HIV-related risk behaviors among female sex workers in Ho Chi Minh City, Vietnam.

This study quantitatively and qualitatively described HIV risk behaviors among Vietnamese female sex workers (FSWs) who work at three distinct venues in Ho Chi Minh City: street, massage parlors, and bars/clubs. Although 35% of the participants had never been tested for HIV, 18% of street and 7% of bar/club FSWs reported being positive. Almost all massage parlor FSWs had never used a condom for oral sex. Inconsistent condom use for vaginal sex with customers was more prevalent among bar/club FSWs (85%) than massage parlor (72%) and street FSWs (68%). Many participants reported difficulties in negotiating condom use with customers because of economic pressure, maintaining relationships, and lack of bargaining power. Bar/club FSWs revealed a difficult situation where drinking is part of their work. Thirty percent of street FSWs had injected drugs and reported addiction to heroin in relation to their helpless condition as FSWs. Street FSWs had the lowest levels of self-esteem and norms toward practicing safe sex and the highest levels of economic pressure. This study recommends future HIV prevention programs for FSWs in Vietnam that target their specific risk behaviors and work environments.