Commercial sex plays a critical role in rapidly increasing heterosexual transmission of HIV in China. Because of the illegality and stigma associated with sex work, FSWs may constantly live with fears in their daily life. Based on cross-sectional study of low-paid FSWs in China we described their psychological fears related to commercial sex and examined the associations between fears and HIV-related behaviors. Fear of HIV infection was significantly associated with consistent use of condoms with clients.
However, fear of breaching sex worker identity significantly prevented the FSWs from consistently using condoms with clients and taking HIV tests. Fear of being arrested by the police was positively associated with consistent use of condoms but negatively associated with accessing HIV prevention services.
Our findings underlined the importance of examining the triadic interaction of behavioral, psychological and environmental factors in HIV prevention interventions among low-paid FSWs. This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Compared with other women of reproductive age, female sex workers FSWs are taking a disproportionately high burden of HIV infection due to biological, behavioral and structural risk factors [1].
Among this high-risk population, low-paid FSWs were especially vulnerable and marginalized due to their social-demographic characteristics [2] , life history e. Low-paid FSWs refer to the FSWs who usually work on the street or lower-tier commercial sex venues and charge much less for each sex trade [5]. Struggling at the low end of the commercial sex hierarchy, they were fragile in both physical and psychological well-beings with problems of partner violence e.
