墨西哥13个城市中客户对女性性工作者实施暴力行为的患病率及相关因素
Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities.
作者信息
Semple Shirley J, Stockman Jamila K, Pitpitan Eileen V, Strathdee Steffanie A, Chavarin Claudia V, Mendoza Doroteo V, Aarons Gregory A, Patterson Thomas L
机构信息
Department of Psychiatry, University of California San Diego, La Jolla, California, 92093-0680, United States of America.
Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, 92093-0507, United States of America.
出版信息
PLoS One. 2015 Nov 23;10(11):e0143317. doi: 10.1371/journal.pone.0143317. eCollection 2015.
BACKGROUND
Globally, client-perpetrated violence against female sex workers (FSWs) has been associated with multiple health-related harms, including high-risk sexual behavior and increased exposure to HIV/STIs. This study examined correlates of client-perpetrated sexual, physical, and economic violence (e.g., robbery) against FSWs in 13 cities throughout Mexico.
METHODS
FSWs (N = 1,089) who were enrolled in a brief, evidence-based, sexual risk reduction intervention for FSWs (Mujer Segura) were interviewed about their work context, including experiences of violence perpetrated by clients, sexual risk and substance use practices, financial need, and social supports. Three broad categories of factors (sociodemographic, work context, behavioral and social characteristics of FSWs) were examined as correlates of sexual, physical, and economic violence.
RESULTS
The prevalence of different types of client-perpetrated violence against FSWs in the past 6 months was: sexual (11.7%), physical (11.8%), economic (16.9%), and any violence (22.6%). Greater financial need, self-identification as a street worker, and lower perceived emotional support were independently associated with all three types of violence. Alcohol use before or during sex with clients in the past month was associated with physical and sexual violence. Using drugs before or during sex with clients, injection drug use in the past month, and population size of city were associated with sexual violence only, and FSWs' alcohol use score (AUDIT-C) was associated with economic violence only.
CONCLUSIONS
Correlates of client-perpetrated violence encompassed sociodemographic, work context, and behavioral and social factors, suggesting that approaches to violence prevention for FSWs must be multi-dimensional. Prevention could involve teaching FSWs strategies for risk avoidance in the workplace (e.g., avoiding use of alcohol with clients), enhancement of FSWs' community-based supports, development of interventions that deliver an anti-violence curriculum to clients, and programs to address FSWs' financial need by increasing their economic opportunities outside of the sex trade.
背景
在全球范围内，嫖客对女性性工作者实施的暴力与多种健康相关危害有关，包括高风险性行为以及更高的感染艾滋病毒/性传播感染几率。本研究调查了墨西哥13个城市中嫖客对女性性工作者实施的性暴力、身体暴力和经济暴力（如抢劫）的相关因素。
方法
对参与一项针对女性性工作者的简短、循证性降低性风险干预措施（Mujer Segura）的1089名女性性工作者进行访谈，内容涉及她们的工作环境，包括嫖客实施暴力的经历、性风险和物质使用行为、经济需求以及社会支持。研究考察了三大类因素（社会人口统计学因素、工作环境因素、女性性工作者的行为和社会特征）作为性暴力、身体暴力和经济暴力的相关因素。
结果
在过去6个月中，嫖客对女性性工作者实施的不同类型暴力的发生率分别为：性暴力（11.7%）、身体暴力（11.8%）、经济暴力（16.9%）以及任何形式的暴力（22.6%）。更大的经济需求、自我认定为街头工作者以及较低的感知情感支持与所有三种类型的暴力均独立相关。在过去一个月中，与嫖客发生性行为之前或期间饮酒与身体暴力和性暴力有关。与嫖客发生性行为之前或期间使用毒品、过去一个月内注射毒品以及城市人口规模仅与性暴力有关，而女性性工作者的酒精使用评分（AUDIT-C）仅与经济暴力有关。
结论
嫖客实施暴力的相关因素包括社会人口统计学因素、工作环境因素以及行为和社会因素，这表明针对女性性工作者的暴力预防方法必须是多维度的。预防措施可包括教导女性性工作者在工作场所避免风险的策略（如避免与嫖客饮酒）、加强女性性工作者基于社区的支持、制定向嫖客传授反暴力课程的干预措施，以及通过增加她们在性交易之外的经济机会来解决女性性工作者经济需求的项目。
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