Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 3/2020

01-03-2020 | Intoxication | Original Paper

Inconsistent Condom Use Among Female Sex Workers: Partner-specific Influences of Substance Use, Violence, and Condom Coercion

Authors: Michele R. Decker, Ju Nyeong Park, Sean T. Allen, Bradley Silberzahn, Katherine Footer, Steven Huettner, Noya Galai, Susan G. Sherman

Published in: AIDS and Behavior | Issue 3/2020

Login to get access

Abstract

Female sex workers (FSWs) are disproportionately affected by HIV. Inconsistent condom use (ICU) represents the most proximal risk for acquisition and transmission. We evaluate associations of partner-specific factors including physical and sexual violence, coercion, and substance use with ICU with clients and regular non-paying partners, respectively, among FSWs. Baseline survey data from a prospective cohort of 250 street-based FSW in Baltimore, Maryland, USA included partner-level drug and alcohol use, violence, condom coercion and ICU, in addition to individual and structural exposures. Logistic regression analyses were stratified by partner type, followed by path analysis where indicated. Within client and regular non-paying partnerships, FSWs reported prevalent recent violence (34.8%, 16%, respectively), condom coercion (42.4%, 9.9%, respectively) and ICU (39.2%, 44.4%, respectively). Recent physical or sexual violence enabled coercive condom negotiation (AORclient 8.22, 95% CI 4.30, 15.73; AORnonpayingpartner 3.01 95% CI 1.05, 8.63). ICU with clients was associated with client condom coercion (AOR 1.76, 95% CI 1.03, 3.02), and client intoxication during sex (AOR 2.25, 95% CI 1.13, 4.45). In path analysis of client-FSW partnerships, condom coercion fully mediated the influences of both sex worker intoxication and recent violence on ICU. ICU with non-paying partners was associated with FSW intoxication during sex (AOR 8.66, 95% CI 3.73, 20.10), and past-year police violence (AOR 2.92, 1.30, 6.57). Partner-level substance use and gendered power differentials influenced FSWs’ ICU patterns differently by partner type. ICU with clients was rooted solely in partner factors, and coercive condom negotiation mediated the roles of violence and partner-level substance use on ICU. By contrast, ICU with non-paying partners was rooted in partner-level substance use and police violence as a structural determinant. Addressing HIV risk behavior for FSWs requires condom promotion efforts tailored to partner type that addresses power differentials.
Literature
1.
Centers for Disease Control and Prevention. Lifetime risk of HIV diagnosis in the United States. Atlanta: Centers for Disease Control and Prevention; 2016.
2.
Baral S, Beyrer C, Muessig K, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(7):538–49.PubMed
3.
Decker MR, Beyrer C, Sherman SG. Ending the invisibility of sex workers in the US HIV/AIDS surveillance and prevention strategy. AIDS. 2014;28(15):2325–7.PubMed
4.
Miles IJ, Le BC, Wejnert C, Oster A, DiNenno E, Paz-Baily G. HIV infection among heterosexuals at increased risk - United States 2010. Morb Mortal Wkly Rep. 2013;62(10):183–8.
5.
Paz-Bailey G, Noble M, Salo K, Tregear SJ. Prevalence of HIV among U.S. female sex workers: systematic review and meta-analysis. AIDS Behav. 2016;20(10):2318–31.PubMedPubMedCentral
6.
Shannon K, Goldenberg SM, Deering KN, Strathdee SA. HIV infection among female sex workers in concentrated and high prevalence epidemics: why a structural determinants framework is needed. Curr Opin HIV AIDS. 2014;9(2):174–82.PubMedPubMedCentral
7.
Decker MR, Lyons C, Billong SC, et al. Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice. Sex Transm Infect. 2016;92(8):599–604.PubMed
8.
Decker MR, Pearson E, Illangasekare SL, Clark E, Sherman SG. Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator. BMC Public Health. 2013;13:876.PubMedPubMedCentral
9.
Decker MR, Crago AL, Chu SK, et al. Human rights violations against sex workers: burden and effect on HIV. Lancet. 2015;385(9963):186–99.PubMed
10.
Sherman SG, Footer K, Illangasekare S, Clark E, Pearson E, Decker MR. “What makes you think you have special privileges because you are a police officer?” A qualitative exploration of police’s role in the risk environment of female sex workers. AIDS care. 2015;27(4):473–80.PubMed
11.
Rhodes T, Wagner K, Strathdee S, Shannon K, Davidson P, Bourgois P. Structural violence and structural vulnerability within the risk environment: theoretical and methodological perspectives for a social epidemiology of HIV risk among injection drug users and sex workers. In: O’Campo P, Dunn JR, editors. Rethinking social epidemiology. Dordrecht: Springer; 2012.
12.
Dunkle KL, Wingood GM, Camp CM, DiClemente RJ. Economically motivated relationships and transactional sex among unmarried African American and white women: results from a U.S. national telephone survey. Public Health Rep. 2010;125(Suppl 4):90–100.PubMedPubMedCentral
13.
Decker MR, Miller E, McCauley HL, et al. Sex trade among young women attending family-planning clinics in Northern California. Int J Gynaecol Obstet. 2012;117(2):173–7.PubMedPubMedCentral
14.
Nemoto T, Iwamoto M, Colby D, et al. HIV-related risk behaviors among female sex workers in Ho Chi Minh City, Vietnam. AIDS Educ Prev. 2008;20(5):435–53.PubMed
15.
Sherman SG, Reuben J, Chapman CS, Lilleston P. Risks associated with crack cocaine smoking among exotic dancers in Baltimore,MD. Drug Alcohol Depend. 2011;114(2–3):249–52.PubMed
16.
Beattie TS, Bhattacharjee P, Ramesh BM, et al. Violence against female sex workers in Karnataka state, south India: impact on health, and reductions in violence following an intervention program. BMC Public Health. 2010;10:476.PubMedPubMedCentral
17.
Wirtz AL, Schwartz S, Ketende S, et al. Sexual violence, condom negotiation, and condom use in the context of sex work: results from two West African countries. J Acquir Immune Defic Syndr. 2015;68(Suppl 2):S171–9.PubMed
18.
Lang DL, Salazar LF, DiClemente RJ, Markosyan K. Gender based violence as a risk factor for HIV-associated risk behaviors among female sex workers in Armenia. AIDS Behav. 2013;17(2):551–8.PubMed
19.
George PE, Bayer AM, Garcia PJ, et al. Is intimate partner and client violence associated with condomless anal intercourse and HIV among male sex workers in Lima, Peru? AIDS Behav. 2016;20(9):2078–89.PubMedPubMedCentral
20.
Clements-Nolle K, Guzman R, Harris SG. Sex trade in a male-to-female transgender population: psychosocial correlates of inconsistent condom use. Sexual Health. 2008;5(1):49–54.PubMed
21.
Rhodes T, Simić M, Baroš S, Platt L, Žikić B. Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study. BMJ. 2008;337:a811.PubMedPubMedCentral
22.
Tounkara FK, Diabate S, Guedou FA, et al. Violence, condom breakage, and HIV infection among female sex workers in Benin,West Africa. Sex Transm Dis. 2014;41(5):312–8.PubMedPubMedCentral
23.
Choi SY, Chen KL, Jiang ZQ. Client-perpetuated violence and condom failure among female sex workers in southwestern China. Sex Transm Dis. 2008;35(2):141–6.PubMed
24.
Decker MR, McCauley HL, Phuengsamran D, Janyam S, Seage GR 3rd, Silverman JG. Violence victimisation, sexual risk and sexually transmitted infection symptoms among female sex workers in Thailand. Sex Transm Infect. 2010;86(3):236–40.PubMed
25.
Bryant J, Brener L, Hull P, Treloar C. Needle sharing in regular sexual relationships: an examination of serodiscordance, drug using practices, and the gendered character of injecting. Drug Alcohol Depend. 2010;107(2–3):182–7.PubMed
26.
El-Bassel N, Terlikbaeva A, Pinkham S. HIV and women who use drugs: double neglect, double risk. Lancet. 2010;376(9738):312–4.PubMed
27.
Wingood GM, DiClemente RJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Educ Behav. 2000;27(5):539–65.PubMed
28.
Pulerwitz J, Amaro H, De Jong W, Gortmaker SL, Rudd R. Relationship power, condom use and HIV risk among women in the USA. AIDS Care. 2002;14(6):789–800.PubMed
29.
Lang DL, Salazar LF, Wingood GM, DiClemente RJ, Mikhail I. Associations between recent gender-based violence and pregnancy, sexually transmitted infections, condom use practices, and negotiation of sexual practices among HIV-positive women. J Acquir Immune Defic Syndr. 2007;46(2):216–21.PubMed
30.
Hahm HC, Lee J, Rough K, Strathdee SA. Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women. AIDS Behav. 2012;16(1):179–88.PubMedPubMedCentral
31.
Rushing R, Watts C, Rushing S. Living the reality of forced sex work: perspectives from young migrant women sex workers in northern Vietnam. J Midwifery Women’s Health. 2005;50(4):e41–4.
32.
Ghimire L, Smith WC, van Teijlingen ER, Dahal R, Luitel NP. Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal. BMC Womens Health. 2011;11:42.PubMedPubMedCentral
33.
Kabbash IA, Abdul-Rahman I, Shehata YA, Omar AA. HIV infection and related risk behaviours among female sex workers in greater Cairo,Egypt. East Mediterr Health J. 2012;18(9):920–7.PubMed
34.
Shannon K, Kerr T, Strathdee SA, Shoveller J, Montaner JS, Tyndall MW. Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers. BMJ. 2009;339:b2939.PubMedPubMedCentral
35.
Nemoto T, Iwamoto M, Colby D, et al. HIV-related risk behaviors among female sex workers in Ho Chi Minh City, Vietnam. AIDS Educ Prev. 2008;20(5):435.PubMed
36.
Argento E, Shannon K, Nguyen P, Dobrer S, Chettiar J, Deering KN. The role of dyad-level factors in shaping sexual and drug-related HIV/STI risks among sex workers with intimate partners. Drug Alcohol Depend. 2015;157:166–73.PubMedPubMedCentral
37.
Deering KN, Shaw SY, Thompson LH, et al. Fertility intentions, power relations and condom use within intimate and other non-paying partnerships of women in sex work in Bagalkot District, South India. AIDS Care. 2015;27(10):1241–9.PubMed
38.
Travasso SM, Mahapatra B, Saggurti N, Krishnan S. Non-paying partnerships and its association with HIV risk behavior, program exposure and service utilization among female sex workers in India. BMC Public Health. 2014;14:248.PubMedPubMedCentral
39.
Wong ML, Lubek I, Dy BC, Pen S, Kros S, Chhit M. Social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia. Sex Transm Infect. 2003;79(2):163–5.PubMedPubMedCentral
40.
Beksinska A, Prakash R, Isac S, et al. Violence experience by perpetrator and associations with HIV/STI risk and infection: a cross-sectional study among female sex workers in Karnataka, south India. BMJ Open. 2018;8(9):e021389.PubMedPubMedCentral
41.
Ulibarri MD, Strathdee SA, Lozada R, et al. Condom use among female sex workers and their non-commercial partners: effects of a sexual risk intervention in two Mexican cities. Int J STD AIDS. 2012;23(4):229–34.PubMedPubMedCentral
42.
Pando MA, Coloccini RS, Reynaga E, et al. Violence as a barrier for HIV prevention among female sex workers in Argentina. PLoS ONE. 2013;8(1):e54147.PubMedPubMedCentral
43.
Draughon Moret JE, Carrico AW, Evans JL, et al. The impact of violence on sex risk and drug use behaviors among women engaged in sex work in Phnom Penh, Cambodia. Drug Alcohol Depend. 2016;161:171–7.PubMed
44.
Centers for Disease Control and Prevention. HIV Surveillance Report, 2015. Atlanta: CDC; 2016.
45.
Sherman SG, Park JN, Galai N, et al. Drivers of HIV infection among cisgender and transgender female sex worker populations in Baltimore city: Results from the SAPPHIRE study. J Acquir Immune Defic Syndr. 2019;80(5):513–21.PubMed
46.
Allen ST, Footer KH, Gala IN, Park JN, Silberzahn B, Sherman SG. Implementing targeted sampling: lessons learned from recruiting female sex workers in Baltimore, MD. J Urban Health. 2018;96(3):442–51.PubMedCentral
47.
Strauss MAHS, Boney-Mccoy S, Sugarman DB. The Revised Conflict Tactics Scales (CTS2): development and preliminary psychometric data. J Fam Issues. 1996;17:283–316.
48.
Decker MR, Wirtz AL, Moguilnyi V, et al. Female sex workers in three cities in Russia: HIV prevalence, risk factors and experience with targeted HIV prevention. AIDS Behav. 2014;18(3):562–72.PubMed
49.
Fonner VA, Kennedy CE, O’Reilly KR, Sweat MD. Systematic assessment of condom use measurement in evaluation of HIV prevention interventions: need for standardization of measures. AIDS Behav. 2014;18(12):2374–86.PubMedPubMedCentral
50.
Steiger JH. Structural model evaluation and modification: an interval estimation approach. Multivar Behav Res. 1990;25:173–80.
51.
Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107(2):238.PubMed
52.
Tucker LR, Lewis C. A reliability coefficient for maximum likelihood factor analysis. Psychometrika. 1973;38(1):1.
53.
Patterson TL, Goldenberg S, Gallardo M, et al. Correlates of HIV, sexually transmitted infections, and associated high-risk behaviors among male clients of female sex workers in Tijuana, Mexico. AIDS. 2009;23(13):1765–71.PubMed
54.
Semple SJ, Strathdee SA, Gallardo Cruz M, Robertson A, Goldenberg S, Patterson TL. Psychosexual and social-cognitive correlates of sexual risk behavior among male clients of female sex workers in Tijuana, Mexico. AIDS Care. 2010;22(12):1473–80.PubMedPubMedCentral
55.
Broz D, Wejnert C, Pham HT, et al. HIV infection and risk, prevention, and testing behaviors among injecting drug users—National HIV Behavioral Surveillance System, 20 U.S. cities, 2009. Morb Mortal Wkly Rep Surveill Summ. 2014;63(6):1–51.
56.
El-Bassel N, Gilbert L, Witte S, Wu E, Chang M. Intimate partner violence and HIV among drug-involved women: contexts linking these two epidemics–challenges and implications for prevention and treatment. Subst Use Misuse. 2011;46(2–3):295–306.PubMed
57.
El-Bassel N, Gilbert L, Rajah V, Foleno A, Frye V. Fear and violence: raising the HIV stakes. AIDS Educ Prev. 2000;12(2):154–70.PubMed
58.
Gilbert L, El-Bassel N, Rajah V, Foleno A, Frye V. Linking drug-related activities with experiences of partner violence: a focus group study of women in methadone treatment. Violence Vict. 2001;16(5):517–36.PubMed
59.
Plotzker RE, Metzger DS, Holmes WC. Childhood sexual and physical abuse histories, PTSD, depression, and HIV risk outcomes in women injection drug users: a potential mediating pathway. Am J Addict. 2007;16(6):431–8.PubMed
60.
El-Bassel N, Caldeira NA, Ruglass LM, Gilbert L. Addressing the unique needs of African American women in HIV prevention. Am J Public Health. 2009;99(6):996–1001.PubMedPubMedCentral
61.
Fuller CM, Vlahov D, Ompad DC, Shah N, Arria A, Strathdee SA. High-risk behaviors associated with transition from illicit non-injection to injection drug use among adolescent and young adult drug users: a case-control study. Drug Alcohol Depend. 2002;66(2):189–98.PubMed
62.
Decker MR, Benning L, Weber KM, et al. Physial and sexual violence predictors: 20 years of the Women’s Interagency HIV Study Cohort. Am J Prev Med. 2016;51(5):731–42.PubMedPubMedCentral
63.
64.
Decker MR, Wirtz AL, Baral SD, et al. Injection drug use, sexual risk, violence and STI/HIV among Moscow female sex workers. Sex Transm Infect. 2012;88(4):278–83.PubMed
65.
Wirtz AL, Peryshkina A, Mogilniy V, Beyrer C, Decker MR. Current and recent drug use intensifies sexual and structural HIV risk outcomes among female sex workers in the Russian Federation. Int J Drug Policy. 2015;26(8):755–63.PubMedPubMedCentral
66.
Footer KHA, Park JN, Allen ST, et al. Police-related correlates of client-perpetrated violence among female sex workers in Baltimore City, Maryland. Am J Public Health. 2019;109(2):289–95.PubMedPubMedCentral
67.
WHO. 16 ideas for addressing violence against women in the context of HIV epidemic: A programming tool. Geneva: World Health Organization; 2013.
68.
Khan A. Gender-based Violence and HIV: A Program Guide for Integrating Gender-based Violence Prevention and Response in PEPFAR Programs. Arlington, VA: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAR-One, Task Order 1;2011.
69.
Middleton LS. Technical Paper: Review of Training and Programming Resources on Gender-Based Violence against Key Populations. Arlington, VA: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAR-Two, Task Order 2 and the International HIV/AIDS Alliance; 2013.
70.
L’Engle KL, Mwarogo P, Kingola N, Sinkele W, Weiner DH. A randomized controlled trial of a brief intervention to reduce alcohol use among female sex workers in Mombasa, Kenya. J Acquir Immune Defic Syndr. 2014;67(4):446–53.PubMed
71.
Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States–2014: A Clinical Practice Guideline. Atlanta: CDC; 2014.
72.
Tomko C, Park JN, Allen ST, et al. Awareness and interest in HIV pre-exposure prophylaxis among street-based female sex workers: results from a US context. AIDS Patient Care STDs. 2019;33(2):49–57.PubMedPubMedCentral
73.
Peitzmeier SM, Tomko C, Wingo E, et al. Acceptability of microbicidal vaginal rings and oral pre-exposure prophylaxis for HIV prevention among female sex workers in a high-prevalence US city. AIDS Care. 2017;29(11):1453–7.PubMedPubMedCentral
Metadata
Title
Inconsistent Condom Use Among Female Sex Workers: Partner-specific Influences of Substance Use, Violence, and Condom Coercion
Authors
Michele R. Decker
Ju Nyeong Park
Sean T. Allen
Bradley Silberzahn
Katherine Footer
Steven Huettner
Noya Galai
Susan G. Sherman
Publication date
01-03-2020
Publisher
Springer US
Published in
AIDS and Behavior / Issue 3/2020
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02569-7

Other articles of this Issue 3/2020

AIDS and Behavior 3/2020 Go to the issue

Original Paper

High Rates of Unprotected Receptive Anal Intercourse and Their Correlates Among Young and Older MSM in Brazil

Original Paper

Changes in Characteristics and Behavior Among African American Men Who Have Sex with Men and Women in the Context of Reductions in HIV Diagnoses Among Women

Original Paper

Traditional Male Circumcision is Associated with Sexual Risk Behaviors in Sub-Saharan Countries Prioritized for Male Circumcision

Original Paper

Association of Adolescent- and Parent-Reported Relationship Functioning with HIV Sexual Risk Among Adolescents in Botswana

Original Paper

Associations Between Violence and HIV Risk Behaviors Differ by Perpetrator Among Russian Sex Workers

Original Paper

Do Sexual Partners Talk to Each Other About HIV? Exploring Factors Associated with HIV-Related Partner Communication Among Men and Women in Tanzania

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits