The longitudinal association of venue stability with consistent condom use among female sex workers in two Mexico–USA border cities

Abstract

Summary We examined the relationship between venue stability and consistent condom use (CCU) among female sex workers who inject drugs (FSW-IDUs; n = 584) and were enrolled in a behavioural intervention in two Mexico–USA border cities. Using a generalized estimating equation approach stratified by client type and city, we found venue stability affected CCU. In Tijuana, operating primarily indoors was significantly associated with a four-fold increase in the odds of CCU among regular clients (odds ratio [OR]: 3.77, 95% confidence interval [CI]: 1.44, 9.89), and a seven-fold increase among casual clients (OR: 7.18, 95% CI: 2.32, 22.21), relative to FSW-IDUs spending equal time between indoor and outdoor sex work venues. In Ciudad Juarez, the trajectory of CCU increased over time and was highest among those operating primarily indoors. Results from this analysis highlight the importance of considering local mobility, including venue type and venue stability, as these characteristics jointly influence HIV risk behaviours.

HIV infection among female sex workers in concentrated and high prevalence epidemics

“…For example, internal mobility and circular migration for sex work (e.g., between districts, travel to religious festivals) [40,41,43] and venue instability (e.g., mobility between different sex work venues) [27,42,58] have been linked to elevated HIV prevalence in a number of settings whereas migration to higher-income settings has been shown to be protective against HIV infection [59]. Variation in HIV transmission risks among migrant sex workers have been increasingly shown to be a product of intersecting macrostructural factors (e.g., political and economic instability and HIV burden of place of origin, immigration policies, language, and cultural contexts of host-setting) and the work environment features they engender (e.g., economic opportunities and social mobility, violence and policing, health access) [40,41,60,61].…”

“…A large number of studies have examined types of venues and their relationships with HIV risks or protections among FSWs, underscoring the heterogeneous and context- specific nature of work environments [39,42,46,47,50,54,58,65,67,69–76]. Only a handful of studies have started to disentangle the complexities and unique and iterative effects of policy, physical, social, and economic features of work environments that are specific to local sex industries and shape HIV prevention, treatment, and care [54,77,78,79,80,81].…”

Factors Associated with Sexual Risks and Risk of STIs, HIV and Other Blood-Borne Viruses Among Women Using Heroin and Other Drugs: A Systematic Literature Review

“…Most publications were cross-sectional (n = 25), four were longitudinal [49–52], and one was a case study [53]. There were 23 quantitative studies and seven qualitative studies [53–59].…”

“…There was also a direct impact of economic pressure on general HIV-related sexual risk and on inconsistent condom use in the past 6 months [51]. One study suggested a non-significant correlation between self-rated financial situation and consistent condom use5 [52]. …”

Theoretical Foundations of Research Focused on HIV Prevention Among Substance-Involved Women

“…Eleven of these interventions occurred in the U.S. with sub-populations of women affected by substance use (racial/ethnic minority, 21, 22 incarcerated, 23, 24 and homeless 25 women), engaged in active substance use, 26–32 or living with HIV. 33 The others targeted substance-using female sex workers in Mexico 34, 35 and South Africa, 36 high-risk heterosexual women in the U.S. Virgin Islands 37 and Puerto Rico, 38 and pregnant IDU accessing methadone in Australia. 39 …”