Physical and Sexual Violence Affecting Female Sex Workers in Abidjan, Cote d'Ivoire: Prevalence, and the Relationship with the Work Environment, HIV, and Access to Health Services
Physical and Sexual Violence Affecting Female Sex Workers in Abidjan, Cote d'Ivoire: Prevalence, and the Relationship with the Work Environment, HIV, and Access to Health Services
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DOI：
10.1097/qai.0000000000001310
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发表时间：
2017-05-01
影响因子：
3.6
通讯作者：
Baral, Stefan
中科院分区：
文献类型：
--
作者：
Lyons, Carrie E.;Grosso, Ashley;Baral, Stefan
背景：暴力是一种侵犯人权的行为，也是了解女性性工作者（FSW）艾滋病的重要手段。然而，关于科特迪瓦女性性工作者之间暴力行为的相关性的数据有限。表征的流行和暴力的决定因素和与艾滋病毒的结构性风险的关系，可以告知发展和实施全面的艾滋病毒预防和治疗programmes.Methods：FSW。在科特迪瓦阿比让通过应答者驱动抽样（RDS）招募了18岁儿童。共有466名参与者完成了社会行为问卷和艾滋病毒检测。使用粗估计和RDS调整后的估计数计算暴力的流行率估计数。结果：本研究中女性性工作者躯体暴力发生率为53.6%（250/466），性暴力发生率为43.2%（201/465）。警察拒绝保护与身体（调整后的比值比[aOR]：2.8; 95%置信区间[CI]：1.7至4.4）和性暴力（aOR：3.0; 95% CI：1.9至4.8）有关。勒索与身体暴力（aOR：2.5; 95% CI：1.5 - 4.2）和性暴力（aOR：2.4; 95% CI：1.5 - 4.0）相关。身体暴力与恐惧（aOR：2.2; 95%CI：1.3至3.1）和避免寻求医疗服务（aOR：2.3; 95%CI：1.5至3.8）。结论：暴力行为在阿比让的FSW中普遍存在，并与工作环境和获得护理的功能相关。这些关系突出了影响FSW的侵权行为的层次，强调需要进行结构性干预和政策改革，以改善工作环境，并解决警察骚扰，污名化和侵犯权利的行为，以减少暴力和改善获得艾滋病毒干预措施的机会。
Background: Violence is a human rights violation, and an important measure in understanding HIV among female sex workers (FSW). However, limited data exist regarding correlates of violence among FSW in Cote d'Ivoire. Characterizing prevalence and determinants of violence and the relationship with structural risks for HIV can inform development and implementation of comprehensive HIV prevention and treatment programs.Methods: FSW. 18 years were recruited through respondent driven sampling (RDS) in Abidjan, Cote d'Ivoire. In total, 466 participants completed a socio-behavioral questionnaire and HIV testing. Prevalence estimates of violence were calculated using crude and RDS-adjusted estimates. Relationships between structural risk factors and violence were analyzed using chi(2) tests and multivariable logistic regression.Results: The prevalence of physical violence was 53.6% (250/466), and sexual violence was 43.2% (201/465) among FSW in this study. Police refusal of protection was associated with physical (adjusted Odds Ratio [aOR]: 2.8; 95% confidence interval [CI]: 1.7 to 4.4) and sexual violence (aOR: 3.0; 95% CI: 1.9 to 4.8). Blackmail was associated with physical (aOR: 2.5; 95% CI: 1.5 to 4.2) and sexual violence (aOR: 2.4; 95% CI: 1.5 to 4.0). Physical violence was associated with fear (aOR: 2.2; 95% CI: 1.3 to 3.1) and avoidance of seeking health services (aOR: 2.3; 95% CI: 1.5 to 3.8).Conclusions: Violence is prevalent among FSW in Abidjan and associated with features of the work environment and access to care. These relationships highlight layers of rights violations affecting FSW, underscoring the need for structural interventions and policy reforms to improve work environments, and to address police harassment, stigma, and rights violations to reduce violence and improve access to HIV interventions.