15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1202)

Huang YY, Henderson GE, Pan SM, Cohen MS
Sociology Department, Renmin University, Beijing, China

BACKGROUND: The number of female sex workers (FSWs) in China has increased in the past decade; current estimates range from half a million to three-four million. In 2000, HIV prevalence among FSWs in Guangxi and Yunnan provinces was 10.7% and 4.6%, but recent studies have shown that most FSWs in China have little knowledge of HIV/AIDS, and reports of consistent condom use among clients and prostitutes vary but generally range from 15%-30%. FSWs' lack of negotiating power with clients regarding risky sexual practices is often attributed to their lack of political and economic power, particularly where prostitution is illegal, as in China. Yet power and autonomy in any occupation also depend on control over the terms of work, which can and do vary.

METHODS: We conducted a qualitative observation and interview study to investigate the working lives of 158 falang xiaojie, brothel-based prostitutes working in 45 hair salons, barbershops, and small Karaoke dancing bars, in two Chinese cities. In contrast to higher-level prostitutes, falang xiaojie have lower economic and educational resources, are generally full time prostitutes and are more likely to provide direct sexual intercourse services, and thus are at higher risk for acquiring HIV/AIDS.

RESULTS: We demonstrate that even within this one type of FSW, there is considerable variation in work conditions and content, including employment status (slave based, live and work in brothel, and employment-based), method of client recruitment (FSW initiated, manager initiated, manager and client initiated), and the content of work (knowledge of sex practices and sexual health). These in turn are related to FSWs' power and autonomy vis-a-vis clients.

CONCLUSIONS: Programs to reduce FSWs' risk of HIV/AIDS in China should design programs and select targets for intervention (managers, FSWs, or their clients) based upon an assessment of FSWs' degree of control over the work setting.

040711
TuOrC1202

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