This study examined correlates of unprotected vaginal and anal sex UVA with male clients among female sex workers FSWs. Baseline data were gathered from 1, FSWs recruited from 13 cities across Mexico enrolled in an evidence-based sexual risk reduction intervention. We used generalized estimating equations GEE to predict total UVA while controlling for the nested structure of the data.
Total UVA with clients in the past month was examined in relation to selected sociodemographic, substance-use, and micro- and macro-environmental factors. Greater number of UVA acts was associated with three micro-level environmental factors i. These findings suggest the development of social and structural approaches to HIV prevention for FSWs in Mexico, including modification of venue-based policies that pressure FSWs to maximize client volume, changes to the work environment that promote availability and affordability of condoms, and improved population health.
Moreover, our findings call for the development of context-specific HIV interventions that take into account variations in the sexual risk behaviors and HIV risk environments of FSWs throughout Mexico. In a meta-analysis, FSWs had High rates of unprotected sex and low rates of condom negotiation with clients have also been documented among FSWs in LMIC around the globe, including Mexico Munkhbaatar et al.
Sex work in most cities in Mexico is tolerated in zonas rojas red light districts. The purpose of the present study was to identify correlates of unprotected vaginal and anal sex UVA with clients among FSWs in 13 cities across eight states in Mexico. To develop effective interventions, HIV prevention researchers must have an empirically-based understanding of social, behavioral, and macro- and micro- environmental factors associated with unprotected sex in this high-risk population.
They include sociodemographic, substance-use, and environmental factors, both micro-level e. Previous research has shown associations between sexual risk behavior with clients and lower education Fernandes et al.
