Characteristics of substance abusing female sex workers and identifying the changing trends in sex work dynamics in Imphal, Northeast India: A mixed-method study

Background: Substance abuse by female sex workers (FSWs) is particularly prevalent in the Northeastern states in India. It is important to understand how the FSWs actually function in different contexts. Objectives: The study aimed to describe various characteristics of substance abusing FSWs and to explore the changing trends in sex work dynamics in Imphal, Northeast India. Methods: This community-based, mixed-method, cross-sectional study was conducted among FSWs in Imphal from May 2017 to August 2019. 288 FSWs were recruited using respondent-driven sampling method and were interviewed using a semistructured questionnaire after obtaining written informed consent. Focus group discussions and in-depth interviews were conducted with participants and key informants. Results: The mean ± standard deviation age of the respondents was 30.9 ± 6.1 years; 53.8% were Christian. Majority (98.3%) of the respondents reported sex work as their only source of income; drug use (41.3%) and poverty and debt (35%) were main reasons for involvement in sex work. The most common place of solicitation was lodge/hotel (72.9%); condom was not used during the last sexual act by 2.1%; and heroin was frequently used before having sex by 52.1% and 9.3% used mobile phones for soliciting clients. “Pimps helped in getting customers but want to avoid paying half to them.” “It's easy to contact customers on mobile phone. I have 10–12 regular customers contacting through mobile.” Conclusions: Substances abusing FSWs predominantly uses heroin before sexual act and continue to practice unprotected sex. Newer technology like mobile phones was used for soliciting clients.