ArticleHealth policy and planning2019
The cost of safe sex: estimating the price premium for unprotected sex during the Avahan HIV prevention programme in India.
Article in Health policy and planning, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- HIV self-testing and oral pre-exposure prophylaxis are empowering for sex workers and their intimate partners: a qualitative study in Uganda.Journal of the International AIDS Society · 2021Trial
- Condom use prevalence during the COVID-19 pandemic among female sex workers in Dakar, Senegal: a retrospective, cross-sectional analysis.Health policy and planning · 2025Article
- Does the Risk Premium Differ Between Women Engaging in Commercial and Transactional Sex? Evidence From Urban Cameroon.Health economics · 2025Article
- The Relationship Between Past Condom Use and Condom Use Intention Among Male Construction Worker Clients of Sex Workers in the Western Cape, South Africa: A Parallel Multiple Mediator Model.Archives of sexual behavior · 2025Article
- "It's Almost Like Playing 'The Price is Right'": Factors Considered by Online Male Sex Workers When Setting the Price for Their Services.Archives of sexual behavior · 2024Article
- Sexual Health Needs Among Men Who Engage in Transactional Sex with Men in the UK.Archives of sexual behavior · 2024Article
- Partnership preferences, economic drivers, and health consequences of Gambian men's interactions with foreign tourists: A mixed methods study.PLOS global public health · 2023Article
- Selling sex in the context of substance use: social and structural drivers of transactional sex among men who use opioids in Maryland.Harm reduction journal · 2022Article
- The economics of sex work and major sporting events: Learning from the 2010 FIFA World Cup in South Africa.Social sciences & humanities open · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is some evidence that female sex workers (FSWs) receive greater earnings for providing unprotected sex. In 2003, the landscape of the fight against HIV/AIDS dramatically changed in India with the introduction of Avahan, the largest HIV prevention programme implemented globally. Using a unique, cross-sectional bio-behavioural dataset from 3591 FSWs located in the four Indian states where Avahan was implemented, we estimate the economic loss faced by FSWs who always use condoms. We estimate the causal effect of condom use on the price charged during the last paid sexual intercourse using the random targeting of Avahan as an instrumental variable. Results indicate that FSWs who always use condoms face an income loss of 65% (INR125, US$2.60) per sex act compared to peers providing unprotected sex, consistent with our expectations. The main finding confirms that clients have a preference for unprotected sex and that policies aiming at changing clients' preferences and at improving the bargaining power of FSWs are required to limit the spread of HIV.
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