The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe
Identifieur interne : 000118 ( Pmc/Curation ); précédent : 000117; suivant : 000119The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe
Auteurs : Jocelyn Elmes ; Kundai Nhongo [Zimbabwe] ; Helen Ward ; Timothy Hallett ; Constance Nyamukapa [Zimbabwe] ; Peter J. White [Royaume-Uni] ; Simon Gregson [Zimbabwe]Source :
- The Journal of Infectious Diseases [ 0022-1899 ] ; 2014.
Abstract
Url:
DOI: 10.1093/infdis/jiu493
PubMed: 25381377
PubMed Central: 4231645
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<author><name sortKey="Elmes, Jocelyn" sort="Elmes, Jocelyn" uniqKey="Elmes J" first="Jocelyn" last="Elmes">Jocelyn Elmes</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Disease Epidemiology</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nhongo, Kundai" sort="Nhongo, Kundai" uniqKey="Nhongo K" first="Kundai" last="Nhongo">Kundai Nhongo</name>
<affiliation wicri:level="1"><nlm:aff id="af5"><institution>Biomedical Research and Training Institute</institution>
,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
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<country xml:lang="fr">Zimbabwe</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Ward, Helen" sort="Ward, Helen" uniqKey="Ward H" first="Helen" last="Ward">Helen Ward</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Disease Epidemiology</addr-line>
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<author><name sortKey="Hallett, Timothy" sort="Hallett, Timothy" uniqKey="Hallett T" first="Timothy" last="Hallett">Timothy Hallett</name>
<affiliation><nlm:aff id="af2"><addr-line>MRC Centre for Outbreak Analysis and Modelling</addr-line>
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</affiliation>
<affiliation><nlm:aff id="af3"><addr-line>NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology</addr-line>
,<institution>School of Public Health, Imperial College London</institution>
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<author><name sortKey="Nyamukapa, Constance" sort="Nyamukapa, Constance" uniqKey="Nyamukapa C" first="Constance" last="Nyamukapa">Constance Nyamukapa</name>
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,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
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<country xml:lang="fr">Zimbabwe</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="White, Peter J" sort="White, Peter J" uniqKey="White P" first="Peter J." last="White">Peter J. White</name>
<affiliation><nlm:aff id="af2"><addr-line>MRC Centre for Outbreak Analysis and Modelling</addr-line>
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<affiliation><nlm:aff id="af3"><addr-line>NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology</addr-line>
,<institution>School of Public Health, Imperial College London</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control</addr-line>
,<institution>Public Health England</institution>
,<addr-line>London</addr-line>
,<country>United Kingdom</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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</author>
<author><name sortKey="Gregson, Simon" sort="Gregson, Simon" uniqKey="Gregson S" first="Simon" last="Gregson">Simon Gregson</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Disease Epidemiology</addr-line>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af5"><institution>Biomedical Research and Training Institute</institution>
,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
</nlm:aff>
<country xml:lang="fr">Zimbabwe</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<idno type="doi">10.1093/infdis/jiu493</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe</title>
<author><name sortKey="Elmes, Jocelyn" sort="Elmes, Jocelyn" uniqKey="Elmes J" first="Jocelyn" last="Elmes">Jocelyn Elmes</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Disease Epidemiology</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nhongo, Kundai" sort="Nhongo, Kundai" uniqKey="Nhongo K" first="Kundai" last="Nhongo">Kundai Nhongo</name>
<affiliation wicri:level="1"><nlm:aff id="af5"><institution>Biomedical Research and Training Institute</institution>
,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
</nlm:aff>
<country xml:lang="fr">Zimbabwe</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ward, Helen" sort="Ward, Helen" uniqKey="Ward H" first="Helen" last="Ward">Helen Ward</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Disease Epidemiology</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hallett, Timothy" sort="Hallett, Timothy" uniqKey="Hallett T" first="Timothy" last="Hallett">Timothy Hallett</name>
<affiliation><nlm:aff id="af2"><addr-line>MRC Centre for Outbreak Analysis and Modelling</addr-line>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af3"><addr-line>NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology</addr-line>
,<institution>School of Public Health, Imperial College London</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nyamukapa, Constance" sort="Nyamukapa, Constance" uniqKey="Nyamukapa C" first="Constance" last="Nyamukapa">Constance Nyamukapa</name>
<affiliation wicri:level="1"><nlm:aff id="af5"><institution>Biomedical Research and Training Institute</institution>
,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
</nlm:aff>
<country xml:lang="fr">Zimbabwe</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="White, Peter J" sort="White, Peter J" uniqKey="White P" first="Peter J." last="White">Peter J. White</name>
<affiliation><nlm:aff id="af2"><addr-line>MRC Centre for Outbreak Analysis and Modelling</addr-line>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af3"><addr-line>NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology</addr-line>
,<institution>School of Public Health, Imperial College London</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control</addr-line>
,<institution>Public Health England</institution>
,<addr-line>London</addr-line>
,<country>United Kingdom</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gregson, Simon" sort="Gregson, Simon" uniqKey="Gregson S" first="Simon" last="Gregson">Simon Gregson</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Disease Epidemiology</addr-line>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af5"><institution>Biomedical Research and Training Institute</institution>
,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
</nlm:aff>
<country xml:lang="fr">Zimbabwe</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of Infectious Diseases</title>
<idno type="ISSN">0022-1899</idno>
<idno type="eISSN">1537-6613</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
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<front><div type="abstract" xml:lang="en"><p><bold><italic>Background.</italic>
</bold>
Higher prices for unprotected sex threaten the high levels of condom use that contributed to the decline in Zimbabwe's human immunodeficiency virus (HIV) epidemic. To improve understanding of financial pressures competing against safer sex, we explore factors associated with the price of commercial sex in rural eastern Zimbabwe.</p>
<p><bold><italic>Methods.</italic>
</bold>
We collected and analyzed cross-sectional data on 311 women, recruited during October–December 2010, who reported that they received payment for their most-recent or second-most-recent sex acts in the past year. Zero-inflated negative binomial models with robust standard errors clustered on female sex worker (FSW) were used to explore social and behavioral determinants of price.</p>
<p><bold><italic>Results.</italic>
</bold>
The median price of sex was $10 (interquartile range [IQR], $5–$20) per night and $10 (IQR, $5–$15) per act. Amounts paid in cash and commodities did not differ significantly. At the most-recent sex act, more-educated FSWs received 30%–74% higher payments. Client requests for condom use significantly predicted protected sex (<italic>P</italic>
< .01), but clients paid on average 42.9% more for unprotected sex.</p>
<p><bold><italic>Conclusions.</italic>
</bold>
Within a work environment where clients' preferences determine condom use, FSWs effectively use their individual capital to negotiate the terms of condom use. Strengthening FSWs' preferences for protected sex could help maintain high levels of condom use.</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">jid</journal-id>
<journal-id journal-id-type="hwp">jinfdis</journal-id>
<journal-title-group><journal-title>The Journal of Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-1899</issn>
<issn pub-type="epub">1537-6613</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25381377</article-id>
<article-id pub-id-type="pmc">4231645</article-id>
<article-id pub-id-type="doi">10.1093/infdis/jiu493</article-id>
<article-id pub-id-type="publisher-id">jiu493</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Developing and Applying Theoretical Frameworks in the Epidemiology of Sexually Transmitted Infections</subject>
</subj-group>
</article-categories>
<title-group><article-title>The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Elmes</surname>
<given-names>Jocelyn</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nhongo</surname>
<given-names>Kundai</given-names>
</name>
<xref ref-type="aff" rid="af5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ward</surname>
<given-names>Helen</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hallett</surname>
<given-names>Timothy</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nyamukapa</surname>
<given-names>Constance</given-names>
</name>
<xref ref-type="aff" rid="af5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>White</surname>
<given-names>Peter J.</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
<xref ref-type="aff" rid="af3">3</xref>
<xref ref-type="aff" rid="af4">4</xref>
<xref ref-type="author-notes" rid="AN1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gregson</surname>
<given-names>Simon</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
<xref ref-type="aff" rid="af5">5</xref>
<xref ref-type="author-notes" rid="AN1">a</xref>
</contrib>
<aff id="af1"><label>1</label>
<addr-line>Department of Infectious Disease Epidemiology</addr-line>
</aff>
<aff id="af2"><label>2</label>
<addr-line>MRC Centre for Outbreak Analysis and Modelling</addr-line>
</aff>
<aff id="af3"><label>3</label>
<addr-line>NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology</addr-line>
,<institution>School of Public Health, Imperial College London</institution>
</aff>
<aff id="af4"><label>4</label>
<addr-line>Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control</addr-line>
,<institution>Public Health England</institution>
,<addr-line>London</addr-line>
,<country>United Kingdom</country>
</aff>
<aff id="af5"><label>5</label>
<institution>Biomedical Research and Training Institute</institution>
,<addr-line>Avondale</addr-line>
,<country>Zimbabwe</country>
</aff>
</contrib-group>
<author-notes><fn id="AN2"><p>Presented in part: STI and AIDS World Congress, Vienna, Austria, 14–17 July 2013. Oral session O07.5.</p>
</fn>
<fn id="AN1"><label>a</label>
<p>P. J. W. and S. G. are senior authors.</p>
</fn>
<corresp>Correspondence: Jocelyn Elmes, PhD, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Pl, London W2 1PG, UK (<email>jocelyn.elmes07@imperial.ac.uk</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>01</day>
<month>12</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>12</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
. </pmc-comment>
<volume>210</volume>
<issue>Suppl 2</issue>
<issue-title>Developing and Applying Theoretical Frameworks in the Epidemiology of Sexually Transmitted Infections</issue-title>
<fpage>S569</fpage>
<lpage>S578</lpage>
<permissions><copyright-statement>© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="creative-commons" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="jiu493.pdf"></self-uri>
<abstract><p><bold><italic>Background.</italic>
</bold>
Higher prices for unprotected sex threaten the high levels of condom use that contributed to the decline in Zimbabwe's human immunodeficiency virus (HIV) epidemic. To improve understanding of financial pressures competing against safer sex, we explore factors associated with the price of commercial sex in rural eastern Zimbabwe.</p>
<p><bold><italic>Methods.</italic>
</bold>
We collected and analyzed cross-sectional data on 311 women, recruited during October–December 2010, who reported that they received payment for their most-recent or second-most-recent sex acts in the past year. Zero-inflated negative binomial models with robust standard errors clustered on female sex worker (FSW) were used to explore social and behavioral determinants of price.</p>
<p><bold><italic>Results.</italic>
</bold>
The median price of sex was $10 (interquartile range [IQR], $5–$20) per night and $10 (IQR, $5–$15) per act. Amounts paid in cash and commodities did not differ significantly. At the most-recent sex act, more-educated FSWs received 30%–74% higher payments. Client requests for condom use significantly predicted protected sex (<italic>P</italic>
< .01), but clients paid on average 42.9% more for unprotected sex.</p>
<p><bold><italic>Conclusions.</italic>
</bold>
Within a work environment where clients' preferences determine condom use, FSWs effectively use their individual capital to negotiate the terms of condom use. Strengthening FSWs' preferences for protected sex could help maintain high levels of condom use.</p>
</abstract>
<kwd-group><kwd>female sex work</kwd>
<kwd>payments</kwd>
<kwd>condom use</kwd>
<kwd>sub-Saharan Africa</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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