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Debel L, Ayalew J, Abdella S, Bulti J, Bejiga B, Wariso FB, Belete W, Habtesilase A, Lulseged S. Gender-based violence and associated factors among female sex workers in Ethiopia. Evidence from The National Bio-behavioral Survey, 2020. Front Public Health 2024; 11:1213725. [PMID: 38356655 PMCID: PMC10864632 DOI: 10.3389/fpubh.2023.1213725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 12/08/2023] [Indexed: 02/16/2024] Open
Abstract
Background Gender-based violence (GBV) is usually defined as unequal power relations between men and women, which poses a widespread public health problem. The study evaluated the prevalence and factors associated with GBV among female sex workers (FSWs) in Ethiopia. Method We used cross-sectional bio-behavioral data collected using respondent-driven sampling (RDS) in 2020 from 16 towns in Ethiopia. Descriptive statistics was analyzed to summarize the study population characteristics and prevalence of GBV, and a multilevel logistic regression model was applied to identify associated factors for GBV. A p-value of ≤0.05 was used as a threshold for statistical significance. Result Of 6,085 participants, 28.1% had experienced GBV during the last 12 months, among which 12.7% and 22.3% experienced physical and sexual violence, respectively. FSWs aged 15-24, and 25-34 than those 35 years or more, had a non-paying than paying partners, had 31-60, 61-90, and over 91 than those had less than 30 paying partners, ever had anal sex than those not, condom failure than those not, mobile female sex workers when compared with those not mobile at different town; 3-5 and ≥ 6 years than those less than 3 years stayed in selling sex, street-based, and multiple places selling sex than those used other venues were significantly associated with GBV. Conclusion Gender-based violence is a substantial problem among FSWs in Ethiopia, with significant implications for program planning on prevention and response to mitigate the occurrence and impact of GBV among FSWs.
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Affiliation(s)
- Lemessa Debel
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Jemal Ayalew
- Department of Statistics, Wollo University, College of Natural Science, Dessie, Ethiopia
| | - Saro Abdella
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Jaleta Bulti
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Birra Bejiga
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Fayiso Bati Wariso
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Wudinesh Belete
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Abebe Habtesilase
- Ethiopian Public Health Institute, HIV/TB Research Directorate, Addis Ababa, Ethiopia
| | - Silesh Lulseged
- Addis Ababa University, Faculty of Medicine, College of Health Sciences, Addis Ababa, Ethiopia
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Rasouli MA, Zareie B, Gouya MM, Hadavandsiri F, Mahboobi M, Moradi Y, Moradi R, Moradi G. Lifetime and past-month alcohol use and related factors among female sex workers in Iran. Brain Behav 2023; 13:e3288. [PMID: 37872677 PMCID: PMC10726872 DOI: 10.1002/brb3.3288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/07/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE Alcohol use is more common among female sex workers (FSWs). This study assessed the prevalence of lifetime and past-month alcohol use and related factors among FSWs in Iran. METHODS We conducted a cross-sectional survey among 1464 women from 8 major cities in Iran. Behavioral data were collected by trained interviewers and conducted face-to-face in a private room. Weighted analysis was used to determine the lifetime and past-month alcohol use prevalence. Univariate and multivariate logistic regression was used to investigate the association between alcohol use and independent variables. RESULTS The most alcohol used in lifetime and past-month (weekly, less than once a week, and daily) in FSWs was 52.7% (12.25%, 12.94%, and 1.83%), respectively. In the final model, factors that were independently associated with alcohol use included the 31-40 years (AOR = 2.41, 95% CI: 1.13-5.15), education level of diploma (AOR = 2.43, 95% CI: 1.31-4.51), history of lifetime drug use (AOR = 2.79, 95% CI: 2.01-3.89), history of lifetime group sex (AOR = 2.07, 95% CI: 1.41-3.03), history of intentional abortion (AOR = 1.42, 95% CI: 1.06-1.92), six or more sexual clients in the last month (AOR = 3.25, 95% CI: 1.80-5.87), history of lifetime anal sex (AOR = 2.47, 95% CI: 1.82-3.35), and FSWs the married, temporarily married, and living with partner were positively associated with lifetime alcohol use. CONCLUSION Alcohol use is prevalent among FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with alcohol use among this vulnerable population in Iran. Designing intervention programs, it is suggested to consider other variables affecting alcohol use in FSWs.
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Affiliation(s)
- Mohammad Aziz Rasouli
- Department of Epidemiology and BiostatisticsFaculty of Medicine, Kurdistan University of Medical SciencesSanandajIran
| | - Bushra Zareie
- Department of Epidemiology, School of Public HealthHamadan University of Medical SciencesHamadanIran
| | - Mohammad Mehdi Gouya
- Iranian Center for Communicable Disease ControlMinistry of Health and Medical EducationTehranIran
| | - Fatemeh Hadavandsiri
- School of Public Health and SafteyShahid Beheshti University of Medical SciencesTehranIran
| | - Marzieh Mahboobi
- Iranian Center for Communicable Disease ControlMinistry of Health and Medical EducationTehranIran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Rozhin Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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Kamali K, Maleki A, Yazdi SAB, Faghihzadeh E, Hoseinzade Z, Hajibabaei M, Sharafi SE, Noorbala AA. The prevalence of violence and its association with mental health among the Iranian population in one year after the outbreak of COVID-19 disease. BMC Psychiatry 2023; 23:33. [PMID: 36639790 PMCID: PMC9839182 DOI: 10.1186/s12888-022-04444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND COVID-19 spread between and across nearly every country, with considerable negative health consequences. The current study aimed to determine the prevalence of violence and its association with mental health among Iranians older than 15 years in 2020. METHODS Data was collected through National Mental Health Survey on 24,584 Iranians older than 15 years in 2020. were analyzed to determine the prevalence of violence and its association with mental health. Multi-stage sampling method was used, and data on demographic characteristics and domestic-social violence and mental health (GHQ-28) were collected. Data analysis was administered using descriptive statistics and a chi-square test at a 95% level. RESULTS The mean age of participants was 44.18 ± 16.4 years. The overall prevalence of domestic and social violence was 11.4% and 5.5%, respectively. Verbal violence was the most common type; with 61.8% and 66.8% for domestic and social violence, respectively. A suspected case of mental disorder, female gender, being younger than 25 years, living apart together, unemployment, low education, and history of COVID-19 infection presented a significant association with domestic and social violence (p > 0.05). CONCLUSION In comparison to the previous study in 2015, the prevalence of violence has increased. Therefore, domestic and social violence are the social concerns of Iranian society, indicating the necessity of appropriate interventions, particularly for those suspected of mental disorders and young women with low education levels.
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Affiliation(s)
- Koorosh Kamali
- grid.469309.10000 0004 0612 8427Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- grid.469309.10000 0004 0612 8427Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyed Abbas Bagheri Yazdi
- grid.415814.d0000 0004 0612 272XDepartment of Mental Health, Ministry of Health and Medical Education of Iran, Tehran, Iran
| | - Elham Faghihzadeh
- grid.469309.10000 0004 0612 8427Department of Epidemiology and Biostatistics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zarrintaj Hoseinzade
- grid.469309.10000 0004 0612 8427Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Marzieh Hajibabaei
- grid.411705.60000 0001 0166 0922Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Elham Sharafi
- grid.411705.60000 0001 0166 0922Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ali Noorbala
- Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., Tehran, 13185/1741, Iran.
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Mehmandoost S, Sharifi H, Shokoohi M, Khezri M, Mirzazadeh A, Shahesmaeili A, Gahlekhani N, Kamali K, Haghdoost AA, Karamouzian M. Sexualized Substance Use among Female Sex Workers in Iran: Findings from a Nationwide Survey. Subst Use Misuse 2022; 58:298-305. [PMID: 36576274 PMCID: PMC10881188 DOI: 10.1080/10826084.2022.2161824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Female sex workers (FSWs) are at higher risk of HIV due to high-risk sexual and drug use related behaviors. This study characterized sexualized substance use among FSWs in Iran. Methods: In 2015, 1,337 FSWs were recruited from centers for vulnerable women and through outreach efforts in 13 major cities in Iran. Data were collected via face-to-face interviews from consenting FSWs on a range of socio-demographic and behavioral characteristics. The primary outcome of interest was sexualized substance use, defined as reporting alcohol or drug use before or during sex in the past month. Bivariable and multivariable modified Poisson regression models were used to assess the correlates of sexualized substance use. Adjusted prevalence ratio (aPR) and 95% confidence interval (CI) were reported. Results: The prevalence of sexualized substance use was 31.3% (95% CI: 28.7, 34.0). Inconsistent condom use during sex with clients in the past month (aPR = 1.31; 95% CI: 1.01, 1.71), regular (i.e., at least weekly in the past month) alcohol use (aPR = 2.87; 95% CI: 2.17, 3.80), regular opioid use (aPR = 2.09; 95% CI: 1.45, 3.02), regular stimulant use (aPR = 2.68; 95% CI: 2.12, 3.39), and self-reported HIV negative status (aPR= 1.88; 95% CI: 1.14, 3.10) were significantly and positively associated with sexualized substance use. Conclusions: Sexualized substance use was associated with riskier sexual behavior and self-reported HIV sero-negativity. Harm reduction messaging to FSWs needs to go beyond focusing on sexual health promotion and further highlight the risks associated with sexualized substance use.
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Affiliation(s)
- Soheil Mehmandoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nima Gahlekhani
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kianoush Kamali
- Midlife Health Office, Department of Population Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Centre On Drug Policy Evaluation, St. Michael's Hospital, Toronto, Canada
- Brown School of Public Health, Brown University, Providence, Rhode Island, USA
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