Migration and Mobility: Correlates of Recent HIV Testing Among Substance Using Female Sex Workers at the Mexico–Guatemala Border

The goal of this paper is to determine the association between traveling to engage in sex work in another country and recent access to HIV testing among substance-using female sex workers (FSWs) in the Mexico–Guatemala border region. From 2012 to 2015, through modified time-location sampling and peer referral, 255 FSWs were recruited at Mexico’s southern border. Participants completed questionnaires on sociodemographics, migration and mobility experiences, work environment factors, and substance use. A conceptual framework, as depicted by a directed acyclic graph (DAG), guided our analysis. Crude and adjusted logistic regression models were used to evaluate the relationships between mobility experiences and HIV testing in the past year. Overall HIV testing was low (41%); after considering relevant covariates (i.e., interaction with health services and organizations, and sex work characteristics) traveling to engage in sex work in another country was found to be positively associated with HIV testing in the past year. Future efforts need to consider voluntary and non-stigmatizing prevention HIV services and focus on reaching out to less mobile women.

Motivations and livelihood dynamics in the urban informal economy: the case of Dire Dawa City, Eastern Ethiopia

This article assesses the motivations for participation in the informal economy in general and street vending in particular and explores vendors’ livelihood dynamics in Dire Dawa city, Eastern Ethiopia. Data were collected from fixed and itinerant vendors who were found vending a variety of goods and services in the city during data collection. A descriptive survey design was employed in this study. Time location sampling procedure – a new method of two-stage sampling that has been widely used to select the hard-to-reach segment of society – was employed to select 198 street vendors. Data were collected using a questionnaire survey, in-depth interviews and observation during 2016/17. The study revealed that the majority of vendors report that they engaged in street vending for survival. But some consider it is an opportunity for income, employment and growth, and livelihood improvement in the city. The majority of vendors indicated that there have been improvements in their lives since they started vending. Thus, this study points to the need to employ multiple perspectives to capture the reality underneath livelihoods in the informal economy. Policy approaches that recognise the vitality of public spaces for street vending activities, the integrality of vendors to the socio-economic fabric of the city, and their modest contributions to the socio-economic development of the city are necessary.

Join the Commune: A Controlled Study of Social Branding Influencers to Decrease Smoking Among Young Adult Hipsters

Purpose: To evaluate the impact of a Social Branding intervention in bars and nightclubs on smoking behavior. Design: Quasi-experimental controlled study. Setting: Bars and nightclubs in San Diego and San Francisco (intervention) and Los Angeles (control). Participants: “Hipster” young adults (age 18-26) attending bars and nightclubs. Intervention: Anti-tobacco messages delivered through monthly anti-tobacco music/social events, opinion leaders, original art, direct mail, promotional activities, and online media. Measures: A total of 7240 surveys were collected in 3 cities using randomized time location sampling at baseline (2012-2013) and follow-up (2015-2016); data were analyzed in 2018. The primary outcome was current smoking. Analysis: Multivariable logistic regression assessed correlates of smoking, adjusting for covariates including electronic cigarette use; differences between cities were evaluated using location-by-time interactions. Results: Smoking in San Francisco decreased at a significantly faster rate (51.1%-44.1%) than Los Angeles (45.2%-44.5%) ( P = .034). Smoking in San Diego (mean: 39.6%) was significantly lower than Los Angeles (44.8%, P < .001) at both time points with no difference in rate of change. Brand recall was not associated with smoking behavior, but recall was associated with anti-tobacco attitudes that were associated with smoking. Conclusion: This is the first controlled study of Social Branding interventions. Intervention implementation was accompanied by decreases in smoking (San Francisco) and sustained lower smoking (San Diego) among young adult bar patrons over 3 years.

Sexual Exploitation as a Minor, Violence, and HIV/STI Risk among Women Trading Sex in St. Petersburg and Orenburg, Russia

Child sexual exploitation (CSE) is a major risk factor for acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STI), violence and other health concerns, yet few studies have examined these associations in Russia until now. This study examines the prevalence of CSE (those entering the sex trade as a minor) among women in the sex trade in Russia and how exposures and behaviors related to violence and HIV/STI structural risks differ from those who entered the sex trade as an adult. Women in the sex trade (N = 896) in St. Petersburg and Orenburg, Russia were recruited via time-location sampling and completed structured surveys. Adjusted logistic regression analyses assessed associations between CSE victimization and HIV risk-related exposures. Of the 654 participants who provided their age at first sexual exploitation, 11% reported CSE prior to age 18. Those who reported CSE were more likely to be organized by others and to be prohibited from leaving a room or house and from using condoms; three-quarters experienced rape when trading sex; a third were involved in pornography before age 18 and they had less education if they entered the sex trade as a minor. In adjusted analyses, those entering the sex trade as a minor were significantly more likely than those entering the sex trade as an adult to report drug use prior to age 18 (AOR = 5.75, 95% CI = 2.53–13.09) to have ≥5 clients/day (past 12 months; AOR = 3.55, 95% CI = 1.56–8.08), to report receiving police assistance (AOR: 3.10, 95% CI = 1.26–7.54), and to have fewer experiences of police extortion (AOR = 0.35, 95% CI = 0.10–1.24). They were four times more likely to participate in pornography before the age of 18 (AOR = 4.08, 95% CI = 1.32, 12.60) and three times more likely to have been sexually abused as child (AOR = 2.93, 95% CI = 1.27, 7.54). Overall, entry as a minor was related to greater risk for victimization and an inability to protect oneself from STI/HIV.

Prevalence and correlates of cervical abnormalities among female sex workers in Tijuana, Mexico

In Tijuana, Mexico, sex work is regulated by the municipal health department and includes regular testing for HIV and other sexually transmitted infections (STIs) for registered female sex workers (FSWs). However, Papanicolaou (Pap) testing is missing from current sexual health assessments. We aimed to answer the following research questions: (1) What is the prevalence of cervical abnormalities among a sample of FSWs in Tijuana, Mexico? (2) What are the correlates of cervical abnormalities among a sample of FSWs in Tijuana, Mexico? From 2013 to 2014, a cohort of 300 FSWs in Tijuana, Mexico were recruited using modified time–location sampling. Participants were given Pap, HIV, and STI tests. The prevalence of an abnormal Pap was 11.7% (35/300). FSWs ever registered with municipal health services were less likely to have an abnormal Pap result (4.8% versus 14.4%, p = 0.03), were more likely to report a previous Pap test (88.1% versus 70.4%, p = .001), and were more likely to report a sexual health checkup in the last year (60.7% versus 37.0%, p < 0.001) than those who had never been registered. FSWs, including those who registered with the municipality, remain at risk for cervical abnormalities.