*Division of Global Public Health, Department of Medicine University of California, San Diego, CA; †Departamento de Estudios de Poblacion, El Colegio de la Frontera Norte, Tijuana, Mexico; ‡Faculty of Medicine, Universidad Autonoma de Ciudad Juarez, Ciudad Juarez, Mexico; and §Pro-COMUSIDA, Tijuana, Mexico.
J Acquir Immune Defic Syndr. 2013 Aug 15;63(5):639-46. doi: 10.1097/QAI.0b013e318296de71.
To investigate individual, interpersonal, and social-structural factors associated with involuntary sex exchange among female sex workers (FSWs) along the Mexico-U.S. border.
In 2010 to 2011, 214 FSWs from Tijuana (n = 106) and Ciudad Juarez (n = 108) aged ≥ 18 years who reported lifetime use of heroin, cocaine, crack, or methamphetamine, having a stable partner, and having sold/traded sex in the past month completed quantitative surveys and HIV/sexually transmitted infection testing. Logistic regression was used to identify correlates of involuntary sex exchange among FSWs.
Of 214 FSWs, 31 (14.5%) reported involuntary sex exchange These women were younger at sex industry entry [adjusted odds ratio (AOR): 0.84/1-year increase, 95% confidence interval (CI): 0.72 to 0.97] and were significantly more likely to service clients whom they perceived to be HIV/sexually transmitted infection-infected (AOR: 12.41, 95% CI: 3.15 to 48.91). In addition, they were more likely to have clients who used drugs (AOR: 7.88, 95% CI: 1.52 to 41.00), report poor working conditions (AOR: 3.27, 95% CI: 1.03 to 10.31), and report a history of rape (AOR: 4.46, 95% CI: 1.43 to 13.91).
Involuntary sex exchange is disproportionate among FSWs who begin to exchange sex at a younger age, and these women experience elevated risk of violence and HIV/STIs related to their clients' behaviors and their working conditions. These data suggest the critical need for evidence-based approaches to preventing sexual exploitation of women and girls and to reducing harm among current sex workers. Multilevel interventions for all females who exchange sex and their clients that target interpersonal and social-structural risks (eg, measures to improve safety and reduce exploitation within the workplace) are needed.
本研究旨在调查墨西哥-美国边境地区女性性工作者（FSW）中与非自愿性性交易相关的个体、人际和社会结构因素。
2010 年至 2011 年，来自蒂华纳（n=106）和华雷斯城（n=108）的 214 名年龄≥18 岁、报告曾使用过海洛因、可卡因、快克或冰毒、有稳定伴侣、且在过去一个月内有过卖/交易性行为的 FSW 完成了定量调查和 HIV/性传播感染检测。使用逻辑回归来确定 FSW 中非自愿性性交易的相关因素。
在 214 名 FSW 中，有 31 名（14.5%）报告了非自愿性性交易。这些女性进入性行业的年龄更小[调整后的优势比（AOR）：每增加 1 岁，0.84；95%置信区间（CI）：0.72 至 0.97]，并且更有可能为她们认为感染了 HIV/性传播感染的客户提供服务（AOR：12.41；95%CI：3.15 至 48.91）。此外，她们更有可能有使用毒品的客户（AOR：7.88；95%CI：1.52 至 41.00），报告较差的工作条件（AOR：3.27；95%CI：1.03 至 10.31），以及有被强奸的经历（AOR：4.46；95%CI：1.43 至 13.91）。
在那些更早开始进行性交易的 FSW 中，非自愿性性交易的比例不成比例，这些女性面临与客户行为和工作条件相关的更高的暴力和 HIV/性传播感染风险。这些数据表明，迫切需要采取循证方法来预防妇女和女孩的性剥削，并减少当前性工作者的伤害。需要针对所有进行性交易的女性及其客户采取多层次干预措施，针对人际和社会结构风险（例如，改善工作场所内的安全性和减少剥削的措施）。
