Risk behavior and health service needs of sex workers returning to brothels in South Korea

Concerns about HIV and other sexually transmitted infections (STIs) have risen due to the return of sex workers (SWs) who had left their brothels following harsh police crackdowns conducted after a 2004 enactment of the special anti-prostitution law. This study used the health risk and behavior component of a 2006 survey on 1078 brothel-based SWs living in 11 major red-light districts in South Korea. We divided our sample into two groups depending on whether or not they had left their brothels (R-SWs and N-SWs). R-SWs accounted for 30% of the sample, with N-SWs consisting of new SWs (65%) and SWs who had never left their brothels (5%). While the rate of condom use did not differ between the two groups, R-SWs reported a higher level of self-perceived risk of acquiring HIV or other STIs, perhaps as a result of the difference in previous contractions of STIs (24% vs 14%, p<0001). Despite a higher perception of risk, however, R-SWs were less likely to leave their brothels. Furthermore, R-SWs were more likely to report current illness, possibly due to infection with STIs (11% vs 8%, p<03). Before returning to their brothels, a majority of R-SWs reported continuing sex work in facilities such as karaoke bars and nightclubs, with 24% reporting acquiring STIs during this period. Our findings suggest that special attention should be paid to returning SWs' health needs, and a more effective system should be established to monitor SWs who leave their brothels, yet continue to provide sexual services.