Survival sex among a diverse sample of women with histories of intimate partner violence: Results from a domestic violence shelter.

Abstract

Objective: The current study sought to investigate the prevalence and correlates of survival sex among a diverse sample of women residing in a domestic violence (DV) shelter. Method: Two hundred seven women (44% Black, 37.7% White, 10.6% Multiracial, 4.3% Latina, 1% Arab, 1% Asian/Pacific Islander, and 1.4% Indigenous or Aboriginal) residing in a Summit County, Ohio, DV shelter completed a survey assessing their involvement in survival sex, the associated contextual factors (e.g., age at first incidence of survival sex, the reason for engaging in survival sex), and self-report measures assessing substance use, post-traumatic stress disorder (PTSD) symptoms, intimate partner violence (IPV) victimization, adverse childhood experiences (ACEs), and empowerment. Results: More than two-thirds of participants reported engaging in survival sex, and participants who did were more likely to have elevated rates of substance use, PTSD symptoms, ACEs, and IPV victimization, along with lower empowerment. Most commonly, women reported engaging in survival sex for fear that the other person would take away valuable support or things they needed. Participants also reported engaging in survival sex for securing shelter, for money, for food, and to obtain drugs or alcohol. Notably, a sizable minority of women first engaged in survival sex as minors, suggesting overlap with the phenomenon of domestic minor sex trafficking. Conclusions: Engaging in survival sex may be commonly experienced by women residing in DV shelters and is associated with trauma history and post-traumatic stress symptoms. Despite the small, non-representative sample, results indicate education for providers is necessary to interact effectively with this population. Clinical Impact StatementWomen residing in DV shelters may be more likely to engage in survival sex to meet their needs or avoid resource loss. Those with trauma histories and PTS symptoms may be more likely to engage in survival sex behavior. Women who engage in survival sex likely have a wide range of interpretations of their experiences, which requires openness from service provides. Utilizing a trauma-focus lens, providers should aim to avoid victim-blaming and engender a sense of empowerment in women who engage in survival sex behavior to help them identify safe methods of obtaining their needed resources.