Georgetown guyana prostitution

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HIV risk perception, risk behavior, and seroprevalence among female commercial sex workers in Georgetown, Guyana 1. Keith H. Carter, 2 Bhiro P. Harry, 3 Michael Jeune, 4 and Devian Nicholson 5. These data are consistent with the human immunodeficiency virus HIV being transmitted mainly by sexual intercourse 2.

Although females ed for Of the male and female patients whose ages Georgetown guyana prostitution recorded in this period, As ofGuyana's Bureau of Statistics estimated the national population at Among the country's 10 geopolitical regions, Region Four where the capital, Georgetown, is located had a total population ofwith Within the female population of Region Four, those years old ed for The HIV seroprevalence among female commercial sex workers engaged in prostitution has been shown to vary in different parts of the world.

Among other things, such variations have been associated with the worker's age, educational level, marital status, mobility, of clients, time in practice, price, condom use patterns, history of sexually transmitted diseases STDsand drug abuse Overall, however, investigations among female commercial sex workers have generally led to recommendations Georgetown guyana prostitution educational and other HIV prevention activities be provided for such workers 15, It has been found that street prostitutes have been overrepresented in some studies of HIV seroprevalences in female sex workers, and it has been pointed out that differences in working conditions and work organization could influence the degree of risk to which they are exposed.

More generally, both methodologic and logistic problems can thwart efforts to obtain a representative sample of the prostitute population; and, indeed, the samples in a of studies that have recruited prostitutes from medical clinics must be regarded as potentially biased The marketing of both sex and recreational drugs is illegal in Guyana; and of course, as has been ly pointed out, connections between these two activities Georgetown guyana prostitution important implications for HIV epidemiology and prevention 17, Female sex workers in Georgetown have recently been targeted by the police in an effort to remove them from the city's streets.

Perhaps partly as a result, those who publicly offer their services in Georgetown tend to do so at specific locations: one group operates at a very limited of hotels; a second group congregates along certain streets; a third works out of bars; and a fourth works at Port Georgetown, the country's main harbor, which provides access to visiting ocean-going vessels.

Our study found that those who congregated on certain streets generally charged the lowest fees and had the poorest socioeconomic status-probably a reflection Georgetown guyana prostitution their usual clients' socioeconomic situation.

As a result, for purposes of the present survey these street workers were classified as belonging to a "lower" stratum; while those at the bars, hotels, and port all of whom tended to charge higher fees were classified as belonging to a "higher" stratum.

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The study's primary purpose was to obtain baseline information on HIV seroprevalence among the group studied that could be used in future comparative studies and could also provide information relevant to health education efforts. Because empirical data on illicit drug use in Guyana was lacking, and because other studies have found a ificant relationship between such drug use and HIV seroprevalences in female commercial sex workers, information Georgetown guyana prostitution illicit drug use was solicited More specifically, the survey conducted in April sought data that would provide an estimate of the HIV prevalence among female commercial sex workers in Georgetown guyana prostitution that would indicate the possible influence of the workers' socioeconomic status on HIV prevalences; and that would also provide information about these workers' knowledge, attitudes, beliefs, and practices relating to both HIV and AIDS.

The study, carried out during the second and third weeks of April including one Saturday eveningstarted with preliminary visits to known female commercial sex worker gathering sites. The sex workers found at those sites were contacted, apprised of the survey plans, and asked to encourage participation by their colleagues.

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Cooperation was also sought from hotel and bar managers and proprietors, who were assured that the survey had nothing to do with the police. In addition, assistance was obtained from the health officers at Port Georgetown, who encouraged sex workers at the port to participate.

The female commercial sex workers were given the dates and times after 7 p.

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Care was then taken to honor the arranged schedule. At two localities, repeat visits were requested by the sex workers to allow absent coworkers Georgetown guyana prostitution participate. These repeat visits were made as requested. The female sex workers were informed that an unlinked anonymous survey was being carried out in which they would be asked to answer a of questions and donate a sample of blood. The payments were intended to compensate the participants for time lost and to reduce the of refusals.

Subsequently, none of the female sex workers, hotel managers, or bar proprietors refused our request for cooperation with the survey, although one of the sex workers refused to participate. As ly noted, because of these rates and because the street-walkers appeared to have a lower socioeconomic status than the others, we decided to classify them as belonging to a "lower" stratum and the members of the other groups as belonging to a "higher" stratum. Preliminary visits to the areas where sex workers were known to congregate suggested that approximately female commercial sex workers were operating openly in the city.

As a result, it was decided that the survey would continue until a minimum sample of female sex workers had been interviewed. No limit was placed Georgetown guyana prostitution the to be interviewed from each stratum. All the female sex workers who volunteered were allowed to participate, but every effort was made to ensure that no one was interviewed more than Georgetown guyana prostitution. The likelihood of double participation was reduced by the fact that most localities were visited only once, because most of the sex workers tended to work only at specific Georgetown guyana prostitution.

At those sites where repeat visits were undertaken at the request of the sex workersthe sex workers themselves identified coworkers who had been absent on the visit; and natural leaders among them helped to ensure that no one was given repeat interviews. To cover the hotels and Port Georgetown, each of three ly trained interviewers KC, BH, and MJ were ased specific areas for conducting interviews. To cover the street-walker areas and bars, a bus was employed to provide an appropriate site for interviews. Each interview questionnaire had ly been coded and taped to a similarly coded test tube for containing the participant's blood sample.

The code on the questionnaire and corresponding tube was covered, and was therefore not known to either the interviewer or the participant. The maximum time that elapsed between blood extraction from a participant and refrigerated storage of that person's serum was approximately six hours. For purposes of data management, the EPI-Info program was used to receive and analyze the information provided on each participant's questionnaire and the HIV test.

A total of female sex workers were identified and recruited at the various survey sites. One individual refused to participate, leaving a total of The distribution of these participants in terms of HIV positivity, by socioeconomic strata and 19 characteristics surveyed, is shown in a table 1.

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The substantially greater HIV seroprevalence found in the lower stratum No participant was under 15 or over 39 years old, most being in the year age group; and there were HIV positives in both age groups. By age group versusthe differences in HIV seropositivity were not statistically ificant. However, those 38 participants in the lower stratum who were Georgetown guyana prostitution old ed for two-thirds of the HIV positives. Similarly, marital status Georgetown guyana prostitution revealed no ificant differences in HIV seroprevalences until these data were broken down by strata. Likewise, no overall association was found between HIV seropositivity and education.

Only one participant, from the higher stratum, said she had no formal education. However, the ificantly higher HIV seroprevalences in the lower strata were found to carry across both educational. Nearly all the participants in the lower stratum reported having more than five clients per week, as compared to relatively few of the participants in the upper stratum.

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No statistically ificant difference was found between the HIV seroprevalence of those practicing commercial sex for more or less than 12 months. However, nearly all the lower stratum participants six out of seven who reported practicing commercial sex less than 12 months were HIV-positive. Similarly, no statistically ificant difference appeared between those operating only in Georgetown as compared to those working other areas. Reported overseas locations included neighboring Suriname as well as English, French, and Dutch-speaking Caribbean islands.

However, all seropositives within the higher stratum said they had worked exclusively in Georgetown. Regarding condom use, ninety-two However, no statistically ificant difference was observed between the HIV prevalence of these participants and of those who said they made this request only occasionally or never. However, perhaps owing to sample size, Georgetown guyana prostitution statistically ificant differences in HIV prevalences were found between those in the same stratum reporting different patterns of condom use.

However, the overall HIV seropositivity of those with both Guyanese and foreign clients did not differ ificantly from that of those reporting only Guyanese clients. Only 15 participants Regarding other STDs, no statistically ificant difference was found in the HIV seroprevalences of those who said they did or did not have an Georgetown guyana prostitution within the preceding two years. A wide range of explanations-some relating to condom use, some to luck, and some to religion-were given by the 34 Georgetown guyana prostitution these 43 participants who offered reasons why they did not consider themselves at risk of HIV table 1.

Twelve of the sex workers Two-thirds of those reporting cocaine use were in the lower stratum. The difference between the HIV seroprevalences of those with and without this knowledge was not statistically ificant. Table 2 provides data on the HIV prevalences of 28 participants who said they used either marijuana or cocaine. Within the two age groups studied and yearsa larger share of the younger group 24 out of 78 as compared to 4 out of 30 reported being marijuana or cocaine users.

This suggests, if the study subjects were representative of all female sex workers in Georgetown, that between a one-sixth and one-third of the latter are infected with HIV. Of course, it needs to be acknowledged that willingness to participate in the study could have been influenced by pressure from hotel managers and bar owners, good rapport with the port health authorities, and peer pressure exerted by other female sex workers; and that payment to the sex workers remuneration for time spent could also have led to some selection bias, especially among certain participants in the lower stratum who requested subsequent interviewer visits to ensure that colleagues participated.

One should also note the small s sampled in some as a result of stratification. In general, there is no reason to p that the apply to all female sex workers in Guyana; but it seems reasonable to conclude that they do provide worthwhile information about risk perceptions, risky behaviors, and HIV seroprevalences among those who work in Georgetown. All but one of the study participants, all of whom were over 15 years old, had received primary school education. HIV infections were detected among subjects belonging to all of the ethnic groups studied. In general, participants charging lower fees tended to have more clients per week, and the observed rate of HIV positivity tended to increase with the of clients.

Although condom use is considered important, not much more than half the participants had condoms available for use by clients. At the same time, Guyanese clients appear less likely than foreigners to have condoms and more likely than foreigners Georgetown guyana prostitution be transmitting or receiving the virus. Hence, there is a need to make much greater educational efforts in Guyana and to counter the myth that the virus is being circulated by foreigners. After several years of discussion, one assumes there is a general understanding that condom use is one way of reducing the risk of HIV transmission.

However, it also seems quite obvious that there is a great Georgetown guyana prostitution for further condom promotion and marketing in Guyana. The HIV seroprevalence was lower among female sex workers with a longer time in service. This contrasts somewhat with another study among lower socioeconomic strata prostitutes in Nairobi, Kenya, that found higher seropositivity among those with a longer period in prostitution 4.

Most of the Georgetown guyana prostitution participants felt they would lose clients if they tried to enforce condom use; however, those who said they would have sex without a condom were also more likely to have a positive history of STD. Although this difference was not statistically ificant, it suggests that people who are concerned may tend to take greater precautions than those who are not. One must also bear in mind the possibility that participants gave responses which they felt would please the interviewers.

Only 22 Although most of the participants said economic motives determined their decision to become prostitutes, a good deal of illicit drug use was reported to the interviewers.

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Hence, it appears there could be some relationship between serving as a prostitute and satisfying drug needs. Overall, fewer survey participants in the higher stratum were aware that free condoms were available at the Genitourinary Medicine Clinic and the Guyana Responsible Parenthood Association; and all the seropositives in the higher stratum lacked this knowledge.

The fact that those in the higher stratum had less knowledge about condom availability probably reflects use of the free public health service by those in the lower stratum. It should also be noted, however, that some of those in the higher stratum who traveled overseas had the experience in some foreign territories where they Georgetown guyana prostitution of having to report to the public health system for medical permits.

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That experience could be related to their having acquired information about free condoms in Guyana. More broadly, a of the survey participants were of the opinion that they should be registered, have occasional medical check-ups, and receive certificates of health that would permit them to operate openly, as is done in some neighboring territories. Changes to the law on marketing of sex may need to be considered.

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