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Published:
Apr 29, 2013Article Details
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Main Article Content
Characteristics, sexual behaviour and risk factors of female, male and transgender sex workers in South Africa
Abstract
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.
