Intersections of Sex Work, Mental Ill-Health, IPV and Other Violence Experienced by Female Sex Workers: Findings from a Cross-Sectional Community-Centric National Study in South Africa.
Intersections of Sex Work, Mental Ill-Health, IPV and Other Violence Experienced by Female Sex Workers: Findings from a Cross-Sectional Community-Centric National Study in South Africa.
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DOI：
10.3390/ijerph182211971
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发表时间：
2021-11-15
影响因子：
--
通讯作者：
Coetzee J
中科院分区：
文献类型：
--
作者：
Jewkes R;Milovanovic M;Otwombe K;Chirwa E;Hlongwane K;Hill N;Mbowane V;Matuludi M;Hopkins K;Gray G;Coetzee J
女性性工作者（FSW）面临心理健康问题的风险增加，包括情绪障碍和药物滥用，我们需要了解这些问题的根源以治疗和预防它们，特别是了解他们出售性行为的背景如何影响他们的心理健康。我们进行了多阶段，以社区为中心，横断面调查3005 FSW链接到SW计划在12个网站在所有9个省的南非。我们采访了在过去六个月内从事过性交易的成年女性，她们是通过SW网络招募的。我们发现FSW的心理健康状况非常差，52.7%患有抑郁症，53.6%患有创伤后应激障碍（PTSD）。结构方程模型显示了从童年创伤和艾滋病毒阳性状态到精神疾病的直接途径。间接途径由粮食不安全、控制性伴侣、非伴侣强奸、有害酒精使用、科普性工作的物质使用、性工作环境指标（即，贩卖地点（街头、酒馆和妓院）、贩卖频率和遭受性工作者污名。童年创伤的所有路径都有最终的共同路径，从遭受性别暴力（非伴侣强奸或亲密伴侣暴力）到精神疾病，但粮食不安全介导的路径除外。因此，FSW的不良心理健康风险往往是由他们的工作地点和易受暴力，药物滥用和耻辱介导的。法律的改革对减少暴力和精神疾病风险的潜在贡献是不可避免的。治疗精神疾病和药物滥用应是家庭社会福利方案的一个基本要素。
Female sex workers (FSWs) are at increased risk of mental health problems, including mood disorders and substance abuse, and we need to understand the origins of these to treat and prevent them, and particularly understand how the context in which they sell sex impacts their mental health. We conducted a multi-stage, community-centric, cross-sectional survey of 3005 FSWs linked to SW programmes in twelve sites across all nine provinces of South Africa. We interviewed adult women who had sold sex in the preceding six months, who were recruited via SW networks. We found that FSWs have very poor mental health as 52.7% had depression and 53.6% has post-traumatic stress disorder (PTSD). The structural equation model showed direct pathways from childhood trauma and having HIV+ status to mental ill-health. Indirect pathways were mediated by food insecurity, controlling partners, non-partner rape, harmful alcohol use, substance use to cope with SW, indicators of the circumstances of SW, i.e., selling location (on streets, in taverns and brothels), frequency of selling and experiencing SW stigma. All paths from childhood trauma had final common pathways from exposure to gender-based violence (non-partner rape or intimate partner violence) to mental ill-health, except for one that was mediated by food insecurity. Thus, FSWs’ poor mental health risk was often mediated by their work location and vulnerability to violence, substance abuse and stigma. The potential contribution of legal reform to mitigate the risks of violence and mental ill-health are inescapable. Treatment of mental ill-health and substance abuse should be an essential element of FSW programmes.
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影响因子：
4.5
作者：
Beattie TS;Bhattacharjee P;Ramesh BM;Gurnani V;Anthony J;Isac S;Mohan HL;Ramakrishnan A;Wheeler T;Bradley J;Blanchard JF;Moses S
通讯作者：
Moses S
影响因子：
3.7
作者：
Jewkes R;Morrell R;Sikweyiya Y;Dunkle K;Penn-Kekana L
通讯作者：
Penn-Kekana L
影响因子：
2.5
作者：
Patel, Sangram Kishor;Saggurti, Niranjan;Prabhakar, Parimi
通讯作者：
Prabhakar, Parimi
影响因子：
3.7
作者：
Gibbs, Andrew;Jewkes, Rachel;Washington, Laura
通讯作者：
Washington, Laura
影响因子：
4.2
作者：
Doroszkiewicz, Corinne;Gold, David;Tator, Charles H.
通讯作者：
Tator, Charles H.