Vulnerability and Involvement In Drug Use and Sex Work

Many qualitative studies about the exchange of sex for money, drugs, and less tangible outcomes (i.e., social status) contend that this activity contributes to high levels of internalized stigma among people in sex work. The cis (n = 33) and trans people (n = 5) who participated in our project about health, violence, and social services acknowledged the stigma associated with sex work but were not governed by the dominant discourse about its moral stain. They shared nuanced insights about the relationship between sex work and self-respect as people who use their earnings to mitigate the struggles of poverty and ongoing drug use, and care for themselves more broadly. This study sheds new light on the ways that cis and trans people negotiate issues of money, agency, and self-care, contributing to the literature on consensual sex work that examines different aspects of stigma, safety, and health with a nuanced, non-binary gender analysis.

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Prevalence and associated factors of sexualized drug use in sex work among transgender women sex workers in China

AIDS Care ◽

10.1080/09540121.2020.1851017 ◽

2020 ◽

pp. 1-9

Author(s):

Xiaoyan Fan ◽

Joseph T.F. Lau ◽

Yong Cai ◽

Jinghua Li ◽

Tiecheng Ma ◽

...

Keyword(s):

Drug Use ◽

Sex Work ◽

Sex Workers ◽

Associated Factors ◽

Transgender Women

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Protecting the unprotected: mixed-method research on drug use, sex work and rights in Pakistan's fight against HIV/AIDS

Sexually Transmitted Infections ◽

10.1136/sti.2008.033670 ◽

2009 ◽

Vol 85 (Suppl 2) ◽

pp. ii31-ii36 ◽

Cited By ~ 28

Author(s):

S Mayhew ◽

M Collumbien ◽

A Qureshi ◽

L Platt ◽

N Rafiq ◽

...

Keyword(s):

Drug Use ◽

Sex Work ◽

Mixed Method ◽

Mixed Method Research ◽

Hiv Aids

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‘Exiting’ drug use and sex work: Career paths, interventions and government strategy targets

Drugs Education Prevention and Policy ◽

10.3109/09687631003776901 ◽

2010 ◽

Vol 18 (2) ◽

pp. 145-156 ◽

Cited By ~ 4

Author(s):

Linda Cusick ◽

Belinda Brooks-Gordon ◽

Rosie Campbell ◽

Fiona Edgar

Keyword(s):

Drug Use ◽

Sex Work ◽

Career Paths

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Programmatic mapping to determine the size and dynamics of sex work and injecting drug use in Mauritius

African Journal of AIDS Research ◽

10.2989/16085906.2018.1462216 ◽

2018 ◽

Vol 17 (2) ◽

pp. 129-136 ◽

Cited By ~ 7

Author(s):

Amita Pathack ◽

Ahmed Saumtally ◽

Sarah Soobhany ◽

Carly A Comins ◽

Said A H Kinoo ◽

...

Keyword(s):

Drug Use ◽

Sex Work ◽

Injecting Drug Use

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

Addiction ◽

10.1111/j.1360-0443.2012.04016.x ◽

2012 ◽

Vol 108 (1) ◽

pp. 161-170 ◽

Cited By ~ 25

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

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Law, Criminalisation and HIV in the World: Have countries that criminalise achieved more or less successful AIDS pandemic response?

10.1101/2021.06.04.21258360 ◽

2021 ◽

Author(s):

Matthew M Kavanagh ◽

Schadrac C Agbla ◽

Mara Pillinger ◽

Marissa Joy ◽

Alaina Case ◽

...

Keyword(s):

Drug Use ◽

Sex Work ◽

Viral Suppression ◽

Hiv Transmission ◽

People Living With Hiv ◽

Gender Based Violence ◽

Same Sex ◽

The World ◽

Laws And Policies ◽

Living With Hiv

How does the use of criminal law affect disease-fighting efforts, particularly in a pandemic? This longstanding question for governments around the world is felt acutely in the context of the COVID-19 and HIV pandemics. Many countries have laws and policies that criminalise behaviours, making same-sex relationships, illicit drug use, and sex work illegal. Meanwhile, some countries have enshrined gender- and rights-protective institutions in law. Under the global AIDS strategy of the last five years, national AIDS response efforts in countries have focused on reaching people living with HIV with testing and antiretroviral treatment to suppress the HIV virus, preventing mortality and HIV transmission. At the end of this 5-year push, this article provides an ecological analysis of whether those countries with criminalising legal environments achieved more or less success. In countries where same-sex relationships were fully criminalised, the portion of people living with HIV who knew their status was 11% lower and viral suppression rates were 8% lower. Under sex-work criminalization, the rate of people living with HIV who knew their status was 10% lower and viral suppression 6% lower. Drug use criminalisation was associated with 14% lower knowledge of status and viral. On the other hand in countries with laws advancing non-discrimination, human rights institutions, and gender-based violence response, HIV services indicators were significantly better. This ecological evidence on the relationships between the legal environment and successful HIV response provides support for a strategy that includes a focus on law reform to achieve goals missed in 2020.

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The Financial Lives and Capabilities of Women Engaged in Sex Work: Can Paradoxical Autonomy Inform Intervention Strategies?

Global Journal of Health Science ◽

10.5539/gjhs.v13n6p69 ◽

2021 ◽

Vol 13 (6) ◽

pp. 69

Author(s):

Lyla S. Yang ◽

Susan S. Witte ◽

Carolina Vélez-Grau ◽

Tara McCrimmon ◽

Assel Terlikbayeva ◽

...

Keyword(s):

Drug Use ◽

Hiv Prevention ◽

Food Insecurity ◽

Sex Work ◽

Controlled Trial ◽

Well Being ◽

Poverty Line ◽

Computer Assisted ◽

Daily Lives ◽

Cluster Randomized

INTRODUCTION: Despite growing attention to structural approaches to HIV prevention, including economic empowerment interventions for key populations, few studies examine the financial lives of women engaged in sex work (WESW) and even fewer examine the financial lives of those who also use drugs. The purpose of this paper is to examine the financial status, sex work involvement, and individual and structural vulnerabilities of women involved in sex work and drug use in Kazakhstan. METHODS: We used baseline data from Project Nova, a cluster-randomized controlled trial that tested the efficacy of a combined HIV risk reduction and microfinance intervention for WESW in two cities in Kazakhstan. We collected data on income, savings, debt, sex work, drug use, homelessness, food insecurity, HIV status, attitudes towards safety, and financial knowledge from 400 participants through computer-assisted self-interview techniques. Descriptive statistics were utilized to describe and characterize the sample and aforementioned measures. RESULTS: Findings illustrate the paradoxical nature of sex work, wherein women may achieve economic independence despite the great adversities they encounter in their daily lives and work. The majority of women (65%) in this study reported being the highest income earner in the household, caring for up to 3 dependents, and demonstrated entrepreneurial characteristics and aspirations for the future. However, many were still living below the poverty line (72.5%), as well as experiencing high levels of homelessness (58%) and food insecurity (89.5%). CONCLUSION: Study findings underscore the need for better understanding of the existing capabilities of WESW and those who use drugs, including financial autonomy and community supports, that may guide the design of programs that most effectively promote women’s economic well-being and ensure that it is not at the expense of wellness and safety. Designing such programs requires incorporating a social justice lens into social work and public health interventions, including HIV prevention, and attention to the human rights of the most marginalized and highest risk populations, including WESW and those who use drugs.

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

Journal of Interpersonal Violence ◽

10.1177/0886260520978188 ◽

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.

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