Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
AIDS Behav. 2022 Aug;26(8):2632-2642. doi: 10.1007/s10461-022-03599-4. Epub 2022 Feb 5.
Among women who exchange sex (WES), social cohesion is associated with multi-level HIV-risk reduction factors, and client condom coercion (CCC) is associated with increased HIV-risk. Sexual minority WES (SM-WES) face exacerbated HIV-risk, yet relevant research is scant. We examined the role of sexual orientation in the relationship between social cohesion and CCC among cisgender WES (n = 384) in Baltimore, Maryland using stratified logistic regression, controlling for potential confounders. Forty-five percent of WES experienced CCC. SM-WES reported significantly higher social cohesion than heterosexual WES. The relationship between social cohesion and CCC differed by sexual orientation. Among SM-WES, higher social cohesion was independently associated with decreased odds of experiencing CCC, controlling for food insecurity, crack use, police harassment, and method of finding clients. Among heterosexual WES, no significant association was found. Ongoing research and practice with WES should (1) collect sexual orientation data to allow for deeper understanding and tailored interventions, (2) leverage and nurture social cohesion and (3) tailor interventions to populations with attention to sexual orientation.
在性工作者（WES）中，社会凝聚力与多层次的 HIV 风险降低因素有关，而客户 condom 强制（CCC）与 HIV 风险增加有关。性少数群体性工作者（SM-WES）面临更严重的 HIV 风险，但相关研究很少。我们使用分层逻辑回归，在马里兰州巴尔的摩的顺性别性工作者（n=384）中，检查了性取向在社会凝聚力与 CCC 之间关系中的作用，控制了潜在的混杂因素。45%的性工作者经历了 CCC。SM-WES 报告的社会凝聚力明显高于异性恋性工作者。社会凝聚力与 CCC 的关系因性取向而异。在 SM-WES 中，在控制了食物不安全、吸食冰毒、警察骚扰和寻找客户的方法后，较高的社会凝聚力与降低经历 CCC 的几率独立相关。在异性恋性工作者中，没有发现显著的相关性。针对性工作者的持续研究和实践应该：（1）收集性取向数据，以便更深入地了解和量身定制干预措施；（2）利用和培养社会凝聚力；（3）根据性取向调整干预措施，以针对特定人群。
