Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Harm Reduct J. 2023 Jan 27;20(1):11. doi: 10.1186/s12954-023-00738-5.
The criminalization of sex work and drug use creates unequal power dynamics easily exploited by police. Women who exchange sex (WES) in settings around the globe have reported coerced sex and sexual assault by police, and some have reported police as paying clients. Little research has examined nuances underlying WES's sexual interactions with police.
A cohort of cisgender WES (N = 308) was recruited through targeted sampling in Baltimore, Maryland and completed a structured survey every 6 months for 18 months. Follow-up surveys included detailed questions about recent sexual encounters with police. In bivariate and multivariate models using generalized estimating equations to account for intra-person correlation, we examined correlates of reporting recent sex with police over time.
One-third reported recent sex with police at any study visit. At each time point, about 90% of women who reported sex with police reported any uniformed or non-uniformed police had paid for sex. Between 72 and 85% had been solicited for paid sex by uniformed police. Between 41 and 50% of women who reported recent sex with police indicated they had done so because they feared arrest otherwise; one-third were directly pressured for sex by police to avoid arrest or trouble. In the final adjusted model, severe food insecurity [adjusted odds ratio (aOR) = 2.05; 95% confidence interval (CI) 1.13-3.71], Black race (vs. white, non-Hispanic; aOR = 1.90; 95% CI 1.13-3.17), recent arrest (aOR = 1.51; 95% CI 1.01-2.27), nonfatal overdose (aOR = 1.94; 95% CI 1.24-3.01), and client- or non-paying intimate partner-perpetrated violence (aOR = 2.46; 95% CI 1.63-3.71) were significantly independently associated with recent sex with police.
Sexual encounters between WES and police in Baltimore are common and often coerced to avoid arrest in a setting where both drug use and sex work are criminalized. Recent sex with police was more prevalent among WES who were racially marginalized, highly structurally vulnerable, and/or at high risk for drug overdose-and therefore subject to the dual-criminalization of sex work and drug use. This indicates deep power imbalances and their exploitation by police as the root of such sexual encounters and adds to the evidence regarding the need for decriminalization to support the health and wellbeing of WES.
性工作和吸毒的犯罪化造成了不平等的权力动态，容易被警察利用。在全球各地的环境中进行性交易的女性（WES）报告称，她们曾受到警察的强迫性行为和性侵犯，有些女性报告称警察是付费客户。很少有研究探讨 WES 与警察之间性互动的细微差别。
通过在马里兰州巴尔的摩的有针对性抽样，招募了一组顺性别 WES（N=308），并在 18 个月内每 6 个月完成一次结构化调查。随访调查包括最近与警察发生性关系的详细问题。在使用广义估计方程来解释个体相关性的双变量和多变量模型中，我们研究了随着时间的推移报告最近与警察发生性关系的相关性。
三分之一的人在任何研究访问中都报告了最近与警察发生性关系。在每个时间点，大约 90%报告与警察发生性关系的女性报告说，任何穿制服或不穿制服的警察都曾为性付费。约 72%至 85%的女性曾被穿制服的警察招揽卖淫。约 41%至 50%的报告最近与警察发生性关系的女性表示，她们这样做是因为担心被捕；三分之一的女性是因为害怕被捕或惹上麻烦而直接被迫与警察发生性关系。在最终调整后的模型中，严重的食物不安全（调整后的优势比[aOR]=2.05；95%置信区间[CI]为 1.13-3.71）、黑人种族（与白人、非西班牙裔相比；aOR=1.90；95%CI 为 1.13-3.17）、最近被捕（aOR=1.51；95%CI 为 1.01-2.27）、非致命性药物过量（aOR=1.94；95%CI 为 1.24-3.01）以及由客户或非付费亲密伴侣实施的暴力行为（aOR=2.46；95%CI 为 1.63-3.71）与最近与警察发生性关系显著相关。
巴尔的摩的 WES 与警察之间的性接触很常见，通常是为了避免被捕，而在一个同时将吸毒和性工作定为犯罪的环境中，这种情况经常发生。最近与警察发生性关系的 WES 中，种族边缘化程度较高、结构脆弱性较高、/或药物过量风险较高的女性更为普遍，因此受到性工作和吸毒双重犯罪化的影响。这表明存在深刻的权力失衡，以及警察对这些性接触的利用，这是这些性接触的根源，并为性工作去罪化以支持 WES 的健康和幸福提供了更多证据。
