Local Brasilia sex women

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Local Brasilia sex women

Try out PMC Labs and tell us what you think. Learn More. To establish the correlates of HIV infection, we used logistic regression models taking into the dependence of observations resultant from the recruitment chains. The analysis included socio-demographic sex work characteristics, sexual behavior, history of violence, alcohol and drug use, utilization of health services, and occurrence of other sexually transmitted infections STIs. HIV prevalence was estimated as 5. Regarding socio-demographic and sex work characteristics, low educational level, street as the main work venue, low price per sexual encounter, and longer exposure time as a sex worker were found to be associated with HIV infection, even after controlling for the homophily effect.

The main factors associated with HIV infection identified in our study characterize a specific type of street-based sex work in Brazil and provided valuable information for developing interventions.

Local Brasilia sex women

However, there is a further need of addressing social and contextual factors, including illicit drug use, violence, exploitation, as well as stigma and discrimination, which can influence sexual behavior. Since the beginning of the acquired immune deficiency syndrome AIDS epidemic, female sex workers FSWs have been nationally and internationally recognized as a population at high risk for acquiring human immunodeficiency virus HIV infection. FSWs are considered a high-risk group for acquiring HIV infection [ 317 ] due to their social vulnerability and factors associated with their work such as multiple sex partners, inconsistent condom use, or coinfection with other sexually transmitted infections STIs.

Based on improvements in data analysis techniques, [ 39 ] the aim of this study was to identify factors associated with HIV infection using logistic regression models. The sample size was set at FSW in each city. Women were eligible to participate in the study if they met the following inclusion criteria: age 18 years old or over; to report working as a sex worker in one of the cities of the study; to have had at least one sexual intercourse in exchange for money in the past four months; and to present a valid coupon to participate.

Fieldwork was conducted in health services located in the 12 cities. Seeds were well-connected FSW in their community who reported large social networks. Each seed received 3 coupons to distribute to other sex workers from her social network.

Recruits of the seeds in the survey were considered the first wave of the study. After participating in the interview, each participant received 3 additional coupons to distribute to their peers and this process was repeated until the sample size was achieved in each city.

Local Brasilia sex women

The RDS method also draws on the strategy of giving incentives to the participants. A 1st incentive, that is, primary incentive, is given to participants when they complete their participation in the study. Thereafter, a 2nd incentive, that is, secondary incentive, is given to participants for each peer successfully recruited into the study.

The choice of sites, in general a health service, for data collection and the level of incentives were established according to the formative research carried out in each city before the RDS survey. The questionnaire included modules on: socio-demographic characteristics and information related to commercial sex activity, knowledge about HIV and other STI transmission, sexual behavior, history of HIV and syphilis testing, STI history, use of alcohol and illicit drugs, access to prevention activities, access to and utilization of health services, discrimination, and violence.

The questionnaire was deed for tablets and could be self-administered according to the participant's desire and readiness. Tests for HIV, syphilis, and hepatitis B and C were conducted by standard rapid tests using peripheral venous blood collection, according to protocols recommended by the Brazilian Ministry of Health. All tests occurred before the interview and all participants received pre- and posttest counseling. Participants who tested positive for any of the rapid tests had their blood samples taken for confirmatory laboratory testing and received additional posttest counseling, both for psychological impact and to encourage partner notification, and were referred to public health systems for follow-up.

A reactive result on the initial HIV rapid test was followed by a 2nd HIV rapid test, from a different manufacturer and samples reactive on rapid tests were further submitted to confirmatory assays. The proposed weighting for data collected by RDS is proportional to the inverse of network size of each participant. The tendency of a participant to recruit peers with similar characteristics is usually referred to as homophily. Additionally, the logistic regression models were performed by taking into the complex sample de, by considering each city as a stratum and the participants recruited by the same FSW as a cluster.

Taking into the homophily effect and the dependence between recruiters and their recruited participants, the de effect was estimated at 1. Analysis of the association between socio-demographic variables, characteristics related to sex work, prevention activities and HIV infection adjusted by the recruiter's HIV test among FSW, Brazil, Regarding commercial sex characteristics, HIV infection was associated with time in commercial sex work: HIV prevalence ranged from 1. Additionally, an inverse association was found for the price of each sexual encounter, the higher the price the smaller the odds of HIV infection.

In relation to participation in prevention activities, women who were affiliated to or participated in an FSW-NGO in the past 6 months had 1. STI counseling in the last 6 months prior to the survey was not statistically ificant. On the other hand, the use of illicit drugs at least once a week was highly ificant: HIV prevalence varied from 4. Although HIV prevalence was smaller for consistent condom use with clients, the OR was not statistically ificant. Regarding the occurrence of STI s over the 12 months prior to the survey, presence of blisters on the vagina or anus indicated a chance 2.

Educational level remained statistically ificant, highlighting the stronger effect of illiteracy or very low level of education, as well as price per sexual encounter, time of exposure to sex work, and the workplace street vs others after controlling for all other variables that also showed ificant effects on HIV infection. Syphilis reactive treponemal test was the most important predictor of HIV infection, with corresponding adjusted OR of 2. A large and ificant homophily effect was found as well.

The recruitment of a large of FSWs in 12 Brazilian cities, in a short time period, at a relatively low cost compared to studies conducted in high-income countries, and the use of appropriate statistical procedures in data analysis, indicate that RDS is a feasible methodology for the study of FSW in Brazil. The experience of the RDS study enabled us to improve the techniques for data analysis and all the logistic regression models used in the present study took into the HIV infection homophily effect and the intraclass correlation between recruited FSW by the same participant.

In relation to socio-demographic and commercial sex characteristics, low educational level, street as the main work venue, low price per sexual encounter, and longer exposure time as a sex worker were found to be the main predictors of HIV infection. As to the use of alcohol and illicit drug use, our findings reiterate the effects of a greater HIV vulnerability associated to unprotected sex. The possibility of not using condoms in some specific situations, such as not having condom available at the time of the sexual encounter, showed a ificant effect on HIV infection as well.

Data from surveys in Brazil evidenced a tendency for FSW to report consistent condom use with clients, especially when interviewed by health staff. However, when questions are asked indirectly, they reveal not using condoms in several circumstances. Regarding participation in prevention activities, the showed a higher chance of HIV infection among women who reported being affiliated to or participating in FSW-oriented NGOs. Unfortunately, in the current situation of weakening of NGOs in Brazil, the role of these institutions has been less and less focused on prevention and health promotion, as had historically occurred in Brazil.

Frequency of HIV testing represents the individual concern with preventive health care but also self-perception of risk. The occurrence of other STI indicated by the presence of blisters on the vagina or anus and syphilis were the most ificant determinants of HIV infection. History of sexual violence was shown to be a relevant factor associated with HIV infection.

Although prostitution in Brazil is not considered a crime under the National Constitution, FSW constantly experience human rights violations such as physical and sexual violence usually perpetrated by partners, family members, and clients. Engagement in violent and unprotected sexual practices, even against their will, reflects the stigma and discrimination suffered by these women, factors that have been shown to be strongly associated with adverse health outcomes. The of the multivariate analysis showed that the association of some variables with HIV infection persisted, such as effect of lower education and cheaper fee for services, working at street spots, longer exposure time of sex work, syphilis, and crack use at least once a week.

It is important to note that the use of multivariate models on the data collected by RDS often renders variables that lose statistical ificance due to the complex sampling de with over-control of the homophily effect, or to adjustments for confounding.

Other limitations are related to the cross-sectional de, for which the analysis of causality is restricted since temporality is not addressed in this type of study. In conclusion, the main factors associated with HIV infection identified in this multivariate analysis characterize a specific type of street-based commercial sex work in Brazil: older women with none or very low degree of instruction, who charge less for the sexual encounter and frequently engage in higher risk sexual behavior.

The small fee per sexual encounter is a determinant of the type of client, in general of low socioeconomic status and who are more likely to request unprotected sex.

Local Brasilia sex women

Ultimately, although the statistical analyses provide valuable information for developing targeted interventions, there is a further need to address other contextual factors. FSWs are exposed to multiple harms including illicit drug use, violence and criminality, exploitation, as well as stigma and discrimination. The authors thank the participants of the study and to the local teams that carried out the fieldwork in the 12 cities. Consent for publication: see institutional consent. Authorship: This manuscript has not been submitted or accepted for publication elsewhere.

Local Brasilia sex women

All authors contributed to the concept of the paper and data analysis. All authors have read and approved the paper, have met the criteria for authorship as established by the International Committee of Medical Journal Editors, believe that the paper represents honest work, and are able to verify the validity of the reported. No funding bodies had any role in study de, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no conflicts of interest to disclose. National Center for Biotechnology InformationU.

Journal List Medicine Baltimore v.

Local Brasilia sex women

Medicine Baltimore. Published online May Author information Article notes Copyright and information Disclaimer. Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution 4.

Local Brasilia sex women

This article has been cited by other articles in PMC. : HIV prevalence was estimated as 5. Conclusions: The main factors associated with HIV infection identified in our study characterize a specific type of street-based sex work in Brazil and provided valuable information for developing interventions. Keywords: Brazil, female sex workers, HIV infection, homophily, respondent-driven sampling, risk factors.

Introduction Since the beginning of the acquired immune deficiency syndrome AIDS epidemic, female sex workers FSWs have been nationally and internationally recognized as a population at high risk for acquiring human immunodeficiency virus HIV infection. Open in a separate window.

Figure 1. Data analysis The proposed weighting for data collected by RDS is proportional to the inverse of network size of each participant. Acknowledgments The authors thank the participants of the study and to the local teams that carried out the fieldwork in the 12 cities. HIV risk perception, risk behavior, and seroprevalence among female commercial sex workers in Georgetown, Guyana.

Local Brasilia sex women

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Changes in attitudes, risky practices, and HIV and syphilis prevalence among female sex workers in Brazil from to