Influence of Profession as Risk of STIs in Intimate Partner Relationship in South Asian Countries

Mixing of sexual partners as part of the profession of female sex workers (FSWs) can be a risk in intimate partner relationship, which is primarily based on love and affection. Sexual relation with one partner provides emotional and psychological support. However, when it is a web of partners, it often results in unprotected sex, consequently creating a pathway for disease and increasing the vulnerability of FSWs to sexually transmitted infections (STIs). This paper analyses the subtleties of sexual behavior of FSWs and their vulnerability toward STIs in intimate partner relationship in South Asian countries. The basic data used in this paper have been taken from 3 countries, 1271 FSWs from Bangladesh, 1404 FSWs from Nepal, and 7399 FSWs from India. The data were collected through modified time location cluster sampling as a part of mapping and size estimation of most-at-risk populations (MARPs) in Nepal and key affected populations (KAPs) in Bangladesh during the period of 2010–2016. The data for India are taken from the integrated behavioral and biological assessment (IBBA), which assesses the prevalence of high risk population in India. The findings reveal that the majority of the FSWs were married, which reveals dynamics of sexual activity placing them at higher risk of STIs. About half of the FSWs had more than 15 coituses in the last 30 days in Nepal, which is a high risk factor. Unprotected sex is reported high across all three countries irrespective of all background characteristics. Condom use during intercourse in Bangladesh is less likely in older FSWs and more likely among educated FSWs who had coital frequency of 7 or more in the last 30 days. Interestingly, unmarried FSWs in Nepal are less likely to use condom in their last sex as against India where FSWs are more likely to use condom in their last sex. The prevalence of STI among uneducated FSWs is found higher in Bangladesh as compared to Nepal and India. The socio-demographic background characteristics showed a significant association with unprotected sex, coital frequency and prevalence of STI across all three countries.