Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR.
Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR.
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DOI：
10.1186/s12905-020-01088-1
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发表时间：
2020-10-02
期刊：
影响因子：
--
通讯作者：
Orellana ER
中科院分区：
文献类型：
--
作者：
Menza TW;Lipira L;Bhattarai A;Leon VC;Orellana ER
报告性交易的女性感染艾滋病毒和其他性传播感染（STI）的风险增加。然而，在美国，与性交易相关的社会、行为和创伤相关脆弱性尚未得到充分研究，并且报告性交易的女性获得艾滋病毒生物医学预防的数据也很有限。 2016 年，我们对俄勒冈州波特兰市通过受访者驱动抽样招募的社会经济地位较低的女性进行了一项基于人口的横断面调查。我们使用广义线性模型计算抽样设计，计算了发生率，并评估了交易性行为的相关性。我们还比较了报告和未报告性交易的女性的健康结果、艾滋病毒筛查以及艾滋病毒暴露前预防 (PrEP) 的知识和采用情况。在 334 名女性中，13.6% 的人报告过性交易（95% 置信区间 [CI]：6.8，20.5%）。报告性交易的女性年龄较大，更有可能被认为是黑人，女同性恋或双性恋，经历过童年创伤和最近的性暴力，并且无家可归。没有不良童年经历 (ACE) 的女性中有 6% (95% CI: 1.8, 10.5%) 报告过性交易，而报告有 11 次 ACE 的女性中有 23.8% (95% CI: 13.0, 34.6%) (P < 0.001)。交易性行为与甲基苯丙胺和阿片类药物的联合使用以及无套性行为密切相关。报告有性交易的女性更有可能被诊断出患有细菌性传播感染和丙型肝炎；然而，艾滋病毒筛查和暴露前预防知识和使用率较低。在俄勒冈州波特兰市社会经济地位较低的妇女样本中，性交易的特点是边缘化身份、无家可归、童年创伤、性暴力、药物滥用和易感染艾滋病毒/性传播感染的性行为。解决这些社会、行为和创伤相关因素并增加艾滋病毒生物医学预防的多层次干预措施对于从事性交易的妇女的性健康至关重要。
Women who report transactional sex are at increased risk for HIV and other sexually transmitted infections (STIs). However, in the United States, social, behavioral, and trauma-related vulnerabilities associated with transactional sex are understudied and data on access to biomedical HIV prevention among women who report transactional sex are limited. In 2016, we conducted a population-based, cross-sectional survey of women of low socioeconomic status recruited via respondent-driven sampling in Portland, Oregon. We calculated the prevalence and, assessed the correlates of, transactional sex using generalized linear models accounting for sampling design. We also compared health outcomes, HIV screening, and knowledge and uptake of HIV pre-exposure prophylaxis (PrEP) between women who did and did not report transactional sex. Of 334 women, 13.6% reported transactional sex (95% confidence interval [CI]: 6.8, 20.5%). Women who reported transactional sex were older, more likely to identify as black, to identify as lesbian or bisexual, to experience childhood trauma and recent sexual violence, and to have been homeless. Six percent (95% CI: 1.8, 10.5%) of women with no adverse childhood experiences (ACEs) reported transactional sex compared to 23.8% (95% CI: 13.0, 34.6%) of women who reported eleven ACEs (P < 0.001). Transactional sex was strongly associated with combination methamphetamine and opiate use as well as condomless sex. Women who reported transactional sex were more likely to report being diagnosed with a bacterial STI and hepatitis C; however, HIV screening and pre-exposure prophylaxis knowledge and use were low. In a sample of women of low socioeconomic status in Portland, Oregon, transactional sex was characterized by marginalized identities, homelessness, childhood trauma, sexual violence, substance use, and sexual vulnerability to HIV/STI. Multi-level interventions that address these social, behavioral, and trauma-related factors and increase access to biomedical HIV prevention are critical to the sexual health of women who engage in transactional sex.
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发表时间：
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影响因子：
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