Background Global literature suggests women often have higher sexual risks under the influence of alcohol abuse. However, data are limited from vulnerable population such as the female sex workers (FSW) in developing countries. The current study aims to fill out the literature gap by examining the association between alcohol abuse and sexual victimisation among FSWs in China.

Methods A cross-sectional survey was conducted among 1022 FSWs who were recruited through community outreach from nine different types of entertainment establishments in Guangxi, China. The FSWs completed a self-administered survey on their demographic, information, alcohol use/abuse behaviours (AUDIT), and sexual victimisation experience. Multivariate regression was employed to assess the relationship between alcohol abuse and sexual victimisation.

Results FSWs who were younger, less educated, never married, and working in an alcohol-serving establishment were more likely to have higher risks of alcohol abuse (p<0.05). FSWs who were at higher risks of alcohol abuse reported significantly higher sexual victimisation experience (p<0.001). Multivariate models indicated significant relationships between alcohol abuse and sexual victimisation experience while controlling for potential demographic confounders, such as having been made drunk by client (aOR=1.10, 95% CI 1.07 to 1.16), “having been stripped off (aOR=1.07, 95% CI 1.02, 1.13)”, “having been taking advantages (aOR=1.08,95% CI=1.05 to 1.12)”, “having been asked for extra demands (aOR=1.08, 95% CI 1.05 to 1.11)”, and “having been sexually assaulted (aOR=1.08, 95% CI 1.04 to 1.13)”.

Conclusion Alcohol abuse was prevalent and associated with sexual victimisation experience among FSWs in China. Culturally appropriate interventions are urgently needed to reduce alcohol use related sexual risks among this vulnerable population.