Pedersen Courtney J, Wickersham Jeffrey A, Altice Frederick L, Kamarulzaman Adeeba, Khoshnood Kaveh, Gibson Britton A, Khati Antoine, Maviglia Francesca, Shrestha Roman
Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Front Psychiatry. 2022 Jun 14;13:879479. doi: 10.3389/fpsyt.2022.879479. eCollection 2022.
The use of amphetamine-type stimulants (ATS) has been associated with increased sexual risk behaviors and HIV transmission, among other adverse health outcomes. However, ATS use among female sex workers (FSWs) in Malaysia has not yet been characterized. We examined the prevalence and correlates associated with ATS use among Malaysian FSW. Between February and December 2016, 492 FSWs, including cisgender ( = 299) and transgender ( = 193) women, were recruited using respondent-driven sampling in Greater Kuala Lumpur, Malaysia. A structured questionnaire was used to collect demographic characteristics, sexual behaviors, ATS and other substance use, behavioral health issues, involvement in criminal justice, and experience of physical and sexual trauma. Logistic regression analyses were conducted to determine factors associated with active ATS use, defined as ATS use in the last 30 days. Nearly one-third (32.3%) of participants reported active ATS use. In the multivariable model, ATS use was associated with drug use during sex work (aOR = 17.10; 8.32-35.15), having moderate to severe level of substance use disorder (aOR = 3.38; 1.48-7.70), and engaging in sex work with multiple clients per day (two clients: aOR = 3.39; 1.36-8.46; three clients: aOR = 5.06; 1.81-14.10). A high prevalence of ATS use was documented in our sample. The presence of moderate to severe substance use disorder, the use of drugs during sex work activity, and having multiple sex work clients per day were significantly associated with active ATS use. Given these findings, prevention and harm reduction strategies need to be tailored to address the increasing ATS use and the associated adverse health consequences among FSWs in Malaysia.
使用苯丙胺类兴奋剂（ATS）与增加性风险行为及艾滋病毒传播等其他不良健康后果有关。然而，马来西亚女性性工作者（FSW）中ATS的使用情况尚未得到描述。我们调查了马来西亚FSW中ATS使用的流行率及其相关因素。2016年2月至12月期间，在马来西亚吉隆坡大都会采用应答者驱动抽样法招募了492名FSW，包括顺性别女性（n = 299）和跨性别女性（n = 193）。使用结构化问卷收集人口统计学特征、性行为、ATS及其他物质使用情况、行为健康问题、参与刑事司法情况以及身体和性创伤经历。进行逻辑回归分析以确定与近期ATS使用（定义为过去30天内使用过ATS）相关的因素。近三分之一（32.3%）的参与者报告近期使用过ATS。在多变量模型中，ATS使用与性工作期间使用毒品（调整后比值比[aOR]=17.10；95%置信区间[CI]：8.32 - 35.15）、有中度至重度物质使用障碍（aOR = 3.38；95%CI：1.48 - 7.70）以及每天与多个客户进行性工作（两个客户：aOR = 3.39；95%CI：1.36 - 8.46；三个客户：aOR = 5.06；95%CI：1.81 - 14.10）有关。我们的样本中记录了较高的ATS使用流行率。中度至重度物质使用障碍的存在、性工作活动期间使用毒品以及每天有多个性工作客户与近期ATS使用显著相关。鉴于这些发现，需要制定针对性的预防和减少伤害策略，以应对马来西亚FSW中日益增加的ATS使用及其相关的不良健康后果。
