期间报告卖淫的人。采用多元广义估计方程，我们评估了不使用安全套的性行为的患病率和相关因素。结果共有232名CSW被纳入分析，73.7%的CSW报告说，如果不使用安全套，他们会得到更多的钱，其中30.6%的CSW接受。与不使用安全套的性行为相关的变量包括每日使用快速球[调整后的比值比（AOR）= 1.21，95%置信区间（CI）：0.23-0.62]，每日吸食快克（AOR = 1.51，95% CI：1.04-2.19）、每日注射海洛因（AOR = 1.76，95% CI：1.27-2.43）和与客户一起吸毒（AOR = 3.22，95% CI：2.37-4.37）。人类免疫缺陷病毒血清阳性不显著（AOR = 0.98，95% CI：0.67-1.44）。讨论和结论。调查结果突出的作用，客户端在促进无保护的性行为，通过经济影响和剥削的CSW药物使用。艾滋病毒血清状况与是否为不使用安全套的性行为提供更多的钱无关。新的干预措施应针对妇女地位委员会和客户。[约翰斯顿CL，卡伦C，李K，伍德E，克尔T.为性工作中的无保护性行为提供经济奖励。Drug Alcohol Rev 2009]。
Introduction and Aims. Commercial sex workers (CSW) are often portrayed as vectors of disease transmission. However, the role clients play in sexual risk taking and related decision making has not been thoroughly characterised. Design and Methods. Participants were drawn from the Vancouver Injection Drug Users Study, a longitudinal cohort. Analyses were restricted to those who reported selling sex between June 2001 and December 2005. Using multivariate generalised estimating equation, we evaluated the prevalence of and factors associated with being offered money for sex without a condom. Results. A total of 232 CSW were included in the analyses, with 73.7% reporting being offered more money for condom non-use, and 30.6% of these CSW accepting. Variables independently associated with being offered money for sex without a condom included daily speedball use [adjusted odds ratio (AOR) = 1.21, 95% confidence interval (CI): 0.23-0.62], daily crack smoking (AOR = 1.51, 95% CI: 1.04-2.19), daily heroin injection (AOR = 1.76, 95% CI: 1.27-2.43) and drug use with clients (AOR = 3.22, 95% CI: 2.37-4.37). Human immunodeficiency virus seropositivity was not significant (AOR = 0.98, 95% CI: 0.67-1.44). Discussion and Conclusions. Findings highlight the role clients play in contributing to unprotected sex through economic influence and exploitation of CSW drug use. HIV serostatus has no bearing on whether more money is offered for sex without a condom. Novel interventions should target both CSW and clients. [Johnston CL, Callon C, Li K, Wood E, Kerr T. Offer of financial incentives for unprotected sex in the context of sex work. Drug Alcohol Rev 2009].