The HIV epidemic continues to develop among older adults in China, including older female sex workers. Yet, few studies have been conducted among this relatively hidden population. The objectives of this study were to investigate the reasons for women's entry into sex work during their thirties and to develop typology of older women sex workers.
Semi-structured in-depth interviews with sixty-three older women sex workers and six focus groups interviews with stakeholders were conducted in three cities in China in Data were analysed inductively using constant comparative method.
The mean age of participants was 43 years old and the mean age of entry into sex work was 39 years old. The primary reasons for entry into sex work include heavy economic burdens, limited employment opportunities, and the appealing nature of sex work. Street-based and venue-based older sex workers were identified based on where they solicited clients.
Street-based older sex workers were more likely to engage in unsafe commercial sex due to financial incentives, whereas those in entertainment venues were unlikely to use condoms with regular clients.
The development of effective HIV interventions needs to consider older women sex workers unique characteristics and target factors that impede safer sex practices. China is now facing a new challenge of a growing HIV epidemic among older adults.
