Violence against Chinese female sex workers from their stable partners: a hierarchical multiple regression analysis

Risk and Protective Factors Associated With Intimate Partner Violence Against Chinese Women: A Systematic Review

Intimate partner violence (IPV) is a global health challenge leading to various detrimental health outcomes. Chinese women are a vulnerable population often overlooked in IPV research. Guided by the social-ecological model, this systematic review aims to synthesize literature on the risk and protective factors for IPV among Chinese women. A comprehensive search was conducted in nine major English and Chinese databases for articles with data collected since 2006 on adult Chinese women, leading to 29 papers in the final analysis. Risk and protective factors associated with IPV identified in this review include factors at the individual level such as demographics (e.g., a younger age, unplanned pregnancy, abortion, having children, and migration), socioeconomic status (e.g., income and partners' education level), attitudinal factors (e.g., attitudes justifying IPV and traditional beliefs about gender roles), behavioral factors (e.g., alcohol use of women, partners' alcohol use and frequency, and partners' high frequency of gambling), adverse childhood experiences (e.g., witnessed violence in childhood), and other personal characteristics (e.g., chronic illness and good health status). Factors at the relationship level include conflicts, power in intimate relationships, and social capital (e.g., the size of social networks, network participation of women and their partners, and social control). Community-level factors related to geographic locations were also explored while no factors were identified at the societal level. None of the included studies examined the intersections of factors within the same level or across different levels. Recommendations for future research, practice, and policy are also discussed.

The Intimate Relationship Experiences of Women Engaged in Transactional Sex Work in Barbados

This phenomenological study, consisting of individual interviews with a sample of 30 women engaged in sex work, examines the intimate relationships of women engaged in sex work in Barbados. Participants often entered relationships with men they met while engaged in sex work. Most experienced relationships that became transactional, abusive, and exploitative. Intimate partner violence (IPV) challenged their ability to negotiate condom use with intimate partners placing them at risk for HIV. A cycle emerged of entering relationships to exit the violent conditions of sex work and then re-entering sex work to escape IPV. Implications for mental health, HIV prevention, IPV, and empowerment services are described.

Exploring the Linkages between Substance Use, Natural Disasters, Pandemics, and Intimate Partner Violence against Women: A Rapid Review in the Context of COVID-19

Rates of intimate partner violence (IPV) and substance use have risen during the COVID-19 pandemic, with potentially enduring effects on women’s health. A rapid review was conducted on IPV and women’s substance use in the context of the COVID-19 pandemic. The rapid review explored two separate research questions with a view to integrate the literature related to: (1) containment, social isolation, pandemics, disasters, lockdowns, and IPV; and (2) the relationships between substance use and IPV. Two different searches for each question were conducted between May and October 2020 and n = 47 articles were included. Women experience multiple physical and mental health consequences related to IPV that can be exacerbated by public health crises such as pandemics and disasters. Perpetrators may use these events as a tactic to threaten, isolate, or use coercive control. Similar tactics are reported in the complex relationship between IPV and substance use, where substance use can accompany IPV and/or be used as a coping mechanism for survivors. The findings highlight long standing women’s health concerns made further visible during the COVID-19 pandemic. Additional research is needed to identify actions required to reduce gender inequities and harms associated with IPV and substance use, and to adequately tailor and prepare effective responses in the context of future public health crises.

Alcohol Use and Experiences of Partner Violence Among Female Sex Workers in Coastal Andhra Pradesh, India

This cross-sectional study describes the prevalence and context of violence by sexual partners against female sex workers (FSWs, N = 589) in Andhra Pradesh and its association with alcohol use by FSWs and abusive partners. In all, 84% of FSWs reported alcohol use; 65% reported lifetime physical abuse by a sexual partner. Most abused women suffered abuse from multiple partners, often triggered by inebriation or FSW's defiance. In multivariate logistic regressions, frequency of FSW's alcohol use was associated with abuse by clients and primary partner, whereas partner's alcohol use was only significant for abuse by primary partner, not clients.

Prevalence and correlates of sexual and gender-based violence against Chinese adolescent women who are involved in commercial sex: a cross-sectional study

OBJECTIVES

Despite the vast quantity of research among Chinese female sex workers (FSWs) to address concerns regarding HIV/sexually transmitted infection (STI) risk, there is a paucity of research on issues of sexual and gender-based violence (SGBV) and the missed opportunity for sexual and reproductive health (SRH) promotion among young FSWs. Our research aimed to assess the prevalence and correlates of SGBV among Chinese adolescent FSWs, and to explore SRH service utilisation.

DESIGN AND METHODS

A cross-sectional study using a one-stage cluster sampling method was employed. A semistructured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine individual and structural correlates of SGBV.

SETTING AND PARTICIPANTS

Between July and September 2012, 310 adolescent women aged 15-20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months were recruited and completed their interview in Kunming, Yunnan Province, China.

RESULTS

Findings confirm the high prevalence of SGBV against adolescent FSWs in China, with 38% (118/310) of participants affected in the past year. Moreover, our study demonstrated the low uptake of public health services and high rates of prior unwanted pregnancy (52%; 61/118), abortion (53%; 63/118) and self-reported STI symptoms (84%; 99/118) in participants who were exposed to SGBV. Forced sexual debut was reported by nearly a quarter of FSWs (23%; 70/310) and was independently associated with having had a drug-using intimate partner and younger age (<17 years old) at first abortion. When controlling for potential confounders, having experienced SGBV was associated with frequent alcohol use, having self-reported symptoms of STI, having an intimate partner and having an intimate partner with illicit drug use.

CONCLUSIONS

This study calls for effective and integrated interventions addressing adolescent FSWs' vulnerability to SGBV and broader SRH consequences.

Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China

OBJECTIVE

In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China.

METHODS

A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine correlates of low knowledge and unmet need for modern contraception.

RESULTS

SRH knowledge was poor among the 310 adolescents surveyed; only 39% had heard of any long-acting reversible contraception (implant, injection or IUD). Despite 98% reporting not wanting to get pregnant, just 43% reported consistent condom use and 28% currently used another form of modern contraception. Unmet need for modern contraception was found in 35% of adolescents, and was associated with having a current non-paying partner, regular alcohol use, and having poorer SRH knowledge. Past abortion was common (136, 44%). In the past year, 76% had reported a contraception consultation but only 27% reported ever receiving SRH information from a health service.

CONCLUSIONS

This study demonstrated a low level of SRH knowledge, a high unmet need for modern contraception and a high prevalence of unintended pregnancy among adolescent FSWs in Kunming. Most girls relied on condoms, emergency contraception, or traditional methods, putting them at risk of unwanted pregnancy. This study identifies an urgent need for Chinese adolescent FSWs to be able to access quality SRH information and effective modern contraception.