China's 30-year economic boom
has created a unique social and economic market for commercial sex, as well as
for a workforce of migrant women from rural China. This qualitative study
explores the impact of the rapidly changing social and economic environment on
migration patterns, knowledge of sexually transmitted infections (STIs), STI
risk behaviours and health beliefs among female streetwalkers in Shanghai.
Qualitative data were collected in 2010 through semi-structured in-depth
interviews with 16 streetwalkers to characterise their migration passages,
sexual health and behaviours, and peer networks. Many streetwalkers reported
histories of childhood impoverishment, of family or partner violence or trauma,
of migration consistent with the timeline and routes of economic development
and of a scarcity in health, social or economic support.
Their knowledge of the
prevention and treatment of HIV and STIs was limited. They had little
bargaining power on condom use and the majority resorted to vaginal douching and
self-management with antibiotics as preventative measures.
The study identifies
streetwalkers' perspectives on the changing environment, their options and
actions and, finally, HIV/STI risks that were unique to this hidden population.
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1a Department of International Health , Georgetown University , Washington , DC , USA
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