{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:48:29Z","timestamp":1791560909232,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100004417","name":"Global Fund to Fight AIDS, Tuberculosis and Malaria","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004417","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Early sex work initiation among female sex workers (FSWs) increases their vulnerabilities to high-risk sexual practices and sexually transmitted infections (STIs). We examined the association of early sex work with condomless sex indicators, HIV, and other STIs, including human papillomavirus, chlamydia, trichomoniasis, syphilis, and gonorrhea, among FSWs in Iran. We recruited 1347 FSWs from 13 cities in 2015, with 1296 participants (94.2%) reporting information about their age of sex work initiation. Early sex work was defined as the initiation of selling sex before 18 years of age. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported using multivariable logistic regression. Overall, 10.1% of FSWs reported early sex work initiation. FSWs who initiated sex work earlier were more likely to report last-month inconsistent condom use (aOR\u2009=\u20093.31, 95% CI: 1.82, 6.02) and condomless sex with last client (aOR\u2009=\u20091.72, 95% CI: 1.15, 2.56). There was no statistically significant association between early sex work and HIV (aOR\u2009=\u20091.40, 95% CI: 0.43, 4.53) and any other STIs (aOR\u2009=\u20091.01, 95% CI: 0.69, 1.48), except for chlamydia (aOR\u2009=\u20092.09, 95% CI: 1.08, 4.04). These findings suggest that FSWs with early sexual debut would benefit from differentiated interventions including screening for STIs and enhanced counseling for condom use.<\/jats:p>","DOI":"10.1177\/0956462420913431","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T05:22:14Z","timestamp":1592025734000},"page":"671-679","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9712-6221","authenticated-orcid":false,"given":"Mehrdad","family":"Khezri","sequence":"first","affiliation":[{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3810-752X","authenticated-orcid":false,"given":"Mostafa","family":"Shokoohi","sequence":"additional","affiliation":[{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"},{"name":"Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Mirzazadeh","sequence":"additional","affiliation":[{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"},{"name":"Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Karamouzian","sequence":"additional","affiliation":[{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"},{"name":"Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3566-0247","authenticated-orcid":false,"given":"Hamid","family":"Sharifi","sequence":"additional","affiliation":[{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AliAkbar","family":"Haghdoost","sequence":"additional","affiliation":[{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D","family":"Baral","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,13]]},"reference":[{"key":"bibr1-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182a98ee6"},{"key":"bibr2-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-016-0073-6"},{"key":"bibr3-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052549"},{"key":"bibr4-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-0063-3"},{"key":"bibr5-0956462420913431","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2016.112"},{"key":"bibr6-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.08.019"},{"key":"bibr7-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08355-1"},{"key":"bibr8-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(19)30123-3"},{"key":"bibr9-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25042"},{"key":"bibr10-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-1118-7"},{"key":"bibr11-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/BF03405440"},{"key":"bibr12-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000447"},{"key":"bibr13-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1349-y"},{"key":"bibr14-0956462420913431","doi-asserted-by":"crossref","unstructured":"Karamouzian M, Nasirian M, Ghaffari Hoseini S, et\u00a0al. HIV and other sexually transmitted infections among female sex workers in Iran: a systematic review and meta-analysis.\n                      Arch Sex Behav\n                      . Epub ahead of print 2019. DOI: 10.1007\/s10508-019-01574-0","DOI":"10.1007\/s10508-019-01574-0"},{"key":"bibr15-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051028"},{"key":"bibr16-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053800"},{"key":"bibr17-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147587"},{"key":"bibr18-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182755"},{"key":"bibr19-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1844-0"},{"key":"bibr20-0956462420913431","first-page":"98","volume":"42","author":"Fahimfar N","year":"2013","journal-title":"Iran J Public Health"},{"key":"bibr21-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.03.011"},{"key":"bibr22-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.12.025"},{"key":"bibr23-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.09.037"},{"key":"bibr24-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2019.04.011"},{"key":"bibr25-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.178715"},{"key":"bibr26-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1177\/106002809002400319"},{"key":"bibr27-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0564-3"},{"key":"bibr28-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2009.096834"},{"key":"bibr29-0956462420913431","volume":"2012","author":"Urada LA","year":"2012","journal-title":"AIDS Res Treat"},{"key":"bibr30-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-476"},{"key":"bibr31-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.06.009"},{"key":"bibr32-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2012.720361"},{"key":"bibr33-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.5.536"},{"key":"bibr34-0956462420913431","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.2.19833"},{"key":"bibr35-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60931-4"},{"key":"bibr36-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-018-9921-z"},{"key":"bibr37-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1177\/1077801215569079"},{"key":"bibr38-0956462420913431","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2130-5"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462420913431","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462420913431","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462420913431","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:40:32Z","timestamp":1777675232000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462420913431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1177\/0956462420913431"],"URL":"https:\/\/doi.org\/10.1177\/0956462420913431","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}