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Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers

BACKGROUND: Female sex workers (FSWs) have elevated rates of sexually transmitted infections (STIs) including HIV, yet few studies in the United States have characterized the STI burden in this population. METHODS: Data were derived from the EMERALD study, a structural community-based intervention w...

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Autores principales: Sherman, Susan G., Tomko, Catherine, White, Rebecca Hamilton, Nestadt, Danielle Friedman, Silberzahn, Bradley E., Clouse, Emily, Haney, Katherine, Galai, Noya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360669/
https://www.ncbi.nlm.nih.gov/pubmed/33633073
http://dx.doi.org/10.1097/OLQ.0000000000001400
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author Sherman, Susan G.
Tomko, Catherine
White, Rebecca Hamilton
Nestadt, Danielle Friedman
Silberzahn, Bradley E.
Clouse, Emily
Haney, Katherine
Galai, Noya
author_facet Sherman, Susan G.
Tomko, Catherine
White, Rebecca Hamilton
Nestadt, Danielle Friedman
Silberzahn, Bradley E.
Clouse, Emily
Haney, Katherine
Galai, Noya
author_sort Sherman, Susan G.
collection PubMed
description BACKGROUND: Female sex workers (FSWs) have elevated rates of sexually transmitted infections (STIs) including HIV, yet few studies in the United States have characterized the STI burden in this population. METHODS: Data were derived from the EMERALD study, a structural community-based intervention with FSWs in Baltimore, MD. Participants (n = 385) were recruited through targeted sampling on a mobile van. Prevalent positive chlamydia or gonorrhea infections were determined by biological samples. Multivariable logistic regressions modeled correlates of confirmed positive STI (gonorrhea or chlamydia). RESULTS: Confirmed STI positive prevalence was 28%, 15% chlamydia and 18% gonorrhea. Approximately two-thirds of the sample (64%) was younger than 40 years, one-third (36%) were Black, and 10% entered sex work in the past year. The sample was characterized by high levels of structural vulnerabilities (e.g., housing instability and food insecurity) and illicit substance use. Female sex workers were more likely to have a positive STI if they had financial dependent(s) (P = 0.04), experienced food insecurity at least weekly (P = 0.01), entered sex work in the past year (P = 0.002), and had 6 or more clients in the past week (P = 0.01). Female sex workers were less likely to have a positive STI test result if they were 40 years or older compared with FSW 18 to 29 years old (P = 0.02), and marginally (P = 0.08) less likely with high (vs. low) social cohesion. CONCLUSIONS: More than a quarter of FSWs had confirmed chlamydia or gonorrhea. In addition to STI risks at the individual level, STIs are driven by structural vulnerabilities. Results point to a number of salient factors to be targeted in STI prevention among FSWs.
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spelling pubmed-83606692021-08-18 Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers Sherman, Susan G. Tomko, Catherine White, Rebecca Hamilton Nestadt, Danielle Friedman Silberzahn, Bradley E. Clouse, Emily Haney, Katherine Galai, Noya Sex Transm Dis Original Studies BACKGROUND: Female sex workers (FSWs) have elevated rates of sexually transmitted infections (STIs) including HIV, yet few studies in the United States have characterized the STI burden in this population. METHODS: Data were derived from the EMERALD study, a structural community-based intervention with FSWs in Baltimore, MD. Participants (n = 385) were recruited through targeted sampling on a mobile van. Prevalent positive chlamydia or gonorrhea infections were determined by biological samples. Multivariable logistic regressions modeled correlates of confirmed positive STI (gonorrhea or chlamydia). RESULTS: Confirmed STI positive prevalence was 28%, 15% chlamydia and 18% gonorrhea. Approximately two-thirds of the sample (64%) was younger than 40 years, one-third (36%) were Black, and 10% entered sex work in the past year. The sample was characterized by high levels of structural vulnerabilities (e.g., housing instability and food insecurity) and illicit substance use. Female sex workers were more likely to have a positive STI if they had financial dependent(s) (P = 0.04), experienced food insecurity at least weekly (P = 0.01), entered sex work in the past year (P = 0.002), and had 6 or more clients in the past week (P = 0.01). Female sex workers were less likely to have a positive STI test result if they were 40 years or older compared with FSW 18 to 29 years old (P = 0.02), and marginally (P = 0.08) less likely with high (vs. low) social cohesion. CONCLUSIONS: More than a quarter of FSWs had confirmed chlamydia or gonorrhea. In addition to STI risks at the individual level, STIs are driven by structural vulnerabilities. Results point to a number of salient factors to be targeted in STI prevention among FSWs. Lippincott Williams & Wilkins 2021-09 2021-02-23 /pmc/articles/PMC8360669/ /pubmed/33633073 http://dx.doi.org/10.1097/OLQ.0000000000001400 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Studies
Sherman, Susan G.
Tomko, Catherine
White, Rebecca Hamilton
Nestadt, Danielle Friedman
Silberzahn, Bradley E.
Clouse, Emily
Haney, Katherine
Galai, Noya
Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers
title Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers
title_full Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers
title_fullStr Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers
title_full_unstemmed Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers
title_short Structural and Environmental Influences Increase the Risk of Sexually Transmitted Infection in a Sample of Female Sex Workers
title_sort structural and environmental influences increase the risk of sexually transmitted infection in a sample of female sex workers
topic Original Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360669/
https://www.ncbi.nlm.nih.gov/pubmed/33633073
http://dx.doi.org/10.1097/OLQ.0000000000001400
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