Sexualized Drug Use Among Female Sex Workers from Eight Cities in China

There is a rich literature on sexualized drug use (i.e., drug use before or during sex) for men who have sex with men but less data from female sex workers (FSW), particularly from low- and middle-income countries. We describe the sexual and reproductive health outcomes in FSW reporting sexualized drug use. In 2019, we conducted a cross-sectional study in eight cities from seven provinces in China. We recruited FSW through community organizations working with sex workers and included those aged 18 years or above, exchanged sex at least once for money or goods in the past three months, and had traded sex for longer than a year. Multivariable logistic regression models were used. In total, 650 women participated: average age was 38.8 years (SD 10.2), 57.1% reported a monthly income over 5000 RMB ($USD 707), and 12.8% completed high school or above. Among participants, 65 (10.0%, 95% confidence interval (CI) 7.8–12.6) reported a history of sexualized drug use. Compared to FSW who never reported a history of sexualized drug use, FSW who reported a history of sexualized drug use had greater odds of working for a manager compared to being self-employed (adjusted odds ratio (AOR) 4.04, 95% CI 2.12–7.69), work in a sauna (AOR 2.43, 95% CI 1.09–5.41), charging a higher price for vaginal sex (AOR 2.15, 95% CI 1.14–4.06), and ever diagnosed with STIs (AOR 4.51, 95% CI 2.61–7.80). One in ten FSW reported sexualized drug use. Although they had similar risk profiles in terms of consistency of condom use and reproductive health outcomes, these women were more likely to report past STIs than those who reported no sexualized drug use. Health workers who work with substance users should devote attention to the sexual practices of their clients to make sure that they have safer sex

Confidence interval · Cross-sectional study · Environmental health · Family medicine · Logistic regression · Odds · Odds ratio · Public health · Sex work · Sociology · Demography · HIV, Drug Use, Sexual Risk · Internal Medicine · Medicine · Sex work and related issues · Sexuality, Behavior, and Technology

• Pleasure and Vulnerability

  Open Access•Blanca Romero-Panadero, Paule González-Recio et al.•The Journal of Sex Research•2026

  Incluir item

• Sexualized Substance Use among Female Sex Workers in Iran

  Soheil Mehmandoost, Hamid Sharifi et al.•Substance Use & Misuse•2023

  Incluir item

• Self-Care Practices and Associated Sexual Health Risks Among Cisgender Women Sex Workers in Colombia

  Open Access•Luis Albeiro Perdomo Sandoval, Diego Fernando Villamil Camacho et al.•Sexuality Research and Social…•2024

  Incluir item

• Sexualized Substance Use and Psychosocial Vulnerabilities Among Sex Workers in Spain

  Andrés R Riquleme, Andrés R Riquelme et al.•The Journal of Sex Research•2026

  Incluir item

• Violence by clients towards female prostitutes in different work settings

  Open Access•Stephanie Church, Marion Henderson et al.•BMJ•2001

  Incluir item

• Correlates of injection drug use among female sex workers in two Mexico–U.S. border cities

  Open Access•Steffanie A Strathdee, Morgan M Philbin et al.•Drug and Alcohol Dependence•2008

  Incluir item

• Syndemics and the biosocial conception of health

  Open Access•M Singer, Nicola Bulled et al.•The Lancet•2017

  Incluir item

• Burden of HIV among female sex workers in low-income and middle-income countries

  Open Access•Stefan D Baral, Stefan Baral et al.•The Lancet Infectious Diseases•2012

  Incluir item

• Female prostitutes in south London

  Michael Gossop, B Powis et al.•AIDS Care•1995

  Incluir item

• Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers

  Kate Shannon, Thomas Kerr et al.•AIDS Care•2008

  Incluir item

• Injecting Drug Use Among Mexican Female Sex Workers on the US-Mexico Border

  A Cepeda, Kathryn M M Nowotny et al.•Journal of Ethnicity in Substance…•2015

  Incluir item

• Factors associated with history of drug use among female sex workers (FSW) in a high HIV prevalence state of India

  Open Access•Gajendra Kumar Medhi, Jagadish Mahanta et al.•BMC Public Health•2012

  Incluir item

• Dual Epidemics of Drug Use and Syphilis Among Chinese Female Sex Workers

  Open Access•Meizhen Liao, Shengli Su et al.•AIDS and Behavior•2015

  Incluir item

• Rapid Assessment of HIV Risk Behavior in Drug Using Sex Workers in Three Cities in South Africa

  Open Access•Charles D H Parry, Charles Parry et al.•AIDS and Behavior•2008

  Incluir item

• Outcomes of a Behavioral Intervention to Reduce HIV Risk Among Drug-involved Female Sex Workers

  Open Access•Hilary L Surratt, Catherine O’Grady et al.•AIDS and Behavior•2014

  Incluir item

• Alcohol and Other Drug Use, Partner Violence, and Mental Health Problems Among Female Sex Workers in Southwest China

  Chen Zhang, Xiaoming Li et al.•Health Care For Women International•2013

  Incluir item

• Police sexual coercion and its association with risky sex work and substance use behaviors among female sex workers in St. Petersburg and Orenburg, Russia

  Open Access•Veronika Odinokova, Maia Rusakova et al.•International Journal of Drug…•2014

  Incluir item

• Rethinking risk

  Open Access•Jennifer Syvertsen, Jennifer L Syvertsen et al.•International Journal of Drug…•2014

  Incluir item

• Stigmatization Among Drug-Using Sex Workers Accessing Support Services in Dublin

  Open Access•Teresa Whitaker, Paul Ryan et al.•Qualitative Health Research•2011

  Incluir item