Table 2.
HIV risk environment among female sex workers from three Russian cities, comparing injection drug use risk groups (N=754)
| Characteristic | Non-injecting (n=591) |
Formerly injecting (n= 82) |
Active injecting (n= 81) |
Total (n=754) |
p-value |
|---|---|---|---|---|---|
| % (n) | % (n) | % (n) | % (n) | ||
| HIV prevalence* | 1.5 (9) | 8.5 (7) | 16.1 (13) | 3.9 (29) | 0.001 |
| Sexual risk outcomes (last 6 months): | |||||
|
Avg. percentage of clients for oral sex Mean (95%CI) |
75.1 (66.0 – 84.2) | 90.1 (60.6 – 100) | 78.0 (69.0 – 87.0) | 78.0 (69.0 – 87.0) | |
|
Avg. percentage of clients for vaginal sex Mean (95%CI) |
80.9 (72.1 – 89.8) | 77.7 (48.8 – 100) | 78.2 (69.5 – 87.0) | 78.2 (69.5 – 87.0) | |
|
Avg. percentage of clients for anal sex Mean (95%CI) |
16.5 (8.4 – 24.7) | 9.6 (7.1 – 12.2) | 44.3 (0.1 – 88.8) | 18.8 (9.7 – 27.9) | |
| Condom use during vaginal sex** | 0.10 | ||||
| Always | 85.3 (504) | 91.5 (75) | 62.9 (51) | 83.6 (630) | |
| Any unprotected vaginal sex | 14.7 (87) | 8.5 (7) | 37.0 (30) | 16.5 (124) | |
| Condom use during anal sex | 0.01 | ||||
| Always or no anal sex | 95.6 (565) | 95.1 (78) | 82.7 (67) | 94.2 (710) | |
| Any unprotected anal sex | 4.4 (26) | 4.9 (4) | 17.3 (14) | 5.8 (44) | |
| Structural HIV risk outcomes: violence and coercion (last 6 months) | |||||
| Police extortion: Had to pay or compensate police to sell sex | |||||
| Yes, money* | 19.0 (112) | 31.7 (26) | 42.0 (34) | 22.8 (172) | 0.05 |
| Yes, sex* | 4.0 (23) | 6.1 (5) | 12.4 (10) | 5.0 (38) | 0.01 |
| Yes, information* | 2.7 (16) | 2.4 (2) | 9.9 (8) | 3.5 (26) | 0.03 |
| Any police extortion (at least one of the above)* | 23.7 (140) | 35.4 (29) | 55.6 (45) | 28.4 (214) | 0.01 |
| Physical violence by client* | 6.3 (37) | 6.1 (5) | 39.5 (32) | 9.8 (74) | 0.01 |
| Client coerced or physically forced to have vaginal sex* | 8.6 (51) | 9.7 (8) | 33.3 (27) | 11.4 (86) | 0.001 |
| Substance use (current): | |||||
| Substance use when trading sex: | |||||
| Alcohol | 68.0 (402) | 89.0 (73) | 59.3 (48) | 69.4 (523) | 0.03 |
| Legal drugs | 2.3 (14) | 8.5 (7) | 11.1 (9) | 4.0 (30) | 0.01 |
| More than one type of substance (including illegal drugs) | 5.1 (30) | 22.0 (18) | 51.9 (42) | 11.9 (90) | 0.01 |
|
Percentage of clients estimated to inject Mean (95%CI) |
31.2 (26.8 – 35.8) | 30.4 (24.5 – 36.2) | 36.4 (30.6 – 42.2) | 31.7 (28.0 – 35.4) | |
| Aware of transmission risk related to using a shared needle | 96.1 (568) | 93.9 (77) | 91.4 (74) | 95.4 (719) | 0.01 |
| Engagement in HIV services: | |||||
| Involved with GLOBUS via (last 12 months): | 0.36 | ||||
| None | 24.5 (145) | 14.6 (12) | 38.3 (31) | 24.9 (188) | |
| Outreach only | 33.8 (200) | 46.3 (38) | 34.6 (28) | 35.3 (266) | |
| GLOBUS program clinic + outreach | 41.6 (246) | 39.0 (32) | 27.2 (22) | 39.8 (300) | |
| Ever tested for HIV | 88.3 (515) | 97.6 (80) | 70.4 (57) | 87.4 (652) | 0.12 |
*
Significant at p<0.05;
**
marginally significant at p<0.10 in chi2 analysis of tabulations (adjusted for clustering);