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Close to one third of the solo IDU in fkck u studied here solo having unprotected sex with their resistance partners. On the whole, sex la IDU 4.
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Two refused to give blood although they completed their clinical examination. NSEP or sex workers. Of these 22, 13 knew of the services but did not use them and the reasons cited included: Amongst the women who provided blood samples and underwent clinical examination, 26 Although similar proportions of sex workers and non-sex workers On the other hand, sex workers were more likely to be receiving condoms than non-sex workers Discussion The links between sex work and injecting drug use have been shown to be important determinants in the spread of an HIV epidemic [ 21 - 23 ]. In Bangladesh, considerable risk behavior among male IDU has been documented through the annual Behavioral Surveillance Survey BSS [ 19 ] in whom the risks for HIV are not only through their risky injection practices but also their sexual behaviors.
There is very limited information available about female IDU in the South and South East Asian region; most information is obtained through data on injection drug use in sex worker communities [ 2425 ]. Similarly, in Bangladesh female IDU have been difficult to access and information is largely confined to drug taking behaviors among female sex workers from brothels, streets and hotels obtained from the BSS [ 19 ]. The female IDU enrolled in this study were identified through CARE, Bangladesh and through the networks of drug users and sex workers because of which sampling was not random and hence the data are not necessarily representative. Despite this limitation, this study is the first comprehensive report on female IDU in Bangladesh, which provides a comparative analysis of the risks and vulnerabilities of female IDU who do and do not sell sex.
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This study revealed high I want a fuck in dhaka of risk behavior and important similarities waant differences in injecting and sexual risk behaviors for sex worker and wan worker female IDU. The study findings suggest that it is not only their individual behaviors but the circumstances that female IDU live in that can further marginalize and make them more vulnerable. We observed a substantial proportion of fjck workers and non-sex fuvk were living on the streets which is pertinent to HIV as homelessness has been shown to be associated with higher HIV infection rates in IDU [ 2627 ]. However, non-sex worker IDU were better off than sex worker IDU in this regard as they were more likely to be living with their relatives from wwnt they were receiving financial support.
On the other hand, a higher proportion of non-sex workers were supporting themselves financially by selling drugs, which carries many risks including incarceration and exposure to violence. The pattern of drug use between sex worker and non-sex worker female IDU described here was similar and this has also been reported from other fuxk [ 18 ]. However, riskier injection practices were documented among sex worker female IDU. Such higher injection risks among sex worker female drug users have been reported from a study conducted among crack users in Kentucky, USA [ 7 ] but not in another conducted in IDU from Sydney, Australia [ 18 ]. However with rising HIV rates among IDU in Central Bangladesh there is no room for complacency [ 10 ] and it is essential that the harm reduction services are expanded, intensified with broad and active support from all relevant sectors.
We observed high risk sexual behaviors for both sex worker and non-sex worker groups of female IDU, and not surprisingly behaviors tended to be riskier for sex worker IDU. Although more sex worker IDU reported condom use during the last sex act, more reported anal sex, they had concurrent commercial and non-commercial sex partners and a substantial proportion had never used condoms with their non-commercial sex partners. Moreover, sex worker female IDU commonly reported serial sex with multiple partners group sexwhich was not reported at all by non-sex worker IDU. Although we were lacking data on the context of group sex and cannot assume that they were consensual, anecdotal reports suggest that group sex may occur within the context of sex work, with male clients pooling money to share a female sex worker.
Such high levels of sexual risk behavior in female IDU are not unique to Bangladesh [ 28 ] and this has also been observed in places where IDU are accessing HIV prevention programs [ 29 ]. Consistent with the high risk sexual behaviors we observed, the prevalence of syphilis was high, especially among sex worker IDU who had a higher lifetime prevalence of syphilis. However, there was no significant difference in the prevalence of active syphilis between the two groups of female IDU which was also comparable to that reported by the national HIV surveillance data from street-recruited female sex workers in Central Bangladesh [ 13 ].
Although this study did not measure other STIs, other studies of sex workers from different sites in Bangladesh have recorded very high rates of the different STIs including gonorrhea, chlamydia, trichonomiasis, syphilis and herpes simplex 2 [ 3031 ].
The fjck risk behaviors we documented among sex worker IDU are similar to those observed among female sex workers from Central S reported in the BSS dhska Bangladesh [ 13 ]. However, compared to the BSS, the frequency of reported condom use we observed was higher. The reason for this discrepancy is not clear but we cannot rule out the possibility of socially desirable responding since i study was conducted in collaboration wang CARE, Bangladesh. Female IDU are often more vulnerable to HIV than their male counterparts due to greater overlap between sex and drug use networks [ 32 ].
Close to one third of the female IDU in either group studied here reported having unprotected sex with their injection partners. These women are not only extremely vulnerable to HIV but they may also represent 'transmission bridges' to the general community through commercial sex. This study was conducted in close collaboration with two nongovernmental organizations that provide services to female sex workers: The goal of the study was to provide information to inform the development of interventions to meet the reproductive health needs of female sex workers. Data were collected May—July 12,through surveys and in-depth interviews with hotel-based and street-based female sex workers in Dhaka.
Nearly women were interviewed. The survey found that about 40 percent of the female sex workers had had at least one abortion.
In addition, the majority of those interviewed wanh did wqnt want any more children or indicated they did not want a pregnancy within the next 12 months. Knowledge and use of contraceptive methods were high; over 95 percent reported currently using condoms, and 48 percent of hotel-based and 36 percent of street workers were using a method aside from condoms primarily pills and injectables. These other methods were not substituting for condoms and for most, other methods were used in addition to condoms. Condoms, however, were not being used effectively or consistently.
Many female sex workers do not feel they can force a client to use a condom, and if they insist, the client may go to a different woman or even beat them.