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Sex Work and Risky Sexual Behaviors among Foreign Entertainment Workers in Urban Singapore: Findings from Mystery Client Survey

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Abstract

Globalization has led to a rapid influx of female workers from Asian countries with high prevalence of HIV to Singapore, with many entering the entertainment industry. We assessed the prevalence of sexual services, condom use, and self-initiated screening for sexually transmitted infections (STIs) and associated variables among foreign female entertainment workers in Singapore. A cross-sectional survey of 317 female entertainment workers, using mystery clients, was conducted on a two-stage proportional cluster sample of 93 entertainment establishments stratified by geographical zone in Singapore. We found a high prevalence (71 %) of sexual services in entertainment establishments with 53 % of the female entertainment workers reporting selling sex. Consistent condom use for sex with paying clients in a usual week in the past 3 months was low, ranging from 37.9 % for oral sex, 46.9 % for anal sex, to 51.9 % for vaginal sex. On multivariate logistic regression, consistent condom use for vaginal sex with clients showed a significant independent association with the entertainment worker’s behavior of asking clients to use condoms and a borderline association with entertainment worker being a Chinese national. Less than half (48.9 %) of the sex workers had ever been screened for STIs either locally or in their home country. The only independent factor significantly associated with STI screening was having to support one’s family. In summary, a high percentage of foreign female entertainment workers in Singapore reported selling sex. Condom use and STI screening were low among them. Access to STI screening, treatment, and education services should be enhanced for foreign female entertainment workers in Singapore.

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Acknowledgments

This study was funded and supported by Ministry of Health and Department of STI Control, National Skin Centre. We thank Sharon Low, Vidhya, Hu Yun, and all the interviewers for their painstaking efforts in conducting the interviews and coordinating the survey. This paper contains the personal opinions of the authors and do not reflect the official views of the Ministry of Health, Singapore.

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Authors and Affiliations

  1. Saw Swee Hock School of Public Health (MD 3), National University of Singapore, Singapore, Singapore

    Mee-Lian Wong, Roy Chan & David Koh

  2. Department of STI Control, National Skin Centre, Singapore, Singapore

    Roy Chan & Hiok Hee Tan

  3. Health Promotion Board, Singapore, Singapore

    Eunice Yong

  4. Action for AIDS, Singapore, Singapore

    Lionel Lee

  5. Ministry of Health, Singapore, Singapore

    Jeffrey Cutter & Joanne Tay

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  1. Mee-Lian Wong
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  2. Roy Chan
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  3. Hiok Hee Tan
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  4. Eunice Yong
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  6. Jeffrey Cutter
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  8. David Koh
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Correspondence to Mee-Lian Wong.

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Wong, ML., Chan, R., Tan, H.H. et al. Sex Work and Risky Sexual Behaviors among Foreign Entertainment Workers in Urban Singapore: Findings from Mystery Client Survey. J Urban Health 89, 1031–1044 (2012). https://doi.org/10.1007/s11524-012-9723-5

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