China, as other Southeast Asian countries, has witnessed an
increased use in amphetamine-type stimulants (ATS) amongst urban youth. Amongst
female adolescents who both sell sex and use ATS, risk behaviours are
compounded resulting in even poorer health outcomes. However, limited knowledge
exists on ATS use patterns and ATS-related risk behaviours, particularly in
this context. This research aimed to improve the understanding of these issues
amongst female adolescents who use ATS and sell sex, and to inform future
programming.
This study utilised monthly focus group discussions (four in
total) with the same study participants in Yunnan, China. From within a
drug-treatment programme, female adolescents who reported both a history of
drug use and selling sex were purposively enrolled in the study.
Participating adolescent females were aged 17-19 years
and were all internal-migrants with low literacy. All reported polydrug use
(mainly methamphetamine and heroin, whereas ecstasy and ketamine have been
infrequently employed). Being less informed about risks of drug use and lack of
sexual and reproductive health knowledge seemed to contribute to problematic
drug use, rough and prolonged sexual intercourse, inconsistent condom use and
ineffective contraceptive practice. For their income, participants largely
relied on selling sex, which was frequently coupled with drug sharing services
to clients. However, despite the practices, women did not self-identify as sex
workers, and therefore did not think that existing intervention services
targeting female sex workers were relevant to them. Moreover, criminalization
and stigmatisation of drug use and selling sex impeded their access to care
services.
Current harm reduction and HIV/sexually transmitted
infection (STI) prevention services are unlikely to address the demand of
female adolescents engaged in drug use and commercial sex. Our findings
highlight that a comprehensive and coordinated harm reduction and sexual and
reproductive health response should be conducted involving these most
vulnerable adolescents.
Full article
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By:
- 1International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185, UZP114, 9000, Ghent, Belgium. Xudong.Zhang@UGent.be.
- 2Centre for International Health, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia. Xudong.Zhang@UGent.be.
- 3International HIV Research Group, School of Public Health and Community Medicine, UNSW, Sydney, 2052, Australia. a.kelly@unsw.edu.au.
- 4Sexual & Reproductive Health Unit, Institute of Medical Research, PO Box 60, Goroka, EHP, Papua New Guinea. a.kelly@unsw.edu.au.
- 5City College, Kunming University of Science and Technology, East Ring Road 50, 650051, Kunming, China. christycjj128@hotmail.com.
- 6Department of Prevention and Education, Yunnan Institute for Drug Abuse, Xi Hu Lu 300, 650228, Kunming, China. luojiankm@126.com.
- 7International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185, UZP114, 9000, Ghent, Belgium. Marleen.Temmerman@UGent.be.
- 8International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185, UZP114, 9000, Ghent, Belgium. sluchters@burnet.edu.au.
- 9Centre for International Health, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia. sluchters@burnet.edu.au.
- 10Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne, Victoria, 3004, Australia. sluchters@burnet.edu.au.
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