scholarly journals An evaluation of a community-based combination HIV prevention intervention for female sex workers (FSW) in Baltimore, Maryland: EMERALD study design (Preprint)

2020 ◽  
Author(s):  
Bradley Silberzahn ◽  
Catherine A. Tomko ◽  
Emily Clouse ◽  
Katherine Haney ◽  
Sean T. Allen ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Harm Reduction ◽  
Randomized Trial ◽  
Sex Workers ◽  
Female Sex Workers ◽  
The United States ◽  
Community Empowerment ◽  
Outreach Program ◽  
Female Sex

BACKGROUND Cisgender female sex workers (FSW) experience high rates of HIV and sexually transmitted infections (STIs) including chlamydia and gonorrhea. Community empowerment-based responses to the risk environment of female sex workers have been associated with significant reductions in HIV/STI risk and associated risk behaviors, yet evaluations of U.S. based interventions targeting FSW are limited. OBJECTIVE We describe the design, implementation, and evaluation of an ongoing comprehensive community-level intervention targeting FSW in Baltimore City, Maryland. METHODS The two intervention components are the SPARC drop-in center and the accompanying comprehensive mobile outreach program (in the west Baltimore area). The mission of SPARC is to provide low-barrier harm reduction services to at-risk non-men, with a special focus on women who sell sex and use drugs. SPARC addresses clients’ needs through nonjudgmental, convenient, safe, and non-stigmatizing interactions. Services are provided through a harm reduction framework and include: reproductive health and sexual health screenings; medication assisted treatment; legal aid, counseling; showers, lockers, laundry; and the distribution of harm reduction tools including naloxone and sterile drug use supplies (e.g., cookers, cotton, syringes, pipes). The SPARC intervention is being evaluated through the EMERALD study, which consists of: a prospective two-group comparative non-randomized trial (n=385); a cross sectional survey (n=100); and in-depth interviews assessing SPARC implementation (n=45). Participants enrolled in the non-randomized trial complete a survey and HIV/STI testing at four intervals (baseline, 6-, 12-, 18-months). Participants recruited from pre-defined areas closest to SPARC comprised the intervention group, and participants from all other areas of Baltimore were in the control. RESULTS We hypothesize that addressing structural drivers and more immediate medical needs, in combination with peer outreach, will lead to community empowerment and reduce FSWs’ HIV/STI cumulative incidence and behavioral risks. CONCLUSIONS In the United States, structural interventions aimed to reduce HIV and STIs among FSW are scarce, and to our knowledge this is the first intervention of its kind in the United States. The results of the EMERALD study can be used to inform the development of future interventions targeting FSW and other at-risk populations. CLINICALTRIAL NCT04413591

scholarly journals Erratum to: A Systematic Review of HIV and STI Behavior Change Interventions for Female Sex Workers in the United States

2015 ◽  
Vol 19 (12) ◽  
pp. 2380-2380
Author(s):  
Neetu Abad ◽  
Brittney N. Baack ◽  
Ann O’Leary ◽  
Yuko Mizuno ◽  
Jeffrey H. Herbst ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Behavior Change ◽  
Sex Workers ◽  
Female Sex Workers ◽  
The United States ◽  
Female Sex ◽  
Behavior Change Interventions

A Systematic Review of HIV and STI Behavior Change Interventions for Female Sex Workers in the United States

2015 ◽  
Vol 19 (9) ◽  
pp. 1701-1719 ◽  
Author(s):  
Neetu Abad ◽  
Brittney N. Baack ◽  
Ann O’Leary ◽  
Yuko Mizuno ◽  
Jeffrey H. Herbst ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Behavior Change ◽  
Sex Workers ◽  
Female Sex Workers ◽  
The United States ◽  
Female Sex ◽  
Behavior Change Interventions

Older Male Clients of Female Sex Workers in the United States

2016 ◽  
Vol 46 (6) ◽  
pp. 1867-1876 ◽  
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

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 Vaping Restrictions: Is Priority to the Young Justified?

2020 ◽  
Author(s):  
Monica Magalhaes
Keyword(s):  
Public Health ◽  
United States ◽  
At Risk ◽  
Young People ◽  
Harm Reduction ◽  
Ethical Dilemma ◽  
The United States ◽  
Youth Smoking ◽  
Health Authorities ◽  
Public Health Authorities

Abstract The vast majority of smokers become dependent on nicotine in youth. Preventing dependence has therefore been crucial to the recent decline in youth smoking. The advent of vaping creates an opportunity for harm reduction to existing smokers (mostly adults) but simultaneously also undermines prevention efforts by becoming a new vehicle for young people to become dependent on nicotine, creating an ethical dilemma. Restrictions to access to some vaping products enacted in response to the increase in vaping among youth observed in the United States since 2018 have arguably prioritized prevention of new cases of dependence—protecting the young—over harm reduction to already dependent adults. Can this prioritization of the young be justified? This article surveys the main bioethical arguments for prioritizing giving health benefits to the young and finds that none can justify prioritizing dependence prevention over harm reduction: any reasons for prioritizing the current cohort of young people at risk from vaping will equally apply to current adult smokers, who are overwhelmingly likely to have become nicotine-dependent in their own youth. Public health authorities’ current tendency to prioritize the young, therefore, does not seem to be ethically justified. Implications This article argues that commonsense reasons for prioritizing the young do not apply to the ethical dilemma surrounding restricting access to vaping products.

scholarly journals Estimating the size of key populations for HIV in Singapore using the network scale-up method

2019 ◽  
Vol 95 (8) ◽  
pp. 602-607
Author(s):  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Mark I C Chen ◽  
Adrian Roellin ◽  
Mee Lian Wong ◽  
...  
Keyword(s):  
At Risk ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Scale Up ◽  
Transmission Error ◽  
Barrier Effects ◽  
Female Sex ◽  
Male Clients ◽  
Populations At Risk ◽  
Network Scale

ObjectivesTo develop a localised instrument and Bayesian statistical method to generate size estimates—adjusted for transmission error and barrier effects—of at-risk populations in Singapore.MethodsWe conducted indepth interviews and focus group to guide the development of the survey questionnaire. The questionnaire was administered between July and August 2017 in Singapore. Using the network scale-up method (NSUM), we developed a Bayesian hierarchical model to estimate the number of individuals in four hidden populations at risk of HIV. The method accounted for both transmission error and barrier effects using social acceptance measures and demographics.ResultsThe adjusted size estimate of the population of male clients of female sex workers was 72 000 (95% CI 51 000 to 100 000), of female sex workers 4200 (95% CI 1600 to 10 000), of men who have sex with men 210 000 (95% CI 140 000 to 300 000) and of intravenous drug users 11 000 (95% CI 6500 to 17 000).ConclusionsThe NSUM with adjustment for attitudes and demographics allows national-level estimates of multiple priority populations to be determined from simple surveys of the general population, even in relatively conservative societies.

scholarly journals P5.13 Willingness to use pre-exposure prophylaxis among female sex workers in the mexico-united states border region

2017 ◽  
Author(s):  
Heather Pines ◽  
Strathdee AS ◽  
Hendrix CW ◽  
Bristow CC ◽  
A Harvey-Vera ◽  
...  
Keyword(s):  
United States ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Border Region ◽  
Female Sex ◽  
Willingness To Use ◽  
Exposure Prophylaxis

scholarly journals Evaluating Recruitment among Female Sex Workers and Injecting Drug Users at Risk for HIV Using Respondent-driven Sampling in Estonia

2010 ◽  
Vol 87 (2) ◽  
pp. 304-317 ◽  
Author(s):  
Anneli Uusküla ◽  
Lisa G. Johnston ◽  
Mait Raag ◽  
Aire Trummal ◽  
Ave Talu ◽  
...  
Keyword(s):  
At Risk ◽  
Sex Workers ◽  
Drug Users ◽  
Female Sex Workers ◽  
Injecting Drug Users ◽  
Respondent Driven Sampling ◽  
Female Sex
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