Background: In a study of female sex workers (FSW) servicing truck driver clients in Mexican border cities, we evaluated differences in HIV/STI risk behaviors by workplace.
Design and methods: Our study was cross-sectional and its population comprised 100 FSWs from Nuevo Laredo (US border) and 100 FSWs from Ciudad Hidalgo (Guatemalan border). The main outcome was primary place of sex work defined as unstable (street, vehicle, gas station, etc.) vs stable (bar, brothel, and hotel). Logistic regression was used to identify correlates associated with trading sex at unstable workplaces in the last month.
Results: Of the FSW surveyed, 18% reported an unstable workplace. The majority of FSW surveyed were young (<30), single, had <9th grade education, and had worked in the sex trade for a median of 4.9 years. After controlling for study site, FSW with unstable vs. stable workplaces were more likely to have a majority/all truck driver clientele, but were less likely to have visited a gynecologist in the last year (OR 0.1, 95%CI 0.03-0.4) or ever had an HIV test (OR 0.1, 95%CI 0.06-0.3), and there was a trend towards lower condom use self-efficacy scores (OR 0.8 per unit increase, 95%CI 0.7-1.0). On multivariate regression, unstable workplace was associated with having majority/all truck driver clientele, being surveyed in Nuevo Laredo, and decreased odds of ever having an HIV test.
Conclusions: Among Mexican FSW with truck driver clients, providing safe indoor spaces for sex work may help facilitate public health interventions that improve HIV/STI and reproductive health outcomes.
Keywords: HIV; female sex workers; risk behavior; sexually transmitted infection; work environment.