High-Risk and Sexual Behaviors Among Female Sex Workers in Shiraz, Iran.

Background and Aim: Female sex workers are an undeniable and often overlooked part of our society. Due to their hidden nature, they can pose potential risks to our communities. This study aims to shed light on the high-risk sexual behaviors of female sex workers in Fars province. Methods: In this cross-sectional study, we enrolled 196 female heterosexual sex workers. We collected information through interviews. Qualitative variables were reported in numbers and percentages, while quantitative variables were described. We used logistic regression models and multivariate analysis. Results: The results showed that a significant number of sex workers engaged in risky behaviors. Alcohol and drug use were prevalent among the participants, with 73.8% and 77.3% reporting alcohol and drug use, respectively. Sex workers who were never married and current smokers (70.8% and 69.7%) were more likely to engage in oral sex and anal intercourse. Furthermore, our findings revealed that 58.2%, 56.6%, and 47.4% of female sex workers had a history of oral, anal, and both oral and anal sex, respectively. Moreover, younger sex workers (under 20 years old) had a higher prevalence of anal and oral sex compared to other age groups. Living in high-level areas (66.7%) and the city center (75.0%) was associated with a higher likelihood of engaging in oral and anal sex. Lastly, the rates of STD and HPV infection were higher among this population. Conclusion: Smoking, alcohol and drug/substance use, never married status, and having more customers per day were identified as risk factors for engaging in oral sex and anal intercourse among female sex workers. The prevalence of these behaviors among sex workers in Fars province is alarmingly high, especially among younger individuals.