Correlates of Inconsistent Refusal of Unprotected Sex among Armenian Female Sex Workers

This cross-sectional study assessed the prevalence and correlates of inconsistent refusal of unprotected sex among female sex workers (FSWs) in Armenia. One hundred and eighteen street-based FSWs between the ages of 20 and 52 completed a questionnaire assessing FSWs' demographic, psychosocial, and behavioral characteristics. 

A total of 52.5% (n = 62) of FSWs reported inconsistent refusal of unprotected sex with clients in the past 3 months. Logistic regression analysis controlling for participants' age and education revealed that perceiving more barriers toward condom use, reporting more types of abuse, and setting lower fees for service significantly predicted inconsistent refusal of unprotected sex. HIV-risk-reduction behavioral interventions tailored to FSWs working in Yerevan Armenia should address the factors identified in this study toward the goal of enhancing refusal of unprotected sex and ultimately preventing acquisition of sexually transmitted infections (STIs) including HIV.

Table 1

Descriptive statistics and bivariate associations between inconsistent and consistent refusers of unprotected sex in the past 3 months.

Variable	Inconsistent refusers (n = 62)	Consistent refusers (n = 56)	P
	Mean (SD) % (N)	Mean (SD) % (N)
∗Age	33.5 (7.3)	34.0 (6.1)	0.64
∗Education (≥10 years)	59.7% (37)	57.1% (32)	0.78
Marital status (single)	21.0% (13)	14.3% (8)	0.34
Having a steady partner	50.0% (31)	50.0% (28)	1.0
Having children	62.9% (39)	62.5% (35)	0.96
Number of clients in 7 days	6.1 (5.3)	5.8 (5.1)	0.72
∗Fees for service1	9.4 (5.4)	11.9 (6.2)	0.02
∗Types of abuse	1.5 (1.2)	0.6 (0.8)	<0.01
Alcohol consumption	2.5 (3.2)	1.9 (4.1)	0.39
∗Barriers to condom use	22.2 (8.1)	15.4 (7.8)	<0.01

*Variables included in the logistic regression model.

1Fees for service in thousands AMD (Armenian currency) (1,000AMD = $2.6).

Table 2

Logistic regression model.

Predictors/covariates	AOR1 [95% CI2]	P
Age	1.0 [0.9–1.1]	0.58
Education (≥10 years)	1.3 [0.5–3.3]	0.57
Fees for service	0.9 [0.8–1.0]	0.02
Experiences of abuse	2.1 [1.4–3.3]	<0.01
Barriers to condom use	1.1 [1.0–1.2]	<0.01
Constant	0.5	0.67

1AOR: adjusted odds ratio using consistent refusal of unprotected sex as the reference category.

2CI: confidence interval.

Full article at: http://goo.gl/ySOqJD

By: Karine Markosyan, 1 ,* Delia L. Lang, 2 , 3 and Ralph J. DiClemente 2 , 3 , 4 , 5

²Emory University, Rollins School of Public Health, Atlanta, GA 30322, USA

³Emory Center for AIDS Research, Atlanta, GA 30322, USA

⁴Department of Pediatrics, Division of Infectious Diseases, Epidemiology, and Immunology, Emory University School of Medicine, Atlanta, GA 30322, USA

⁵

1Center for Health Services Research and Development, American University of Armenia, 40 Baghramyan Avenue, 0019 Yerevan, Armenia

2Emory University, Rollins School of Public Health, Atlanta, GA 30322, USA

3Emory Center for AIDS Research, Atlanta, GA 30322, USA

4Department of Pediatrics, Division of Infectious Diseases, Epidemiology, and Immunology, Emory University School of Medicine, Atlanta, GA 30322, USA

1Center for Health Services Research and Development, American University of Armenia, 40 Baghramyan Avenue, 0019 Yerevan, Armenia

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