Servin Argentina E, Reed Elizabeth, Brouwer Kimberly C, Magis-Rodriguez Carlos, Boyce Sabrina, Strathdee Steffanie A, Silverman Jay G
From the *Division of Global Public Health, Department of Medicine, University of California; †Division of Health Promotion and Behavioral Science, San Diego State University, ‡Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA.; §National Center for the Prevention and Control of HIV/AIDS, Ministry of Health of Mexico, Mexico; and ¶Center on Gender Equity and Health, Department of Medicine, University of California, San Diego, La Jolla, CA.
Sex Transm Dis. 2017 Aug;44(8):477-482. doi: 10.1097/OLQ.0000000000000634.
Globally, female sex workers (FSWs) have been identified as a high-risk group for human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). However, as women of reproductive age, FSWs also have children. Few studies have investigated if financial responsibilities associated with motherhood increase women's vulnerability to HIV and STIs among FSWs.
From March 2013 to March 2014, 603 FSWs aged ≥18 years were recruited from Tijuana and Ciudad Juarez (Mexico) to participate in a study assessing HIV/STI risk environments.
Findings from logistic regression models indicate that FSWs who reported motherhood were more likely to report (in the past 30 days): a higher client volume (>30 clients) (adjusted odds ratio [AOR], 1.91; 95% confidence interval [CI], 1.27-2.87) and always using alcohol right before or during sex with clients in the past 30 days (AOR, 1.77; 95% CI, 1.19-2.61). In contrast, they were more likely to report consistent condom use for vaginal or anal sex with clients (AOR, 1.68; 95% CI, 1.10-2.55), less likely to report using drugs right before or during sex with clients (AOR, 0.38; 95% CI, 0.26-0.56) and less likely to have tested positive for STIs at baseline (AOR, 0.63; 95% CI, 0.43-0.91).
These results provide a glimpse of the complex relationship between motherhood and women who are sex workers. Understanding the convergence of motherhood and sex work and how this can influence a woman's decision when engaging in sex work and affect her health is essential to designing effective programs addressing reduce risk for HIV and STIs among FSWs in this region and elsewhere.
在全球范围内,女性性工作者已被认定为感染人类免疫缺陷病毒(HIV)和性传播感染(STIs)的高危人群。然而,作为育龄女性,女性性工作者也有子女。很少有研究调查为人母所带来的经济责任是否会增加女性性工作者感染HIV和性传播感染的易感性。
2013年3月至2014年3月,从蒂华纳和华雷斯城(墨西哥)招募了603名年龄≥18岁的女性性工作者,参与一项评估HIV/性传播感染风险环境的研究。
逻辑回归模型的结果表明,报告自己为人母的女性性工作者更有可能报告(在过去30天内):更高的客户量(>30名客户)(调整后的优势比[AOR],1.91;95%置信区间[CI],1.27 - 2.87)以及在过去30天内与客户发生性行为之前或期间总是饮酒(AOR,1.77;95% CI,1.19 - 2.61)。相比之下,她们更有可能报告在与客户进行阴道或肛交时始终使用避孕套(AOR,1.68;95% CI,1.10 - 2.55),在与客户发生性行为之前或期间使用毒品的可能性较小(AOR,0.38;95% CI,0.26 - 0.56),并且在基线时性传播感染检测呈阳性的可能性较小(AOR,0.63;95% CI,0.43 - 0.91)。
这些结果让我们初步了解了为人母与女性性工作者之间的复杂关系。了解为人母与性工作的交织情况,以及这如何影响女性在从事性工作时的决策并影响其健康,对于设计有效的项目以降低该地区及其他地区女性性工作者感染HIV和性传播感染的风险至关重要。