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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...

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Autores principales: Duff, Putu, Tyndall, Mark, Buxton, Jane, Zhang, Ruth, Kerr, Thomas, Shannon, Kate
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
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.
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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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