No Door to Lock

Kushel, Margot; Evans, Jennifer L.; Perry, Sharon; Robertson, Marjorie J.; Moss, Andrew R.

doi:10.1001/archinte.163.20.2492

Cited by 227 publications

(60 citation statements)

References 53 publications

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“…This research has drawn marked associations between sexwork and experiences of violence, life traumas, exploitation and abuse, homelessness, and mental illness (Baker et al, 2001, Potterat et al, 1998). Homelessness in particular exacerbates vulnerability: homeless or marginally-housed FSWs are more likely than FSWs with more stable housing to engage in riskier sexual activities, with a higher risk associated with those with simultaneous drug use (Kushel et al, 2003, Surratt and Inciardi, 2004). …”

Section: Resultsmentioning

confidence: 99%

Mapping U.S. long-haul truck drivers’ multiplex networks and risk topography in inner-city neighborhoods

Apostolopoulos¹,

Sönmez²,

Lemke³

et al. 2015

Health & Place

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This article illustrates how urban inner-city trucking milieux may influence STI/BBI/HIV acquisition and transmission risks for U.S. long-haul truckers, as well as their social and risk relationships. Using mixed methods, we collected ethnoepidemiological and biological data from long-haul truck drivers and their risk contacts in inner-city trucking milieux in Atlanta, Georgia, United States. Key findings indicate that within the risk-endemic environment of distressed inner-city areas, diverse trucking risk milieux can amplify STI/BBI/HIV risk for multiplex networks of truckers. Inner-city neighborhood location, short geographic distance among risk contacts, and trucker concurrency can potentially exacerbate transmission via bridging higher-risk individuals with lower-risk populations at disparate geographic and epidemiological locations.

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Section: Resultsmentioning

confidence: 99%

Mapping U.S. long-haul truck drivers’ multiplex networks and risk topography in inner-city neighborhoods

Apostolopoulos¹,

Sönmez²,

Lemke³

et al. 2015

Health & Place

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“…In phase one, the team of four analysts (three of whom were the interviewers) used grounded theory methodologies (Strauss and Corbin, 1990) to construct memo summaries of each interview, which included basic background information, current circumstances, notable events and quotations, and analyst impressions and interpretations. Because previous research (Chan, Dennis, & Funk, 2008; Cohen et al, 2009; Hooper, et al, 1997; Kushel et al, 2003; Luhrmann, 2008) indicated a potential relationship between lifetime histories of traumatic exposure, housing instability, current living situations, and sexual and drug use behaviors, we sought to keep narratives “intact” in the initial data analysis phase. The interview transcript and summaries were then discussed at a 2-hour meeting devoted to analyzing each participant’s interview.…”

Section: Methodsmentioning

confidence: 99%

Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: The intersection of policy, drug use, trauma, and urban space

Knight¹,

López²,

Comfort³

et al. 2014

International Journal of Drug Policy

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Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women. We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs. Women in the study lived in a range of SRO built environments, from publicly-funded, newly built SROs to privately-owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.’s framework of socio-structural vulnerability, we explore how SROs can operate as “mental health risk environments” in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women’s mental health. The degree to which SRO built environments were “trauma-sensitive” at the macro level significantly influenced women’s mental health at meso- and micro- levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro- level to manage their mental health symptoms. Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women.

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“…Transwomen, however, are faced with additional hardships associated with homelessness as many are exposed to increased levels of physical, sexual, emotional, and psychological injury due to the increased exposure to transphobia while living in public or while attempting to access services for the unstably housed (Kushel, Evans, Perry, Robertson, & Moss, 2003; Sakamoto, Chin, Chapra, & Ricciardi, 2009). More than half of all transgender persons attempting to access homeless shelter services report harassment by shelter staff and/or residents, almost a third report having been turned away or refused services, and over 20% report having been sexually assaulted by shelter staff and/or residents (Grant et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Housing Status and HIV Risk Behaviors Among Transgender Women in Los Angeles

2014

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Due to social stigma, lack of social support, and minimal legal employment opportunities, transgender women (transwomen) face elevated rates of unstable housing. This study examined the association between housing status and HIV risk behaviors among 517 transwomen encountered through street outreach. Seven variables (including sociodemographics, HIV status, housing status, and sexual partner type) were used to estimate partial associations during multivariable analyses; housing status was coded trichotomously (housed, marginally housed, and homeless) for these analyses. Results demonstrated that homeless and marginally housed transwomen engaged in significantly higher rates of illicit drug use than housed transwomen; however, marginally housed and housed transwomen engaged in significantly higher rates of illegal hormone injections than homeless transwomen. Rates of sex work were high in the sample as a whole, though sex with an exchange partner was most common among the marginally housed transwomen. Multivariate logistic regression revealed that unstable housing moderated the association between HIV status and engagement in unprotected serodiscordant anal intercourse. The marginally housed transwomen exhibited the greatest risk profile for HIV acquisition or transmission.

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No Door to Lock

Abstract: Sexual and physical assault are common experiences for homeless and marginally housed persons. Housing is associated with lower rates of sexual assault among women. Strategies to decrease sexual and physical assault and its consequences are needed in this population.

Cited by 227 publications

References 53 publications

Mapping U.S. long-haul truck drivers’ multiplex networks and risk topography in inner-city neighborhoods

Mapping U.S. long-haul truck drivers’ multiplex networks and risk topography in inner-city neighborhoods

Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: The intersection of policy, drug use, trauma, and urban space

Housing Status and HIV Risk Behaviors Among Transgender Women in Los Angeles

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