Alcohol use and client-perpetrated sexual violence against female sex workers in China

Abstract

The global literature suggests that female sex workers (FSWs) experience high rates of sexual violence perpetrated by their clients, especially when FSWs are under the influence of alcohol. However, such data are limited in China. The current study is aimed to fill in the literature gap by examining the association between alcohol use by FSWs and client-perpetrated sexual violence against FSWs in China. A total of 1022 FSWs were recruited through community outreach in Guangxi, China. Female sex workers completed a self-administered survey on their demographic information, alcohol use, and sexual violence perpetrated by clients. Multivariable regression was employed to assess the relationship between alcohol use and client-perpetrated sexual violence among FSWs while controlling for possible confounders. Results indicated that alcohol use was positively associated with the experience of sexual violence in both bivariate and multivariable analyses. Women who were at a higher risk level of alcohol use were more likely to experience sexual violence perpetrated by clients even after controlling confounders (e.g. demographics and alcohol-serving practice). Given the association between alcohol use and client-perpetrated sexual violence, preventing or reducing alcohol use among FSWs could be an effective strategy to protect these women from sexual violence perpetrated by their clients. Alternatively, psychological counseling and other support should be available to these women so they can reduce their alcohol use as a maladaptive coping strategy. We call for culturally appropriate alcohol use reduction components, incorporated with sexual violence reduction strategies including adaptive coping skills training as well as empowerment, and targeting both FSWs and their clients.

Keywords:

• China
• female sex workers
• alcohol use
• sexual violence
• clients
• prevention

Acknowledgments

The study described in this report was supported by NIH Research Grant R01AA018090 by the National Institute for Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute for Alcohol Abuse and Alcoholism. The authors want to thank Xiaoyi Fang, Xiuyun Lin, and other faculty and graduate students at Beijing Normal University School of Psychology for their participation in instrument development and field data collection. The authors also want to thank Joanne Zwemer for assistance with manuscript preparation.