Sexual Behaviors, Knowledge and Attitudes of Female Sex Workers’ towards HIV/AIDS in Shiraz

Background: Human Immunodeficiency Virus (HIV) epidemics are largely linked to high-risk populations such as female commercial sex workers (FSWs). This study assessed sexual behaviors, attitudes and knowledge of this marginalized group. Methods: We conducted a cross- sectional study on 278 selfidentified FSWs by using Respondent Driven Sampling (RDS) method in Shiraz, south of Iran, from June 2010 to March 2011. Volunteer women were interviewed in order to explore issues such as sexual behavior, sexual violence, work conditions, contraceptive methods, HIV/AIDS knowledge, HIV test, and source of HIV information. Results: The majority of participants (95.1%) knew about condoms; however, only 40.6% used condoms consistently. Despite the subject’s wide knowledge regarding modes of transmission, 61% and 40% did not use any protection with anal and oral intercourse, respectively. 21% of FSWs experienced sexual violence. Nearly half (45.2%) of them had an HIV test and more than three-quarters knew their test results. The women in our study preferred to receive their information from health workers (63%) and peer group (45.2%). Conclusion: This study sheds light on the existing knowledge and practices of this high-risk group. Although the majority of FSWs were familiar with HIV/AIDS, risky behaviors such as anal and oral sex are still in practice; this calls for education and HIV prevention campaigns focusing on risk education awareness. Efforts in addressing the problem of inconsistent condom use needs to be directed towards client specific approaches and must be regarded a top priority.