scholarly journals Patterns and Epidemiology of Illicit Drug Use Among Sex Workers Globally: A Systematic Review

2021 ◽  
pp. 95-118
Author(s):  
Jenny Iversen ◽  
Pike Long ◽  
Alexandra Lutnick ◽  
Lisa Maher
Keyword(s):  
Drug Use ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Future Research ◽  
Random Effects Model ◽  
Female Sex ◽  
Pooled Prevalence

AbstractIntroduction: Sex workers who use drugs represent two distinct populations, yet programmatic and policy responses are siloed and failed to acknowledge the ways in which populations overlap and needs intersect. Although prevalence of drug use among sex workers is believed to be higher than the general population, no published estimates of global prevalence exist. We aimed to estimate the prevalence of lifetime illicit drug use among sex workers overall, by gender (cis, transgender, and non-binary), and sub-region.Methods: We searched electronic databases for studies measuring the prevalence of illicit drug use among sex workers from the past decade [2009–2018]. Data were combined to generate pooled prevalence and associated 95% confidence intervals of lifetime use using a random effects model. Countries were categorised into geographic sub-regions, and sub-regional pooled estimates of lifetime use among female sex workers generated and mapped.Results: Among 86 studies in 46 countries, pooled prevalence of lifetime illicit drug use among sex workers was 35% (95% CI 30–41%). There was significant diversity (I2 > 90.0%, P < 0.01), and prevalence ranged from 1.2% to 84%. Most studies reported lifetime drug use among female sex workers (32 studies from 20 countries), and pooled prevalence in this sub-group was 29% (95% CI 24–34%). Insufficient data precluded generation of estimates for male and transgender sex workers.Conclusions: Our review identified significant gaps in data quality and availability. Future research in partnership with sex workers is necessary to explore the diversity of populations and contexts in which drug use and sex work intersect, inform more accurate estimates of prevalence, identify differences in risks and exposures, and guide the creation, implementation, and evaluation of programmes and services.

Correlates of alcohol and illicit drug use before commercial sex among transgender women with a history of sex work in China

Sexual Health ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 45 ◽  
Author(s):  
Qian Wang ◽  
Ruijie Chang ◽  
Ying Wang ◽  
Xueqin Jiang ◽  
Shuxian Zhang ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Commercial Sex ◽  
Female Sex ◽  
Alcohol And Drugs ◽  
Combined Use

Background Research on substance use among transgender female sex workers in China is scarce. The aims of this study were to examine: (1) the prevalence of alcohol or illicit drug use before commercial sex among this population; and (2) correlates of alcohol and illicit drug use. Methods: Complete survey data were analysed from 397 transgender female sex workers recruited from three of the largest cities in China: Shenyang, Shanghai and Guangzhou. Information was collected about demographics, alcohol or illicit drug use, alone or in combination, and their psychosocial correlates using structured questionnaires. Multinomial logistic regression models were used to examine the association between substance use and its correlates. Results: Before commercial sex, approximately one-third of the sample reported exclusive alcohol use (28.5%), 9.3% reported exclusive drug use and 7.3% reported combined use of alcohol and drugs. Before commercial sex, participants with low self-esteem had twice the odds of using alcohol exclusively (adjusted odds ratio (aOR) 2.05; 95% confidence interval (CI) 1.01–4.17), those with higher levels of loneliness had almost threefold the odds of exclusive drug use (aOR 2.92; 95% CI 1.21–7.07) and those with depression (aOR 2.97; 95% CI 1.11–7.96) and unknown HIV status (aOR 3.00; 95% CI 1.02–8.87) had threefold the odds of combined use of alcohol and drugs. Conclusion: Programs aimed at reducing alcohol or drug use among transgender female sex workers in China may consider adding components that help support mental health and encouraging HIV screening.

scholarly journals Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in northern Mexico

Addiction ◽  
2012 ◽  
Vol 108 (1) ◽  
pp. 161-170 ◽  
Author(s):  
Meghan D. Morris ◽  
Hector Lemus ◽  
Karla D. Wagner ◽  
Gustavo Martinez ◽  
Remedios Lozada ◽  
...  
Keyword(s):  
Drug Use ◽  
Sex Work ◽  
Injection Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Injection Drug ◽  
Factors Associated ◽  
Northern Mexico ◽  
Female Sex

Co-occurring Threats to Agency Among Female Sex Workers in Baltimore, Maryland

2020 ◽  
pp. 088626052097818
Author(s):  
Danielle F. Nestadt ◽  
Catherine Tomko ◽  
Kristin E. Schneider ◽  
Deanna Kerrigan ◽  
Michele R. Decker ◽  
...  
Keyword(s):  
Drug Use ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Latent Class ◽  
Community Empowerment ◽  
Sense Of Agency ◽  
Structural Factors ◽  
Unequal Distribution ◽  
Female Sex

Driven largely by the unequal distribution of power, female sex workers (FSW) globally bear a disproportionately high burden of HIV, sexually transmitted infections, and interpersonal violence. Prior literature has identified a number of multi-level factors that may serve to constrain FSWs’ agency, or their ability to define and take action to realize goals. Among these are work-based violence and substance use, which are potentiated by the criminalization of sex work and structural vulnerability. Quantitative research related to U.S.-based FSWs’ own sense of agency, as well as the barriers that may impede it, is sparse. We sought to identify patterns of various threats to agency and explore to what extent they were associated with perceived agency among a cohort of 381 FSW in Baltimore, Maryland, United States, using latent class analysis. Latent class indictors were past-six-month experience of client-perpetrated sexual violence, client-perpetrated physical violence, homelessness, food insecurity, arrest, daily crack-cocaine use, and daily heroin use. Perceived agency was measured using the short form of the Pearlin Mastery Scale. We identified three typologies of threatened agency among women in our sample: a “threatened by structural factors, drug use, and violence” class, a “threatened by structural factors and drug use” class, and a “less threatened” class. Mean perceived agency score was significantly lower for the class characterized by client-perpetrated violence than for either of the other classes. This suggests violence, in the context of deeper, structural power imbalances embedded in hunger, homelessness, and drug use, may dramatically reduce one’s sense of agency and operate as a critical barrier to empowerment. Our study adds important insights to the broader FSW community empowerment literature and supports the need for interventions to bolster both individual and collective agency among U.S.-based FSW, including interventions to prevent sex work-related violence.

The Mental and Physical Health of Female Sex Workers: A Comparative Study

2001 ◽  
Vol 35 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Sarah E. Romans ◽  
Kathleen Potter ◽  
Judy Martin ◽  
Peter Herbison
Keyword(s):  
Social Networks ◽  
Physical Health ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
General Health Questionnaire ◽  
Psychiatric Morbidity ◽  
Convenience Sample ◽  
Female Sex ◽  
Mental And Physical Health

Objectives: The objective of this study was to compare the mental and physical health, adult abuse experiences and social networks of female sex workers with data previously collected from two large community samples of age-matched women. Method: A convenience sample of sex workers were interviewed and completed two wellestablished questionnaires, the General Health Questionnaire (GHQ-28) and the Intimate Bond Measure (IBM). Sex workers were invited to reflect on their experiences of their work. Results: There were no differences in mental health on the GHQ-28 or in self-esteem (measured by an item on the Present State Examination) between the two groups. Neither were there any differences in their assessment of their physical health or the quality of their social networks. Sex workers were less likely to be married and had been exposed to more adult physical and sexual abuse than the comparison group. They were more likely to smoke and to drink heavily when they drank. One-third said that their general practitioner was not aware of their work. A subgroup not working with regular clients or in a massage parlour had higher GHQ-28 scores and may be an at-risk group. Narrative information about the work, particularly its intermittent nature, is presented. Conclusions: No evidence was found that sex work and increased adult psychiatric morbidity are inevitably associated, although there may be subgroups of workers with particular problems. The illegal and stigmatized nature of sex work are likely to make usual public health strategies more difficult to apply, considerations which should give concern from a preventive health standpoint.

scholarly journals The Female Sex Work Industry in a District of India in the Context of HIV Prevention

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Raluca Buzdugan ◽  
Shiva S. Halli ◽  
Jyoti M. Hiremath ◽  
Krishnamurthy Jayanna ◽  
T. Raghavendra ◽  
...  
Keyword(s):  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Work Setting ◽  
Vulnerability Factors ◽  
Modes Of Operation ◽  
Sex Worker ◽  
Work Settings ◽  
Female Sex ◽  
Female Sex Work

HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified. In addition to previously documented brothel, lodge, street,dhaba(highway restaurant), and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges,dhabas, and on highways describe factors that put them at high HIV risk. Of these,dhabaand highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme.

scholarly journals Lifetime and past-month substance use and injection among street-based female sex workers in Iran

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Payam Roshanfekr ◽  
Mehrdad Khezri ◽  
Salah Eddin Karimi ◽  
Meroe Vameghi ◽  
Delaram Ali ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
Injection Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Injection Drug ◽  
Logistic Regression Models ◽  
Female Sex ◽  
History Of ◽  
Group Sex

Abstract Background Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. Results Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20–6.20]), ever incarceration (AOR 5.06 [2.48–10.28]), and ever group sex (AOR 2.44 [1.21–4.92]). Conclusions Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

scholarly journals FACTORS ASSOCIATED WITH THE LIKELIHOOD OF FURTHER MOVEMENT AMONG MOBILE FEMALE SEX WORKERS IN INDIA: A MULTINOMIAL LOGIT APPROACH

2015 ◽  
Vol 48 (4) ◽  
pp. 539-556 ◽  
Author(s):  
Dipak Suryawanshi ◽  
Varun Sharma ◽  
Niranjan Saggurti ◽  
Shalini Bharat
Keyword(s):  
Sex Work ◽  
Sex Workers ◽  
Perceived Risk ◽  
Sexual Coercion ◽  
Female Sex Workers ◽  
Multinomial Logit ◽  
Consistent Condom ◽  
Cross Sectional Survey ◽  
Factors Associated ◽  
Female Sex

SummaryFemale sex workers (FSWs) are vulnerable to HIV infection. Their socioeconomic and behavioural vulnerabilities are crucial push factors for movement for sex work. This paper assesses the factors associated with the likelihood of movement of sex workers from their current place of work. Data were derived from a cross-sectional survey conducted among 5498 mobile FSWs in 22 districts of high in-migration across four states in southern India. A multinomial logit model was constructed to predict the likelihood of FSWs moving from their current place of work. Ten per cent of the sampled mobile FSWs were planning to move from their current place of sex work. Educational attainment, marital status, income at current place of work, debt, sexual coercion, experience of violence and having tested for HIV and collected the results were found to be significant predictors of the likelihood of movement from the current place of work. Consistent condom use with different clients was significantly low among those planning to move. Likewise, the likelihood of movement was significantly higher among those who had any STI symptom in the last six months and those who had a high self-perceived risk of HIV. The findings highlight the need to address factors associated with movement among mobile FSWs as part of HIV prevention and access to care interventions.

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