The Use of Female Sex Workers Among Men in Nepal: Prevalence, STIs/HIV-Related Risk Behaviors, and Gender Ideology

Heterosexual sex involving female sex workers (FSWs) is widely documented for its role in facilitating the spread of sexually transmitted infections (STIs)/HIV. Critical to such studies, and increasingly considered essential to HIV prevention efforts, is the gender constructs and power dynamics within relationships. However, little efforts have been made, which focus on male clients of FSWs, particularly on the relationship between gender ideologies and men’s sexual contact with FSWs, within the Nepali context. 

The present study aims to fill this critical gap by assessing the prevalence of use of FSWs and its association with STIs/HIV-related risk behaviors and gender ideologies among Nepali men. We used data from the nationally representative Nepal Demographic Health Survey (NDHS) 2011. For the purpose of analyses, we included a sample of 4,121 men, aged 15–49 years. During data analyses, we used multivariate logistic regression models, adjusted for the following variables: age, region, residence, religion, educational level, wealth index, employment status, and cigarette smoking status. 

Of the total sample, approximately 5% reported the use of FSWs in their lifetime. In regression models, men who had sex with FSWs were more likely to report a history of STIs, not using condom all the time, more than one sexual partner, and have had early sexual debut. Respondents reporting the endorsement of violence against wives and male sexual entitlement were significantly more likely to report sexual contact with FSWs. 

Our findings highlight the need to develop and implement specifically tailored interventions toward male clients of FSWs, with a particular emphasis on promoting equitable gender roles and beliefs.

Full article at:    http://goo.gl/e97o7T

By: Roman Shrestha,^1,2 Pramila Karki,^2,3 and Michael Copenhaver^2,3

¹Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA

²Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA

³Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA

Prim Prev Insights. Author manuscript; available in PMC 2016 Jun 27.

Published in final edited form as:

Prim Prev Insights. 2016; 6: 11–17.

Published online 2016 Jun 9. doi:  10.4137/PPRI.S39664

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