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The current study was designed to fill the literature gap by examining the roles of the pro-alcohol social environment in alcohol use among female sex workers (FSWs) in China. In this study, a total of 1,022 FSWs were recruited through community outreach from both alcohol-serving and nonalcohol-serving commercial sex venues in Guangxi, China. The pro-alcohol social environment was measured in four areas: institutional norms, institutional practices, risk perceptions and peer norms. The measures of the pro-alcohol social environment were significantly associated with the venues' alcohol-serving practices, with FSWs from those venues reporting a more positive pro-alcohol social environment than their counterparts from nonalcohol-serving venues. However, these pro-alcohol social environment measures were independently predictive of alcohol use after controlling for venues' alcoholserving practices and other demographic characteristics. Public health interventions need to target environmental-structural factors through altering pro-alcohol-use social norms and practices at both institutional and individual levels among FSWs in China.

Pro-Alcohol-Use Social Environment and Alcohol Use among Female Sex Workers in China: Beyond the Effects of Serving Alcohol