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AIDS Res Treat. 2012; 2012: 812635.
Published online 2012 July 17. doi:  10.1155/2012/812635
PMCID: PMC3405561
Age Differences among Female Sex Workers in the Philippines: Sexual Risk Negotiations and Perceived Manager Advice
Lianne A. Urada, 1 * Robert M. Malow, 2 Nina C. Santos, 3 and Donald E. Morisky 4
1Division of Global Public Health, Department of Medicine, University of California San Diego, School of Medicine, 9500 Gilman Drive, MC 0507, La Jolla, CA 92093-0507, USA
2Department of Health Promotion and Disease Prevention, Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC II-579A Miami, FL 33199, USA
3School of Public Health, University of California, Berkeley. 50 University Hall #7360, Berkeley, CA 94720, USA
4Doctoral Training Program in the Social and Behavioral Determinants of HIV/AIDS Prevention, Department of Community Health Sciences, 10833 Le Conte Ave, Fielding School of Public Health, University of California, CHS 26-070 Los Angeles, CA 90095-1772, USA
*Lianne A. Urada: lurada/at/ucsd.edu
Academic Editor: Bonita Stanton
Received March 15, 2012; Revised May 19, 2012; Accepted May 19, 2012.
Abstract
Consistent condom use among high risk groups such as female sex workers (FSWs) remains low. Adolescent female sex workers are especially at higher risk for HIV/STI infections. However, few published studies have compared the sexual risk negotiations among adolescent, emerging adult, and older age groups or the extent a manager's advice about condom use is associated with an FSW's age. Of 1,388 female bar/spa workers surveyed in the southern Philippines, 791 FSW who traded sex in the past 6 months were included in multivariable logistic regression models. The oldest FSWs (aged 36–48) compared to adolescent FSWs (aged 14–17) were 3.3 times more likely to negotiate condoms when clients refused condom use. However, adolescent FSWs received more advice from their managers to convince clients to use condoms or else to refuse sex, compared to older FSWs. Both adolescent and the oldest FSWs had elevated sexually transmitted infections (STIs) and inconsistent condom use compared to other groups. Having a condom rule at the establishment was positively associated with condom negotiation. Factors such as age, the advice managers give to their workers, and the influence of a condom use rule at the establishment need to be considered when delivering HIV/STI prevention interventions.
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