TY - JOUR
T1 - Short-term interruptions to sex work among a prospective cohort of street-based cisgender female sex workers in Baltimore
AU - White, Rebecca Hamilton
AU - Park, Ju Nyeong
AU - Galai, Noya
AU - Decker, Michele R.
AU - Allen, Sean T.
AU - Footer, Katherine H.A.
AU - Sherman, Susan G.
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Street-based female sex workers (FSW) often cycle in and out of sex work engagement. For many FSW, substance use plays a critical role in sex work entry, continuation, and interruptions. We examined individual, interpersonal, and structural correlates of short-term interruptions of sex work among street-based FSW in an urban environment. Methods: Data were from 205 FSW in Baltimore, MD, USA followed as part of an observational prospective cohort study between April 2016-Februrary 2018. The primary outcome was short-term interruptions of sex work (stopping sex work) over the past 3 months, asked every 3 months over a 12-month follow-up. We assessed the relationship between individual, structural, and interpersonal factors for each woman's prior visit and current visit with short-term sex work interruptions. We employed modified Poisson regression with Generalized Estimating Equations to identify correlates of short-term interruptions of sex work. Results: Eighty-two women (40%) reported stopping sex work over the past 3 months at least once during follow-up. Past drug treatment (adjusted incidence rate ratio [aIRR] 1.40; 95% CI: 1.06–1.86) and not having used drugs in the past 3 months (aIRR 2.70; 95% CI: 1.96–3.71) were positively associated with short-term interruption to sex work. Past intimate partner violence (IPV) (aIRR 0.52; 95% CI: 0.31–0.86) and current homelessness (aIRR 0.61; 95% CI: 0.41–0.91) were negatively associated with short-term interruption. Results were inconclusive for the association between recent prostitution arrest and short-term interruptions to sex work (IRR 0.86; 95% CI: 0.40–1.86). Conclusion: The study suggests that similar to other professions, women leave sex work for numerous reasons. Substance use cessation and participation in drug treatment programs may contribute to short-term interruptions of sex work by reducing reliance on sex work for income among street-based FSW. Structural vulnerabilities including homelessness and IPV are driving continued street-based sex work, speaking to the need for holistic structural interventions.
AB - Background: Street-based female sex workers (FSW) often cycle in and out of sex work engagement. For many FSW, substance use plays a critical role in sex work entry, continuation, and interruptions. We examined individual, interpersonal, and structural correlates of short-term interruptions of sex work among street-based FSW in an urban environment. Methods: Data were from 205 FSW in Baltimore, MD, USA followed as part of an observational prospective cohort study between April 2016-Februrary 2018. The primary outcome was short-term interruptions of sex work (stopping sex work) over the past 3 months, asked every 3 months over a 12-month follow-up. We assessed the relationship between individual, structural, and interpersonal factors for each woman's prior visit and current visit with short-term sex work interruptions. We employed modified Poisson regression with Generalized Estimating Equations to identify correlates of short-term interruptions of sex work. Results: Eighty-two women (40%) reported stopping sex work over the past 3 months at least once during follow-up. Past drug treatment (adjusted incidence rate ratio [aIRR] 1.40; 95% CI: 1.06–1.86) and not having used drugs in the past 3 months (aIRR 2.70; 95% CI: 1.96–3.71) were positively associated with short-term interruption to sex work. Past intimate partner violence (IPV) (aIRR 0.52; 95% CI: 0.31–0.86) and current homelessness (aIRR 0.61; 95% CI: 0.41–0.91) were negatively associated with short-term interruption. Results were inconclusive for the association between recent prostitution arrest and short-term interruptions to sex work (IRR 0.86; 95% CI: 0.40–1.86). Conclusion: The study suggests that similar to other professions, women leave sex work for numerous reasons. Substance use cessation and participation in drug treatment programs may contribute to short-term interruptions of sex work by reducing reliance on sex work for income among street-based FSW. Structural vulnerabilities including homelessness and IPV are driving continued street-based sex work, speaking to the need for holistic structural interventions.
KW - Arrest
KW - Female sex workers
KW - Homelessness
KW - Intimate partner violence
KW - Substance use
KW - Women who use drugs
UR - http://www.scopus.com/inward/record.url?scp=85088665247&partnerID=8YFLogxK
U2 - 10.1016/j.drugpo.2020.102858
DO - 10.1016/j.drugpo.2020.102858
M3 - Article
C2 - 32726687
AN - SCOPUS:85088665247
SN - 0955-3959
VL - 84
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
M1 - 102858
ER -