1. Economic vulnerability, violence, and sexual risk factors for HIV among female sex workers in Tijuana, Mexico
- Author
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Reed, Elizabeth, West, Brooke S, Frost, Elizabeth, Salazar, Marissa, Silverman, Jay G, McIntosh, Craig T, Gómez, María Gudelia Rangel, Urada, Lianne A, and Brouwer, Kimberly C
- Subjects
Public Health ,Health Sciences ,Behavioral and Social Science ,Sexually Transmitted Infections ,Violence Against Women ,HIV/AIDS ,Prevention ,Violence Research ,Adolescent Sexual Activity ,Pediatric ,Clinical Research ,Infectious Diseases ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Aetiology ,Prevention of disease and conditions ,and promotion of well-being ,2.3 Psychological ,social and economic factors ,Infection ,Reproductive health and childbirth ,Peace ,Justice and Strong Institutions ,Gender Equality ,Cross-Sectional Studies ,Female ,HIV Infections ,Humans ,Mexico ,Risk Factors ,Sex Workers ,Unsafe Sex ,Violence ,Female sex workers ,Mobility ,Sexual risk ,HIV ,Public Health and Health Services ,Social Work ,Public health - Abstract
Economic vulnerability is often reported to underlie involvement in sex work among female sex workers (FSW), but may also create urgency in women's work, limiting women's negotiating power with clients and in turn, increasing their vulnerability for violence and HIV. This study assessed economic vulnerability in relation to violence and sexual risk behaviors for HIV among a sample of FSW in Tijuana, Mexico. FSW at least 18 years of age were recruited through venue-based sampling for a survey (n = 228) and in-depth interviews (n = 50) to investigate HIV risk factors in this region. Using crude and adjusted logistic regression models, we assessed lack of financial support from others as well as reports of financial hardship separately in relation to experiencing sexual violence (e.g. by clients, police, relationship partners, in the past 6 months), physical violence (past 6 months), STI diagnosis, and inconsistent condom use (past 30 days). Qualitative interviews (n = 50), conducted with a subsample of the survey participants, were also examined for related themes. FSW who reported no financial support were more likely to report sexual violence (OR = 2.1; 95% CI:1.1-4.2). FSW who reported financial hardship were more likely to experience sexual violence (OR = 1.9; 95% CI:1.1-3.6) and physical violence (OR = 1.9; 95% CI:1.1-3.6), as well as to report past 30-day inconsistent condom use (OR = 2.4; 95%CI: 1.3-4.6) and to test positive for an STI (OR = 1.9; 95% CI:1.1-3.4). Qualitative data substantiated these findings. Findings suggest that interventions to improve economic well-being may be useful to prevent the intersecting concerns of violence and HIV among FSW.
- Published
- 2022