Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, Maryland; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, Maryland.
Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, Maryland.
Womens Health Issues. 2021 Mar-Apr;31(2):148-156. doi: 10.1016/j.whi.2020.11.002. Epub 2020 Dec 6.
Resilience represents adaptability and empowerment and can buffer against the consequences of traumatic events. Cisgender and transgender women in street-based sex work are at high risk for trauma, yet data on their resilience are sparse. A clearer understanding of resilience and its correlates is useful for informing sex worker-centered interventions.
Using the Connor-Davidson 10-item Resilience Scale (range, 0-40), we describe resilience among 165 cisgender and 42 transgender street-based women sex workers in Baltimore, Maryland. Longitudinal cohort data were used to examine correlates of resilience in each population. Analyses are conducted using multiple linear regression.
The mean resilience score was 24.2 (95% confidence interval, 23.6-24.8) among cisgender women sex workers and 32.2 among transgender women sex workers (95% confidence interval, 30.8-32.7). Among cisgender participants, positive correlates of resilience were being Black, Hispanic, or other race (ß = 2.7; p = .004), having housing (ß = 1.9; p = .034), social cohesion score (ß = 0.18; p = .047), and daily drug injection (ß = 3.7; p < .001); negative correlates of resilience were sexual violence (ß = -4.8; p = .006) and exposure to egregious police acts (ß = -0.6; p = .015). Among transgender participants, higher education level (ß = 8.8; p < .001), food security (ß = 3.5; p = .005), and housing stability (ß = 2.0; p < .001) were associated with increased resilience, and daily noninjection drug use (excluding marijuana; ß = -3.3; p < .001) and physical violence (ß = -2.9; p < .001) were associated with reduced resilience.
This study is the first to characterize factors that may influence resilience among cisgender and transgender women sex workers. Results highlight tangible intervention targets for promoting mental health and safety among a uniquely vulnerable population of women.
韧性代表适应力和赋权能力,可以缓冲创伤事件的后果。从事街头性工作的跨性别和顺性别女性面临着很高的创伤风险,但关于她们韧性的数据却很少。更清楚地了解韧性及其相关性对于为以性工作者为中心的干预措施提供信息是有用的。
使用康纳-戴维森 10 项韧性量表(范围为 0-40),我们描述了马里兰州巴尔的摩市 165 名顺性别和 42 名跨性别街头性工作者女性的韧性。使用纵向队列数据来检查每个群体中韧性的相关性。使用多元线性回归进行分析。
顺性别女性性工作者的平均韧性得分为 24.2(95%置信区间,23.6-24.8),跨性别女性性工作者的韧性得分为 32.2(95%置信区间,30.8-32.7)。在顺性别参与者中,韧性的积极相关性因素包括为黑人、西班牙裔或其他种族(ß=2.7;p=.004)、有住房(ß=1.9;p=.034)、社会凝聚力得分(ß=0.18;p=.047)和每日药物注射(ß=3.7;p<.001);韧性的负相关因素包括性暴力(ß=-4.8;p=.006)和遭受恶劣警察行为(ß=-0.6;p=.015)。在跨性别参与者中,更高的教育水平(ß=8.8;p<.001)、食品安全(ß=3.5;p=.005)和住房稳定(ß=2.0;p<.001)与韧性增加相关,而每日非注射药物使用(不包括大麻;ß=-3.3;p<.001)和身体暴力(ß=-2.9;p<.001)与韧性降低相关。
这项研究首次描述了可能影响顺性别和跨性别女性性工作者韧性的因素。结果突出了促进这一独特弱势群体女性心理健康和安全的切实可行的干预目标。