Factors associated with inconsistent condom use with clients (N=4282) and non-paying partners (N=2276), and increased HIV prevalence (N=2838) among Pakistani female sex workers in 2011 across 12 cities
| Inconsistent condom use with clients in the last month (N=3179) | Inconsistent condom use with non-commercial partners in the last month (N=1896) | HIV positive* (N=25) | ||||
|---|---|---|---|---|---|---|
| Characteristic | Adjusted OR (95% CI) | p Value | Adjusted OR (95% CI) | p Value | Adjusted OR (95% CI) | p Value |
| Illiterate (unable to read/write) | 1.8 (1.4 to 2.2) | <0.001 | 1.9 (1.4 to 2.7) | <0.001 | – | – |
| Duration in sex work | ||||||
| <2 years | Ref | Ref | – | – | ||
| ≥2 years | 1.5 (1.1 to 1.9) | 0.004 | 1.7 (1.1 to 2.4) | 0.009 | ||
| Usual method of solicitation | ||||||
| Mediator | Ref | Ref | – | – | ||
| Phone | 0.73 (0.57 to 0.93) | 0.01 | 0.70 (0.47 to 0.97) | 0.04 | ||
| Public places | 0.62 (0.47 to 0.82) | 0.001 | 0.59 (0.42 to 0.82) | 0.002 | ||
| Referral | 0.62 (0.46 to 0.84) | 0.002 | 0.55 (0.34 to 0.88) | 0.02 | ||
| Number of clients per month | ||||||
| <60 | – | – | Ref | – | – | |
| ≥60 | 1.5 (1.2 to 1.8) | 0.001 | ||||
| Have a non-commercial partner in the last 1 month | 1.5 (1.1 to 1.9) | 0.005 | – | – | – | – |
| Injected drugs in the previous 6 months | – | – | – | – | 4.7 (1.1 to 19.6) | 0.04 |
| In the past 6 months, had sex with a man who injects drugs | ||||||
| No | Ref | – | – | – | – | |
| Yes | 1.7 (1.2 to 2.3) | 0.001 | ||||
| Don't know | 1.6 (1.2 to 2.0) | <0.001 | ||||
| Experienced sexual violence in the previous 6 months | 1.4 (1.1 to 1.7) | 0.01 | 1.4 (1.1 to 1.9) | 0.04 | ||
| Has not accessed prevention programmes for FSWs | 3.2 (2.2 to 4.4) | <0.001 | 1.9 (1.3 to 2.8) | 0.003 | 7.5 (1.5 to 39.1) | 0.02 |
| Region | ||||||
| Lahore | Ref | Ref | † | – | ||
| Other Punjab | 1.9 (1.4 to 2.8) | <0.001 | 1.6 (1.0 to 2.6) | 0.05 | ||
| Karachi | 0.71 (0.45 to 1.1) | 0.1 | 0.56 (0.33 to 0.96) | 0.03 | ||
| Other Sindh | 1.9 (1.2 to 3.1) | 0.008 | 1.6 (0.75 to 3.4) | 0.2 | ||
| Quetta | 0.69 (0.40 to 1.2) | 0.2 | 0.57 (0.33 to 0.99) | 0.05 | ||
| Peshawar | 1.5 (1.0 to 2.2) | 0.05 | 0.95 (0.49 to 1.8) | 0.9 | ||
| Haripur | 1.6 (0.83 to 3.1) | 0.2 | 2.4 (1.5 to 3.8) | 0.001 | ||
*For HIV prevalence, only regions in which at least one case of HIV was detected were included for analysis (Lahore, Other Punjab, Karachi, Other Sindh, Haripur). The adjusted ORs for each covariate associated with HIV prevalence were only adjusted for region.
†Adjusted ORs are not shown for region although region is included in the adjusted ORs for each of the following covariates separately: ‘has not accessed prevention programmes for FSWs’ and ‘injected drugs in the previous 6 months’.
Usual methods of solicitation: ‘mediator’ refers to solicitation via network operators (brothel madams, pimps); ‘phone’ refers to solicitation via mobile/cellular phones; ‘public places’ refers to direct solicitation in public venues; and solicitation via ‘referral’ pertains to referral from other clients.
Inconsistent condom use refers to self-reported ‘sometimes’ or ‘never’ condom use in the month preceding the survey. Note that covariate ‘typology’ was not included in the regression model development because of correlation with ‘usual method of solicitation’. For outcomes relating to condom use, all 12 cities were included, and the adjusted ORs from the final regression model are shown.
FSW, female sex worker.