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The purpose of this paper is to describe working conditions, health outcomes, social, and psychological factors related to HIV risk among Asian women who work at massage parlors in San Francisco. We conducted environmental mapping to identify communities and massage parlors where Asian women work as masseuses, and conducted survey interviews with masseuses using venue-based snowball sampling. Difficult work conditions contributed to participants' HIV risk, including multiple sex customers each workday, long working hours, physical and verbal abuse from customers, economic pressures, and poor access to health care. Inconsistent condom use for vaginal sex with customers was positively associated with their fatalistic ideas and weak norms toward practicing safe sex with customers. Interventions should address cultural and occupational contexts in which Asian masseuses engage in sex work, and should focus on altering massage parlor policies and work environments.
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Asian women who work at massage parlors in San Francisco have high levels of risk for sexually transmitted infections STIs , including HIV, and being victims of violence, which jeopardizes their health and wellbeing. On the basis of mapping, the targeted districts in San Francisco where massage parlors were located, 23 massage parlors were identified where commercial sex activity took place. Using snowball-sampling methods, 43 Asian female massage parlor workers were recruited for focus groups; 21 participants were Vietnamese and 22 were Thai. Qualitative analyses revealed frequent exposure to violence including verbal or physical abuse from customers and gang members, as well as persistent HIV risk behaviors associated with multiple daily sex partners, inconsistent condom use with customers, and forced sex. Social factors related to gender, immigration status, and socioeconomic status appeared to be closely tied to the health and wellbeing of Asian masseuses.
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