Dataset Information

Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal.

ABSTRACT: We use a cohort of female sex workers (FSWs) in Senegal to show how large anticipated economic shocks lead to increased risky sexual behavior. Exploiting the exogenous timing of interviews, we study the effect of Tabaski, the most important Islamic festival celebrated in Senegal, in which most households purchase an expensive animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3 percentage points (pp) (65.5%) and 43.1 pp (22.7%) in the 9 days before Tabaski, or a maximum of 49.5 pp (76%) in the 7 day period preceding Tabaski. The evidence suggests the economic pressures from Tabaski are key to driving the behavior change observed through the price premium for condomless sex. Those most exposed to the economic pressure from Tabaski were unlikely to be using condoms at all in the week before the festival. Our findings show that Tabaski leads to increased risky behaviors for FSWs, a key population at high risk of HIV infection, for at least 1 week every year and has implications for FSWs in all countries celebrating Tabaski or similar festivals. Because of the scale, frequency, and size of the behavioral response to shocks of this type, policy should be carefully designed to protect vulnerable women against anticipated shocks.

SUBMITTER: Cust H

PROVIDER: S-EPMC10952657 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal.

Cust Henry H Lépine Aurélia A Treibich Carole C Powell-Jackson Timothy T Radice Rosalba R Tidiane Ndour Cheikh C

Health economics 20231102 1

We use a cohort of female sex workers (FSWs) in Senegal to show how large anticipated economic shocks lead to increased risky sexual behavior. Exploiting the exogenous timing of interviews, we study the effect of Tabaski, the most important Islamic festival celebrated in Senegal, in which most households purchase an expensive animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3 percentage points (pp) (65.5%) and 43.1 pp (22.7%) in the 9 days before T ...[more]

PMID: 37916862

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Project description:BackgroundFemale sex workers (FSWs) in Mozambique face significant health risks, including high HIV prevalence, combination of factors, including inconsistent condom use, engagement in risky sexual behaviors, and various socio-ecological determinants of health. Understanding the determinants of these practices is crucial for developing targeted interventions.MethodsThis cross-sectional study analyzed data from the second round of Biobehavioral Survey (BBS) conducted from 2019 to 2020 in five urban areas to examine determinants of inconsistent condom use and risky sexual behaviors among FSWs. Modified Poisson regression models were used to assess the effect of various socio-demographic, economic, and behavioral factors on the outcomes, providing adjusted relative risk (aRR) with 95% confidence intervals (CI).ResultsAmong the 2,565 FSWs who reported inconsistent condom use, younger FSWs (15-24 years old, 29.1%), single (27.3%), with secondary or higher education (26.1%), nationals (25.9%), and residents of Tete City (30.5%) had a higher prevalence of inconsistent condom use. Initiating sex work < 18 years (31.0%), binge drinking (23.7%), and experiencing physical violence (29.0%) were significantly associated with this behavior. Among the 2,564 FSWs reporting risky sexual behaviors, a higher prevalence was observed in FSWs aged 15-24 (75.6%), those with secondary or higher education (75.8%), nationals (74.4%), and those residing in Quelimane (87.3%). Early sexual debut (< 15 years, 79.3%), initiating sex work before 18 years of age (77.7%), and illicit drug use (82.2%) were all associated with increased risky sexual practices. Inconsistent condom use among FSWs was significantly associated with residing in Tete (aRR = 2.4, 95% CI: 1.77-3.25), not being aware of female condom (aRR = 1.22, 95% CI: 1.03-1.45) and having experienced sexual a physical violence. Moreover, being married was significantly linked to risky sexual behavior among female sex workers (aRR = 1.27, 95% CI: 1.19-1.37), along with initiating sexual activity before age 15, having at least five years of sex work experience, engaging in binge drinking, and experiencing sexual and physical violence.ConclusionThe study highlights the complex set of factors as age, education, geographic location, years of sex work services, early sexual debut, and illicit drug use that influence sexual risks behavior among FSWs in Mozambique. Tailored interventions addressing not only sexual health education and services, but also economic empowerment and illicit drug use is imperative for mitigating these risks.

Dataset Information

Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal.

Publications

Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal.

Similar Datasets

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