188147 Correlates of early initiation into sex work in two Mexico-U.S. border cities

Monday, October 27, 2008: 1:20 PM

Oralia Loza, MA , International Health and Cross-Cultural Medicine, University of California San Diego, La Jolla, CA
Steffanie Strathdee, PhD , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Shirley Semple, PhD , Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
Maria Remedios Lozada, Dra , Patronato Pro-COMUSIDA, Tijuana, Mexico
Hugo Staines , Escuela de Medicina, Universidad Autonoma de Cuidad Juarez, Juarez, Mexico
Miguel Angel Fraga, MD , Facultad de Medicina, Universidad Autonoma de Baja California, Tijuana, Baja California, Mexico
Gustavo A. Martinez, Dr , Salud y Desarrollo Comunitario de Ciudad Juarez, A.C.; Federación Méxicana de Asociaciones Privadas, Ciudad Juarez, Mexico, Ciudad Juarez, Chihuahua, 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
Thomas Patterson, PhD , Dept of Psychiatry, University of California, La Jolla, CA
Objective: To examine correlates of early initiation into sex work in two Mexico-US border cities.

Methods: Female sex workers (FSWs) ≥18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent baseline interviews. Correlates of early initiation into sex work (<18 years) were identified with logistic regression.

Results: Of 920 FSW interviewed in Tijuana (N=474) and Ciudad Juarez (N=446), 9.8% were early initiators. Median age of entry into sex work was 26 years (range: 6-58). After adjusting for age, compared to older initiators, early initiators were more likely to use inhalants (21.1% vs 9.6%, p=0.002), initiate sex work to pay for alcohol (36.7% vs 18.4%, p<.001), report child abuse (42.2% vs 18.7%, p<.0001) and were less likely to be migrants (47.8% vs 62.3%, p=0.02). Factors independently associated with early initiation included inhalant use (adjOR=2.39), initiating sex work to pay for alcohol (adjOR=1.88) and history of child abuse (adjOR=2.92) while age (adjOR=1.52 per 5 year increase), education (adjOR=2.05 per 5 year increase), migration (adjOR=1.74), initiating sex work to pay for rent/utilities/food (adjOR=3.05) and to support children (adjOR=39.62) were associated with initiating sex work later.

Conclusions: Our findings suggest different pathways for entering sex work among younger versus older initiators. Interventions are needed to prevent inhalant use and provide coping skills for abuse among younger girls, whereas income generating strategies, child care, and services for migrants may help to delay or prevent entry into sex work for older girls in these settings.

Learning Objectives:
Session participants will be able to: describe the environment of female sex workers in two Mexico-US border cities list significant factors independently associated with early initiation identify pathway differences for early versus later initiators into sex work

Keywords: Sex Workers, Adolescents, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have prepared this abstract as part of my dissertation training and with the mentorship and guidance of my doctoral advisor.
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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See more of: Epidemiology