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Public health
Research
Prevalence and correlates of sexual and gender-based violence against Chinese adolescent women who are involved in commercial sex: a cross-sectional study
  1. Xu-Dong Zhang1,
  2. Sierra Myers2,
  3. Hong-Juan Yang1,
  4. Yun Li3,
  5. Ji-Hong Li4,
  6. Wei Luo5,
  7. Stanley Luchters2,6,7
  1. 1Yunnan Research Centre for Hygiene and Health Management, School of Management and Economics, Kunming University of Science and Technology, Kunming, China
  2. 2Burnet Institute, Melbourne, Victoria, Australia
  3. 3The Affiliated Hospital, Kunming University of Science and Technology, Kunming, China
  4. 4Kunming Maternal and Child Health Care Centre, Kunming, China
  5. 5Sexually Transmitted Disease Unit, Kunming Centre for Disease Control, Kunming, China
  6. 6Department of Obstetrics and Gynaecology, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
  7. 7Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
  1. Correspondence to Dr Xu-Dong Zhang; zhangxudong{at}kmust.edu.cn

Abstract

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.

  • PUBLIC HEALTH
  • SOCIAL MEDICINE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-013409

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    Footnotes

    • X-DZ and SM contributed equally.

    • Contributors XZ designed and implemented the study, conducted data collection and analysis. XZ and SM wrote the first draft of the manuscript. SL participated in the design of the study, contributions to interpretation of the findings and final review. HY, YL, JL and WL coordinated the study and commented on the revisions. All authors critically reviewed the manuscript, contributed to its revision and approved the final version.

    • Funding This research was financially and technically supported by National Natural Sciences Foundation of China (71463034; Hong-Juan Yang, PI) and Yunnan Provincial Scientific and Innovative Research Scheme (2016DH001; Wei Li, PI). The authors gratefully acknowledge the contribution to this work of the Victorian Operational Infrastructure Support Programme received by the Burnet Institute. Funding was provided by the National Health and Medical Research Council of Australia (NHMRC) (Career Development Fellowship to Stanley Luchters).

    • Competing interests None declared.

    • Ethics approval Ethics approval for this research study was obtained from the Ethics Committee of Kunming Public Health Bureau for the study protocol, informed consent forms, information sheets and for any subsequent modifications.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.