Patterns of health care utilization and health behaviors among street sex workers in Hong Kong

Objective: To describe the current use of health services by the street-based female sex workers (FSWs) and to explore beliefs behind these health behaviors. Study setting: Community outreach approach in a few red-light districts in Hong Kong. Study design: A 30 min face-to-face interview was carried out in 89 women by direct approach and snowballing, followed by a focus group discussion drawn from the participants of the questionnaire. Results: While these FSWs' perception of personal health was good, a considerable proportion suffered from illnesses but the consultation rate was a third of the mean rate of the general population in Hong Kong. Many street workers experienced difficulty in utilizing health service in Hong Kong and even when they did, it was mainly for acute problems. Affordable access to health public services was excluded and many found private services unaffordable due to the high price charged by the practitioners. It was common for these women to self-medicate, delay in seeking medical help, or travel back to China for treatment. Conclusion: The current empirical understanding of the health and health service utilization by sex workers is unbalanced. In order to reduce sexually transmitted infections (STIs) and HIV among the street sex workers, it is essential to address the fundamental issue of health care access.