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University of Melbourne

1. Bruce, Eunice Adjoa Kwansemah. Studies of female sex workers in Port Moresby, Papua New Guinea.

Degree: 2010, University of Melbourne

Background: In Papua New Guinea (PNG) like other developing countries, female sex workers (FSWs) are the group most vulnerable to and affected by the HIV epidemic predominantly through heterosexual contact. Female sex workers are therefore a risk group considered to play a significant role in the transmission of HIV including other sexually transmissible infections (STIs). Since the advent of the HIV epidemic in PNG, the government has implemented several strategies to curb the epidemic. Despite the strategies that include a nationwide awareness campaigns, access to free condoms and other prevention measures, the prevalence of HIV is steadily rising and condom use remains inconsistent and low. This thesis documents risk behaviors and contextual factors that create vulnerability to HIV in FSWs. The thesis adds to the body of research knowledge; strategies to reduce vulnerability and prevent transmission based on intervention linked approaches. The overall aim of the thesis is to make this information readily accessible to a wider audience, so as to contribute to programmatic efforts to scale up effective HIV interventions in FSWs in resource constrained settings. Methods: Data were collection from March 2003 to September 2004 and involved a series of approaches that included reviewing published and unpublished literature, mapping of sex workers sites to estimate the population of sex workers using nomination technique, a cross sectional KAPB survey to document risk behaviors, clinical trials to test other for STI diagnosis and treatment options plus a qualitative study using focus group discussions. Results: In total, 1 literature review and 5 research studies were conducted. The number of FSWs surveyed ranged from 79 – 212, from 19 different sites across Port Moresby and ranged in age between 14-43 years old. The review showed that the major risks for acquiring HIV in FSWs included high rates of inconsistent condom use with both clients (range: 0–63%) and regular sexual partners (range: 0–34%), high prevalence of sexually transmitted infections; the four most common were: Trichomonas (range: 21–56%), Gonorrhea (range: 20–39%), Syphilis (range: 16–34%) and Chlamydia (range: 14–33%). In addition, there was a steady rise in the prevalence of HIV over time; the highest 21% reported in 2004. The mapping exercise through extrapolation showed that there were approximately 2000 FSWs in 42 locations across Port Moresby, of which 212 were directly contacted through nomination and 338 through structured observation. The findings of the KAPB survey placed FSWs in Port Moresby among the predominantly young, poorly educated, least knowledgeable about STIs and HIV risks, least employed in the normal working sector, had substantial numbers of sexual partners, used condoms inconsistently, used marijuana and alcohol frequently, sought treatment services infrequently and had concerns about stigma in…

Subjects/Keywords: female sex workers; HIV; chlamydia trachomatis; neisseria gonorrhea; trichomonas vaginalis; syphilis; condom; clients; regular sexual partners; literature review; mapping; nomination; key informants; KAPB survey; STI symptoms; screening; leukocyte esterase; positive predictive value; periodic presumptive treatment; polymerase chain reaction; VDRL; TPHA; focus group discussion; HIV perception; perceived vulnerability; risk behaviours; safer sex practices; HIV policy; prevention interventions; Port Moresby; Papua New Guinea

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APA (6th Edition):

Bruce, E. A. K. (2010). Studies of female sex workers in Port Moresby, Papua New Guinea. (Doctoral Dissertation). University of Melbourne. Retrieved from

Chicago Manual of Style (16th Edition):

Bruce, Eunice Adjoa Kwansemah. “Studies of female sex workers in Port Moresby, Papua New Guinea.” 2010. Doctoral Dissertation, University of Melbourne. Accessed May 09, 2021.

MLA Handbook (7th Edition):

Bruce, Eunice Adjoa Kwansemah. “Studies of female sex workers in Port Moresby, Papua New Guinea.” 2010. Web. 09 May 2021.


Bruce EAK. Studies of female sex workers in Port Moresby, Papua New Guinea. [Internet] [Doctoral dissertation]. University of Melbourne; 2010. [cited 2021 May 09]. Available from:

Council of Science Editors:

Bruce EAK. Studies of female sex workers in Port Moresby, Papua New Guinea. [Doctoral Dissertation]. University of Melbourne; 2010. Available from: