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In Eastern Europe and Central Asia,
the prevalence of HIV continues to rise. And although injection drug use (IDU)
remains a leading risk factor, transmission via heterosexual sex is increasing.
While commercial sex work plays a central role globally in the heterosexual
transmission of HIV and STI, little is known about female sex workers (FSWs) in
this region.
The authors of the current study
evaluated STI and HIV prevalence among FSWs in Moscow and potential risk
factors, including IDU, sexual risks, and violence victimization. During an
eight-month period in 2005, 147 Moscow FSWs completed a clinic-based survey and
were tested for STI and HIV.
The results indicated that HIV
prevalence was 4.8 percent, and 31.3 percent of the women were infected with at
least one STI including HIV. Sexual behaviors found to be significantly
associated with STI/HIV included anal sex (adjusted odds ratio 3.48), high
volume of clients (AOR 2.71 for three or more clients daily), recent
“subbotnik” (sex demanded by police, AOR 2.50), and regularly being presented
with more clients than was originally agreed to (AOR 2.45).
Also associated with STI/HIV were
past-year experiences of physical violence from clients (AOR 3.14) and threats
of violence by pimps (AOR 3.65). “IDU was not significantly associated with
STI/HIV,” the researchers reported. “Anal sex and high client volume partially
mediated the associations of abuse with STI/HIV.”
“Findings illustrate substantial
potential for heterosexual STI/HIV transmission in a setting better known for
IDU-related risk,” the authors concluded. “Many of the STI/HIV risks observed
are not modifiable by FSWs alone. STI/HIV prevention efforts for this
vulnerable population will benefit from reducing coercion and abuse perpetrated
by pimps and clients.”
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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