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181053 Abuse by clients among female sex workers in two Mexico-U.S. border cities

Tuesday, October 28, 2008: 3:00 PM

Monica D. Ulibarri, PhD , Department of Psychiatry, University of California, San Diego, San Diego, CA
Steffanie Strathdee, PhD , Department of Global Public Health, University of California, San Diego, La Jolla, CA
Maria Remedios Lozada, Dra , Coordinator of HIV/AIDS Program in Tijuana, ISESALUD Public Health Department, Tijuana, Mexico
Miguel Fraga, MD , Escuela de Medicina, University of California, Tijuana, CA, Mexico
Carlos Magis-Rodriguez, MD, MPH , Secretaría de Salud, Centro Nacional para la Prevención del VIH/SIDA, Anzures, Mexico D.F., Mexico
Adela De la Torre, PhD , Center for Public Policy, Race, Ethnicity & Gender, University of California Davis, Davis, CA
Hortensia Amaro, PhD , Institute on Urban Health Research, Northeastern University, Boston, MA
Patricia O'Campo, PhD , Centre for Research on Inner City Health, University of Toronto, Toronto, ON, Canada
Thomas Patterson, PhD , Dept of Psychiatry, University of California, La Jolla, CA
Audio (mp3) recording Multimedia recording
Background: History of abuse has been associated with greater vulnerability to HIV infection among women.

Objective: To examine prevalence and correlates of abuse by clients among female sex workers (FSWs) in Tijuana and Ciudad Juarez, two Mexico-U.S. border cities where HIV prevalence is rising.

Method: FSWs aged ≥18 who were not knowingly HIV-positive and reported having unprotected sex with ≥1 client in the prior two months were studied. In separate logistic regression models, we identified factors independently associated with three types of abuse by clients: physical, sexual and emotional, considering HIV-status, psychological distress, and drug use as potential covariates.

Results: Among 924 FSWs, median age and duration in sex work was 32 and 4 years, respectively. Prevalence of physical, sexual and emotional abuse by clients in the past 6 months was 18%, 10%, and 26%, respectively. In multivariate models, greater psychological distress was independently associated with at least two-fold increased odds of physical, sexual, and emotional abuse by clients. Having injected drugs in the past month was independently associated with at least three-fold increased odds of emotional and sexual abuse, but not physical abuse. HIV+ serostatus was independently associated only with sexual abuse (AdjOR: 2.32; 95% CI: 1.08-4.97).

Conclusions: FSWs along the Mexico-U.S. border region report frequently experiencing abuse from clients, which may have serious mental health and HIV risk consequences. Injection drug use may increase FSWs' vulnerability towards abuse from clients. Our findings suggest the need for screening and violence prevention services for FSWs in the Mexico-U.S. border region.

Learning Objectives:
1. Describe the prevalence of client perpetrated violence among female sex workers in two U.S.-Mexico border cities. 2. List three predictors of client perpetrated violence among female sex workers in two U.S.-Mexico border cities.

Keywords: Sex Workers, Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the primary person who conducted the analysis and writing of the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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