Sexual relationship power and intimate partner violence among sex workers with non-commercial intimate partners in a Canadian setting

Abstract

There is little information on the private lives of women engaged in sex work, particularly how power dynamics within intimate relationships may affect intimate partner violence (IPV). Using baseline data of sex workers enrolled in a longitudinal cohort, ‘AESHA’ (An Evaluation of Sex Workers’ Health Access), the present study examined the association between sexual relationship power and IPV among sex workers in non-commercial partnerships in Vancouver, Canada. Pulweritz's Sexual Relationship Power Scale (SRPS) and The World Health Organization (WHO) Intimate Partner Violence Against Women scale (Version9.9) were used. Bivariate and multivariate logistic regression techniques were used to investigate the potential confounding effect of sexual relationship power on IPV among sex workers. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) were reported. Of 510 sex workers, 257 (50.4%) reported having an non-commercial intimate partner and were included in this analysis. In the past 6 months, 84 (32.7%) sex workers reported IPV (physical, sexual or emotional). The median age was 32 years, 39.3% were of Aboriginal ancestry, and 27.6% were migrants. After controlling for known confounders (e.g., age, Aboriginal ancestry, migrant status, childhood trauma, non-injection drug use), low relationship power was independently associated with 4.19 increased odds (95% CI: 1.93-9.10) and medium relationship power was associated 1.95 increased odds (95% CI:0.89-4.25) of IPV. This analysis highlights how reduced control over sexual-decision making is plays a critical role in IPV among sex workers, and calls for gender-focused and coupled-based interventions tailored to noncommercial intimate partnerships of sex workers.

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

“…On average SRPS values for women in this study were consistent with studies of nondrug using women (Conroy et al, 2016; Muldoon et al, 2015), but lower than RC and DMD values reported in a study of drug-involved women (Campbell et al, 2012). Significant findings emerge that provide support for the importance of sexual relationship power dynamics in the context of sexual behaviors for WWID.…”

“…The SRPS has primarily been applied to nonsubstance using heterosexual partnerships in the field of HIV prevention research (Campbell et al, 2009; Conroy et al, 2016; Muldoon, Deering, Feng, Shoveller, & Shannon, 2015), in which lower SRPS scores have been associated with higher risk and inconsistent condom use and for HIV infection (Bonacquisti & Geller, 2013; Dunkle et al, 2004; Jewkes, Dunkle, Nduna, & Shai, 2010). However, we are unaware of any investigation of relationship dynamics in the intersecting injecting and sexual relationships of young WWID, or one that quantifies the impact of sexual relationship power on injecting or sexual risk behaviors in the context of WWID’s sexual relationships.…”

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial

“…Among FSWs in Nigeria, 36% reported physical violence and 32% reported psychological abuse in the past six months (Fawole and Dagunduro, 2014). Physical and emotional violence perpetrated by non-commercial sex partners was reported by 20% and 25% of Canadian FSWs, respectively (Muldoon et al, 2015). Alcohol use has been consistently associated with violence against FSWs (Li et al, 2010; Scorgie et al, 2012; Wechsberg et al, 2005, 2006) .…”

A Qualitative Investigation of the Impact of a Livelihood Intervention on Gendered Power and Sexual Risk Behaviors Among HIV-Positive Adults in Rural Kenya

“…FI may also exacerbate gender-based imbalances in relationship power that can increase sexual risk by enhancing male control and decision-making dominance in sexual relationships, including the timing and frequency of sex (Patel et al, 2014; Shannon et al, 2012). Women’s low sexual relationship power has also been associated with less condom use (Campbell et al, 2009; Pettifor, Measham, Rees, & Padian, 2004; Pulerwitz, Amaro, De Jong, Gortmaker, & Rudd, 2002) and with physical violence and forced sex (Muldoon, Deering, Feng, Shoveller, & Shannon, 2015; Pulerwitz, Gortmaker, & De Jong, 2000). …”