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published_or_final_version / Community Medicine / Master / Master of Public Health

Background AIDS as a burden to all over the world caused serious problems in some developing regions by threatening health of the population and stability of the society, especially in cross-border areas that have a complex crowd with many migrants. The HIV/AIDS situation of cross-border FSWs in China-Burma border region is not comprehensively known so far. Only have a clearly understanding of their circumstances, can health workers provide target health services for them. Objectives In view of the increasing HIV epidemic in China-Burma border areas in the past several years, this study tries to understand the HIV prevalence among two groups of cross-border FSWs; further describe socio-demographic characteristics in each group; identify risk behaviours related to consistent condom use; interpret HIV risk factors that contribute to HIV infection in each group of FSWs; describe health services currently being provided and particular health services needs of these FSWs. Methods This cross-sectional research design comprises two parts. Part one is a questionnaire based face-to-face interview to obtain self-reported information. A total of 142 cross-border FSWs were recruited from Ruili City, China (Burmese FSWs) and Laukkai City, Burma (Chinese FSWs). Convenience sampling method was used. Risk factors that mutually adjusted were analysed in two logistic regression models regarding condom use and HIV infection in each group and odds ratios (ORs) were obtained with 95% confidence intervals (CI). Part two of this study is voluntary venous blood drawing and testing for HIV infection. 136 cross-border FSWs [6 of part one (questionnaire interview) participants refused] attended part two study. Results In general, Burmese cross-border FSWs tended to be older, lower educated and married and had higher HIV prevalence (18.8%) compared with Chinese women (5%). Frequency of condom use with the paying clients was higher than with the regular partners in both groups. After adjustment, drug users had statistically significant OR of 6.89 (95% CI: 1.12 to 42.38) for condom use frequency in last sex behaviour compare to non-users in Burmese FSWs; based on Chinese FSWs’ condom use model, the more paying clients, the higher frequency of condom use they had (OR: 0.63 with 95% CI: 0.45 to 0.9). Age (year of birth) had a significant impact with two opposite direction on HIV infection in both Burmese group and the whole study population: positively relate to HIV infection in Burmese model (OR: 1.20 with 95% CI: 1.02 to 1.41); nevertheless, when Chinese ones were added, year of birth negatively related to HIV infection with OR of 0.84 (95% CI: 0.74 to 0.96). Generally, Burmese women had proportionally higher health services acceptance proportion to Chinese women. “HIV/AIDS awareness” and “HIV counselling and testing” were the most widely provided services in Burmese and Chinese group, respectively, and “free condom distribution” was the most needed health services of both cross-border FSWs. Conclusion This study provides better understanding about cross-border FSWs working in China-Burma border areas in which little information about their demographics, HIV infection, and high-risk behaviour has been known. From public health perspective, development and implementation of public health interventions and policies can get inspiration and support from this study. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 174-184). / Also available by subscription via World Wide Web / xv,184 leaves, bound ill. 29 cm

MPH / Department of Public Health / The exchange of money or gifts for sexual relationships, also called transactional sex, is considered a sexual risk behaviour worldwide and continues to pose sexually-transmitted infections,unwanted pregnancies risks and other health complications among people engaging in these type of relationships. The aim of the study was to explore the perceptions of students regarding transactional sex and its effects on health at the University of Venda. The study utilized a qualitative, descriptive phenomenological design to understand the perceptions of students regarding transactional sex. The target populations of the study were registered students at the University of Venda. Purposive technique was used to recruit 18 participants. Data was collected using in-depth interviews and analyzed using using Tesch’s thematic analysis. The study concluded that students at the University of Venda perceive transactional sex as a material-based relationship, prostutition, immoral behaviour and abusive relationship.Students perceived socio-economic status, social classes, behavioural aspects and peer pressure to be the driving factors pushing students to engage in transactional sex. Transactional sex is common among the University community and has far-reaching public health as well as social consequences. Students at the University of Venda perceive transactional sex an a bad behavior. This calls for the University to ensure that there are enough extra-mural activities for students to engage in,which could generate some pocket money, awarenesses and educate student not to engage in transactional sex and also provide health talks through printing of pamplets communicating massages against this practie.

This study attempts to understand prostitution from their definition of the situation. It differs in its method from other studies on prostitution in that the investigation was based on the prostitutes' own perspectives as interpreted by the researcher using the interpretative epistemological tradition. A comparative analysis of prostitution in two economically stable African Countries, namely Nigeria and Botswana was made. This study investigated society's perception of prostitutes and how it impacts upon their empowerment and emancipation as vulnerable members of the society and their participation in prevention and control of sexually transmitted infection including HIV/AIDS. Also the role of governments and individuals in creating and sustaining prostitution, an extensive insight to the modus operandi of prostitution and suggestions on how best to address prostitution in society, were discussed. A triangulated methodology of three hundred and twenty five sexworkers (325) that includes a quantitative study of two hundred and five sex workers complimented with a qualitative study of one hundred and twenty sex workers participating in focus group discussion and case studies informed the study. The findings of the research suggest that in the prostitutes' own definition of the situation; prostitutes contribute to the maintenance of societal equilibrium, the society creates and sustains prostitution. Economic need rather than lack of morals creates prostitutes and their situation of vulnerability as women is being reinforced by their status as prostitutes. Violence from partners that includes the police and the inability to reprimand their clients, are some hazards of prostitution and these result in their mobility and creates a challenge in adequately addressing the issue of prostitution in society, including their limited participation in the control of STDs. Respondents in Botswana had a very good knowledge of STI's /HIV/AIDS and had no difficulties in going to hospital in the event of any STD's as compared with Nigerian respondents. The Nigerian respondents' indulged in self-medication with antibiotics and traditional herbs mixed in local gin before and after a sexual act, rather than go to hospitals. The research findings should assist the government and international community's policies and programmes aimed at addressing prostitution and STDs/HIV/AIDS. / Sociology / D.Litt. et Phil.(Sociology)

This study attempts to understand prostitution from their definition of the situation. It differs in its method from other studies on prostitution in that the investigation was based on the prostitutes' own perspectives as interpreted by the researcher using the interpretative epistemological tradition. A comparative analysis of prostitution in two economically stable African Countries, namely Nigeria and Botswana was made. This study investigated society's perception of prostitutes and how it impacts upon their empowerment and emancipation as vulnerable members of the society and their participation in prevention and control of sexually transmitted infection including HIV/AIDS. Also the role of governments and individuals in creating and sustaining prostitution, an extensive insight to the modus operandi of prostitution and suggestions on how best to address prostitution in society, were discussed. A triangulated methodology of three hundred and twenty five sexworkers (325) that includes a quantitative study of two hundred and five sex workers complimented with a qualitative study of one hundred and twenty sex workers participating in focus group discussion and case studies informed the study. The findings of the research suggest that in the prostitutes' own definition of the situation; prostitutes contribute to the maintenance of societal equilibrium, the society creates and sustains prostitution. Economic need rather than lack of morals creates prostitutes and their situation of vulnerability as women is being reinforced by their status as prostitutes. Violence from partners that includes the police and the inability to reprimand their clients, are some hazards of prostitution and these result in their mobility and creates a challenge in adequately addressing the issue of prostitution in society, including their limited participation in the control of STDs. Respondents in Botswana had a very good knowledge of STI's /HIV/AIDS and had no difficulties in going to hospital in the event of any STD's as compared with Nigerian respondents. The Nigerian respondents' indulged in self-medication with antibiotics and traditional herbs mixed in local gin before and after a sexual act, rather than go to hospitals. The research findings should assist the government and international community's policies and programmes aimed at addressing prostitution and STDs/HIV/AIDS. / Sociology / D.Litt. et Phil.(Sociology)

Evidence of male sex work has a history as long as female sex work. There is century old evidence of male Sumarians and Greeks selling sex to other men. Men are today still selling sex to other men. This study showed that the elimination of sex work is practically impossible, and could only be accomplished by the gross denial of basic human rights. Male sex workers have not received the same attention from researchers as have their female counterparts. This is so despite the large numbers of male sex workers in cities all over the world who potentially contribute to the worldwide sexually transmitted infection rates. It is known that wherever indiscriminate sexual activities take place, the risk of transmission of infections are greater. The activities between the male sex worker and his client(s) determine the health problems they are exposed to. The purpose of this research was to determine what transpires between male sex workers and their client(s) in order to provide the sex workers with knowledge to better take care of their own health as well as the health of their clients. A qualitative research design was used to collect data by means of in-depth interviews and participant observation sessions. Research strategies that were also used included: description, ethnography, phenomenology, and the biographic methods of qualitative research. The research revealed that men who have sex with men (MSM) were exposed to forty-nine different preventable sexually transmitted infections including HIV/AIDS, trauma, violence, and alcohol and drug abuse. All these conditions relate to the lifestyle and activities of male sex workers. Recommendations were made regarding the removal of factors that hinder the delivery of programmes on safer sex to MSM. A booklet on safer sex for MSM was compiled by the researcher and distributed to all informants upon completion of the research. The neglected topic of male sex work was highlighted and health practitioners and other decision makers can now use the information in this thesis to make a contribution towards the better management of male sex work in South Africa in the interest of public health. / Health Studies / D.Litt et Phil. (Health Studies)

Evidence of male sex work has a history as long as female sex work. There is century old evidence of male Sumarians and Greeks selling sex to other men. Men are today still selling sex to other men. This study showed that the elimination of sex work is practically impossible, and could only be accomplished by the gross denial of basic human rights. Male sex workers have not received the same attention from researchers as have their female counterparts. This is so despite the large numbers of male sex workers in cities all over the world who potentially contribute to the worldwide sexually transmitted infection rates. It is known that wherever indiscriminate sexual activities take place, the risk of transmission of infections are greater. The activities between the male sex worker and his client(s) determine the health problems they are exposed to. The purpose of this research was to determine what transpires between male sex workers and their client(s) in order to provide the sex workers with knowledge to better take care of their own health as well as the health of their clients. A qualitative research design was used to collect data by means of in-depth interviews and participant observation sessions. Research strategies that were also used included: description, ethnography, phenomenology, and the biographic methods of qualitative research. The research revealed that men who have sex with men (MSM) were exposed to forty-nine different preventable sexually transmitted infections including HIV/AIDS, trauma, violence, and alcohol and drug abuse. All these conditions relate to the lifestyle and activities of male sex workers. Recommendations were made regarding the removal of factors that hinder the delivery of programmes on safer sex to MSM. A booklet on safer sex for MSM was compiled by the researcher and distributed to all informants upon completion of the research. The neglected topic of male sex work was highlighted and health practitioners and other decision makers can now use the information in this thesis to make a contribution towards the better management of male sex work in South Africa in the interest of public health. / Health Studies / D.Litt et Phil. (Health Studies)