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.

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

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.

Typologies and Correlates of Police Violence Against Female Sex Workers Who Inject Drugs at the México–United States Border: Limits of De Jure Decriminalization in Advancing Health and Human Rights

2020 ◽  
pp. 088626052097582
Author(s):  
Brooke S. West ◽  
Brandy F. Henry ◽  
Niloufar Agah ◽  
Alicia Vera ◽  
Leo Beletsky ◽  
...  
Keyword(s):  
United States ◽  
Sexual Violence ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Latent Class ◽  
Equation Modeling ◽  
Police Violence ◽  
Female Sex ◽  
Sexually Assaulted

Decriminalization of sex work is increasingly promoted as a structural measure to improve the health of vulnerable groups. In México, sex work is not illegal, but knowledge of policies’ street-level impact is limited. This study describes typologies of police violence against female sex workers who inject drugs (FSWID), identifying risk and protective factors for violence exposure to inform policy responses. Survey data were collected during 2008–2010 among HIV-negative FSWID in a behavioral intervention in Tijuana and Ciudad Juarez ( N = 584). Latent class analysis identified typologies of police violence in the past 6 months: asked for money, money taken, syringes taken, asked for sex, and sexually assaulted. Structural equation modeling (SEM) predicted latent class membership using sociodemographic, behavioral and risk environment factors, controlling for age, education, marital status, and city. Recent police violence was reported by 68% of FSWID, with three typologies emerging: Low (36.6%); Material (47.8%): having money/syringes taken or being asked for money; and Material/Sexual (15.7%): material violence and being asked for sex or sexually assaulted. In multivariable SEM, Material Violence was associated with: being jailed [adjusted Odds Ratio (aOR) = 4.34], HIV testing (aOR = 2.18), and trading sex indoors (aOR = 1.66). Factors associated with Material/Sexual Violence included: being jailed (aOR = 41.18), injecting with clients (aOR = 3.12), earning more money for sex without a condom (aOR = 2.88), being raped by a client (aOR = 2.13), drinking with clients (aOR = 2.03), receiving substance use treatment (aOR = 1.95), being <18 when first trading sex (aOR = .43), trading sex outdoors (aOR = .53), and poor working conditions (aOR = .56). Despite de jure decriminalization of sex work, police violence against FSWID at the México–United States border is pervasive with implications for sex- and drug-related harms. Closing gaps in policy implementation and mitigating material/sexual violence from police is imperative to decreasing economic vulnerability, risk of overdose and HIV, and improving engagement in HIV and harm reduction services.

scholarly journals Mobility for sex work and recent experiences of gender-based violence among female sex workers in Iringa, Tanzania: A longitudinal analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252728
Author(s):  
Zoé Mistrale Hendrickson ◽  
Anna M. Leddy ◽  
Noya Galai ◽  
S. Wilson Beckham ◽  
Wendy Davis ◽  
...  
Keyword(s):  
Sexual Violence ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Community Empowerment ◽  
Recent Experience ◽  
Gender Based Violence ◽  
Female Sex ◽  
Gender Based

Female sex workers are highly mobile, which may influence their risk of experiencing physical and sexual violence. However, there remains a paucity of research, particularly longitudinal, from Sub-Saharan Africa exploring mobility and gender-based violence among female sex workers. To address this gap, this study examined the longitudinal relationship between work-related mobility and recent experience of physical or sexual gender-based violence from a client or partner among female sex workers in Iringa, Tanzania. A secondary data analysis was conducted using baseline and 18-month follow-up data from Project Shikamana, a community empowerment-based combination HIV prevention intervention. Responses from 387 female sex workers aged 18 years and older participating in both baseline and follow-up were analyzed. Unadjusted and adjusted Poisson regression models with robust variance estimations, accounting for clustering of female sex workers’ responses over time, were fit. Final models adjusted for socio-demographic characteristics and aspects of participants’ living situations and work environments. Recent physical or sexual violence from a client or partner was common (baseline: 40%; follow-up: 29%). Twenty-six percent of female sex workers at baseline, and 11% at follow-up, had recently traveled outside of Iringa for sex work. In the final adjusted longitudinal model, female sex workers recently mobile for sex work had a 25% increased risk of any recent experience of physical or sexual gender-based violence when compared with their non-mobile counterparts (adjusted incidence rate ratio: 1.25; 95% CI: 1.03–1.53; p<0.05). Interventions must identify ways–such as mobile support services, linkages and referrals to health and other social services while traveling, or the use of mobile or digital technology–to address mobile female sex workers’ unique needs while traveling. Future quantitative and qualitative research is needed to understand the context of female sex workers’ mobility and how and why mobility influences risk environments and experiences of gender-based violence.

scholarly journals “I Am Almost a Breadwinner for My Family”: Exploring the Manifestation of Agency in Sex Workers’ Personal and Professional Contexts

Affilia ◽  
2021 ◽  
pp. 088610992110227
Author(s):  
Sharvari Karandikar ◽  
Kaitlin Casassa ◽  
Logan Knight ◽  
Megan España ◽  
Njeri Kagotho
Keyword(s):  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Service Providers ◽  
Red Light ◽  
Structural Factors ◽  
Female Sex ◽  
Light Area ◽  
Professional Contexts ◽  
Depth Interviews

While societal and structural factors often constrain women’s agency in patriarchal settings, women nevertheless find creative ways to manifest and develop agency. Female sex workers (FSWs), in particular, are regularly assumed to have little or no agency, but an important body of literature suggests otherwise. To add to this knowledge, this study sought to answer the question: How do FSWs in Mumbai, India, exert agency in personal and professional contexts? In-depth interviews were conducted with 12 FSWs in the Kamathipura red-light area. Four themes emerged: (a) sex work as a rational and empowering choice, (b) resources and assets, (c) sex work as a means of achievement, and (d) managing violence, retribution, and fear. These themes reveal expressions of agency that illustrate how sex workers are intentional, rational, goal-oriented, and resilient. The findings of this study can contribute to the removal of stigma surrounding sex work and inform service providers working with this population in their efforts to treat sex workers with dignity and respect. Further research is needed in this area, especially which centers on the voices of the agentic sex workers themselves.

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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