The impact of violence on sex risk and drug use behaviors among women engaged in sex work in Phnom Penh, Cambodia

the Young Women's Health Study Collaborative

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Violence, substance use, and HIV disproportionately impact female entertainment and sex workers (FESW), but causal pathways remain unclear. Methods: We examined data from an observational cohort of FESW age 15-29 in Phnom Penh, Cambodia for associations between violence exposure and sexual risk and drug use. Validated measures of physical and sexual violence were assessed at baseline. Self-reported outcomes measured quarterly over the next 12-months included past month sexual partners, consistent condom use by partner type, sex while high, and amphetamine type stimulant (ATS) use. Biomarkers measured quarterly included prostate specific antigen (PSA) and urine toxicology. Generalized estimating equations were fit adjusting for age, education, marital status and sex work venue. Results: Of 220 women, 48% reported physical or sexual violence in the preceding 12-months. Physical violence was associated with increased number of sex partners (adjusted incidence rate ratio [aIRR] 1.33; 95% CI: 1.04-1.71), greater odds of sex while high (adjusted odds ratio [aOR] 2.42; 95% CI: 1.10-5.33), increased days of ATS use (aIRR 2.74; 95% CI: 1.29-5.84) and increased odds of an ATS+ urine screen (aOR 2.80, 95%CI: 1.38-5.66). Sexual violence predicted decreased odds of consistent condom use with non-paying partners (aOR 0.24; 95% CI: 0.10-0.59) and greater odds of a PSA+ vaginal swab (aOR 1.83; 95% CI: 1.13-2.93). Conclusions: Physical and sexual violence are prevalent among Cambodian FESW and associated with subsequent sexual risk and drug use behaviors. Clinical research examining interventions targeting structural and interpersonal factors impacting violence is needed to optimize HIV/AIDS prevention among FESW.

Original languageEnglish (US)
Pages (from-to)171-177
Number of pages7
JournalDrug and Alcohol Dependence
Volume161
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Sex Work
Cambodia
Sex Workers
Sex Offenses
Violence
Amphetamine
Odds Ratio
Condoms
Prostate-Specific Antigen
Pharmaceutical Preparations
HIV
Urine
Sexual Partners
Incidence
Marital Status
Toxicology
Acquired Immunodeficiency Syndrome
Biomarkers
Education
Physical Abuse

Keywords

  • Amphetamine
  • Cambodia
  • Female sex workers
  • Prostitution
  • Sexual risk
  • Violence

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

The impact of violence on sex risk and drug use behaviors among women engaged in sex work in Phnom Penh, Cambodia. / the Young Women's Health Study Collaborative.

In: Drug and Alcohol Dependence, Vol. 161, 01.04.2016, p. 171-177.

Research output: Contribution to journalArticle

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abstract = "Background: Violence, substance use, and HIV disproportionately impact female entertainment and sex workers (FESW), but causal pathways remain unclear. Methods: We examined data from an observational cohort of FESW age 15-29 in Phnom Penh, Cambodia for associations between violence exposure and sexual risk and drug use. Validated measures of physical and sexual violence were assessed at baseline. Self-reported outcomes measured quarterly over the next 12-months included past month sexual partners, consistent condom use by partner type, sex while high, and amphetamine type stimulant (ATS) use. Biomarkers measured quarterly included prostate specific antigen (PSA) and urine toxicology. Generalized estimating equations were fit adjusting for age, education, marital status and sex work venue. Results: Of 220 women, 48{\%} reported physical or sexual violence in the preceding 12-months. Physical violence was associated with increased number of sex partners (adjusted incidence rate ratio [aIRR] 1.33; 95{\%} CI: 1.04-1.71), greater odds of sex while high (adjusted odds ratio [aOR] 2.42; 95{\%} CI: 1.10-5.33), increased days of ATS use (aIRR 2.74; 95{\%} CI: 1.29-5.84) and increased odds of an ATS+ urine screen (aOR 2.80, 95{\%}CI: 1.38-5.66). Sexual violence predicted decreased odds of consistent condom use with non-paying partners (aOR 0.24; 95{\%} CI: 0.10-0.59) and greater odds of a PSA+ vaginal swab (aOR 1.83; 95{\%} CI: 1.13-2.93). Conclusions: Physical and sexual violence are prevalent among Cambodian FESW and associated with subsequent sexual risk and drug use behaviors. Clinical research examining interventions targeting structural and interpersonal factors impacting violence is needed to optimize HIV/AIDS prevention among FESW.",
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AU - the Young Women's Health Study Collaborative

AU - Draughon Moret, Jessica E.

AU - Carrico, Adam

AU - Evans, Jennifer L.

AU - Stein, Ellen S.

AU - Couture, Marie Claude

AU - Maher, Lisa

AU - Page, Kimberly

PY - 2016/4/1

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N2 - Background: Violence, substance use, and HIV disproportionately impact female entertainment and sex workers (FESW), but causal pathways remain unclear. Methods: We examined data from an observational cohort of FESW age 15-29 in Phnom Penh, Cambodia for associations between violence exposure and sexual risk and drug use. Validated measures of physical and sexual violence were assessed at baseline. Self-reported outcomes measured quarterly over the next 12-months included past month sexual partners, consistent condom use by partner type, sex while high, and amphetamine type stimulant (ATS) use. Biomarkers measured quarterly included prostate specific antigen (PSA) and urine toxicology. Generalized estimating equations were fit adjusting for age, education, marital status and sex work venue. Results: Of 220 women, 48% reported physical or sexual violence in the preceding 12-months. Physical violence was associated with increased number of sex partners (adjusted incidence rate ratio [aIRR] 1.33; 95% CI: 1.04-1.71), greater odds of sex while high (adjusted odds ratio [aOR] 2.42; 95% CI: 1.10-5.33), increased days of ATS use (aIRR 2.74; 95% CI: 1.29-5.84) and increased odds of an ATS+ urine screen (aOR 2.80, 95%CI: 1.38-5.66). Sexual violence predicted decreased odds of consistent condom use with non-paying partners (aOR 0.24; 95% CI: 0.10-0.59) and greater odds of a PSA+ vaginal swab (aOR 1.83; 95% CI: 1.13-2.93). Conclusions: Physical and sexual violence are prevalent among Cambodian FESW and associated with subsequent sexual risk and drug use behaviors. Clinical research examining interventions targeting structural and interpersonal factors impacting violence is needed to optimize HIV/AIDS prevention among FESW.

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KW - Amphetamine

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KW - Female sex workers

KW - Prostitution

KW - Sexual risk

KW - Violence

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