BMJ, volume 339, issue aug11 3, pages b2939

Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers

K. Shannon 1, 2
, 
T. Kerr 1, 2
, 
S A Strathdee 3
, 
J Shoveller 2
, 
J. S. Montaner 1, 2
, 
M W Tyndall 1, 2
1
 
British Columbia Centre for Excellence in HIV/AIDS St Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada | 
2
 
3
 
Publication type: Journal Article
Publication date: 2009-08-11
BMJ
BMJ
Journal: BMJ
scimago Q1
SJR: 2.803
CiteScore: 19.9
Impact factor: 93.6
ISSN: 09598146, 17561833, 09598138, 14685833, 00071447
DOI:  10.1136/bmj.b2939
PubMed ID:  19671935
General Medicine
General Engineering
General Environmental Science
General Earth and Planetary Sciences
Abstract

Objective To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution.

Design Prospective observational study.

Setting Vancouver, Canada during 2006-8.

Participants Female sex workers 14 years of age or older (inclusive of transgender women) who used illicit drugs (excluding marijuana) and engaged in street level sex work.

Main outcome measure Self reported gender based violence.

Results Of 267 female sex workers invited to participate, 251 women returned to the study office and consented to participate (response rate of 94%). Analyses were based on 237 female sex workers who completed a baseline visit and at least one follow-up visit. Of these 237 female sex workers, 57% experienced gender based violence over an 18 month follow-up period. In multivariate models adjusted for individual and interpersonal risk practices, the following structural factors were independently correlated with violence against female sex workers: homelessness (adjusted odds ratio for physical violence (aORphysicalviolence) 2.14, 95% confidence interval 1.34 to 3.43; adjusted odds ratio for rape (aORrape) 1.73, 1.09 to 3.12); inability to access drug treatment (adjusted odds ratio for client violence (aORclientviolence) 2.13, 1.26 to 3.62; aORphysicalviolence 1.96, 1.03 to 3.43); servicing clients in cars or public spaces (aORclientviolence 1.50, 1.08 to 2.57); prior assault by police (aORclientviolence 3.45, 1.98 to 6.02; aORrape 2.61, 1.32 to 5.16); confiscation of drug use paraphernalia by police without arrest (aORphysicalviolence 1.50, 1.02 to 2.41); and moving working areas away from main streets owing to policing (aORclientviolence 2.13, 1.26 to 3.62).

Conclusions Our results demonstrate an alarming prevalence of gender based violence against female sex workers. The structural factors of criminalisation, homelessness, and poor availability of drug treatment independently correlated with gender based violence against street based female sex workers. Socio-legal policy reforms, improved access to housing and drug treatment, and scale up of violence prevention efforts, including police-sex worker partnerships, will be crucial to stemming violence against female sex workers.

Found 31
By date By citations
American Public Health Association
Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy
Shannon K., Strathdee S.A., Shoveller J., Rusch M., Kerr T., Tyndall M.W.
American Journal of Public Health scimago Q1 wos Q1 , 
2009-02-07,  citations by CoLab: 251 ,  Abstract  
Objectives. We investigated the relationship between environmental–structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of “hot spots” for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estimate the relationship between environmental–structural factors and being pressured by a client into unprotected sexual intercourse. Results. In multivariate analyses, being pressured into having unprotected sexual intercourse was independently associated with having an individual zoning restriction (odds ratio [OR] = 3.39; 95% confidence interval [CI] = 1.00, 9.36), working away from main streets because of policing (OR = 3.01; 95% CI = 1.39, 7.44), borrowing a used crack pipe (OR = 2.51; 95% CI = 1.06, 2.49), client-perpetrated violence (OR = 2.08; 95% CI = 1.06, 4.49), and servicing clients in cars or in public spaces (OR = 2.00; 95% CI = 1.65, 5.73). Conclusions. Given growing global concern surrounding the failings of prohibitive sex-work legislation on sex workers' health and safety, there is urgent need for environmental–structural HIV-prevention efforts that facilitate sex workers' ability to negotiate condom use in safer sex-work environments and criminalize abuse by clients and third parties.
American Public Health Association
Characterizing Perceived Police Violence: Implications for Public Health
Cooper H., Moore L., Gruskin S., Krieger N.
American Journal of Public Health scimago Q1 wos Q1 , 
2008-12-02,  citations by CoLab: 124 ,  Abstract  
Despite growing recognition of violence’s health consequences and the World Health Organization’s recent classification of police officers’ excessive use of force as a form of violence, public health investigators have produced scant research characterizing police-perpetrated abuse. Using qualitative data from a study of a police drug crackdown in 2000 in 1 New York City police precinct, we explored 40 injection drug using and 25 non–drug using precinct residents’ perceptions of and experiences with police-perpetrated abuse. Participants, particularly injection drug users and non–drug using men, reported police physical, psychological, and sexual violence and neglect; they often associated this abuse with crackdown-related tactics and perceived officer prejudice. We recommend that public health research address the prevalence, nature, and public health implications of police violence.
Elsevier
Injecting drug users’ experiences of policing practices in two Mexican–U.S. border cities: Public health perspectives
Miller C.L., Firestone M., Ramos R., Burris S., Ramos M.E., Case P., Brouwer K.C., Fraga M.A., Strathdee S.A.
International Journal of Drug Policy scimago Q1 wos Q1 , 
2008-08-01,  citations by CoLab: 71 ,  Abstract  
Previous research has identified the impact of law enforcement practices on the behaviours and health of injection drug users (IDUs). We undertook a qualitative study of IDUs' experiences of policing practices in two Mexican cities on the U.S. border.In 2004, two teams of Mexican interviewers conducted in-depth interviews with IDUs residing in Tijuana and Ciudad Juarez (Cd. Juarez), Mexico, who had injected drugs at least once in the prior month. Topics included types of drug used, injection settings, access to sterile needles and experiences with police. Field notes and transcribed interviews were analysed to identify emergent themes.Amongst the 43 participants, most reported that it is common for IDUs to be arrested and detained for 36h for carrying sterile or used syringes. Most reported that they or someone they knew had been beaten by police. Interviews suggested five key themes relating to police influence on the risk environment: (1) impact of policing practices on accessibility of sterile syringes, (2) influence of police on choice of places to inject drugs (e.g., shooting galleries), (3) police violence, (4) police corruption and (5) perceived changes in policing practices.Findings suggest that some behaviour of police officers in Tijuana and Cd. Juarez is inconsistent with legal norms and may be negatively influencing the risk of acquiring blood-borne infections amongst IDUs. Implementing a comprehensive and successful HIV prevention programme amongst IDUs requires interventions to influence the knowledge, attitudes and practices of law enforcement officers.
BMJ
State violence towards sex workers
Brooks-Gordon B.
BMJ scimago Q1 wos Q1 , 
2008-07-30,  citations by CoLab: 8 ,  Abstract  
Police power should be reduced and sex workers’ autonomy and status raised
BMJ
Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study
Rhodes T., Simic M., Baros S., Platt L., Zikic B.
BMJ scimago Q1 wos Q1 , 
2008-07-30,  citations by CoLab: 118 ,  Abstract  
Objective To explore female and transvestite sex workers’ perceptions of risk in the sex work environment in Serbia.Design Qualitative interview study.Setting Street based locations for sex work in Belgrade and Pancevo, Serbia.Participants 31 female and transvestite sex workers.Results Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma.Conclusion Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work.
Elsevier
Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work
Shannon K., Kerr T., Allinott S., Chettiar J., Shoveller J., Tyndall M.W.
Social Science and Medicine scimago Q1 wos Q1 , 
2008-02-01,  citations by CoLab: 387 ,  Abstract  
High rates of violence among street-level sex workers have been described across the globe, while in cities across Canada the disappearance and victimization of drug-using women in survival sex work is ongoing. Given the pervasive levels of violence faced by sex workers over the last decades, and extensive harm reduction and HIV prevention efforts operating in Vancouver, Canada, this research aimed to explore the role of social and structural violence and power relations in shaping the HIV risk environment and prevention practices of women in survival sex work. Through a participatory-action research project, a series of focus group discussions were conceptualized and co-facilitated by sex workers, community and research partners with a total of 46 women in early 2006. Based on thematic, content and theoretical analysis, the following key factors were seen to both directly and indirectly mediate women's agency and access to resources, and ability to practice HIV prevention and harm reduction: at the micro-level, boyfriends as pimps and the 'everyday violence' of bad dates; at the meso-level, a lack of safe places to take dates, and adverse impacts of local policing; and at the macro-level, dopesickness and the need to sell sex for drugs. Analysis of the narratives and daily lived experiences of women sex workers highlight the urgent need for a renewed HIV prevention strategy that moves beyond a solely individual-level focus to structural and environmental interventions, including legal reforms, that facilitate 'enabling environments' for HIV prevention.
Elsevier
Correlates of injection drug use among female sex workers in two Mexico–U.S. border cities
Strathdee S.A., Philbin M.M., Semple S.J., Pu M., Orozovich P., Martinez G., Lozada R., Fraga M., de la Torre A., Staines H., Magis-Rodríguez C., Patterson T.L.
Drug and Alcohol Dependence scimago Q1 wos Q1 , 
2008-01-01,  citations by CoLab: 178 ,  Abstract  
Objective To characterize the overlap between injection drug use and sex work by women in Tijuana and Cd. Juarez, situated on the Mexico–U.S. border. Methods FSWs aged ≥18 years who were not knowingly HIV-positive and reported having unprotected sex with ≥1 client in the prior 2 months underwent interviews and testing for HIV, syphilis, gonorrhea and Chlamydia. Logistic regression identified factors associated with injecting drugs within the last month. Results Of 924 FSWs, 18.0% had ever injected drugs. Among FSW-IDUs (N = 114), prevalence of HIV, syphilis titers ≥1:8, gonorrhea and Chlamydia was significantly higher at 12.3%, 22.7%, 15.2% and 21.2% compared to 4.8%, 13.1%, 5.2% and 11.9% among other FSWs (N = 810). FSW-IDUs also had more clients in the past 6 months (median: 300 versus 240, p = 0.02). Factors independently associated with injecting drugs in the past month included living in Tijuana, being younger, being married/common-law, longer duration in the sex trade, speaking English, earning less for sex without condoms, often using drugs before sex, and knowing other FSWs who injected drugs. Conclusions FSW-IDUs had higher STI levels, engaged in riskier behaviors and were more vulnerable to having unsafe sex with clients compared to other FSWs, indicating that this subgroup is an important bridge population requiring focused prevention.
Springer Nature
Community-based HIV prevention research among substance-using women in survival sex work: The Maka Project Partnership
Shannon K., Bright V., Allinott S., Alexson D., Gibson K., Tyndall M.W.
Harm Reduction Journal scimago Q1 wos Q1 Open Access , 
2007-12-08,  citations by CoLab: 126 ,  Abstract  
Substance-using women who exchange sex for money, drugs or shelter as a means of basic subsistence (ie. survival sex) have remained largely at the periphery of HIV and harm reduction policies and services across Canadian cities. This is notwithstanding global evidence of the multiple harms faced by this population, including high rates of violence and poverty, and enhanced vulnerabilities to HIV transmission among women who smoke or inject drugs. In response, a participatory-action research project was developed in partnership with a local sex work agency to examine the HIV-related vulnerabilities, barriers to accessing care, and impact of current prevention and harm reduction strategies among women in survival sex work. This paper provides a brief background of the health and drug-related harms among substance-using women in survival sex work, and outlines the development and methodology of a community-based HIV prevention research project partnership. In doing so, we discuss some of the strengths and challenges of community-based HIV prevention research, as well as some key ethical considerations, in the context of street-level sex work in an urban setting.
BMJ
Protection of sex workers
Goodyear M.D., Cusick L.
BMJ scimago Q1 wos Q1 , 
2007-01-11,  citations by CoLab: 41 ,  Abstract  
Decriminalisation could restore public health priorities and human rights
BMJ
Effective HIV prevention requires gender-transformative work with men
Dunkle K.L., Jewkes R.
Sexually Transmitted Infections scimago Q1 wos Q2 , 
2006-11-10,  citations by CoLab: 89 ,  Abstract  
Broad socially transformative programs that promote gender equality and discourage perpetration of gender-based violence and are needed to combat the global HIV pandemic See linked article, p211 The role of gender-based violence in fuelling the global HIV pandemic is now undeniable. In recent years, research from both developed and developing countries has consistently shown that women who experience gender-based violence and gender inequality are at greater risk of HIV.1–4 Mounting evidence on connections between men’s perpetration of gender-based violence and male HIV risk behaviour suggests that women’s HIV risk is often primarily dependent on the behaviour of the men in their lives. Research from South Africa, India and the United States has suggested that men who are violent towards their female partners or commit rape are more likely to have sex more often, to have sex with concurrent and/or casual sexual partners, to have higher total numbers of sexual partners, to practice anal sex, to participate in transactional sex, to father children, and to use alcohol and drugs.5–9 In this issue of Sexually Transmitted Infections , Jay Silverman and colleagues10 present findings from Bangladesh which show …
Taylor & Francis
Unprotected intercourse for extra money among commercial sex workers in Kinshasa, Democratic Republic of Congo
Ntumbanzondo M., Dubrow R., Niccolai L.M., Mwandagalirwa K., Merson M.H.
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV scimago Q2 wos Q4 , 
2006-10-01,  citations by CoLab: 68 ,  Abstract  
This study assessed the extent and correlates of the practice of engaging in unprotected intercourse for extra money among commercial sex workers (CSWs) in Kinshasa, Democratic Republic of the Congo. We conducted a cross-sectional survey using a structured, interviewer-administered questionnaire among a convenience sample of 136 CSWs. More than one-quarter of CSWs (26.5%) engaged in unprotected intercourse for extra money. These CSWs charged about 3.5 times more for unprotected intercourse than for protected intercourse. Multivariate logistic regression showed that CSWs who engaged in unprotected intercourse for extra money were significantly more likely to live or work in non-downtown (lower socioeconomic) areas of Kinshasa (odds ratio [OR] = 3.07), to have at least one child less than six years of age (OR = 2.95), and to know other CSWs who engaged in the same practice (OR = 9.38). We hypothesize that desperate socioeconomic conditions combined with peer/social norms drive the practice of engaging in unprotected intercourse for extra money. Additional circumstances under which Kinshasa CSWs engaged in unprotected intercourse included intercourse with clients who tore their condoms to increase sexual pleasure (58.8% of CSWs), episodes of condom failure (56.8% of CSWs), and unprotected intercourse with regular noncommercial partners (only 5.3% of CSWs with noncommercial partners always used condoms with these partners).
Taylor & Francis
Drastic elevations in mortality among female injection drug users in a Canadian setting
Spittal P.M., Hogg R.S., Li K., Craib K.J., Recsky M., Johnston C., Montaner J.S., Schechter M.T., Wood E.
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV scimago Q2 wos Q4 , 
2006-02-01,  citations by CoLab: 29 ,  Abstract  
The health and social conditions of women living in Vancouver's Downtown Eastside has recently been the focus of substantial international attention. Since few studies have examined rates and correlates of death among addicted women in Canada, we have characterized patterns of mortality among female injection drug users (IDUs) in Vancouver. The Vancouver Injection Drug Users Study (VIDUS) is a prospective open cohort study of IDUs. The analyses presented here, were restricted to women enrolled between May 1996 and May 2002 and who were aged 14 years or older. We estimated cumulative mortality rates using Kaplan-Meier methods and Cox regression was used to calculate univariate and adjusted relative hazards. Between May 1996 and May 2002, 520 female IDUs have been recruited from the Vancouver area among whom 68 died during the study period. Elevated rates of mortality were observed among those who reported, baseline sex-trade involvement, those with HIV-infection at baseline, and those who lived in unstable housing at baseline (all log-rank: p
Elsevier
Sex-work harm reduction
Rekart M.L.
The Lancet scimago Q1 wos Q1 Open Access , 
2005-12-02,  citations by CoLab: 351 ,  Abstract  
Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.
Elsevier
HIV and intimate partner violence among methadone-maintained women in New York City
El-Bassel N., Gilbert L., Wu E., Go H., Hill J.
Social Science and Medicine scimago Q1 wos Q1 , 
2005-07-01,  citations by CoLab: 130 ,  Abstract  
Intimate partner violence (IPV) has been recognized as a risk factor for HIV and sexually transmitted infections (STIs) among women, particularly among those who are drug involved. This study examines the temporal relationships between sexual and/or physical partner violence (IPV) and sexual risk of HIV/STI transmission in a longitudinal study with a random sample of 416 women enrolled in methadone maintenance treatment programs in New York City. Two hypotheses are tested: whether sexual risk-related factors or risk reduction behavior leads to subsequent IPV (H1); and whether IPV decreases likelihood of subsequent risk reduction behavior (i.e., requesting to use condoms) or increases likelihood of certain sexual risk-related factors (i.e., inconsistent condom use, having unprotected anal sex, having more than one partner, exchanging sex for drugs or money, having had an STI, being HIV positive, having a partner who engaged in HIV risk) (H2). Participants were interviewed at three waves: baseline, six months and twelve months. Hypotheses were examined using propensity score matching and multiple logistic regression analyses. The prevalence rate of any physical or sexual IPV was 46% at baseline. Findings for H1 indicate that women who reported always using condoms at wave 2 were significantly less likely than women who reported inconsistent or no condom use to experience subsequent IPV at wave 3. Similarly, increased risk of IPV at wave 3 was associated with self-reported STIs (OR=2.0, p=.03), and unprotected anal sex (OR= 2.0, p
American Public Health Association
Effects of an Intensive Street-Level Police Intervention on Syringe Exchange Program Use in Philadelphia, Pa
Davis C.S., Burris S., Kraut-Becher J., Lynch K.G., Metzger D.
American Journal of Public Health scimago Q1 wos Q1 , 
2005-01-26,  citations by CoLab: 114 ,  Abstract  
Repeated measurements and mixed-effects models were used to analyze the effects of an intensive long-term street-level police intervention on syringe exchange program use. Utilization data for 9 months before and after the beginning of the intervention were analyzed. Use fell across all categories and time periods studied, with significant declines in use among total participants, male participants, and Black participants. Declines in use among Black and male participants were much more pronounced than decreases among White and female participants.
Found 222
By date By citations
Taylor & Francis
Victim-blaming in sexual violence against sex workers: a systematic review
Velasco J., Sanmartín F.J.
Journal of Sexual Aggression scimago Q2 wos Q2 , 
2025-03-28,  citations by CoLab: 0 , 
Scientific Research Publishing
Marginalization and Health Outcomes in Female Sex Workers: The Mediating Role of Resource Accessibility
Triantafyllidou S., Apostolidou A., Theodoropoulou D., Malfa G., Drolapa S., Valsami V., Antonopoulou M., Kalogeraki C., Papastefanaki K., Tsiaras V., Rodriguez C.V., Kouroupou A., Poulios A.
Psychology , 
2025-02-14,  citations by CoLab: 0 , 
Taylor & Francis
What Works to Reduce Sex Workers’ Risk of Crime Victimization? A Scoping Review
Molnar L., Chopin J.
Journal of Evidence-Based Social Work scimago Q2 wos Q3 , 
2025-01-23,  citations by CoLab: 0 , 
SAGE
Lost Highways: An Examination of the Question of Risk Involved in Sexual Homicides of Hitchhiking Victims
Beauregard E., Chopin J., DeLisi M.
International Journal of Offender Therapy and Comparative Criminology scimago Q1 wos Q3 , 
2025-01-14,  citations by CoLab: 0 ,  Abstract  
Despite cultural references to the dangers of hitchhiking, particularly for sexual homicide, no published research investigates these incidents from both an offender and crime scene perspective. Using the Sexual Homicide International Database (SHIelD), we explore lifestyle risk by comparing sexual homicide cases involving hitchhiking victims to those involving victims engaged in sex trade work. The results, based on the use of bivariate and multivariate statistics, indicate that offenders view hitchhiking victims as opportunities for confinement without physical restraint, often engaging in sexual acts and theft. While not primarily sadistic or sexually deviant, many offenders partake in criminal activities, exhibit psychological disorders, and possess weapons. Hitchhiking facilitates perpetrator-victim encounters due to its environmental characteristics. Victims in the sex trade, typically found in isolated locations, are at the mercy of offenders who drive them to unknown destinations. In contrast, murderers targeting low-risk victims display more sexual preoccupations, inserting foreign objects and engaging in postmortem activities. These distinctions suggest distinct offender profiles for each lifestyle.
Public Library of Science (PLoS)
Exploring commercial sex work among transgender women in Nepal: Contributors and stigma—A mixed-method study
Pokharel H.S., Myia S.D., Chalise A., Paudel S.
PLoS ONE scimago Q1 wos Q1 Open Access , 
2024-12-02,  citations by CoLab: 0 ,  PDF,  Abstract  
Introduction Transgender women are considered as one of the most vulnerable populations for commercial sex work and sexually transmitted infections. This mixed-method study aimed to explore the factors associated with commercial sex work among transgender women of Nepal along with their experience and the stigma associated with it. Methods A concurrent mixed-methods approach was employed in this cross-sectional study conducted from July to December 2022 in the Kathmandu Valley of Nepal. A total of 152 transgender women participated in the quantitative survey, and 17 of them were selected for in-depth interviews (IDIs). The chi-square test was employed at a 5% level of significance to identify factors associated with commercial sex work. Qualitative data from the IDIs were thematically analyzed, with key themes emerging around reasons for engaging in sex work and the stigma associated with it including the Silence, Shame, and Dignity & Treatment domains under sex work stigma. Results Out of 152 transgender women, 104 (64%; 95% CI: 60.5–75.0%) were found to be currently working as a commercial sex worker. Factors such as education, household wealth, homelessness, history of sexual and verbal abuse, including rape and physical attacks, and socialization with others were found to have a statistically significant relation with commercial sex work at p<0.05. Despite engagement in commercial sex work, a higher proportion experienced sex work stigma under the Sex Work Stigma Scale. Conclusion The findings, derived from both quantitative and qualitative studies, emphasize the urgency of targeted interventions to alleviate the challenges faced by this marginalized population. The observed higher proportion of commercial sex work and sex work stigma underscores the pervasive social challenges of transgender women. A comprehensive and coordinated effort is essential, bringing together governmental, private sector, and public awareness initiatives to effectively manage stigma and address the underlying causes of commercial sex work.
Springer Nature
Traumatic Brain Injury
Gimarc K., Moore M., Hinson H.E., Gardner R.C.
2024-10-22,  citations by CoLab: 0 ,  Abstract  
Traumatic brain injury (TBI) poses a significant public health concern, affecting a diverse population and leading to substantial morbidity and mortality. This chapter explores disparities in TBI incidence, management, care, and outcomes across multiple social identities, highlighting inequities and identifying areas for improvement in healthcare delivery.
Duke University Press
Queer of Color Critique and the Decriminalization of Sex Work
Rodríguez J.M.
2024-06-01,  citations by CoLab: 0 ,  Abstract  
This contribution to Q2 is a discussion of the urgency of addressing the ongoing criminalization of sex work in the current historical moment. The article links the myriad issues related to the stigmatization and criminalization of sex work to the theoretical origins of queer of color critique and considers the implications for rights to bodily autonomy.
Mary Ann Liebert
Comparing Stigma and HIV Outcomes Between Transgender and Cisgender Women Sex Workers Living with HIV in the Dominican Republic
Goldenberg T., Karver T., Kerrigan D., Gomez H., Perez M., Donastorg Y., Barrington C.
Transgender Health scimago Q1 wos Q2 , 
2024-06-01,  citations by CoLab: 0 , 
Springer Nature
The impact of policing and homelessness on violence experienced by women who sell sex in London: a modelling study
Walker J.G., Elmes J., Grenfell P., Eastham J., Hill K., Stuart R., Boily M., Platt L., Vickerman P.
Scientific Reports scimago Q1 wos Q1 Open Access , 
2024-04-08,  citations by CoLab: 0 ,  PDF,  Abstract  
AbstractStreet-based sex workers experience considerable homelessness, drug use and police enforcement, making them vulnerable to violence from clients and other perpetrators. We used a deterministic compartmental model of street-based sex workers in London to estimate whether displacement by police and unstable housing/homelessness increases client violence. The model was parameterized and calibrated using data from a cohort study of sex workers, to the baseline percentage homeless (64%), experiencing recent client violence (72%), or recent displacement (78%), and the odds ratios of experiencing violence if homeless (1.97, 95% confidence interval 0.88–4.43) or displaced (4.79, 1.99–12.11), or of experiencing displacement if homeless (3.60, 1.59–8.17). Ending homelessness and police displacement reduces violence by 67% (95% credible interval 53–81%). The effects are non-linear; halving the rate of policing or becoming homeless reduces violence by 5.7% (3.5–10.3%) or 6.7% (3.7–10.2%), respectively. Modelled interventions have small impact with violence reducing by: 5.1% (2.1–11.4%) if the rate of becoming housed increases from 1.4 to 3.2 per person-year (Housing First initiative); 3.9% (2.4–6.9%) if the rate of policing reduces by 39% (level if recent increases had not occurred); and 10.2% (5.9–19.6%) in combination. Violence reduces by 26.5% (22.6–28.2%) if half of housed sex workers transition to indoor sex work. If homelessness decreased and policing increased as occurred during the COVID-19 pandemic in 2020, the impact on violence is negligible, decreasing by 0.7% (8.7% decrease-4.1% increase). Increasing housing and reducing policing among street-based sex workers could substantially reduce violence, but large changes are needed.
Taylor & Francis
Subsistence and Survival: Strategies Women in the Republic of Barbados Engaged in Transactional Sex Work Employ to Stay Safe
Kyriakakis S., Compton-Almo C., Goddard-Durant S.
Journal of Aggression, Maltreatment and Trauma scimago Q1 wos Q3 , 
2024-03-21,  citations by CoLab: 0 , 
Taylor & Francis
“They Don’t Give a Damn About Us” : A Qualitative Study on Experiences and Perceptions Underlying Racial Disparities in Sex Trafficking Specialty Docket Programs
Murnan A., England G., Matthews C., Boch S., Qasem I., Bates S., Manchak S.
Journal of Human Trafficking scimago Q1 , 
2024-03-05,  citations by CoLab: 1 , 
BMJ
Childhood and adolescent factors shaping vulnerability to underage entry into sex work: a quantitative hierarchical analysis of female sex workers in Nairobi, Kenya
Shah P., Kabuti R., Beksinska A., Nyariki E., Babu H., Kungu M., Jama Z., Ngurukiri P., Kaul R., Kyegombe N., Medley G.F., Devries K., Seeley J., Weiss H.A., Beattie T.S., et. al.
BMJ Open scimago Q1 wos Q1 Open Access , 
2023-12-19,  citations by CoLab: 2 ,  Abstract  
ObjectiveTo explore factors associated with early age at entry into sex work, among a cohort of female sex workers (FSWs) in Nairobi, Kenya.BackgroundYounger age at sex work initiation increases the risk of HIV acquisition, condom non-use, violence victimisation and alcohol and/or substance use problems. This study aimed to understand factors in childhood and adolescence that shape the vulnerability to underage sex work initiation.DesignBuilding on previous qualitative research with this cohort, analysis of behavioural–biological cross-sectional data using hierarchical logistic regression.Participants and measuresFSWs aged 18–45 years were randomly selected from seven Sex Workers Outreach Programme clinics in Nairobi, and between June and December 2019, completed a baseline behavioural–biological survey. Measurement tools included WHO Adverse Childhood Experiences, Alcohol, Smoking and Substance Involvement Screening Test and questionnaires on sociodemographic information, sexual risk behaviours and gender-based violence. Descriptive statistics and logistic regression were conducted using hierarchical modelling.ResultsOf the 1003 FSWs who participated in the baseline survey (response rate 96%), 176 (17.5%) initiated sex work while underage (<18 years). In the multivariable analysis, factors associated with entering sex work while underage included incomplete secondary school education (aOR=2.82; 95% CI=1.69 to 4.73), experiencing homelessness as a child (aOR=2.20; 95% CI=1.39 to 3.48), experiencing childhood physical or sexual violence (aOR=1.85; 95% CI=1.09 to 3.15), young age of sexual debut (≤15 years) (aOR=5.03; 95% CI=1.83 to 13.79) and being childless at time of sex work initiation (aOR=9.80; 95% CI=3.60 to 26.66).ConclusionsLower education level and childhood homelessness, combined with sexual violence and sexual risk behaviours in childhood, create pathways to underage initiation into sex work. Interventions designed for girls and young women at these pivotal points in their lives could help prevent underage sex work initiation and their associated health, social and economic consequences.
SAGE
Strategies and Interventions Used to Prevent Violence Against Sex Workers in the United States: A Scoping Review Using the Social-Ecological Model
Carr C., King L.M., Maizel J., Scaglione N.M., Stetten N.E., Varnes J.R., Tomko C.
Trauma, Violence, and Abuse scimago Q1 wos Q1 , 
2023-12-06,  citations by CoLab: 3 ,  Abstract  
Structural factors in the United States, such as criminalization, contribute to disproportionate rates of violence against sex workers and subsequent risk of adverse health outcomes. There is a clear need for systemic interventions and risk reduction strategies to reduce violence in this population. To inform next steps in prevention, this scoping review provides an overview of the literature on violence prevention efforts targeting sex workers in the United States, mapped out according to the social-ecological model (SEM). A comprehensive search of peer-reviewed literature across five databases with no limit on publication date yielded 2,372 documents. Studies were eligible for inclusion if they focused on the U.S. population of sex workers and had a clearly defined aim or purpose of exploring, describing, or evaluating sex work violence prevention interventions or risk reduction strategies. Twelve studies met all eligibility criteria and were selected. Only two of the studies evaluated sexual violence prevention interventions, while the remaining 10 explored strategies sex workers use to minimize the risk of violence. Most research focused on female sex workers, violence from paying clients, and prevention at the individual level of the SEM. Our findings suggest a need for additional violence prevention interventions tailored for diverse groups of sex workers and cognizant of the overlapping forms of violence they face. This scoping review contributes to the limited body of research on the prevention of violence against sex workers in the United States by providing future directions for research and program development that span across the SEM.
Mary Ann Liebert
Prevalence and Associated Factors of Severity of Gender-Based Violence Among Street-Based Female Sex Workers in Bangladesh
Huq M.N., Abdulla F., Hossain M.M., Khan S., Nur R.A.
Violence and Gender scimago Q1 wos Q2 , 
2023-12-01,  citations by CoLab: 5 , 
Elsevier
“I would do anything but that”: Attitudes towards sex work among rural people who use drugs
Rains A., Sibley A.L., Levander X.A., Walters S.M., Nolte K., Colston D.C., Piscalko H.M., Go V.F., Friedmann P.D., Seal D.W.
International Journal of Drug Policy scimago Q1 wos Q1 , 
2023-12-01,  citations by CoLab: 1 ,  Abstract  
Stigma towards people who use drugs and those who engage in sex work is well-documented, leading to consequences such as reduced access to health services and support, especially in rural milieus. Stigma reduction has been recognized as a priority in the opioid overdose crisis, but little attention has been paid to within-group attitudes and beliefs. This study aimed to explore how people who use drugs in rural counties across the United States appraise sex work by themselves or other community members.Qualitative interview data came from the Rural Opioid Initiative (ROI), a project coordinated by research teams across 65 rural counties in 10 states. Interviews were individual and conducted from 2018 to 2020. All participants reported past 30-day opioid use and/or any injection drug use. A working group coded the data, then used an iterative inductive-deductive approach to organize data into themes of stigma among people who use drugs, focusing on stigma towards sex work.Across sites, 355 interviews were conducted. Mean participant age was 36, 55 % of participants were male, and 93 % were white. Participants expressed negative attitudes towards sex work as a function of its criminal-legal repercussions or framed sex work as morally transgressive. Many appraisals were gendered, with the behavior conveyed as being "easier" for women who were often described as "whores," with more neutral terms used to describe men. Some viewed sex work as an implicit "exchange" for drugs. Several participants noted a lack of agency as a feature leading to involvement in sex work, with partner power dynamics influencing an individual's behavior. Finally, a few participants acknowledged the circumstances under which they would newly engage in sex work.We identified several patterns by which people who use drugs evaluate community members who sell sex. These included gendered and morally-charged forms of stigma, which may represent barriers to community acceptance and support among this subgroup.

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PLoS ONE
PLoS ONE, 17, 7.66%
AIDS and Behavior
AIDS and Behavior, 15, 6.76%
Journal of Interpersonal Violence
Journal of Interpersonal Violence, 9, 4.05%
Journal of Urban Health
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Violence Against Women, 7, 3.15%
Culture, Health and Sexuality
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American Journal of Public Health
American Journal of Public Health, 5, 2.25%
Journal of Acquired Immune Deficiency Syndromes
Journal of Acquired Immune Deficiency Syndromes, 5, 2.25%
BMC Public Health
BMC Public Health, 5, 2.25%
Journal of the International AIDS Society
Journal of the International AIDS Society, 5, 2.25%
Journal of Immigrant and Minority Health
Journal of Immigrant and Minority Health, 4, 1.8%
International Journal of Drug Policy
International Journal of Drug Policy, 4, 1.8%
Health Care for Women International
Health Care for Women International, 4, 1.8%
BMJ Open
BMJ Open, 4, 1.8%
Harm Reduction Journal
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Drug and Alcohol Dependence
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AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
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Sexually Transmitted Infections
Sexually Transmitted Infections, 3, 1.35%
Crime and Delinquency
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Sexual Health
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Sexually Transmitted Diseases
Sexually Transmitted Diseases, 2, 0.9%
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Frontiers in Sociology
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Sexuality and Culture
Sexuality and Culture, 2, 0.9%
Sexuality Research and Social Policy
Sexuality Research and Social Policy, 2, 0.9%
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Publishers

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Springer Nature
Springer Nature, 52, 23.42%
SAGE
SAGE, 31, 13.96%
Taylor & Francis
Taylor & Francis, 31, 13.96%
Elsevier
Elsevier, 19, 8.56%
Public Library of Science (PLoS)
Public Library of Science (PLoS), 18, 8.11%
Wiley
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BMJ
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Ovid Technologies (Wolters Kluwer Health)
Ovid Technologies (Wolters Kluwer Health), 7, 3.15%
American Public Health Association
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MDPI
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Mary Ann Liebert, 3, 1.35%
CSIRO Publishing
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Frontiers Media S.A.
Frontiers Media S.A., 2, 0.9%
Oxford University Press
Oxford University Press, 2, 0.9%
Cambridge University Press
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University of Toronto Press Inc. (UTPress)
University of Toronto Press Inc. (UTPress), 1, 0.45%
Social Science Electronic Publishing
Social Science Electronic Publishing, 1, 0.45%
SciELO
SciELO, 1, 0.45%
Springer Publishing Company, 1, 0.45%
Hindawi Limited
Hindawi Limited, 1, 0.45%
Georg Thieme Verlag KG
Georg Thieme Verlag KG, 1, 0.45%
CMA Impact Inc.
CMA Impact Inc., 1, 0.45%
American Psychiatric Association Publishing
American Psychiatric Association Publishing, 1, 0.45%
Duke University Press
Duke University Press, 1, 0.45%
Scientific Research Publishing
Scientific Research Publishing, 1, 0.45%
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