The HIV epidemic continues to
develop among older adults in China, including older female sex workers. Yet,
few studies have been conducted among this relatively hidden population.
The
objectives of this study were to investigate the reasons for women's entry into
sex work during their thirties and to develop typology of older women sex
workers. Semi-structured in-depth interviews with sixty-three older women sex
workers and six focus groups interviews with stakeholders were conducted in
three cities in China in 2012. Data were analysed inductively using constant
comparative method.
The mean age of participants was 43 years old and the mean
age of entry into sex work was 39 years old. The primary reasons for entry into
sex work include heavy economic burdens, limited employment opportunities, and
the appealing nature of sex work.
Street-based and venue-based older sex
workers were identified based on where they solicited clients. Street-based
older sex workers were more likely to engage in unsafe commercial sex due to
financial incentives, whereas those in entertainment venues were unlikely to
use condoms with regular clients.
The development of effective HIV
interventions needs to consider older women sex workers unique characteristics
and target factors that impede safer sex practices.
Table 1
Socio-demographic characteristics of study respondents (N = 63)
| Street-based older sex workers(n = 28) | Venue-based older sex workers (n = 35) | ||
|---|---|---|---|
| Massage or sauna | Entertainments | ||
| n (%) or Mean (SD) | n (%) or Mean (SD) | n (%) or Mean (SD) | |
| Age | 47.3 (6.8) | 39.4 (3.9) | 38.3 (4.4) |
| Age at first sex work | 42.8 (6.0) | 35.9 (4.3) | 34.5 (5.8) |
| Ethnicity | |||
| Han | 22 (78.6) | 11 (55.0) | 15 (100.0) |
| Other | 6 (21.4) | 9 (45.0) | 0 (0.0) |
| Hometown | |||
| Rural | 21 (75.0) | 19 (95.0) | 15 (100.0) |
| Urban | 7 (25.0) | 1 (5.0) | 0 (0.0) |
| Length of stay in study city | |||
| Less than 1 year | 0 (0.0) | 2 (10.0) | 4 (26.7) |
| 1- 3 years | 5 (17.9) | 7 (35.0) | 1 (6.6) |
| 4- 9 years | 7 (25.0) | 8 (40.0) | 4 (26.7) |
| 10 or more years | 16 (57.1) | 3 (15.0) | 6 (40.0) |
| Education | |||
| Primary school or less | 13 (46.4) | 12 (60.0) | 8 (53.3) |
| Middle school | 10 (35.7) | 7 (35.0) | 7 (46.7) |
| High school | 5 (17.9) | 1 (5.0) | 0 (0.0) |
| Marital status | |||
| Unmarried | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Married | 11 (39.2) | 12 (60.0) | 4 (26.7) |
| Divorced | 12 (42.9) | 8 (40.0) | 10 (66.7) |
| Widow | 5 (17.9) | 0 (0.0) | 1 (6.6) |
| Number of children | |||
| None | 0 (0.0) | 0 (0.0) | 1 (6.6) |
| One | 13 (46.4) | 14 (70.0) | 10 (66.7) |
| Two or more | 15 (53.6) | 6 (30.0) | 4 (26.7) |
| Children in school or pre-school | |||
| No | 13 (46.4) | 1 (5.0) | 3 (20.0) |
| Yes | 15 (53.6) | 19 (95.0) | 12 (80.0) |
| Previous occupation | |||
| Office workers | 1 (3.6) | 0 (0.0) | 0 (0.0) |
| Low-paid services* | 22 (78.6) | 13 (65.0) | 10 (66.7) |
| Selling food or fruit in small carts | 5 (17.8) | 3 (15.0) | 2 (13.3) |
| Farmers | 0 (0.0) | 4 (20.0) | 3 (20.0) |
| Study sites | |||
| Qingdao | 18 (64.3) | 3 (15.0) | 1 (6.7) |
| Hefei | 0 (0.0) | 7 (35.0) | 14 (93.3) |
| Nanning | 10 (35.7) | 10 (50.0) | 0 (0.0) |
*Waitress, cleaner, housekeeping, and shop assistant.
Table 2
Typology of older female sex workers
| Street-based (n = 28) | Venue-based (n = 35) | ||
|---|---|---|---|
| Massage or sauna | Entertainment | ||
| Place of solicitation | Streets, parks or other public places | Roadside massage parlours Saunas, beauty salons | Karaoke bars Dance halls |
| Place of having sex | Public: behind streets or in parks | Inside venues | Inside venues |
| Indoor: older FSWs' or clients' apartments, rented room in off-street buildings, roadside hotels | Outside venue: roadside hotels | Outside veneue: roadside hotels | |
| Organizers | No or quasi “leaders” of older sex workers | Venue owners | Venue owners |
| Rules of commercial sex service* | Pay a referral fee (10 RMB per client) to the leaders or the owners of the off-street premises | Share profits with owners (10 to 20 RMB per client) | Share profits with owners (10% to 50% of income per client) |
| Forbidden to sell sex outside venues without permission | |||
| Types of clients | Low-paid manual workers and older men | Low-paid manual workers and older men | Low-paid manual workers and older men, officers, and private business men |
| Service charge* | Less than 50 RMB | 50-100 RMB | 100 RMB or more |
| Common reason for unsafe sex | Financial incentives/erectile dysfunction | Financial incentives or regular clients | Regular clients |
Full article at: http://goo.gl/HmVVID
By: 
a Susan G. Sherman,b Baofa Jiang,c Xiaojing Li,d Yongfang Xu,e Zhenxia Jiang,f andChunpeng Zanga
a Susan G. Sherman,b Baofa Jiang,c Xiaojing Li,d Yongfang Xu,e Zhenxia Jiang,f andChunpeng Zanga
aDepartment of Epidemiology and
Biostatistics, School of Public Health, University of Maryland College Park,
College Park, Maryland, USA
bDepartment of Epidemiology, Johns Hopkins
Bloomberg School of Public Health, Baltimore, Maryland, USA
cDepartment of Epidemiology, Shandong
University School of Public Health, Jinan, China
dDepartment of HIV/AIDS Control and
Prevention, Hefei Center for Disease Control and Prevention, Hefei, China
eDepartment of HIV/AIDS Control and
Prevention, Nanning Center for Disease Control and Prevention, Nanning, China
fDepartment of HIV/AIDS Control and
Prevention, Qingdao Center for Disease Control and Prevention, Qingdao, China
Corresponding
author.
Hongjie Liu: ude.dmu@0121uilh
More at: https://twitter.com/hiv
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