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Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city
BACKGROUND: While crack cocaine has been associated with elevated sexual risks and transmission of HIV/STIs, particularly in the context of street-based sex work, few empirical studies have examined correlates of direct sex-for-crack exchanges. This study longitudinally examined the correlates of se...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833173/ https://www.ncbi.nlm.nih.gov/pubmed/24238367 http://dx.doi.org/10.1186/1477-7517-10-29 |
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author | Duff, Putu Tyndall, Mark Buxton, Jane Zhang, Ruth Kerr, Thomas Shannon, Kate |
author_facet | Duff, Putu Tyndall, Mark Buxton, Jane Zhang, Ruth Kerr, Thomas Shannon, Kate |
author_sort | Duff, Putu |
collection | PubMed |
description | BACKGROUND: While crack cocaine has been associated with elevated sexual risks and transmission of HIV/STIs, particularly in the context of street-based sex work, few empirical studies have examined correlates of direct sex-for-crack exchanges. This study longitudinally examined the correlates of sex-for-crack exchanges and associated effects on sexual risk outcomes among street-based female sex workers (SW) who use drugs in Vancouver, Canada. METHODS: Data were drawn from a prospective cohort of street-based SWs (2006–2008), restricted to those who smoke crack cocaine. Multivariable generalized estimating equations (GEE) were employed to examine the correlates of exchanging sex for crack. A confounding model using GEE quasi-Poisson regression modeled the independent effect of exchanging sex for crack on number of clients/week. RESULTS: Of 206 SWs, 101 (49%) reported sex-for-crack exchanges over 18 months of follow-up. In multivariable GEE analyses, sharing a crack pipe with a client (aOR = 1.98; 95%CI: 1.27-3.08) and smoking crack in a group of strangers (e.g., in an alley or crackhouse) (aOR = 1.70; 95% CI: 1.13-2.58) were independently correlated with sex-for-crack exchanges. In our confounding model, exchanging sex for crack (aIRR = 1.34; 95% CI: 1.07-1.69) remained significantly associated with servicing a greater number (>10) of clients/week. CONCLUSIONS: These findings reveal elevated sexual- and drug- risk patterns among those who exchange sex for crack. The physical and social environment featured prominently in our results as a driver of sex-for-crack exchanges, highlighting the need for gender-sensitive multilevel approaches to harm reduction, STI and HIV prevention that address SWs’ environment, individual level factors, and the interplay between them. |
format | Online Article Text |
id | pubmed-3833173 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38331732013-11-20 Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city Duff, Putu Tyndall, Mark Buxton, Jane Zhang, Ruth Kerr, Thomas Shannon, Kate Harm Reduct J Research BACKGROUND: While crack cocaine has been associated with elevated sexual risks and transmission of HIV/STIs, particularly in the context of street-based sex work, few empirical studies have examined correlates of direct sex-for-crack exchanges. This study longitudinally examined the correlates of sex-for-crack exchanges and associated effects on sexual risk outcomes among street-based female sex workers (SW) who use drugs in Vancouver, Canada. METHODS: Data were drawn from a prospective cohort of street-based SWs (2006–2008), restricted to those who smoke crack cocaine. Multivariable generalized estimating equations (GEE) were employed to examine the correlates of exchanging sex for crack. A confounding model using GEE quasi-Poisson regression modeled the independent effect of exchanging sex for crack on number of clients/week. RESULTS: Of 206 SWs, 101 (49%) reported sex-for-crack exchanges over 18 months of follow-up. In multivariable GEE analyses, sharing a crack pipe with a client (aOR = 1.98; 95%CI: 1.27-3.08) and smoking crack in a group of strangers (e.g., in an alley or crackhouse) (aOR = 1.70; 95% CI: 1.13-2.58) were independently correlated with sex-for-crack exchanges. In our confounding model, exchanging sex for crack (aIRR = 1.34; 95% CI: 1.07-1.69) remained significantly associated with servicing a greater number (>10) of clients/week. CONCLUSIONS: These findings reveal elevated sexual- and drug- risk patterns among those who exchange sex for crack. The physical and social environment featured prominently in our results as a driver of sex-for-crack exchanges, highlighting the need for gender-sensitive multilevel approaches to harm reduction, STI and HIV prevention that address SWs’ environment, individual level factors, and the interplay between them. BioMed Central 2013-11-15 /pmc/articles/PMC3833173/ /pubmed/24238367 http://dx.doi.org/10.1186/1477-7517-10-29 Text en Copyright © 2013 Duff et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Duff, Putu Tyndall, Mark Buxton, Jane Zhang, Ruth Kerr, Thomas Shannon, Kate Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city |
title | Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city |
title_full | Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city |
title_fullStr | Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city |
title_full_unstemmed | Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city |
title_short | Sex-for-Crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city |
title_sort | sex-for-crack exchanges: associations with risky sexual and drug use niches in an urban canadian city |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833173/ https://www.ncbi.nlm.nih.gov/pubmed/24238367 http://dx.doi.org/10.1186/1477-7517-10-29 |
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