Lianne Urada

This study examines the socio-structural sexual health risks of female youth (aged 14-17) working in bar/spa venues and brothels in the Philippines, compared to their older counterparts. Aside from this study, few female sex work studies have interviewed youth under 18. On four southern Philippines islands, 770 female sex workers (FSWs), aged 14-48, were recruited from bar/spa venues and brothels to participate in a socio-structural HIV prevention study. Controlling for the effects of a larger HIV prevention intervention study involving 1484 female bar/spa workers, the minors, compared to older FSWs, had less education (AOR: 0.81, CI: 0.70-0.94), less children (AOR: 0.19, CI: 0.10-0.37), and were more likely to work in illegal brothels (AOR: 4.60, CI: 1.66-12.75) and to be high on drugs during sex (AOR: 2.26, CI: 1.39-3.67). It was less likely that anyone talked to them about HIV prevention (AOR: 0.32, CI: 0.15-0.72), but more likely they were recruited by venue owners (AOR: 5.67, 1.56-20.56) and were told by their managers to have sex without a condom (AOR: 6.80, CI: 2.06-22.39). Results suggest a need for organizational and policy level interventions to protect adolescent females from working in unsafe environments in the Philippines and to prevent youth from being recruited into high-risk situations.

HIV continues to rise in developing countries. Although evidence shows that the consistent and correct use of condoms reduces HIV transmission (Fishbein, 1998), previous studies only partially explain the variance in condom use behavior (Morisky, et al, 2002). The predictors of condom use among female bar workers in the Philippines are explored, using the Theory of Planned Behavior (Azjen,1991), political economy and institutional theory, and added constructs that explains how perceived control (over internal and external factors) influences behavior. Methods: Key informant interviews at national and city government levels, clinics, non-government organizations, and focus groups with female bar workers are conducted. Next, 400 randomly sampled female bar workers and their managers from 20 entertainment establishments across two cities are interviewed, using structured surveys. Measures include condom use, attitudinal and social support scales, with added measures of structural polic...

Purpose: This study describes sex work activity among female bar/spa workers in Metro Manila and examines the association between alcohol/drug use, particularly methamphetamine use, and sex work among this population. Few studies of entertainment workers have differentiated between entertainers who are sex workers and those who are not, an important distinction in terms of risk for HIV/STI and violence. Understanding the prevalence of sex work and its correlates among female bar/spa workers is important to guide broader health considerations for this group, given the heightened physical and mental health issues faced by sex workers globally. Findings may also offer a more nuanced way of understanding who is actively involved in sex work and how to identify them to inform the development of interventions and policies that address commercial sex-related health risks in the Philippines. Methods: This study used a cross-sectional study design with 498 female bar/spa workers recruited fr...

Background: Female sex workers (FSW) in Russia are at high risk for HIV acquisition and transmission due to both their sex work involvement and high rates of injection drug use (IDU) behaviors that also increase their risk for police violence. Studies suggest an association between increased sexual and IDU-related risk for HIV among FSW and violence from police, but there is a paucity of data examining this issue in Russia. This study assesses whether substance use increases risk for sexual coercion from police among FSW in St. Petersburg and Orenburg, Russia. Methods: FSWs in St. Petersburg and Orenburg were recruited via time-location sampling and completed structured surveys on demographics (age, education), sex work risks (e.g., violence during sex work), and substance use. Logistic regression analyses assessed associations between substance use and police sexual coercion, adjusting for sex work risks and demographics. Results: Participants (N=896) were aged 15 and older (94% we...

Introduction The objective of this study was to determine the factors independently associated with trafficking (force/coercion) among female bar/spa workers who traded sex in the Philippines (N = 166). Method 166 female bar/spa workers who traded sex in the past six months were surveyed from 54 venues in Metro Manila (2009-2010). Factors associated with force/coercion into their jobs were examined. The cross-sectional design employed logistic regression and multilevel modeling, controlling for individuals nested within venues. Results The median age of bar/spa workers was 22, median education (n=10 years), 42% had children, and median months worked (n=13). Of the 166 female bar/spa workers who traded sex in the past six months, 19 (11%) self-reported being trafficked, i.e. deceived and/or forced into a job as an entertainer. Trafficking was independently associated with current drug use (adjusted odds ratio [AOR]=1.99, 95% confidence interval [CI]=1.00-3.97), decreased availability...

Kaiser Community-Based HIV Test and Treat Initiative was developed in 2013 to support sites around the country to implement and evaluate innovative models of HIV linkage to care for vulnerable minority and underserved populations living with HIV. This initiative aims to improve early identification of new HIV cases and to increase the HIV care acquisition and maintenance of newly diagnosed individuals in minority communities disproportionately affected by the HIV epidemic. Seven Community Based Organizations (CBOs) have been supported to conduct this work with HIV-infected individuals who are MSM, transgender, substance using, prison releasees, low income minority, and/or rural residents. The cross-site evaluation will identify populations that can be reached via a community HIV test and treat approach, with regard to HIV risk profiles and vulnerabilities attached to HIV linkage to care. Recruitment of HIV infected individuals via community rather than clinical outreach efforts is s...

MEN (Making Employment Needs) Count, is one of the first community-based HIV interventions to address the social-structural context of unemployment and unstable housing for Black heterosexual men’s behavioral risks for HIV. Participants receive three individual sessions with a peer case manager. The sessions include discussion on healthy relationships with women, interpersonal violence reduction in heterosexual relationships, and HIV risk reduction counseling, integrated with employment and housing-supported case management, over a period of 60-90 days. To date, two small pilot studies of MEN Count have been conducted with Black heterosexual men in Boston, MA (N = 50) and Washington, DC (N = 10). Eligible participants were at least 18, unstably housed and/or unemployed and reported unprotected sex with 2 or more sex partners, in the last 6 months. Pilot study results document the utility of MEN Count with regard to HIV risk reduction for unstably housed and/or unemployed Black heter...

Sex work is an increasingly popular form of employment for many men and women around the world. Many countries have implemented punitive practices to reduce the prevalence of sex work, while others like Peru, have taken proactive steps to decriminalize sex work through government regulations and elective sexually transmitted infections (STI) prevention services. While abundant data indicate the risks associated with sex work, few data detail client narratives and insights into transactional sex. This paper provides a unique account of one man’s experience in a brothel and an important perspective to better understand the intricacies and complexities of commercial sex work.

This study examines the socio-structural sexual health risks of female youth (aged 14-17) working in bar/spa venues and brothels in the Philippines, compared to their older counterparts. Aside from this study, few female sex work studies have interviewed youth under 18. On four southern Philippines islands, 770 female sex workers (FSWs), aged 14-48, were recruited from bar/spa venues and brothels to participate in a socio-structural HIV prevention study. Controlling for the effects of a larger HIV prevention intervention study involving 1484 female bar/spa workers, the minors, compared to older FSWs, had less education (AOR: 0.81, CI: 0.70-0.94), less children (AOR: 0.19, CI: 0.10-0.37), and were more likely to work in illegal brothels (AOR: 4.60, CI: 1.66-12.75) and to be high on drugs during sex (AOR: 2.26, CI: 1.39-3.67). It was less likely that anyone talked to them about HIV prevention (AOR: 0.32, CI: 0.15-0.72), but more likely they were recruited by venue owners (AOR: 5.67, 1.56-20.56) and were told by their managers to have sex without a condom (AOR: 6.80, CI: 2.06-22.39). Results suggest a need for organizational and policy level interventions to protect adolescent females from working in unsafe environments in the Philippines and to prevent youth from being recruited into high-risk situations.

... Anthony Patrick Natale, University of Oklahoma, USA; Bipasha Biswas, Saint Louis University, USA; Lianne Urada, University of California ... challenges present including inadequate nutrition, psychological well-being, and quality of life (Schroeder and Nichola, 2005; Atwine et al ...