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Giang HT, Khue PM, Sterk CE, Evans DP, Miedema SS, Yount KM. Prevalence of violence victimisation and poly-victimisation among female sex workers in Haiphong, Viet Nam: A cross-sectional study. Glob Public Health 2024; 19:2308709. [PMID: 38295852 PMCID: PMC11246117 DOI: 10.1080/17441692.2024.2308709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024]
Abstract
This cross-sectional study is the first to describe the prevalence of violence and poly-victimisation among 310 female sex workers (FSWs) who were cisgender in Haiphong, Viet Nam. An adapted version of the WHO-Multi-Country Study on Violence against Women Survey Instrument was administered to assess physical, sexual, economic and emotional forms of violence perpetrated by an intimate partner, paying partner/client, and/or others (e.g. relatives, police, strangers and other FSWs) during adulthood. The ACE-Q scale was administered to assess adverse childhood experiences (ACEs) before age 18 years. Our findings showed that FSWs are exposed to high rates of multiple forms of violence by multiple perpetrators. For any male client-perpetrated violence (CPV), lifetime prevalence was 70.0%, with 12-month prevalence 61.3%. Lifetime prevalence of male intimate partner violence (IPV) was 62.1%, and the 12-month prevalence was 58.2%. Lifetime and prior 12-month prevalence of physical and/or sexual violence by other perpetrators (OPV) was 18.1% and 14.2%, respectively. Sixty-five percent of FSWs reported at least one type of ACE. Overall, 21.6 percent of FSWs reported having experienced all three forms of violence (IPV, CPV and OPV) in their lifetime. Policy and programme recommendations for screening and prevention of violence are needed in this setting.
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Affiliation(s)
- Hoang Thi Giang
- Haiphong University of Medicine and Pharmacy, Haiphong, Viet Nam
| | - Pham Minh Khue
- Haiphong University of Medicine and Pharmacy, Haiphong, Viet Nam
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Beattie TS, Kabuti R, Beksinska A, Babu H, Kung’u M, Shah P, Nyariki E, Nyamweya C, Okumu M, Mahero A, Ngurukiri P, Jama Z, Irungu E, Adhiambo W, Muthoga P, Kaul R, Seeley J, Weiss HA, Kimani J. Violence across the Life Course and Implications for Intervention Design: Findings from the Maisha Fiti Study with Female Sex Workers in Nairobi, Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6046. [PMID: 37297650 PMCID: PMC10253020 DOI: 10.3390/ijerph20116046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural-biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for associations of life course factors with reported experience of physical or sexual violence in the past 6 months. We found substantial overlap between violence in childhood, and recent intimate and non-intimate partner violence in adulthood, with 86.9% reporting one or more types of violence and 18.7% reporting all three. Recent physical or sexual violence (64.9%) was independently associated with life course factors, including a high WHO Adverse Childhood Experiences (ACE) score (AOR = 7.92; 95% CI:4.93-12.74) and forced sexual debut (AOR = 1.97; 95% CI:1.18-3.29), as well as having an intimate partner (AOR = 1.67; 95% CI:1.25-2.23), not having an additional income to sex work (AOR = 1.54; 95% CI:1.15-2.05), having four or more dependents (AOR = 1.52; 95% CI:0.98-2.34), recent hunger (AOR = 1.39; 95% CI:1.01-1.92), police arrest in the past 6 months (AOR = 2.40; 95% CI:1.71-3.39), condomless last sex (AOR = 1.46; 95% CI:1.02-2.09), and harmful alcohol use (AOR = 3.34; 95% CI:1.74-6.42). Interventions that focus on violence prevention during childhood and adolescence should help prevent future adverse trajectories, including violence experience and HIV acquisition.
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Affiliation(s)
- Tara S. Beattie
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Rhoda Kabuti
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Alicja Beksinska
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Hellen Babu
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Mary Kung’u
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | | | - Pooja Shah
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Emily Nyariki
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Chrispo Nyamweya
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Monica Okumu
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Anne Mahero
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Pauline Ngurukiri
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Zaina Jama
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Erastus Irungu
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Wendy Adhiambo
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Peter Muthoga
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
| | - Rupert Kaul
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Janet Seeley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Helen A. Weiss
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Joshua Kimani
- Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
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Women Selling Sex in Russia: Analyzing Women’s Appraisal of Exploitation and Mistreatment Using Cognitive Dissonance and Cultural Sex Script Frameworks. SEXES 2022. [DOI: 10.3390/sexes3030034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Globally, over a third of women have experienced physical or sexual violence in their lifetime. In Russia, human trafficking, sexual exploitation, and physical abuse of women are amongst the world’s highest. Applying cognitive dissonance theory and sexual script theory, this study explores whether women (n = 654) trading sex in Russia appraise their experiences of entering the commercial sex trade as voluntary or forced. Contributing client factors were also analyzed, including beatings (66%), rape (66%), and humiliation (86%) by clients. Multiple logistic regression assessed whether women who reported voluntarily entering the commercial sex trade were more likely to experience physical abuse but less likely to experience rape (AOR:1.37); were more likely to perceive men using them as decent/caring (AOR = 2.54); were more likely to sell sadistic/masochistic services (AOR: 2.31); and less likely to stop selling sex (AOR: 5.84). Implications of this study reveal the importance of intervention strategies that account for a woman’s unawareness of her own exploitation and mistreatment as well as the psychological barriers that prevent her from seeking help. The necessity of recognizing women selling sex as sufferers of coercion and abuse is also emphasized.
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Ikuteyijo OO, Akinyemi AI, Merten S. Exposure to job-related violence among young female sex workers in urban slums of Southwest Nigeria. BMC Public Health 2022; 22:1021. [PMID: 35597935 PMCID: PMC9123769 DOI: 10.1186/s12889-022-13440-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background In Nigeria, many young girls are engaged in commercial sex work as a means of livelihood and support of dependent relatives. Although studies have documented some of the violence related issues among commercial sex workers, the plight of adolescent and young sex workers particularly in urban slums may be different in context and depth. Objective This study explored the lived experiences of violence and health related harm among vulnerable young female sex workers in urban slums in Ibadan and Lagos, Southwest Nigeria. It also analyzed their coping strategies and survival mechanisms. Design The study is cross-sectional and applied an interpretive phenomenological approach to this qualitative study through in-depth interviews. Participants Young female sex workers ages (15–24 years) who reported having experienced violence were recruited for the study. Twelve participants completed the interviews out the 20 initially contacted. Data collection and analysis Primary data were collected using in-depth interviews (IDIs). Data were transcribed using a phenomenological framework analysis. Participants’ reports based on life experiences were identified: lived experience “daily brothel life experience”; sources of violence such as law enforcement agents’ intermittent raids; violence experience with clients who often demanded sexual acts beyond the agreed scope; and coping strategies employed to mitigate the challenges. Settings The study was conducted in brothels of two selected slum areas in Ibadan and Lagos, Southwest Nigeria. Results The results showed that the major motivation for engaging in commercial sex work was for economic reasons. However, there are inherent risks involved particularly for the vulnerable young people. Stigmatization from the community, clients’ uncontrolled-aggressive behavior and harassment from law enforcement agents are some of the frequent violence experiences reported. Self-help coping strategies are usually employed to prevent or mitigate the challenges. Conclusion The plight of this young people required policy and program attention towards alternative economic empowerment to rehabilitate those willing to leave the profession. Also the need to develop arm reduction interventions towards protection of young sex workers against violence. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-13440-1.
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Affiliation(s)
- Olutoyin Opeyemi Ikuteyijo
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Akanni Ibukun Akinyemi
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile Ife, Nigeria
| | - Sonja Merten
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Park JN, Decker MR, Bass JK, Galai N, Tomko C, Jain KM, Footer KHA, Sherman SG. Cumulative Violence and PTSD Symptom Severity Among Urban Street-Based Female Sex Workers. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:10383-10404. [PMID: 31679445 PMCID: PMC7195245 DOI: 10.1177/0886260519884694] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Female sex workers (FSW) are a marginalized and vulnerable population at high risk of gender-based violence within and outside of their occupation. However, FSW remain underrepresented in the trauma and mental health literature. The aims of this study were to (a) characterize exposure to violence among street-based FSW, including violence type, patterns over the life course, and key perpetrator groups, and (b) examine the multivariate associations between posttraumatic stress disorder (PTSD) symptom severity and two constructs (revictimization across life stages and cumulative violence). Data were drawn from the Sex Workers and Police Promoting Health in Risky Environments (SAPPHIRE) study, an observational community-based cohort of street-based FSW recruited through targeted sampling across Baltimore, Maryland (USA) in 2016 to 2017. PTSD symptom severity was measured using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5). At baseline, 61% of FSW screened positive for PTSD symptoms. The mean PCL-5 score was 38.6. We documented extensive histories of sexual and physical violence (lifetime: 81.8%; childhood and adult revictimization: 15.0% for sexual and 37.7% for physical). The vast majority of perpetrators were male and included paying clients, police officers, family members, and intimate partners. Exposure to childhood and adult sexual violence were independently associated with higher PTSD severity (p < .05), with marginal associations observed for physical violence. Data supported a cumulative violence model of PTSD severity (p < .05). Binge drinking also appeared to be a contributing factor (p < .05). The levels of PTSD observed among our sample were comparable with that reported among treatment-seeking war veterans. Our findings underscore the urgent need for tailored trauma-informed interventions and policies to address violence among urban street-based FSW, a population experiencing extremely high levels of violence, PTSD, and substance use.
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Affiliation(s)
- Ju Nyeong Park
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michele R Decker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Judith K Bass
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noya Galai
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine Tomko
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kriti M Jain
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Susan G Sherman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Associations Between Violence and HIV Risk Behaviors Differ by Perpetrator Among Russian Sex Workers. AIDS Behav 2020; 24:812-822. [PMID: 31531737 DOI: 10.1007/s10461-019-02668-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Violence is associated with HIV and HIV risk behaviors among female sex workers (FSW). However, few studies assess multiple forms of violence and multiple HIV risk behaviors to build a comprehensive picture of how violence is implicated in HIV risk. Using respondent-driven sampling, 754 FSW were recruited in the Russian Federation. Surveys collected data on lifetime exposure to client, police, intimate partner, and pimp violence, as well as recent HIV risk behavior in the forms of injecting drug use (IDU), and inconsistent condom use with intimate partners and clients. Multivariable log-binomial and Poisson regression were used to assess associations between violence and HIV risk behavior outcomes. Lifetime client (31.7%), police (16.0%), intimate partner (15.7%), and pimp (11.4%) violence were prevalent. IDU (10.7%) and inconsistent condom use with intimate partners (45.1%) and clients (22.5%) were common. Intimate partner violence (IPV) and client violence were associated with IDU (ARRIPV 2.12, 95% CI 1.10, 4.10; ARRClient 2.75, 95% CI 1.19, 6.32), IPV and police violence were associated with inconsistent condom use with intimate partners (ARRIPV 1.10, 95% CI 1.01, 1.19; ARRPolice 1.11, 95% CI 1.01, 1.21), and IPV and police violence were associated with inconsistent condom use with clients (ARRIPV 1.49, 95% CI 1.02, 2.17; ARRPolice 1.65, 95% CI 1.19, 2.29). Each perpetrator-specific type of violence was associated with a unique set of HIV risk behaviors. Comprehensive violence prevention programming that addresses multiple perpetrators of violence against FSW, including clients, intimate partners and police, is critical for reducing sexual and drug-related HIV risk in FSW.
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Sexual Exploitation as a Minor, Violence, and HIV/STI Risk among Women Trading Sex in St. Petersburg and Orenburg, Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224343. [PMID: 31703331 PMCID: PMC6888172 DOI: 10.3390/ijerph16224343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/16/2022]
Abstract
Child sexual exploitation (CSE) is a major risk factor for acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STI), violence and other health concerns, yet few studies have examined these associations in Russia until now. This study examines the prevalence of CSE (those entering the sex trade as a minor) among women in the sex trade in Russia and how exposures and behaviors related to violence and HIV/STI structural risks differ from those who entered the sex trade as an adult. Women in the sex trade (N = 896) in St. Petersburg and Orenburg, Russia were recruited via time-location sampling and completed structured surveys. Adjusted logistic regression analyses assessed associations between CSE victimization and HIV risk-related exposures. Of the 654 participants who provided their age at first sexual exploitation, 11% reported CSE prior to age 18. Those who reported CSE were more likely to be organized by others and to be prohibited from leaving a room or house and from using condoms; three-quarters experienced rape when trading sex; a third were involved in pornography before age 18 and they had less education if they entered the sex trade as a minor. In adjusted analyses, those entering the sex trade as a minor were significantly more likely than those entering the sex trade as an adult to report drug use prior to age 18 (AOR = 5.75, 95% CI = 2.53-13.09) to have ≥5 clients/day (past 12 months; AOR = 3.55, 95% CI = 1.56-8.08), to report receiving police assistance (AOR: 3.10, 95% CI = 1.26-7.54), and to have fewer experiences of police extortion (AOR = 0.35, 95% CI = 0.10-1.24). They were four times more likely to participate in pornography before the age of 18 (AOR = 4.08, 95% CI = 1.32, 12.60) and three times more likely to have been sexually abused as child (AOR = 2.93, 95% CI = 1.27, 7.54). Overall, entry as a minor was related to greater risk for victimization and an inability to protect oneself from STI/HIV.
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