Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran

Mehrdad Khezri, Mostafa Shokoohi, Ali Mirzazadeh, Mohammad Karamouzian, Hamid Sharifi, Ali Akbar Haghdoost, Stefan D. Baral

Research output: Contribution to journalArticlepeer-review

Abstract

Early sex work initiation among female sex workers (FSWs) increases their vulnerabilities to high-risk sexual practices and sexually transmitted infections (STIs). We examined the association of early sex work with condomless sex indicators, HIV, and other STIs, including human papillomavirus, chlamydia, trichomoniasis, syphilis, and gonorrhea, among FSWs in Iran. We recruited 1347 FSWs from 13 cities in 2015, with 1296 participants (94.2%) reporting information about their age of sex work initiation. Early sex work was defined as the initiation of selling sex before 18 years of age. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported using multivariable logistic regression. Overall, 10.1% of FSWs reported early sex work initiation. FSWs who initiated sex work earlier were more likely to report last-month inconsistent condom use (aOR = 3.31, 95% CI: 1.82, 6.02) and condomless sex with last client (aOR = 1.72, 95% CI: 1.15, 2.56). There was no statistically significant association between early sex work and HIV (aOR = 1.40, 95% CI: 0.43, 4.53) and any other STIs (aOR = 1.01, 95% CI: 0.69, 1.48), except for chlamydia (aOR = 2.09, 95% CI: 1.08, 4.04). These findings suggest that FSWs with early sexual debut would benefit from differentiated interventions including screening for STIs and enhanced counseling for condom use.

Original languageEnglish (US)
Pages (from-to)671-679
Number of pages9
JournalInternational Journal of STD and AIDS
Volume31
Issue number7
DOIs
StatePublished - Jun 1 2020

Keywords

  • HIV
  • Iran
  • Women
  • high-risk sexual behaviors
  • sex workers
  • sexually transmitted infections

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases

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