Washington University in St Louis Brown School, International Center for Child Health and Development (ICHAD), St Louis, MO, USA.
Columbia University, School of Social Work, New York, NY, USA.
Int J STD AIDS. 2023 Aug;34(9):633-640. doi: 10.1177/09564624231167910. Epub 2023 Apr 5.
Women engaged in commercial sex work (WESW) are at a higher risk of acquiring and transmitting HIV. WESW are highly mobile, and their mobility may increase their economic status, and increased access to healthcare and other social services. However, it may also facilitate the spread of HIV infection from higher to lower prevalence regions. This study examined the predictors of mobility among WESW in Uganda using a generalized estimating equations model.
We defined and measured mobility as the change in residence by WESW between baseline, 6 months, and 12 months follow-up. Participants who changed places were considered mobile, and those who never changed were non-mobile. We used data from a longitudinal study, which recruited 542 WESW from Southern Uganda aged 18-55 years and constructed a Generalized Estimating Equations Model.
Findings show that 19.6% of WESW changed residence between baseline and 6 months of follow-up and 26.2% (cumulative) between baseline and 12 months of follow-up. Older women (OR = 0.966, 95% CI = 0.935, 0.997) were associated with decreased odds of mobility, whereas WESW who were HIV positive (OR = 1.475, 95% CI = 1.078, 2.018) and those from large households (OR = 1.066, 95% CI = 1.001, 1.134) were associated with increased odds of mobility. WESW residing in rural areas (OR = 0.535, 95% CI = 0.351, 0.817) were associated with decreased odds of mobility compared to those from fishing sites.
The results indicate risk factors for mobility, further research is needed to determine the directionality of these factors in order to design interventions addressing mobility among WESW.
从事商业性性工作的女性(WESW)感染和传播 HIV 的风险更高。WESW 高度流动,她们的流动性可能会提高她们的经济地位,并增加获得医疗保健和其他社会服务的机会。然而,这也可能促进 HIV 从高流行地区向低流行地区传播。本研究使用广义估计方程模型探讨了乌干达 WESW 流动性的预测因素。
我们将 WESW 在基线、6 个月和 12 个月随访期间的居住地变化定义和测量为流动性。居住地发生变化的参与者被视为流动人口,而从未改变居住地的参与者被视为非流动人口。我们使用了一项纵向研究的数据,该研究从乌干达南部招募了 542 名年龄在 18-55 岁之间的从事商业性性工作的女性,并构建了广义估计方程模型。
研究结果表明,19.6%的从事商业性性工作的女性在基线和 6 个月随访期间改变了居住地,26.2%(累计)在基线和 12 个月随访期间改变了居住地。年龄较大的女性(OR=0.966,95%CI=0.935,0.997)与流动性降低的几率相关,而 HIV 阳性的女性(OR=1.475,95%CI=1.078,2.018)和来自大家庭的女性(OR=1.066,95%CI=1.001,1.134)与流动性增加的几率相关。与来自渔区的女性相比,居住在农村地区的女性(OR=0.535,95%CI=0.351,0.817)流动性降低的几率较低。
研究结果表明了流动性的风险因素,需要进一步研究以确定这些因素的方向性,以便针对从事商业性性工作的女性的流动性设计干预措施。