The Context of Economic Insecurity and Its Relation to Violence and Risk Factors for HIV Among Female Sex Workers in Andhra Pradesh, India
The Context of Economic Insecurity and Its Relation to Violence and Risk Factors for HIV Among Female Sex Workers in Andhra Pradesh, India
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DOI：
10.1177/00333549101250s412
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发表时间：
2010-07-01
影响因子：
3.3
通讯作者：
Blankenship, Kim M.
中科院分区：
文献类型：
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作者：
Reed, Elizabeth;Gupta, Jhumka;Blankenship, Kim M.
Objective.我们研究了女性性工作者（FSWs）的经济不安全和债务的背景，这种背景下如何在FSWs之间变化，以及它与暴力经历和人类免疫缺陷病毒（HIV）的性风险因素的关系。我们招募了年龄≥ 18岁的FSW（n=673），通过响应者驱动的抽样调查艾滋病毒的风险在该地区。使用逻辑回归模型（调整的合作伙伴的地位，教育，财政支持和识字），我们评估债务和性和身体的受害以及性风险之间的关系。我们还进行了定性访谈的调查参与者的子样本，并检查这些相关的主题。在调整后的逻辑回归模型中，报告债务的FSW更有可能报告以下情况：最近的身体暴力（调整后的比值比[AOR] = 2.4，95%置信区间[CI] 1.5，3.9），过去一周内与偶尔来访者发生无保护性行为（AOR=2.3，95% CI 1.2，4.3），过去30天内与客户发生肛交（AOR=2.0，95% CI 1.1，3.9），过去6个月内至少有一次性传播感染症状（AOR=1.6，95% CI 1.1，2.4）。有债务的FSW更有可能报告现任丈夫或其他男性伴侣，而不太可能报告与这些伴侣一起使用避孕套，这进一步增加了他们的性风险。定性数据详细阐述了这些发现。结论。调查结果表明，暴力和艾滋病毒相关的脆弱性，报告债务和进一步强调男性伴侣如何可能有助于债务和经济不安全的FSWs。
Objective. We examined the context of economic insecurity and debt among female sex workers (FSWs), how this context varies among FSWs, and its association with experiences of violence and sexual risk factors for human immunodeficiency virus (HIV).Methods. We recruited FSWs aged >= 18 years (n=673) through respondent-driven sampling for a survey on HIV risk in this region. Using logistic regression models (adjusted for partner status, education, financial support, and literacy), we assessed the relation between debt and sexual and physical victimization as well as sexual risk. We also conducted qualitative interviews with a subsample of the survey participants and examined these for related themes.Results. In adjusted logistic regression models, FSWs who reported debt were more likely to report the following: recent physical violence (adjusted odds ratio [AOR] = 2.4, 95% confidence interval [CI] 1.5, 3.9), unprotected sex with occasional clients in the past week (AOR=2.3, 95% CI 1.2, 4.3), anal sex with clients in the past 30 days (AOR=2.0, 95% CI 1.1, 3.9), and at least one sexually transmitted infection symptom in the past six months (AOR=1.6, 95% CI 1.1, 2.4). FSWs with debt were more likely to report current husbands or other male partners, and less likely to report condom use with these partners, further increasing their sexual risk. Qualitative data elaborated on these findings.Conclusion. Findings indicate the violence- and HIV-related vulnerability of FSWs who report debt and further highlight how male partners may contribute to the debt and economic insecurity of FSWs.