Argento Elena, Muldoon Katherine A, Duff Putu, Simo Annick, Deering Kathleen N, Shannon Kate
Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One. 2014 Jul 10;9(7):e102129. doi: 10.1371/journal.pone.0102129. eCollection 2014.
Intimate partner violence (IPV) is associated with increased risk of HIV among women globally. There is limited evidence and understanding about IPV and potential HIV risk pathways among sex workers (SWs). This study aims to longitudinally evaluate prevalence and correlates of IPV among street and off-street SWs over two-years follow-up.
Longitudinal data were drawn from an open prospective cohort, AESHA (An Evaluation of Sex Workers Health Access) in Metro Vancouver, Canada (2010-2012). Prevalence of physical and sexual IPV was measured using the WHO standardized IPV scale (version 9.9). Bivariate and multivariable logistic regression using Generalized Estimating Equations (GEE) were used to examine interpersonal and structural correlates of IPV over two years.
At baseline, 387 SWs had a male, intimate sexual partner and were eligible for this analysis. One-fifth (n = 83, 21.5%) experienced recent physical/sexual IPV at baseline and 26.2% over two-years follow-up. In multivariable GEE analysis, factors independently correlated with physical/sexual IPV in the last six months include: childhood (<18 years) sexual/physical abuse (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [CI]: 1.14-3.69), inconsistent condom use for vaginal and/or anal sex with intimate partner (AOR = 1.84, 95% CI: 1.07-3.16), <daily prescription opioid use (AOR = 1.72, 95% CI: 1.02-2.89), providing financial support to intimate partner (AOR = 1.65, 95% CI: 1.05-2.59), and sourcing drugs from intimate partner (AOR = 1.62, 95% CI: 1.02-2.26).
Our results demonstrate that over one-fifth of SWs in Vancouver report physical/sexual IPV in the last six months. The socio-structural correlates of IPV uncovered here highlight potential HIV risk pathways through SWs' intimate, non-commercial partner relationships. The high prevalence of IPV among SWs is a critical public health concern and underscores the need for integrated violence and HIV prevention and intervention strategies tailored to this key population.
亲密伴侣暴力（IPV）与全球女性感染艾滋病毒风险增加相关。关于性工作者（SWs）中的亲密伴侣暴力及潜在艾滋病毒风险途径的证据和了解有限。本研究旨在通过两年随访纵向评估街头和非街头性工作者中亲密伴侣暴力的患病率及其相关因素。
纵向数据取自加拿大温哥华地铁区的一个开放前瞻性队列AESHA（性工作者健康获取评估）（2010 - 2012年）。使用世界卫生组织标准化亲密伴侣暴力量表（9.9版）测量身体和性方面亲密伴侣暴力的患病率。使用广义估计方程（GEE）进行双变量和多变量逻辑回归，以检验两年期间亲密伴侣暴力的人际和结构相关因素。
在基线时，387名性工作者有男性亲密性伴侣且符合本分析条件。五分之一（n = 83，21.5%）在基线时经历过近期身体/性方面的亲密伴侣暴力，在两年随访期间这一比例为26.2%。在多变量GEE分析中，与过去六个月身体/性方面亲密伴侣暴力独立相关的因素包括：童年（<18岁）性/身体虐待（调整比值比[AOR]=2.05，95%置信区间[CI]：1.14 - 3.69）、与亲密伴侣进行阴道和/或肛交时不坚持使用避孕套（AOR = 1.84，95% CI：1.07 - 3.16）、<每日使用处方阿片类药物（AOR = 1.72，95% CI：1.02 - 2.89）、向亲密伴侣提供经济支持（AOR = 1.65，95% CI：1.05 - 2.59）以及从亲密伴侣处获取毒品（AOR = 1.62，95% CI：1.02 - 2.26）。
我们的结果表明，温哥华超过五分之一的性工作者在过去六个月报告了身体/性方面的亲密伴侣暴力。此处发现的亲密伴侣暴力的社会结构相关因素突出了通过性工作者亲密的非商业伴侣关系存在的潜在艾滋病毒风险途径。性工作者中亲密伴侣暴力的高患病率是一个关键的公共卫生问题，强调需要针对这一关键人群制定综合的暴力和艾滋病毒预防及干预策略。
