Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, 4th Floor, Providence, RI 02912, USA; and Center for Health Promotion and Health Equity, Brown University School of Public Health, 121 South Main Street, 8th Floor, Providence, RI 02912, USA.
Center for Health Promotion and Health Equity, Brown University School of Public Health, 121 South Main Street, 8th Floor, Providence, RI 02912, USA.
Sex Health. 2020 Nov;17(5):429-436. doi: 10.1071/SH20137.
Background Stigma is associated with poor health among sexual minority individuals. However, no studies have examined the relationship between stigma and problematic drinking among male sex workers (MSWs). This study examined the relationship between sex work stigma and problematic alcohol use among MSWs.
Using baseline data from a cohort of 98 MSWs in the US Northeast enrolled between 2015 and 2016, we used logistic regression to examine associations between sex work stigma and hazardous drinking (Alcohol Use Disorders Identification Test (AUDIT) score ≥8) and sex work while drunk, and tested whether sexual orientation (gay vs non-gay identified) and social network size moderated these associations.
Almost half the sample (n = 46; 44%) reported hazardous drinking and 56 MSWs (57%) reported engaging in sex work while drunk. Sex work stigma was associated with hazardous drinking (adjusted odds ratio (aOR) 1.2, 95% confidence interval (CI) 1.05-1.36). Sexual orientation marginally moderated this relationship (P = 0.07), such that it was only significant among gay-identified MSWs (aOR 1.91, 95% CI 1.11-3.28), not among non-gay MSW. Similarly, sexual orientation moderated the effect of sex work stigma on sex work while drunk (P = 0.02), which was only significant among gay-identified MSWs (aOR 1.65, 95% CI 1.05-1.60). Social network size also moderated the effect of sex work stigma on sex work while drunk (P = 0.02), which was only significant among MSWs with small networks (aOR 1.26, 95% CI 1.00-1.58), suggesting large networks can be protective.
Gay MSWs may be particularly vulnerable to alcohol-related effects of stigma. Future interventions should consider engaging social networks to curb problematic drinking among MSWs.
背景污名与性少数群体个体的健康状况不佳有关。然而，尚无研究调查污名与男男性工作者（MSWs）中问题性饮酒之间的关系。本研究调查了性工作污名与 MSWs 中问题性饮酒之间的关系。
使用 2015 年至 2016 年间在美国东北部入组的 98 名 MSWs 队列的基线数据，我们使用逻辑回归来检验性工作污名与危险饮酒（酒精使用障碍识别测试（AUDIT）得分≥8）和醉酒时性工作之间的关联，并检验性取向（同性恋与非同性恋）和社交网络规模是否调节这些关联。
样本中近一半（n=46；44%）报告有危险饮酒，56 名 MSWs（57%）报告醉酒时从事性工作。性工作污名与危险饮酒相关（调整后的优势比（aOR）1.2，95%置信区间（CI）1.05-1.36）。性取向略微调节了这种关系（P=0.07），仅在同性恋身份的 MSWs 中具有统计学意义（aOR 1.91，95%CI 1.11-3.28），而非同性恋 MSWs 中无统计学意义。同样，性取向调节了性工作污名对醉酒时性工作的影响（P=0.02），仅在同性恋身份的 MSWs 中具有统计学意义（aOR 1.65，95%CI 1.05-1.60）。社交网络规模也调节了性工作污名对醉酒时性工作的影响（P=0.02），仅在网络规模较小的 MSWs 中具有统计学意义（aOR 1.26，95%CI 1.00-1.58），表明大的网络可能具有保护作用。
同性恋 MSWs 可能特别容易受到污名相关的酒精影响。未来的干预措施应考虑利用社交网络来遏制 MSWs 中的问题性饮酒。
