Structural interventions and social suffering: Responding to amphetamine-type stimulant use among female entertainment and sex workers in Cambodia

Coupland, Heidi; Page, Kimberly; Stein, Ellen; Evans, Jennifer L.; Dixon, Thomas; Sokunny, Muth; Maly, Phou; Maher, Lisa

doi:10.1016/j.drugpo.2018.12.002

Cited by 7 publications

(9 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the same manner, another study showed that the increase in severity of drug use had a positive association with the increased frequency of unprotected sex among American men in substance use treatment (Newville et al, 2018 ). Similar evidence has also been observed among PWUD in Brazil (Guimarães et al, 2016 ), Cambodia (Coupland et al, 2019 ; Mburu et al, 2019 ; Page et al, 2019 ), China (Ding et al, 2013 ; Zhao et al, 2019 ), India (Suohu et al, 2012 ), and the Netherlands (Spauwen et al, 2015 ). A recent thematic review showed that drug use facilitated people’s willingness to engage in different types of sex, including undesired and risky ones (Smith et al, 2020 ).…”

Section: Introductionsupporting

confidence: 63%

Sex Under the Influence of Drugs Among People Who Use Drugs in Cambodia: Findings From a National Survey

Saing

Chhoun²,

Chann

et al. 2022

Arch Sex Behav

View full text Add to dashboard Cite

Studies in drug use settings rarely use sex under the influence of drugs as an indicator of sexual risk behaviors. This study explored the prevalence of sex under the influence of drugs and its correlates among people who use drugs (PWUD) in Cambodia. We included 1147 PWUD from 12 provinces in this study. A multiple logistic regression analysis was conducted to identify factors associated with sex under the influence of drugs. Of the total, 39.7% reported having had sex under the influence of drugs in the past three months. After adjustment, sex under the influence of drugs was significantly associated with living in urban areas (AOR 2.97, 95% CI 1.68–5.27), having two to three (AOR 2.48, 95% CI 1.76–3.49) and four or more sexual partners (AOR 6.46, 95% CI 4.24–9.85), engaging in transactional sex (AOR 1.69, 95% CI 1.19–2.39), using methamphetamine (AOR 2.97, 95% CI 2.06–4.31), using drugs for three years or longer (AOR 1.67, 95% CI 1.15–2.41), having been to a drug rehabilitation center (AOR 1.77, 95% CI 1.18–2.41), having a network of ten or more PWUD (AOR 1.82, 95% CI 1.25–2.66), and having high psychological distress (AOR 1.66, 95% CI 1.25–2.22). This study documents the high prevalence of sex under the influence of drugs and its risk factors among male and female PWUD in Cambodia. These findings point to the need for integrating HIV and harm-reduction programs using innovative approaches to address the overlapping risks in this key population.

show abstract

Section: Introductionsupporting

confidence: 63%

Sex Under the Influence of Drugs Among People Who Use Drugs in Cambodia: Findings From a National Survey

Saing

Chhoun²,

Chann

et al. 2022

Arch Sex Behav

View full text Add to dashboard Cite

show abstract

“…Women also talked about using stimulants in addition to alcohol. Related research suggests that amphetamine-type stimulant use among FEWs in Cambodia is used to increase their ability to meet the physiological demands of their work (Dixon et al, 2015), used to manage depression related to economic and social problems (Coupland et al, 2018) and is associated with unprotected sex and STIs (Couture et al, 2011). Women also talked about facing alcohol-related partner violence at home, which may be more prevalent among FEWs due to male partners' feelings of emasculation due to their female partner's work (Panchanadeswara et al, 2009) and also could contribute to women using alcohol and other substances as a coping mechanism.…”

Section: Discussionmentioning

confidence: 99%

“We Cannot Avoid Drinking”: Alcohol Use among Female Entertainment Workers in Cambodia

Brody

Kaplan²,

Tuot³

et al. 2019

Substance Use & Misuse

View full text Add to dashboard Cite

Background: Female entertainment workers (FEWs) in Cambodia work in predominantly alcoholbased venues and therefore may face occupational risks. Studies have suggested that FEWs are pressured to consume alcohol while at the workplace, which may have adverse health outcomes. This study aims to explore the experiences of alcohol use among FEWs in Cambodia. Methods: Twenty-seven focus group discussions (FGDs) with FEWs were conducted across five sites in four provinces in Cambodia. FGD participants were FEWs who worked at entertainment venues, including karaoke TV bars, beer gardens, and massage parlors, as well as women who worked as on-call or street-based sex workers, and women across entertainment venues who were parenting. Results: The authors modified a conceptual model to create a framework based on the major themes identified within the FGDs on autonomy in alcohol use among FEWs. The framework and thematic components highlight the continuum of autonomy from pressured or coerced alcohol use to, economically or socially rational alcohol use to voluntary alcohol use. Factors that impacted alcohol use across the spectrum include experiencing an economic shock, needing to maintain a livelihood, experiencing psychological distress, having the desire to thrive in employment environment and drinking socially for personal enjoyment. Conclusion/Importance: Much of the motivation behind alcohol use is related to the need for economic security. For women who do not have other employment or income-generating options, individual behavior change programing is unlikely to be effective. Structural changes are needed to improve the health and safety of FEWs in Cambodia.

show abstract

“…Much previous work on the acceptability of HIV vaccines among PWUD has relied predominantly on quantitative research [ 23 – 25 ] and has failed to consider the complex interplay of social, structural and environmental contexts and their impact on health outcomes in this population. The broader literature increasingly identifies the need to shift away from a focus on individual choices and behaviours to understanding of underlying conditions and contexts, in order to address HIV risk [ 19 , 26 ]. For example, gendered power relations may play a role in women’s HIV-related vulnerability [ 27 , 28 ], and considerations of contextual factors such as vulnerability to sexual and physical violence, distinctively shape women’s HIV-risk profiles [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Acceptability of a hypothetical preventative HIV vaccine among people who use drugs in Vancouver, Canada

Fleming

Valleriani

et al. 2020

BMC Public Health

Self Cite

View full text Add to dashboard Cite

Background: As research on HIV vaccines continues to advance, studies exploring the feasibility of this intervention are necessary to inform uptake and dissemination strategies with key populations, including people who use drugs (PWUD). Methods: We conducted 25 in-depth qualitative interviews examining HIV vaccine acceptability among PWUD in Vancouver, Canada. Participants were recruited from an ongoing prospective cohort of HIV-negative PWUD. Data were coded using NVivo, and analyzed thematically. Results: Acceptability was framed by practical considerations such as cost and side effects, and was influenced by broader trust of government bodies and health care professionals. While an HIV vaccine was perceived as an important prevention tool, willingness to be vaccinated was low. Results suggest that future vaccine implementation must consider how to minimize the burden an HIV vaccine may place on PWUD. Centering the role of health care providers in information dissemination and delivery may assist with uptake. Conclusions: Our findings suggest improvements in care and improved patient-provider relationships would increase the acceptability of a potential HIV vaccine among this population.

show abstract

Structural interventions and social suffering: Responding to amphetamine-type stimulant use among female entertainment and sex workers in Cambodia

Cited by 7 publications

References 84 publications

Sex Under the Influence of Drugs Among People Who Use Drugs in Cambodia: Findings From a National Survey

Sex Under the Influence of Drugs Among People Who Use Drugs in Cambodia: Findings From a National Survey

“We Cannot Avoid Drinking”: Alcohol Use among Female Entertainment Workers in Cambodia

Acceptability of a hypothetical preventative HIV vaccine among people who use drugs in Vancouver, Canada

Contact Info

Product

Resources

About