Adverse Pregnancy Outcomes and Sexual Violence Among Female Sex Workers Who Inject Drugs on the United States–Mexico Border

This study examines the prevalence of miscarriage/stillbirth among female sex workers who inject drugs (FSW-IDUs) and measures its associations with physical and sexual violence. Baseline data from 582 FSW-IDUs enrolled in an HIV intervention study in Tijuana and Ciudad Juárez, Mexico were used for current analyses. 30% of participants had experienced at least one miscarriage/stillbirth, 51% had experienced sexual violence, and 49% had experienced physical violence. History of miscarriage/stillbirth was associated with sexual violence (adjusted odds ratio [aOR] = 1.7, p = .02) but not physical violence. Additional reproductive risks associated with miscarriage/stillbirth included high numbers of male clients in the previous month (aOR = 1.1 per 30 clients, p = 0.04), history of abortion (aOR = 3.7, p < .001), and higher number of pregnancies (aOR = 1.4 per additional pregnancy, p < .001). Programs and research with this population should integrate reproductive health and consider gender-based violence.

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Client-Initiated Violence Against Zambian Female Sex Workers: Prevalence and Associations With Behavior, Environment, and Sexual History

Journal of Interpersonal Violence ◽

10.1177/0886260519860083 ◽

2019 ◽

pp. 088626051986008 ◽

Cited By ~ 2

Author(s):

Kalonde Malama ◽

Luis Sagaon-Teyssier ◽

Rachel Parker ◽

Amanda Tichacek ◽

Tyronza Sharkey ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Physical Violence ◽

Sexual Debut ◽

Sexual History ◽

Sub Saharan Africa ◽

Gender Based Violence ◽

Cross Sectional ◽

Female Sex ◽

Male Clients

Violence against women is a known risk factor for HIV and affects female sex workers (FSW) in sub-Saharan Africa. Little is known about the magnitude and determinants of violence against FSW in Zambia, where HIV and gender-based violence prevalence are high. We conducted a cross-sectional study, using multivariable logistic regression, to determine the prevalence and correlates of client-initiated physical violence among 419 FSW in Lusaka and Ndola. The prevalence of client-initiated physical violence was 39%. The odds of violence were higher for FSW who: lived in Lusaka, recruited clients from the street, serviced clients in the clients’ homes, had a physically forced sexual debut, and had a higher client volume. Our results call for safer working spaces for FSW and violence prevention interventions for their male clients.

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Older Male Clients of Female Sex Workers in the United States

Archives of Sexual Behavior ◽

10.1007/s10508-016-0733-3 ◽

2016 ◽

Vol 46 (6) ◽

pp. 1867-1876 ◽

Cited By ~ 10

Author(s):

Christine Milrod ◽

Martin Monto

Keyword(s):

United States ◽

Sex Workers ◽

Female Sex Workers ◽

The United States ◽

Female Sex ◽

Male Clients ◽

Older Male Clients

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Sexual and physical violence and associated factors among female sex workers in Rwanda: a cross-sectional survey

International Journal of STD & AIDS ◽

10.1177/0956462418800848 ◽

2018 ◽

Vol 30 (3) ◽

pp. 241-248 ◽

Cited By ~ 2

Author(s):

Mwumvaneza Mutagoma ◽

Laetitia Nyirazinyoye ◽

Dieudonné Sebuhoro ◽

David J Riedel ◽

Joseph Ntaganira

Keyword(s):

Sexual Violence ◽

Sex Workers ◽

Associated Factors ◽

Female Sex Workers ◽

Social Protection ◽

Physical Violence ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Female Sex

Female sex workers (FSWs) frequently face violence in their working place. This study assessed the physical and sexual violence and associated factors among FSWs in Rwanda. A cross-sectional study was conducted among FSWs in Rwanda in 2015. Venue–Day–Time sampling method was used for recruitment. Descriptive analyses and logistic regression models were computed to assess factors associated with violence. In total, 1978 FSWs were recruited. A large proportion (18.3%) had been sexually abused outside of the family circle, and 37.8% had faced physical violence before 15 years of age. Clients were most often reported (67.0%) as perpetrators of physical violence in sex work. Being aged 25 years old and above, and having sexually transmitted infections (STIs) were positively associated with sexual violence (aOR = 2.1[95%CI: 1.80–2.39]) and (aOR = 3.0[95%CI: 1.01–2.14], respectively). Being aged 25 years old and above (aOR = 0.8[95%CI: 0.76–0.89]) and drinking alcohol every day (aOR = 0.6[95%CI: 0.42–0.87]) were negatively associated with physical violence. Sexual and physical violence was common among FSWs in Rwanda. Single FSWs are the most vulnerable to sexual violence. Alcohol consumption and having STIs are associated with violence against FSWs. Human rights and social protection as well as health promotion among FSWs is needed.

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Unmet contraceptive needs among female sex workers (FSWs) in semi urban Blantyre, Malawi

Reproductive Health ◽

10.1186/s12978-020-01064-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Donatien Twizelimana ◽

Adamson S. Muula

Keyword(s):

Side Effects ◽

Sexual Violence ◽

Sex Workers ◽

Female Sex Workers ◽

Outcome Variable ◽

Limited Attention ◽

Reproductive Health Services ◽

Steady Partner ◽

Female Sex ◽

History Of

Abstract Background Research has paid limited attention to understanding factors that are associated with unmet contraceptive needs among female sex workers. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined associated factors among FSWs in semi urban Blantyre, Malawi. Methods We used systematic sampling to recruit 290 female sex workers in semi urban Blantyre between February and March 2019. In this cross sectional study, we used questionnaire interviews to collect quantitative data. We calculated the mean and standard deviation for continuous variables and proportions for categorical variables to describe the data. Logistic regression analysis was used to investigate the association between unmet needs (the outcome variable) and explanatory variables such as: having a steady partner, fear of contraceptives’ side effects and having a history of sexually transmitted infections. Results Out of the 290 study participants 102 (35.2%) reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: female sex workers’ history of physical and sexual violence by clients [OR 3.38, 95% CI (1.10, 10.43)], p < 0.03, participants with a steady partner [OR 3.28, 95% CI (1.89, 5.68)], p < 0.001, and participants who feared side effects of contraceptives [OR 2.99, 95% CI (1.73, 5.20)], p < 0.001. Conclusion Reproductive Health services should address barriers to contraceptives use for instance: violence by female sex workers’ clients, fear and misinformation on contraceptives. There is need to improve awareness of contraceptives. Specific health promotion interventions on female sex workers engaged in a steady partnership are recommended. It is important to enhance the knowledge, attitudes, and counseling skills of health care providers in order to address unmet contraceptive needs among female sex workers in semi-urban Blantyre. Plain English summary Unmet contraceptive needs are defined as lack of contraceptives use in heterosexually active women of childbearing age who do not wish to become pregnant. Unmet contraceptive needs are the main cause of short inter-pregnancy intervals, early childbearing, physical abuse, unintended pregnancy, poor maternal and child health outcomes. Several studies have documented low contraceptives use among female sex workers (FSWs), but research has paid limited attention to understanding factors associated with unmet contraceptive needs among this population in semi urban Blantyre Malawi. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined factors that were associated with unmet contraceptive needs among FSWs in semi urban Blantyre, Malawi. We recruited 290 FSWs and collected quantitative data. These data were analyzed to obtain descriptive statistics. Logistic regression analysis was used to investigate the association between unmet contraceptive needs (the outcome variable) and explanatory variables such as: FSWs with history of physical and sexual violence by clients, having a steady partner, fear of contraceptives’ side effects and having a history of sexually transmitted infections. Out of the 290 FSWs, 35% reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: FSWs’ history of physical and sexual violence by clients, participants with a steady partner and participants who feared contraceptive side effects. Sexual and Reproductive Health services should address barriers to contraceptives use, female sex workers exposure to violence, having a steady partners and concerns about side effects. There is also a need to improve the knowledge, attitudes, and counseling skills of health providers in order to address unmet contraceptive needs among FSWs.

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Prevalence and Correlates of Sexual Violence Experienced by Female Sex Workers in Iran: Results from a National HIV Bio-Behavioral Surveillance Survey

Violence Against Women ◽

10.1177/10778012211008992 ◽

2021 ◽

pp. 107780122110089

Author(s):

Samira Hosseini-Hooshyar ◽

Ali Mirzazadeh ◽

Mohammad Karamouzian ◽

Hamid Sharifi ◽

Razieh Khajehkazemi ◽

...

Keyword(s):

Sexual Violence ◽

Sex Workers ◽

Female Sex Workers ◽

Community Empowerment ◽

Anal Sex ◽

Female Sex ◽

Adverse Health Outcomes ◽

History Of ◽

Using Data ◽

Group Sex

Sexual violence increases the risk of adverse health outcomes among female sex workers (FSWs). Using data from the 2015 national bio-behavioral survey, we explored the experience of sexual violence and its associated factors among Iranian FSWs. Lifetime and recent sexual violence were reported by 40.1% and 16.9%, respectively. History of substance use, ever engaging in anal sex, engaging in group sex within the last year, a high number of clients, recent unstable housing, and incarceration increased the likelihood of experiencing recent sexual violence. These findings underscore the need for community-empowerment and policy-level interventions to address violence among FSWs in Iran.

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HIV-1 and Syphilis Prevalence Among Local Chinese and Cross-border Migrant Female Sex Workers in Sino-Vietnam Border Cities in Guangxi, China: a Nine-year Consecutive Cross-sectional Study

10.21203/rs.3.rs-400830/v2 ◽

2021 ◽

Author(s):

Bingyu Liang ◽

Fei Zhang ◽

Dongmei Wei ◽

Peidong Zhang ◽

Guangwu Wei ◽

...

Keyword(s):

Sex Workers ◽

Associated Factors ◽

Female Sex Workers ◽

Illicit Drugs ◽

Syphilis Infection ◽

Cross Sectional ◽

Female Sex ◽

Male Clients ◽

History Of ◽

Hiv 1

Abstract Background To analyze the trends of HIV-1 and syphilis prevalence as well as associated factors among local Chinese female sex workers (LCFSWs) and cross-border migrant female sex workers (CMFSWs) in Sino-Vietnam border cities in Guangxi, China. Methods A consecutive cross-sectional study was conducted from 2010 to 2018 in three border cities in Guangxi. The survey was conducted through face-to-face interview with a structured questionnaire. HIV-1 and syphilis infections were tested simultaneously. Cochran-Armitage analysis was used to assess the trends of HIV-1, syphilis and HCV prevalence, as well as the trend of risk behaviors, HIV/AIDS knowledge and prevention services. Multivariate logistics regression analysis was used to identify factors associated with HIV-1 and syphilis infection.Results Totally, 19873 LCFSWs and 1723 CMFSWs were enrolled. The overall prevalence of HIV-1 and syphilis infection was 0.91% and 5.14%, respectively. The HIV-1 prevalence among CMFSWs was higher than that among LCFSWs, without a declined trend. However, a downward trend was observed among LCFSWs. Overall, the main associated factors of HIV-1 infection among CMFSWs shifted from age >35 years old, staying in current residence for >12 months, self-reporting sexually transmitted infections (STIs) in the last year during 2010-2015 to inconsistent condoms use in commercial sex in last month, not receiving peer education and self-reporting STIs in the last year during 2016-2018. The main correlated factors of syphilis infection among CMFSWs changed from history of illicit drug use, staying in current residence for more than 12 months, self-reporting of STIs and inconsistent condoms use in commercial sex in the past month during 2010-2015 to working in low-tier venues, self-reporting of STIs in the last year, and sexing with commercial male clients who used aphrodisiac drugs during 2016-2018. For LCFSWs, the relative strong associated factors of HIV-1 infection shifted from receiving less than 6 years of education, illicit drugs use, and self-reporting STIs in the last year during 2010-2015 to sexing with commercial male clients who use aphrodisiac drugs and self-reporting of STIs during 2016-2018, while the main factors of syphilis infection changed from self-reporting STIs in the last year, history of illicit drug use and receiving less than 9 years of education during 2010-2015 to self-reporting of STIs in the last year, sexing with commercial male clients who use aphrodisiac drugs, and history of illicit drugs use during 2016-2018.Conclusions The relatively higher prevalence of HIV-1 infection and frequent risk behaviours among CMFSWs in border cities in Guangxi, indicating that CMFSWs is the high-risk population for HIV-1 infection and transmission in the region, and is the key population of HIV/AIDS prevention and control. Meanwhile, the change of HIV infection-associated risk factors over time suggests that HIV intervention strategies need to be changed accordingly.

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

PLoS ONE ◽

10.1371/journal.pone.0252728 ◽

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.

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