TY - JOUR
T1 - Brief Report
T2 - Longitudinal Associations between Place of Sex Work and Client Condom Coercion among Sex Workers in Baltimore, Maryland
AU - Logie, Carmen H.
AU - White, Rebecca H.
AU - Galai, Noya
AU - Tomko, Catherine
AU - Sherman, Susan G.
N1 - Funding Information:
This project was supported by the National Institute on Drug Abuse (R01DA038499–01) and Johns Hopkins University Center for AIDS Research (1P30AI094189). The funders had no role in the study design, data collection, or in the analysis and interpretation of the results, and this study does not necessarily reflect the views or opinions of the funders. C.H.L.'s participation was supported by a Fulbright Canada Research Chair in Public Health at Johns Hopkins University, and she is also supported by Canada Foundation for Innovation, Canada Research Chairs, and Ontario Ministry of Research & Innovation.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/12/15
Y1 - 2020/12/15
N2 - Introduction: The sex work environment influences sex workers' control over enforcing condom use. Sex work in outdoor and public spaces, compared with indoor spaces, may inhibit condom negotiation. We examined longitudinal associations between public place of sex work and condom coercion among female sex workers.Methods: This cohort study involved 5 data collection points over 1 year among female sex workers (N = 246) in Baltimore, Maryland, recruited by targeted sampling. We conducted bivariate analyses to examine associations between currently conducting any sex work in a public place (PPSW, eg, car, abandoned house, street, park/forest, and public bathroom) vs. exclusively indoor sex work (eg, house, motel, and dance club) with sociodemographic, substance use (eg, injection drug use, crack use), and past 3-month condom coercion (eg, client condom refusal/removal). We used logistic regressions with generalized estimating equations and exchangeable correlation structure to examine longitudinal associations between PPSW and subsequent condom coercion, adjusting for sociodemographic and substance use variables.Findings: Among participants (race/ethnicity: White: 67.5%; Black/African American: 22.8%; Latina/other ethnicity: n = 9.8%; age range: 18-61), most reported daily injection drug use (58.5%), daily crack use (62.2%), and homelessness (62.2%). Most (88.6%) reported any PPSW at baseline. Current PPSW was associated with increased odds of past 3-month condom coercion (adjusted odds ratio [aOR]: 1.85, 95% confidence interval: 1.16 to 2.94, P = 0.01) compared with indoor sex work, as was daily crack use (aOR 1.67, 95% confidence interval: 1.18 to 2.37).Conclusions: Public sex work environments were associated with client condom coercion and confer additional sexual health risks in contexts of illegality. Interventions should address risk disparities in social geographies of sex work.
AB - Introduction: The sex work environment influences sex workers' control over enforcing condom use. Sex work in outdoor and public spaces, compared with indoor spaces, may inhibit condom negotiation. We examined longitudinal associations between public place of sex work and condom coercion among female sex workers.Methods: This cohort study involved 5 data collection points over 1 year among female sex workers (N = 246) in Baltimore, Maryland, recruited by targeted sampling. We conducted bivariate analyses to examine associations between currently conducting any sex work in a public place (PPSW, eg, car, abandoned house, street, park/forest, and public bathroom) vs. exclusively indoor sex work (eg, house, motel, and dance club) with sociodemographic, substance use (eg, injection drug use, crack use), and past 3-month condom coercion (eg, client condom refusal/removal). We used logistic regressions with generalized estimating equations and exchangeable correlation structure to examine longitudinal associations between PPSW and subsequent condom coercion, adjusting for sociodemographic and substance use variables.Findings: Among participants (race/ethnicity: White: 67.5%; Black/African American: 22.8%; Latina/other ethnicity: n = 9.8%; age range: 18-61), most reported daily injection drug use (58.5%), daily crack use (62.2%), and homelessness (62.2%). Most (88.6%) reported any PPSW at baseline. Current PPSW was associated with increased odds of past 3-month condom coercion (adjusted odds ratio [aOR]: 1.85, 95% confidence interval: 1.16 to 2.94, P = 0.01) compared with indoor sex work, as was daily crack use (aOR 1.67, 95% confidence interval: 1.18 to 2.37).Conclusions: Public sex work environments were associated with client condom coercion and confer additional sexual health risks in contexts of illegality. Interventions should address risk disparities in social geographies of sex work.
KW - HIV prevention
KW - condoms
KW - drug use
KW - sex workers
KW - violence
UR - http://www.scopus.com/inward/record.url?scp=85096152696&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000002494
DO - 10.1097/QAI.0000000000002494
M3 - Article
C2 - 32925362
AN - SCOPUS:85096152696
VL - 85
SP - 579
EP - 583
JO - Journal of acquired immune deficiency syndromes (1999)
JF - Journal of acquired immune deficiency syndromes (1999)
SN - 1525-4135
IS - 5
ER -
