Female prostitutes have often been seen as a major source of HIV infection. In this paper we report on a study of HIV-related risk behaviour among street prostitutes in Glasgow. This paper is based on street interviews using a standardized schedule with 68 women. We focus on the extent of HIV testing amongst the women, travel, the sexual services provided, the use of condoms with clients and private partners, and the extent of drug injecting and equipment sharing by the women. It is shown that female street prostitution within Glasgow is, at present, unlikely to be associated with significant heterosexual spread of HIV as most commercial sex is with a condom. However, some risk activities are continuing. Additionally, prostitutes report worrying rates of condom failure with clients. It is suggested that attention should switch away from an exclusive focus on women selling sexual services to target the men who purchase sex. These data indicate that much of the pressure for these women to provide unprotected sex comes from their clients.
PIP: While prostitutes are often pointed to as a major source of HIV infection, a study of HIV-related risk behavior among street prostitutes in Glasgow, Scotland, found near universal condom use with clients. Street interviews were held with 69 women whose medium age was 24 years (range 16-51 years) and median duration of work as prostitute was 2 years (range 2 weeks - 30 years). Interviews explored the extent of HIV testing, travel, sexual services provided, condom use with clients and private partners, and the extend of drug injecting and equipment sharing. 71.6% were IV drug users averaging 7.1 clients/night 5.2 days/weeks. 72% were in private relationships of a 3-year mean duration. Only 1 woman reported consistent condom use with her regular, emotional partner. Despite reports of condom failure with clients, widespread condom use among these women suggests the unlikelihood of significant heterosexual spread of HIV. Interventions aimed at preventing the spread of HIV in commercial sex should, therefore, turn from prostitutes to those clients who pressure women into engaging in unprotected sex. Note is also made that findings reflect data from only 68 of the potentially 1,050 female prostitutes working the streets of Glasgow over a 12-month period.