54 research outputs found

    Aiding intolerance and fear: The nature and extent of AIDS discrimination in South Africa

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    Characteristics, sexual behaviour and risk factors of female, male and transgender sex workers in South Africa

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    Background. In South Africa, information on sex workers' characteristics, sexual behaviour and health needs is limited. Current social, legal and institutional factors impede a safe working environment for sex workers and their clients. Objectives. To describe characteristics and sexual behaviour of female, male and transgender sex workers, and assess their risk factors for unprotected sex. Methods. Repeat cross-sectional surveys among sex workers were conducted in Hillbrow, Sandton, Rustenburg and Cape Town in 2010. Sex workers were interviewed once; any re-interviews were excluded from analysis. Unprotected sex was defined as any unprotected penetrative vaginal or anal sex with last two clients. Results. Trained sex worker-research assistants interviewed 1 799 sex workers. Sex work was a full-time profession for most participants. About 8% (126/1 594) of women, 33% (22/75) of men, and 25% (12/50) of transgender people had unprotected sex. A quarter of anal sex was unprotected. Unprotected sex was 2.1 times (adjusted odds ratio (AOR), 95% CI 1.2 - 3.7; p=0.011) more likely in participants reporting daily or weekly binge drinking than non-binge drinkers. Male sex workers were 2.9 times (AOR, 95% CI 1.6 - 5.3; p<0.001) more likely, and transgender people 2.4 times (AOR, 95% CI 1.1 - 4.9; p=0.021) more likely, than females to have unprotected sex. Sex workers in Hillbrow, where the only sex work-specific clinic was operational, were less likely to have unprotected sex than those in other sites. Conclusion. Tailored sex work interventions should explicitly include male and transgender sex workers, sex work-specific clinics, focus on the risks of unprotected anal sex, and include interventions to reduce harm caused by alcohol abuse

    Towards harm reduction programmes with sex worker clients in South Africa

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    This report explores possible harm reduction approaches to a sex worker client intervention in the South African context. It considers the current evidence base on client interventions globally and sets out key recommendations for an effective client intervention programme. Drawing on this framework and recommendations, the report concludes with an example of a curriculum which could be used as a possible approach to a client intervention plus an educational booklet targeted at sex worker client
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