Female sex work and HIV risks in Croatia

Abstract

The aim of this paper was to analyze and compare the prevalence of HIV-related sexual risk taking among Croatian female sex workers (FSW) in two major urban areas. Two groups of FSWs were interviewed in Zagreb (n=65) and Split (n=89). Participants’ mean age was 33.3 (SD=8.32). Interviews were conducted by outreach organizations that provide health services to sex workers in the two cities. The study used a brief questionnaire with standardized behavioral and HIV knowledge indicators. The two groups of FSWs differed significantly in most socio-demographic and socio-sexual indicators. Women from the Split sample were somewhat younger (χ²=6.87, p<0.05), less educated (χ²=7.71, p<0.05), less likely to be single (χ²=19.81, p<0.001), and less likely to be unemployed (χ²=5.22, p<0.05). In addition, they injected drugs in higher proportion (χ²=35.03, p<0.001), but had less clients in the preceding month (χ²=12.54, p<0.001) and were less likely to be abused by them (χ²=7.18, p<0.01). HIV testing was significantly more prevalent among participants in the Split sample (χ²=4.95, p<0.05). In multivariate analysis, selling sex in Zagreb (OR = 14.48, p<0.01), having secondary or higher education (OR = 4.76, p<0.05), ever tested for HIV (OR = 8.34, p<0.05), and having assessed the risk of getting infected with HIV as high (OR = 0.23, p<0.05) were significantly associated with consistent condom use with clients in the last month. The findings of this first systematic study on HIV-related risks among FSWs in Croatia point to the need to update targeted intervention programs by improving the prevention of HIV risks associated with injecting drug use (Split) and by a more efficient HIV educational approach.

Keywords:

• HIV
• sex work
• risk taking
• condom use
• Croatia

Acknowledgements

The authors would like to thank Iva Jovović, Katja DragiČević, Sanda Peran, Silvana Šerić Puljiz, Denis Ježdik, Gordan Dimić, and Stjepan Lacković for their assistance in data collection. The study was a part of the research project Behavioral HIV/AIDS Surveillance, supported by the Croatian Ministry of Science, Education, and Sports.