HIV, Gender, Race, Sexual Orientation, and Sex Work: A Qualitative Study of Intersectional Stigma Experienced by HIV-Positive Women in Ontario, Canada

Logie, Carmen H.; James, LLana; Tharao, Wangari; Loutfy, Mona

doi:10.1371/journal.pmed.1001124

Cited by 462 publications

(442 citation statements)

References 52 publications

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“…Future studies should examine intersectional stigma [66], including sex work stigma, and its association with the health and wellbeing of MSM who sell sex in Jamaica [34]. …”

Section: Discussionmentioning

confidence: 99%

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

Logie

Lacombe‐Duncan

Kenny

et al. 2018

Global Health Action

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Background: Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability. Objective: We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months). Methods: We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex. Results: Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]). Conclusions: This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings suggest that MSM in Jamaica who sell sex experience intensified social and structural HIV vulnerabilities that should be addressed in multi-level interventions to promote health and human rights.

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“…Future studies should examine intersectional stigma [66], including sex work stigma, and its association with the health and wellbeing of MSM who sell sex in Jamaica [34]. …”

Section: Discussionmentioning

confidence: 99%

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

Logie

Lacombe‐Duncan

Kenny

et al. 2018

Global Health Action

Self Cite

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“…Literature has acknowledged the critical importance of understanding gender as intersectional and institutional [20], alongside other converging factors and identities that influence wellbeing. Applying an intersectional approach [21–24] to understand structural violence in post-earthquake Haiti involves exploring how multiple, intersecting axes of inequality – for example, based on gender, age, poverty, and displacement – produce both oppression and opportunity. Relational approaches [25] enhance understanding of the complexity of gender power dynamics, including diversity within genders, and the intersection of gender and other identities that produce different experiences of masculinity and femininity.…”

Section: Introductionmentioning

confidence: 99%

‘Life under the tent is not safe, especially for young women’: understanding intersectional violence among internally displaced youth in Leogane, Haiti

Logie

Daniel

Ahmed

et al. 2017

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Background: Haiti’s 2010 earthquake devastated social, health, and economic infrastructure and left 2 million persons homeless. Over 6 years later 61,000 people remain displaced, most lacking protection, services, and durable solutions. Structural contexts elevate risks of gender-based violence (GBV) targeting internally displaced (ID) girls and women. Objective: We used an intersectionality framework to explore lived experiences and understanding of violence among ID young men and women in Leogane, Haiti. Methods: We conducted six focus groups, three with ID young women (n = 30) and three with ID young men (n = 30) aged 18–24 years, and 11 in-depth individual interviews with frontline workers in Leogane. Focus groups and interviews were conducted in Kreyol, transcribed verbatim, translated into English, and analyzed using narrative thematic techniques. Results: Findings revealed violence experienced by ID youth was (re)produced at the intersection of gender, poverty, displacement, and age. Multi-level forms of violence included structural (e.g. poverty), community (e.g. gender norms, and interpersonal (e.g. family expectations) dimensions. Coping strategies spanned intrapersonal (hope), community (social support), and structural (employment/education) dimensions. Conclusions: Interventions to reduce violence should be tailored to address the social inequities that emerge at the intersection of youth, poverty, displacement, and hegemonic gender norms.

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“…Female sex-workers (FSW) living with HIV (LWH), however, may experience overlapping stigma due to their involvement in sex-work (Logie, James, Tharao, & Loutfy, 2011;Rogers et al, 2014). There is little research on this phenomenon.…”

Section: Introduction (1520 Words)mentioning

confidence: 99%

Overlapping HIV and sex-work stigma among female sex workers recruited to 14 respondent-driven sampling surveys across Zimbabwe, 2013

et al. 2016

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HIV, Gender, Race, Sexual Orientation, and Sex Work: A Qualitative Study of Intersectional Stigma Experienced by HIV-Positive Women in Ontario, Canada

Abstract: Mona Loutfy and colleagues used focus groups to examine experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada.

Cited by 462 publications

References 52 publications

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

‘Life under the tent is not safe, especially for young women’: understanding intersectional violence among internally displaced youth in Leogane, Haiti

Overlapping HIV and sex-work stigma among female sex workers recruited to 14 respondent-driven sampling surveys across Zimbabwe, 2013

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