Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017–18
Annalisa Zappulla A B , Christopher K. Fairley A B , Basil Donovan C D , Rebecca Guy C , Catriona S. Bradshaw A B , Marcus Y. Chen A B , Tiffany R. Phillips
A B , Kate Maddaford A and Eric P. F. Chow A B E
+ Author Affiliations
- Author Affiliations
A Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia.
B Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia.
C The Kirby Institute, UNSW Sydney, High Street, Kensington, NSW 2052, Australia.
D Sydney Sexual Health Centre, Sydney Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia.
E Corresponding author. Email: eric.chow@monash.edu
Sexual Health 17(1) 53-60 https://doi.org/10.1071/SH19037
Submitted: 26 February 2019 Accepted: 3 September 2019 Published: 13 January 2020
Abstract
Background: Sexually transmissible infections (STIs) are rising among female sex workers (FSW) in Australia. The rise might be explained by changes in sexual practices; however, there is limited behavioural data available. This study aimed to explore the current sexual practices among FSW in Melbourne. Methods: This cross-sectional study was conducted among FSW at Melbourne Sexual Health Centre between September 2017 and March 2018. Participants were asked about current sexual practices with male clients in an average working week. The frequency and proportion of each sexual practice was calculated. Results: There were 180 questionnaires included in the analysis. The median age of the FSW was 28 years (interquartile range [IQR]: 25–34). Most FSW (80.6%) worked in brothels. In an average working week, FSW had a median of 10 (IQR: 7–20) male clients. The most common sexual practices included: vaginal sex (98.3%), fellatio (97.2%), cunnilingus (92.2%) and tongue-kissing (83.7%). FSW had a median number of 10 (IQR: 6–18) vaginal, 10 (IQR: 5–18) fellatio, 7 (IQR: 2–10) cunnilingus and 6 (IQR: 2–10) tongue-kissing clients. Consistent condom use with all clients was highest for vaginal sex (97.1%), followed by anal sex (92.3%), then fellatio (78.9%). Only 3.1% used dental dams consistently for cunnilingus. Conclusion: Consistent condom use with all clients was high among FSWs, especially for vaginal and anal sex. However, one-fifth of FSW had condomless fellatio during an average working week. Tongue-kissing was more common than previously published. Peer-led sexual health education on safe sex practice for FSW is of high importance.
Additional keywords: condom use, saliva, sex work, sexually transmissible infections, tongue-kissing.
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