Sex workers are individuals who offer sexual services in exchange for compensation (i.e., money, goods, or other services). Within the United States the full-service sex work (FSSW) industry generates 14 billion dollars annually there are estimated to be 1-2 million FSSWers, though experts believe this number to be an underestimate. Many FSSWers face the possibility of violence, legal involvement, and social stigmatization. As a result, this population experiences increased risk for mental health disorders. Given these risks and vulnerabilities, FSSWers stand to benefit from receiving mental health care however a constellation of individual, organizational, and systemic barriers limit care utilization. Destigmatization of FSSW and offering of culturally competent mental health care can help empower this traditionally marginalized population. The objective of the current review is to (1) educate clinicians on sex work and describe the unique struggles faced by FSSW and vulnerability factors clinicians must consider, (2) address 5 common myths about FSSW that perpetuate stigma, and (3) advance a research and culturally competent clinical training agenda that can optimize mental health care engagement and utilization within the sex work community.
Objective. To examine sociodemographic and military characteristics of U.S. veterans who do and do not utilize Veterans Affairs (VA) healthcare services as their primary source of healthcare, and examine the relationship between VA utilization and medical and psychosocial characteristics. Methods. Participants were a nationally representative sample of 3,152 military veterans (89.8% male, 83.5% Caucasian, 6.0%, Mage = 62.0, SD = 13.1) who completed a survey assessing healthcare utilization, sociodemographic, military service, medical and psychosocial characteristics. Receiver operator characteristic analyses and logistic and linear regressions were conducted to provide a comprehensive and multivariate examination of factors associated with VA utilization. Results. Veterans who used VA were more likely to be Black, younger, female, unmarried, less educated, and have lower household incomes. They were also more likely to have served longer in the military and in combat. VA users were more likely to screen positive for lifetime psychopathology, endorse current suicidality, and report enduring more traumas. VA users were also more likely to report more medical conditions, endorse a disability, and score lower on measures of functioning. The primary factor differentiating VA users from those that did not use VA was presence of lifetime psychopathology. Conclusion. Results provide a comprehensive profile of veterans who do and do not utilize VA and suggest that veterans who use VA have a substantially elevated health burden compared to other veterans. Results may help inform outreach and engagement initiatives targeting the unique healthcare needs of veterans who do and do not utilize VA services.
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