RESUMO
Women engaged in sex work (WESW) are at heightened risk of experiencing intimate partner violence (IPV) compared to women in the general population. This study examines the impact of an economic empowerment intervention on IPV among WESW in Southern Uganda. We used data from 542 WESW in Southern Uganda recruited from 19 HIV hotspots between June 2019 and March 2020. Eligible participants were 18+ years old, engaged in sex work-defined as vaginal or anal sexual intercourse in exchange for money, alcohol, or other goods, reported at least one episode of unprotected sexual intercourse in the past 30 days with a paying, casual, or regular sexual partner (spouse, main partner). We analyzed data collected at baseline, 6, and 12months of follow up. To examine the impact of the intervention on IPV, separate mixed-effects logistic regression models were run for each type of IPV (physical, emotional, and sexual) as experienced by participants in the last 90 days. Results show that the intervention was efficacious in reducing emotional and physical IPV as evidenced by a statistically significant intervention main effect for emotional IPV, χ2(1) = 5.96, p = 0.015, and a significant intervention-by-time interaction effect for physical IPV, χ2(2) = 13.19, p < 0.001. To qualify the intervention impact on physical IPV, pairwise comparisons showed that participants who received the intervention had significantly lower levels of physical IPV compared to those in the control group at six months (contrasts = -0.12 (95% CI: -0.22, -0.02), p = 0.011). The intervention, time, and intervention-by-time main effects for sexual IPV were not statistically significant. Our findings suggest economic empowerment interventions as viable strategies for reducing emotional IPV among WESW. However, it is also essential to understand the role of interventions in addressing other forms of IPV especially for key populations at high risk of violence, HIV, and STI. The study was registered at ClinicalTrials.gov, ID: NCT03583541.
Assuntos
Empoderamento , Violência por Parceiro Íntimo , Profissionais do Sexo , Humanos , Feminino , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Uganda , Adulto , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto Jovem , Trabalho Sexual/psicologia , Trabalho Sexual/estatística & dados numéricos , Pessoa de Meia-Idade , Parceiros Sexuais/psicologiaAssuntos
Comércio/métodos , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Trabalho Sexual/psicologia , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Betacoronavirus , COVID-19 , Comércio/economia , Emigrantes e Imigrantes/psicologia , Humanos , Pandemias , Refugiados/psicologia , Saúde Reprodutiva , SARS-CoV-2 , Minorias Sexuais e de Gênero/psicologia , Fatores SocioeconômicosAssuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/psicologia , Pneumonia Viral/complicações , Pneumonia Viral/psicologia , Minorias Sexuais e de Gênero , Pessoas Transgênero , Adulto , COVID-19 , California/epidemiologia , Infecções por Coronavirus/epidemiologia , Coleta de Dados , Feminino , Infecções por HIV/epidemiologia , Hispânico ou Latino/psicologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Pneumonia Viral/epidemiologia , SARS-CoV-2 , Trabalho Sexual/psicologia , Comportamento SexualRESUMO
INTRODUCTION: Men who have sex with men (MSM) and transgender women (TW) in Colombia are highly affected by HIV. To improve understanding of the role of HIV risk behaviors in HIV acquisition, we used the syndemic framework, a useful concept to inform prevention efforts. OBJECTIVE: To examine the effect of four psychosocial conditions, namely, forced sex, history of childhood sexual abuse, frequent alcohol use, and illicit drug use on unprotected sex and the synergistic effects ("syndemic" effects) of these conditions on HIV risk behavior. MATERIALS AND METHODS: We enrolled a total of 812 males (54.7% men who have sex with men, MSM; 7.3% transgender women, and 38% non-MSM). The participants were recruited from neighborhoods of low socioeconomic status through free HIV-counseling and -testing campaigns. We performed Poisson regression analysis to test the associations and interactions between the four psychosocial conditions and unprotected sex with regular, occasional, and transactional partners. To test the "syndemic" model, we assessed additive and multiplicative interactions. RESULTS: The prevalence of any psychosocial condition was 94.9% in transgender women, 60.1% in MSM, and 72.2% in non-MSM. A higher likelihood of transactional sex was associated in MSM (prevalence ratio (PR)=7.41, p<0.001) and non-MSM (PR=2.18, p< 0.001) with three or all four conditions compared to those with one condition. Additive interactions were present for all combinations of psychosocial problems on transactional sex n MSM. No cumulative effect or additive interaction was observed in transgender women. CONCLUSIONS: Our study highlights the need for bundled mental health programs addressing childhood sexual abuse, illicit drug use, and frequent alcohol use with other HIV prevention programs.
Introducción. Los hombres que tienen sexo con hombres (HSH), y las mujeres transgenero (MT) en Colombia continuan estando a mayor riesgo de VIH. Para entender como los comportamientos se asocian al VIH, se uso la teoria de la sindemia, la cual se ha considerado muy útil en el desarrollo de estrategias de prevención. Objetivo. Examinar el efecto de cuatro afecciones psicosociales, a saber: historia de sexo forzado, historia de abuso sexual infantil, consumo frecuente de alcohol y consumo de drogas ilícitas en las relaciones sexuales sin protección, así como los efectos sinérgicos (efectos "sindémicos") de estas afecciones sobre el comportamiento de riesgo para HIV. Materiales y métodos. Se hizo un estudio transversal que incluyó 812 participantes (hombres que tienen sexo con hombres, HSH: 54,7 %; mujeres transgénero: 7,3 % y hombres que no tenían sexo con otros hombres: 38 %). Los participantes se reclutaron en barrios de estratos socioeconómicos bajos a través de campañas gratuitas de asesoramiento y pruebas de HIV. Se hizo un análisis de regresión de Poisson para probar las asociaciones e interacciones entre las cuatro condiciones psicosociales y las relaciones sexuales sin protección con parejas regulares, ocasionales y comerciales. Para probar el modelo "sindémico" se evaluaron las interacciones aditivas y multiplicativas. Resultados. La prevalencia de cualquiera de las condiciones psicosociales fue de 94,9 % en mujeres transexuales, de 60,1 % en HSH y de 72,2 % en hombres que no tienen sexo con hombres. Se encontró una mayor probabilidad de tener sexo comercial en los HSH (razón de prevalencia (RP)=7,41, p<0,001) y en los que no tienen sexo con otros hombres (RP=2.18, p<0,001) con tres de las condiciones psicosociales, o con las cuatro, en comparación con aquellos con una sola condición. Las interacciones aditivas se registraron entre todas las combinaciones de problemas psicosociales con el sexo comercial en los HSH. No se observó un efecto acumulativo ni interacciones en mujeres transexuales. Conclusiones. El estudio resalta la necesidad de combinar programas de salud mental que aborden el abuso sexual infantil, el abuso de drogas y el consumo frecuente de alcohol con otros programas de prevención del HIV.
Assuntos
Experiências Adversas da Infância/psicologia , Homens/psicologia , Trabalho Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Sindemia , Pessoas Transgênero/psicologia , Sexo sem Proteção/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Criança , Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Masculino , Prevalência , Estupro/psicologia , Estupro/estatística & dados numéricos , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , População Urbana , Adulto JovemRESUMO
Background and objectives: Hantavirus is a pathogen that causes a viral disease with an acute and severe presentation, and a high mortality rate. In face of a sudden loss, some families may not conceive the complete absence of the deceased relative. Thus, we sought to understand the changes that took place in a family after the death of the provider by Hantavirus Pulmonary Syndrome (HPS). Methods: A descriptive exploratory study with a qualitative approach of the type case report. Data collection took place between October and December 2016 through recorded individual interviews and using questions about family dynamics after family provider's death of HPS, which were assessed by content analysis in the light of Roy's theory. Results: It was observed that the illness and death of the family patriarch weakened the family's strengths and resources, leading to a period of mourning and despair. In addition, unemployment among other family members worsened socioeconomic conditions, seeing drugs as an alternative for support as it became a commercial activity, and the rise of a command in the region that culminated in the arrest of the wife, two daughters and a son of the deceased. Conclusions: In this case, it was evidenced that the family was weakened due to the illness and death of their loved one by HPS, and because of the lack of support and welcome from the reference social services, they chose to act in criminality and it ended up with the arrest of four members.(AU)
Justificativa e objetivos: O hantavírus é um patógeno que causa uma doença viral com caráter agudo e grave e alta taxa de mortalidade. Em face da perda súbita, algumas famílias podem não conceber a completa ausência do parente falecido. Assim, procuramos entender as mudanças que ocorrem em uma família após a morte do provedor pela Síndrome Pulmonar por Hantavírus (SPH). Métodos: Estudo descritivo-exploratório com abordagem qualitativa do tipo estudo de caso. A coleta de dados ocorreu entre outubro e dezembro de 2016 por meio de entrevistas individuais gravadas e com o uso de perguntas sobre a dinâmica familiar após a morte por SPH, sendo analisadas por análise de conteúdo sob a luz da teoria de Roy. Resultados: Observou-se que a doença e a morte do patriarca fragilizaram as forças e recursos da família, levando a um período de luto e desespero. Além disso, o desemprego entre os demais membros da família agravou as condições socioeconômicas, vendo as drogas como uma alternativa para o apoio, o que assumiu o caráter de comércio e a ascensão de um comando na região que culminou com a prisão da esposa, duas filhas e um filho do falecido. Conclusão: Neste caso descrito foi evidenciado que a família ficou fragilizada diante da enfermidade e óbito do seu ente querido por SPH e, em decorrência da falta de apoio e acolhimento dos serviços de referência sociais, optou por atuar na criminalidade e findar com a prisão de quatro membros.(AU)
Justificación y objetivos: El hantavirus es un patógeno que causa una enfermedad viral con un carácter agudo y grave y alta tasa de mortalidad. Ante la pérdida repentina, algunas familias pueden no concebir la ausencia completa del familiar fallecido. Por lo tanto, tratamos de comprender los cambios que se produjeron en una familia después de la muerte del proveedor por Sindrome Pulmonar por Hantavirus (SPH). Métodos: Estudio descriptivo-exploratorio con enfoque cualitativo del tipo estudio de caso. La recopilación de datos ocurrió entre octubre y diciembre de 2016, a través de entrevistas individuales grabadas y con el uso de preguntas sobre la dinámica familiar después de la muerte por SPH, que se analizaron a través del análisis de contenido a la luz de la teoría de Roy. Resultados: Se observó que la enfermedad y la muerte del patriarca familiar debilitaron las fortalezas y los recursos de la familia, lo que llevó a un período de duelo y desesperación. Además, el desempleo entre otros miembros de la familia empeoró las condiciones socioeconómicas, haciéndolos ver a las drogas como una alternativa de renta, lo que asumió el carácter de un comercio y el surgimiento de un comando en la región que culminó con el arresto de la esposa, dos hijas y un hijo del difunto. Conclusiones: En este caso, se evidenció que la familia se debilitó debido a la enfermedad y la muerte de su ser querido por SPH y debido a la falta de apoyo y recepción de los servicios de referencia social, eligieron actuar con criminalidad y por fin terminaron com cuatro miembros detenidos.(AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Luto , Família/psicologia , Síndrome Pulmonar por Hantavirus/psicologia , Crime/psicologia , Morte , Pai , Trabalho Sexual/psicologia , Assistência Pública , Fatores Socioeconômicos , Violência/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tráfico de Drogas/psicologiaRESUMO
This secondary data analysis of a cross-sectional survey conducted in Mombasa, Kenya characterises sexual and reproductive health (SRH) indicators among adolescent girls and young women (AGYW) engaged in casual and transactional sexual relationships as well as sex work. It describes the association between awareness of local HIV programmes and SRH services uptake for AGYW engaged in sex work. Thirty-eight percent of the participants reported a history of pregnancy. Among participants not trying to get pregnant, 27% stated that they were not currently using any form of contraception. Of the participants who had an abortion, 59% were completed under unsafe conditions. For AGYW engaged in sex work, awareness of local HIV prevention programmes was associated with increased STI testing within the last year (29%) as well as at least one HIV test (99%) compared to those who were not aware of local programming (18% and 92%, respectively); however, only 26% of participants engaged in sex work had heard of local HIV prevention programmes. There were no associations between awareness of local HIV programming and rates of dual contraception use, safe abortion, most recent birth attended by a skilled health professional or testing for HIV during pregnancy. Our study found high need for SRH services, particularly, access to contraception and safe abortion. Continued efforts are required to improve access to the full spectrum of SRH interventions, including family planning services and access to safe abortion in addition to HIV prevention to promote health equity.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde Reprodutiva , Trabalho Sexual/psicologia , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Adolescente , Comportamento do Adolescente , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Acessibilidade aos Serviços de Saúde , Humanos , Quênia , Gravidez , Saúde Reprodutiva , Saúde Sexual , Adulto JovemRESUMO
BACKGROUND: Evidence in different countries suggest an association between sex work and drug use. In the Dominican Republic an estimated 60,000-100,000 women work in the sex industry. However, little is known about their drug use behaviors. OBJECTIVE: To characterize the burden of drug use and examine correlates of these behaviors among female sex workers in the Dominican Republic. METHODS: Data for this analysis comes from a cross-sectional study among key populations at risk for HIV. A community sample of female sex workers (N = 389) was recruited using passive and active recruitment strategies. Participants completed a behavioral survey between 2015 and 2016. Logistic regression models were constructed to examine predictors of drug use. RESULTS: Protective factors against marijuana and crack or cocaine use included being heterosexual, having a higher level of education, regular employment, and fewer male sexual partners. Increased odds of crack or cocaine use were associated with incarceration, having slept in a place not meant for human habitation in the last six months, and having ever lived in a batey (a community around a sugar mill where workers and their families live). Participants that used marijuana were generally younger, while those that used crack or cocaine were older. CONCLUSIONS: Our findings highlight characteristics of the social and economic environment that require further research to optimize prevention and care strategies for this population. Public health interventions are needed that address drug use, sexual risk-taking, and helping female sex workers and their families achieve a healthy life.
Assuntos
Profissionais do Sexo/psicologia , Meio Social , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , População Urbana/tendências , Adolescente , Adulto , Estudos Transversais , República Dominicana/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Trabalho Sexual/psicologia , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/economia , Adulto JovemRESUMO
Introduction: Exotic dance clubs (EDCs) can play pivotal roles in the production of drug-related risks for female exotic dancers (FED). We aimed to characterize the structural and occupational factors associated with new drug initiation post-EDC entry among new FED (N = 117) in Baltimore, Maryland. Materials and Methods: Logistic regression models tested the associations of new drug uptake, measured as initiating any illicit drug (including non-prescribed and diverted prescription narcotics) not used prior to EDC employment, with structural (e.g. debt sources, housing instability) and occupational (e.g. sex work, dancing as sole income source) vulnerabilities. Results: Most FED were younger than 24 years-old (60%), identified as Black/African American (61%), and did not complete high school (56%). Twenty-nine (25%) reported using any new drug post-EDC entry, with cocaine (34%) cited most frequently among newly initiated substances. In multivariable analysis, drug initiation was significantly associated with cumulative debt sources (Adjusted Odds Ratio [AOR] = 1.82, 95% Confidence Interval [CI]: 1.19-2.77), dancing as only income source (AOR = 4.21, CI: 1.29-13.71), and sex work (AOR = 9.26, CI: 2.74-31.32). Conclusions: Our findings implicate co-occurring structural and occupational factors in FED's initiation of illicit drugs proceeding EDC employment. Results demonstrate the coping role of drug use for FED in stressful working environments and the multiple vulnerabilities associated with illicit drug uptake. The study reinforces a need for harm reduction interventions (i.e. debt relief, employment connections, increased hourly pay) that consider the contribution of overlapping financial insecurities to the production of occupational risks motivating drug uptake.
Assuntos
Dança/estatística & dados numéricos , Ocupações/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Baltimore/epidemiologia , Fumar Cocaína/economia , Fumar Cocaína/epidemiologia , Fumar Cocaína/psicologia , Dança/economia , Dança/psicologia , Feminino , Humanos , Motivação , Ocupações/economia , Razão de Chances , Risco , Medição de Risco , Trabalho Sexual/psicologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto JovemRESUMO
BACKGROUND: Research has documented many risk factors for commercial sexual exploitation of children as well as serious emotional and behavioral consequences for such victims. OBJECTIVE: This study aims to provide an understanding of risk factors and symptom presentation of girls who are victims or at risk for commercial sexual exploitation. PARTICIPANTS AND SETTING: Ninety-six girls (12-18â¯years) who were referred to a child advocacy center's specialized treatment program for commercially sexually abused girls served as participants (56 confirmed victims, 40 at risk of commercial sexual exploitation). METHODS: At intake participants were administered the Youth Self-Report, the Trauma Symptom Checklist for Children, and the UCLA Post-Traumatic Stress (PTSD) Reaction Index for DSM -5. Parents or guardians were asked to complete the Child Behavior Checklist and the UCLA PTSD Reaction Index for DSM - 5(Parent/Caregiver). RESULTS: Intake information revealed significant differences between groups with confirmed victims reporting higher levels of sex work, kidnapping, physical abuse, physical assault and sexual abuse by a non-family member (pâ¯<â¯.05) than at risk victims. All participants were exposed to traumas, were racially and ethnically diverse and lived primarily with their families. At risk girls were significantly more likely to be in school than the confirmed victims. The UCLA PTSD Index revealed that the confirmed victims had experienced significantly more physical abuse than the at-risk group and 26.7% of confirmed victims and 7.7% of the at risk victims met the DSM criteria for PTSD. Twenty percent of the confirmed victims met criteria for Dissociative subtype, while only 7.7% of at risk victims did. On the CBCL, victims from both groups scored in the clinical range on Externalizing Problems and Total Problems and the at risk group scored significantly higher on the School subscale than the confirmed victims group. CONCLUSION: Commercially sexually exploited girls have experienced multiple traumas in their lives and display emotional and behavioral difficulties. Early detection of girls who may be at risk for sexual exploitation may allow for prevention and intervention as these girls also have traumatic backgrounds and display similar symptoms.
Assuntos
Abuso Sexual na Infância/psicologia , Defesa da Criança e do Adolescente , Trabalho Sexual/psicologia , Adolescente , Lista de Checagem , Criança , Abuso Sexual na Infância/etnologia , Etnicidade , Feminino , Humanos , Medição de Risco , Trabalho Sexual/etnologia , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
Female sex workers (FSWs) in Nepal are vulnerable to an array of occupational risks, which may compromise their psychosocial health and ability to engage in protective behaviors. A peer education (PE) intervention designed to empower and promote the psychosocial health of FSWs was pilot tested in Kathmandu, Nepal. FSWs who were exposed to the PE intervention (n = 96) had significantly higher scores on psychosocial health knowledge, perceived self-efficacy and ability to access resources, happiness, and job control compared with those who were not (n = 64). PE may be a promising way to promote psychosocial health and empowerment among FSWs.
Assuntos
Promoção da Saúde/métodos , Saúde Ocupacional , Grupo Associado , Profissionais do Sexo/psicologia , Adulto , Bullying/psicologia , Esgotamento Profissional/psicologia , Empoderamento , Feminino , Infecções por HIV/transmissão , Felicidade , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Nepal , Projetos Piloto , Autoeficácia , Trabalho Sexual/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
Barriers faced by Black women when navigating commercial sexual exploitation (CSE)-related services remain understudied. This qualitative study explores (a) Black women's experiences of racism when accessing services in CSE-related organizations and (b) the existence and manifestation of racial tensions in practice. In-depth interviews were conducted with 30 adult women who traded sex as adults and 20 CSE-related service providers. Findings suggest that Black women perceive preferential treatment given to White women. Racial tensions between women accessing programs were identified, as well as a promising practice of intergroup dialogue groups addressing racism, privilege, and oppression. Implications are discussed.
Assuntos
Negro ou Afro-Americano/psicologia , Tráfico de Pessoas/psicologia , Racismo/psicologia , Trabalho Sexual/psicologia , Adolescente , Adulto , Agressão , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Comportamento Sexual , Problemas Sociais , Populações Vulneráveis , População Branca/psicologia , Adulto JovemRESUMO
Most research on transactional sex frame men as buyers and females as sellers of sex. We conducted a systematic mapping review of the empirical research on transactional sex where women form the demand (buyer) and men the supply (seller). We included 46 studies, of which 25 explicitly researched women as buyers of sex from male sellers, and 21 studies where this topic was a subset of larger topics. The majority of research on women who trade sexual services from men is published in the last 15 years, by female researchers, using cross-sectional or qualitative/ethnographic design, and from the perspective of males as sellers. While the women appear to be mature and financially independent, the men are young and socioeconomically vulnerable. Men's main motivation for the sexual-economic exchanges with women is financial, whereas women's motivations are largely satisfaction of sexual needs and a stereotyped erotic fantasy of black male hypersexuality. Condoms are often not used. Our review shows that there is a - possibly growing and diversifying - female consumer demand for male sexual services, and transactional sex where women trade sex from men is a complex social phenomenon ï¬rmly grounded in social, economic, political, and sexual relations.
Assuntos
Relações Interpessoais , Trabalho Sexual/psicologia , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Percepção Social , Adulto , Estudos Transversais , Emprego/psicologia , Feminino , Humanos , Masculino , Motivação , Pesquisa Qualitativa , Normas Sociais , Fatores SocioeconômicosAssuntos
Infecções por HIV/epidemiologia , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , Pessoas Transgênero/estatística & dados numéricos , Epidemias , Feminino , Humanos , Masculino , Peru/epidemiologia , Prevalência , Trabalho Sexual/psicologia , Trabalho Sexual/estatística & dados numéricos , Estigma Social , Pessoas Transgênero/psicologiaRESUMO
Transactional sex is an important risk-coping mechanism and a leading contributor to the HIV/AIDS epidemic in sub-Saharan Africa. We use data from a conditional cash transfer (CCT) experiment in rural Tanzania designed to incentivize safer sexual behavior by conditioning transfers on testing negative for sexually transmitted infections (STIs). For women, we find that negative shocks measured by food insecurity lead to a 36% increase in STIs and increases in self-reported risky sexual behavior. We find no significant effects of negative shocks on either STIs or self-reported sexual behavior for men. This CCT design did not appear to mitigate the behavioral response to shocks that we document in women. We propose that this finding can be explained by binding credit constraints and the relatively infrequent timing of the CCTs. When women experience a negative shock, cash needs are immediate, while transfers linked to a CCT are paid out in a specific point in time. If women are unable to access credit during a shock, they may resort to transactional sex even if they face monetary incentives to do otherwise.
Assuntos
Trabalho Sexual/psicologia , Adaptação Psicológica , Adulto , Feminino , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Masculino , Assunção de Riscos , População Rural , Trabalho Sexual/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Tanzânia , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto JovemRESUMO
As prostitution is widely condemned as a form of criminality in China, there is a need to examine how Buddhism functions not as a form of therapy for the purposes of rehabilitating or deterring prostitution but as a force that encourages participation in prostitution. In this work, we argue that rural-urban migrant sex workers who are Buddhists appropriate the religion's teachings of compassion, mindfulness, and karma to find a renewed sense of meaning and purpose in their livelihoods. We illustrate how Buddhism allows sex workers to cultivate the affective labor required for the purposes of servicing male clients in conjunction with finding positive purpose in their lives. In doing so, their bodies gain affirmative value in the form of helping their heterosexual male clients address deficits in their masculinities.
Assuntos
Budismo/psicologia , Atenção Plena , Religião e Sexo , Trabalho Sexual/psicologia , Profissionais do Sexo/psicologia , Adulto , China , Empatia , Feminino , Humanos , Valores Sociais , Fatores SocioeconômicosRESUMO
OBJECTIVE: To increase our understanding about food insecurity among urban adolescents, we conducted a qualitative study in Baltimore City with adolescents to: (i) explore how adolescents experience and cope with food insecurity; and (ii) identify community-based approaches or interventions for addressing food insecurity. DESIGN: A total of eight focus groups were conducted across six neighbourhoods. To gather sociodemographic characteristics and personal data on food insecurity, all consented adolescents completed a brief questionnaire. SETTING: Six purposively selected neighbourhoods in Baltimore City, USA. PARTICIPANTS: A total of fifty-three adolescents between the ages of 14 and 19 years participated in the study. RESULTS: Although half of our sample was classified as food insecure, everyone in the focus groups was aware of adolescents who engaged in risky behaviours to get money for food. Among girls, prostituting was the most commonly mentioned behaviour, whereas for boys, it was selling drugs or stealing to get money for food. Adolescents also described tremendous stigma associated with food insecurity and agreed that food insecurity has to be viewed within a broader set of economic challenges. CONCLUSIONS: Addressing food insecurity among adolescents in disadvantaged neighbourhoods should be a high priority for policy makers and practitioners. Current feeding programmes are not addressing the needs of adolescents; as a result, adolescents are at risk for a variety of harmful behaviours and outcomes, with long-term negative health and social consequences.
Assuntos
Adaptação Psicológica , Comportamento Alimentar/psicologia , Abastecimento de Alimentos , População Urbana/estatística & dados numéricos , Populações Vulneráveis/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Baltimore , Tráfico de Drogas/economia , Tráfico de Drogas/psicologia , Feminino , Grupos Focais , Humanos , Masculino , Pobreza/psicologia , Pesquisa Qualitativa , Assunção de Riscos , Trabalho Sexual/psicologia , Estigma Social , Fatores Socioeconômicos , Adulto JovemRESUMO
The objective of this paper is to expose those socio-structural contexts revealing the social injustice and human rights violations that sub-Saharan women face every day when forced into sex work by unemployment or sickness. Results of a qualitative study highlighting some key structural determinants of sex work and HIV infection among FSWs will be presented and examined through the lens of the WHO conceptual framework for action on the social determinants of health. The results showed that most FSWs had lacked the necessary financial support at some point in their lives. Also, both the socioeconomic and political context failed to provide proper support to prevent involvement in sex work and the consequent risks of HIV. The cultural and societal values placed on the health and well-being of FSWs in Benin appear to depend on the degree to which sexual violence and adultery are perceived as a collective social concern. This portrait of FSWs calls for both long-term interventions through a structural determinant approach to HIV prevention, targeting all the women who could face such a financial situation well before their entry into sex work, while maintaining short and medium-term interventions on the intermediary determinants.
Assuntos
Direitos Humanos , Trabalho Sexual/psicologia , Profissionais do Sexo/psicologia , Determinantes Sociais da Saúde , Estereotipagem , Adolescente , Adulto , Benin , Feminino , Infecções por HIV/prevenção & controle , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Delitos Sexuais , Trabalho Sexual/etnologia , Profissionais do Sexo/estatística & dados numéricos , Classe Social , Fatores Socioeconômicos , Adulto JovemRESUMO
RATIONALE: Women on opioid substitution treatment (WOST) are at high risk for sexually transmitted infections and blood-borne viruses (HIV, Hepatitis B and C). This heightened risk is rooted in social and health inequities. Experiencing stigma is considered to have an important role in maintaining these inequities and is a barrier to promoting sexual health. OBJECTIVE: The aims of this study were to examine (1) the experiences of stigma of WOST, and (2) how experiencing stigma may influence WOST' sexual health. METHOD: Twenty semi-structured interviews with WOST were conducted between October 2016 and April 2017 in South West England (UK). Data were analysed using Framework Analysis. RESULTS: Women's narratives highlighted the intersection of stigma associated with distinct elements of women's identities: (1) female gender, (2) drug use, (3) transactional sex, (4) homelessness, and (5) sexual health status. Intersectionality theory and social identity theory are used to explain sexual health risks and disengagement from (sexual) health services among WOST. Intersectional stigma was related to a lack of female and male condom use and a lack of access to (sexual) health services. CONCLUSION: The approach taken goes beyond individualistic approaches of health promotion and provides suggestions to improve future research, policy and practice. It identifies stigma as a crucial element to address when promoting sexual health among WOST. Importantly, this study focuses on tackling social and health inequities and in doing so advocates for human and women's rights.
Assuntos
Tratamento de Substituição de Opiáceos/psicologia , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Estigma Social , Saúde da Mulher , Adulto , Inglaterra , Feminino , Acessibilidade aos Serviços de Saúde , Pessoas Mal Alojadas/psicologia , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Trabalho Sexual/psicologia , Trabalho Sexual/estatística & dados numéricos , Comportamento Sexual , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
OBJECTIVES: To describe and compare the profile of female sex workers (FSWs) that access or do not access sexual health checkups (SHC). The research question was what are the factors linked to access to SHC for FSWs in the metropolitan region (RM) of Chile? METHODS: A cross-sectional study was conducted in the RM with FSWs over the age of 18. A sample of 370 FSWs was selected by using the time-location sampling method in closed venues and at street-level locations. A survey was applied, validated, and included clinical-epidemiological, behavioral and socio-demographic variables. RESULTS: 38.6% (n = 140) of FSWs that answered the question never used SHC and 37.6% (n = 84) received checkups in a specialized health center for FSWs. FSWs with no SHC were younger, prone to have more group sex, preferably with occasional or no stable partner, and did not know where to get an HIV test. CONCLUSIONS: FSWs have had uncertain access to sexual health controls. FSWs with no SHC and young FSWs presented higher-risk behaviors.
Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Adulto , Chile , Cidades/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Trabalho Sexual/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
Women in prostitution (WIP) experience extremely high levels of sexual, physical, and emotional abuse and are significantly more likely to experience mental health issues and trauma than the general population. Research that addresses the mental health needs of WIP emphasizes treating trauma, both trauma that predated entry into prostitution and trauma experienced during prostitution. Very little research is available on services for WIP, thus providers have limited guidance on providing effective services, particularly trauma-informed care. Although programs exist exclusively to assist women leaving prostitution, little is known about services they offer or if services are trauma-informed. Given this dearth, this study consisted of exploratory program evaluations of eight agencies that focus primarily on serving WIP to understand how trauma is addressed in their services.