a Division of Global Public Health School of Medicine , University of California, San Diego , La Jolla , California , USA.
b Center on Gender Equity and Health, Division of Global Public Health School of Medicine , University of California, San Diego , La Jolla , California , USA.
Subst Use Misuse. 2019;54(5):868-871. doi: 10.1080/10826084.2018.1517367. Epub 2018 Dec 30.
Research has documented consistent associations between entry into sex work as a minor and sexual HIV risk. However, previous studies have not examined whether substance use and related HIV risk are elevated among those who enter sex work under age 18.
Quantitative data were collected via time-location sampling of 603 female sex workers (FSWs) ages 18 years and older residing in two Mexico-US border cities. Age of entry into sex work (categorized as 15 years or younger, 16-17 years, or 18 years and older) was assessed as a predictor of substance use (forced and voluntary) within the first month post-entry and recent (past 30 days) substance use with clients.
Compared to those who entered as adults, participants who entered sex work at age 15 or younger were significantly more likely to report drug use (AOR = 5.2, CI = 2.9-8.9) and forced drug use within the first 30 days of entry (AOR= 6.0, CI = 1.9-18.9), as well as past month drug use with clients (AOR= 3.4, CI = 1.9-5.8). Similar results were found among participants who entered sex work at age 16-17.
Increased risk of recent substance use with clients indicates continuing elevated risk for those entering sex work at these early ages. Early and forced substance use at entry may underlie the elevated risk of HIV infection consistently observed among this population.
研究记录了未成年人进入性工作与性 HIV 风险之间存在一致的关联。然而，以前的研究并未调查在 18 岁以下进入性工作的人中，是否存在物质使用和相关的 HIV 风险增加的情况。
通过对居住在两个墨西哥-美国边境城市的 603 名年龄在 18 岁及以上的女性性工作者（FSW）进行时间地点抽样，收集了定量数据。进入性工作的年龄（分为 15 岁或以下、16-17 岁或 18 岁及以上）被评估为进入性工作后第一个月内物质使用（强制和自愿）和最近（过去 30 天）与客户的物质使用的预测因素。
与那些成年后进入性工作的人相比，15 岁或以下进入性工作的参与者报告药物使用（AOR=5.2，CI=2.9-8.9）和进入性工作后的头 30 天内强制药物使用（AOR=6.0，CI=1.9-18.9）的可能性显著更高，以及过去一个月与客户的药物使用（AOR=3.4，CI=1.9-5.8）。在进入性工作年龄为 16-17 岁的参与者中也发现了类似的结果。
最近与客户的物质使用风险增加表明，这些早期进入性工作的人继续面临着更高的风险。进入性工作时的早期和强制物质使用可能是该人群中持续观察到 HIV 感染风险增加的原因。
