Network and Individual Factors Associated with Drug Use among Female Sex Workers (FSWs) in Southern China: A Mixed-Method Approach

ABSTRACT

Research on women who engage both in drug use and sex work has been limited, as most previous studies have focused on these risk behaviors separately. The current study examines the network properties as well as the demographic and behavioral factors associated with drug use among female sex workers (FSWs) in southern China. We collected survey data (n = 175) in the Hainan province during our 26 months of ethnographic fieldwork in China. Our analyses included Fisher's exact chi-square tests, independent-samples t-tests, Mann-Whitney U, binary logistic regression (LR), as well as ethnographic data analysis. Multivariate analysis showed that women who were younger age, single, more educated, and earning a higher income were more likely to use drugs. Pertaining to network properties, FSWs with a lower percentage of long-term clients (and men) in ego networks were more likely to use drugs; this would imply a mechanism by which drug-using FSWs are more at risk, as the women take a greater number of transient clients. In addition, FSWs who were influential network members (i.e., higher betweenness centrality) and were closely related to other network members (i.e., higher closeness centrality) were more likely to use drugs; this may suggest that drug use is a means of sustaining the high functionality of the workers. Our ethnographic data also showed that club drug use was easily accessible in entertainment venues and was often a means of socialization in FSW communities. Network characteristics correlated to HIV-related risks among FSWs should be further examined in future studies.

KEYWORDS:

• China
• drug use
• female sex workers (FSWs)
• mixed methods
• social networks

Acknowledgement

We are indebted to Bonita Stanton for her insightful comments and strong support. We would also like to thank Tanya Marie Luhrmann, James Holland Jones, Matthew Kohrman, William Jankowiak, Barbara Brents, Peter Gray, H. Russell Bernard, Eugene Cooper, Harumi Befu, Rebecca Bliege Bird, Hongguang Luo, and Chunguang Wang and for their support and advice. Finally, we owe sincere thanks to the women who participated in this research.

Additional information

Funding

This research was made possible with generous support from the National Science Foundation (BCS-0753231), the Freeman Spogli Institute, the Michelle R. Clayman Institute, Center for East Asian Studies, and the Anthropology Department at Stanford University. The revision of this article was supported by College of Humanities & Social Sciences (CHSS), Western Washington University (WWU).