Female Sex Worker's Experiences of Risky Behaviors, and the Causes of These Behaviors from their Viewpoints: A Qualitative Study

The phenomenon of prostitution among women as one of the backgrounds for the spread of human immunodeficiency virus (HIV) and other sexual transmitted infections in recent years attracted the attention of the authorities, especially the Iranian health officials. From 2009, and accordance to the HIV surveillance, centers as centers for vulnerable women has been established by the national health system for harm reduction programs in women. In this study, experiences, risky behaviors, and causes of these behaviors in female sex workers (FSWs) came to the vulnerable women counseling center in 2015, in Sanandaj City, Iran, were studied.
In this qualitative study, semi-structured interviews and focus group discussion techniques were used to collect the data. Individual interviews with service provider personnel vulnerable women, including the director of the women counseling center, the midwife, and social worker consultant, and three focus group discussions with women referred to the center were done.
Sexual partner's unwilling to use harm reduction facilities, non-commitment of men to pay for prostitution, violence, physical and sexual harm, applying for unconventional sexual abuse, and forced use of drugs and alcohol were the main experiences and risk behaviors that prostitutes facing. Lack of adherence to religious, poverty, addiction, divorce, ethical and social distortions, and lack of healthy family relationships were the most important factors affecting the occurrence of prostitution among women.
Even the health and social consequences of the prostitution among women and their risky behaviors are associated with multiple factors (multifactorial), but to deal with this problem, attention to the social determinants of health is very important; and each of the variables identified in this study can become a target for interventional programs in the country, particularly in vulnerable women counseling centers.