Correlates of alcohol and illicit drug use before commercial sex among transgender women with a history of sex work in China

Sexual Health ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 45 ◽  
Author(s):  
Qian Wang ◽  
Ruijie Chang ◽  
Ying Wang ◽  
Xueqin Jiang ◽  
Shuxian Zhang ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Commercial Sex ◽  
Female Sex ◽  
Alcohol And Drugs ◽  
Combined Use

Background Research on substance use among transgender female sex workers in China is scarce. The aims of this study were to examine: (1) the prevalence of alcohol or illicit drug use before commercial sex among this population; and (2) correlates of alcohol and illicit drug use. Methods: Complete survey data were analysed from 397 transgender female sex workers recruited from three of the largest cities in China: Shenyang, Shanghai and Guangzhou. Information was collected about demographics, alcohol or illicit drug use, alone or in combination, and their psychosocial correlates using structured questionnaires. Multinomial logistic regression models were used to examine the association between substance use and its correlates. Results: Before commercial sex, approximately one-third of the sample reported exclusive alcohol use (28.5%), 9.3% reported exclusive drug use and 7.3% reported combined use of alcohol and drugs. Before commercial sex, participants with low self-esteem had twice the odds of using alcohol exclusively (adjusted odds ratio (aOR) 2.05; 95% confidence interval (CI) 1.01–4.17), those with higher levels of loneliness had almost threefold the odds of exclusive drug use (aOR 2.92; 95% CI 1.21–7.07) and those with depression (aOR 2.97; 95% CI 1.11–7.96) and unknown HIV status (aOR 3.00; 95% CI 1.02–8.87) had threefold the odds of combined use of alcohol and drugs. Conclusion: Programs aimed at reducing alcohol or drug use among transgender female sex workers in China may consider adding components that help support mental health and encouraging HIV screening.

scholarly journals Patterns and Epidemiology of Illicit Drug Use Among Sex Workers Globally: A Systematic Review

2021 ◽  
pp. 95-118
Author(s):  
Jenny Iversen ◽  
Pike Long ◽  
Alexandra Lutnick ◽  
Lisa Maher
Keyword(s):  
Drug Use ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Future Research ◽  
Random Effects Model ◽  
Female Sex ◽  
Pooled Prevalence

AbstractIntroduction: Sex workers who use drugs represent two distinct populations, yet programmatic and policy responses are siloed and failed to acknowledge the ways in which populations overlap and needs intersect. Although prevalence of drug use among sex workers is believed to be higher than the general population, no published estimates of global prevalence exist. We aimed to estimate the prevalence of lifetime illicit drug use among sex workers overall, by gender (cis, transgender, and non-binary), and sub-region.Methods: We searched electronic databases for studies measuring the prevalence of illicit drug use among sex workers from the past decade [2009–2018]. Data were combined to generate pooled prevalence and associated 95% confidence intervals of lifetime use using a random effects model. Countries were categorised into geographic sub-regions, and sub-regional pooled estimates of lifetime use among female sex workers generated and mapped.Results: Among 86 studies in 46 countries, pooled prevalence of lifetime illicit drug use among sex workers was 35% (95% CI 30–41%). There was significant diversity (I2 > 90.0%, P < 0.01), and prevalence ranged from 1.2% to 84%. Most studies reported lifetime drug use among female sex workers (32 studies from 20 countries), and pooled prevalence in this sub-group was 29% (95% CI 24–34%). Insufficient data precluded generation of estimates for male and transgender sex workers.Conclusions: Our review identified significant gaps in data quality and availability. Future research in partnership with sex workers is necessary to explore the diversity of populations and contexts in which drug use and sex work intersect, inform more accurate estimates of prevalence, identify differences in risks and exposures, and guide the creation, implementation, and evaluation of programmes and services.

scholarly journals The relationship of illicit drug use to HIV-infection among commercial sex workers in the city of Santos, São Paulo, Brazil

1998 ◽  
Vol 9 (6) ◽  
pp. 427-436 ◽  
Author(s):  
Celia L Szwarcwald ◽  
Francisco I Bastos ◽  
Neide Gravato ◽  
Regina Lacerda ◽  
Pedro N Chequer ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Sex Workers ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Commercial Sex ◽  
Commercial Sex Workers ◽  
Relationship Of ◽  
The Relationship ◽  
The City

Peer and Community Influences on Adolescent Substance Use in the Context of Adverse Childhood Experiences

2021 ◽  
pp. 073112142110187
Author(s):  
Haley Stritzel
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Adverse Childhood Experiences ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Peer Influences ◽  
Childhood Experiences ◽  
Community Influences ◽  
Adverse Childhood ◽  
Peer Substance Use

Both adverse childhood experiences (ACEs) and peer influences consistently predict early tobacco, alcohol, and illicit drug use. However, less research considers how peer and community influences contribute to or modify the association between ACEs and early substance use. This study addresses these gaps in the literature by analyzing multilevel, longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN; N = 1,912). Unstructured socializing and peer substance use largely explained the association between ACEs and drinking, smoking cigarettes, and illicit drug use in the past month. A history of ACEs magnified the association between peer substance use and the number of cigarettes smoked. Collective efficacy also shaped the associations between peer influences, ACEs, and substance use, but in different ways depending on the substance use outcome analyzed.

scholarly journals Lifetime and past-month substance use and injection among street-based female sex workers in Iran

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Payam Roshanfekr ◽  
Mehrdad Khezri ◽  
Salah Eddin Karimi ◽  
Meroe Vameghi ◽  
Delaram Ali ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
Injection Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Injection Drug ◽  
Logistic Regression Models ◽  
Female Sex ◽  
History Of ◽  
Group Sex

Abstract Background Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. Results Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20–6.20]), ever incarceration (AOR 5.06 [2.48–10.28]), and ever group sex (AOR 2.44 [1.21–4.92]). Conclusions Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

scholarly journals Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load

2019 ◽  
Vol 70 (5) ◽  
pp. 867-874 ◽  
Author(s):  
Robin M Nance ◽  
Maria Esther Perez Trejo ◽  
Bridget M Whitney ◽  
Joseph A C Delaney ◽  
Fredrick L Altice ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Substance Use ◽  
Viral Load ◽  
Drug Use ◽  
Viral Suppression ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Hiv Viral Load ◽  
Immunodeficiency Virus ◽  
The Impact

Abstract Background Substance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved. Methods This was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies. We used joint longitudinal and survival models to examine the impact of decreasing drug use and of abstinence for each drug on viral suppression. We repeated analyses using linear mixed models to examine associations between change in frequency of drug use and VL. Results The number of PLWH who were using each drug at baseline ranged from n = 568 (illicit opioids) to n = 4272 (marijuana). Abstinence was associated with higher odds of viral suppression (odds ratio [OR], 1.4–2.2) and lower relative VL (ranging from 21% to 42% by drug) for all 4 drug categories. Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with VL suppression (OR, 2.2, 1.6, respectively). Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with lower relative VL (47%, 38%, respectively). Conclusions Abstinence was associated with viral suppression. In addition, reducing use of illicit opioids or methamphetamine/crystal, even without abstinence, was also associated with viral suppression. Our findings highlight the impact of reducing substance use, even when abstinence is not achieved, and the potential benefits of medications, behavioral interventions, and harm-reduction interventions.

scholarly journals 0872 Correlates Of Restless Sleep Among Female Sex Workers In Baltimore, MD

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A332-A333
Author(s):  
G J Urquhart ◽  
A P Spira ◽  
J N Park ◽  
S G Sherman
Keyword(s):  
Substance Use ◽  
Sleep Quality ◽  
Food Insecurity ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Poor Sleep ◽  
Structural Vulnerability ◽  
The Past ◽  
Female Sex ◽  
High Prevalence

Abstract Introduction Sleep quality is understudied among street-based female sex workers (FSW), a population characterized by high rates of structural vulnerability. FSW may be at higher risk for poor sleep due to food and housing insecurity, violence, substance use and irregular work hours. We studied correlates of restless sleep in an urban, street-based risk environment. Methods Data are from a year-long observational prospective cohort study of street-based FSW (n=250) in Baltimore, MD. Baseline survey data, collected April 2016 to February 2017, included topics such as structural vulnerability, mental and physical health, substance use and lifetime violence. Sleep was measured with item 7 on the CES-D-10 Scale; respondents indicated how many days in the past week their sleep was restless (&lt; 1 day, 1-2 days, 3-4 days, 5-7 days). We conducted bivariate and multivariable logistic analysis to identify correlates of experiencing 5-7 days of restless sleep vs. fewer. Results Median age was 35 years. Most (66%) were Non-Hispanic White, 62% were homeless, 61% reported food insecurity, and 65% injected heroin. We documented a high prevalence of trauma; 81% reported lifetime sexual or physical violence by family members, intimate partners, paying clients, or police officers, and 62% screened positive for PTSD on the PCL-5 Checklist. 54% reported 5-7 days of restless sleep in the past week. Independent associations with frequent restless sleep included older age (age 35+ aOR: 2.67 [1.64-4.36]), food insecurity (aOR: 2.02 [1.42-2.88]), self-reported poor health (aOR: 3.98 [1.99-7.96]), and lifetime violence: a greater number of violent experiences corresponded with higher odds of restless sleep (1-2 vs. 0 experiences aOR: 2.38 [1.43-3.99], 3-4 vs. 0 experiences aOR: 3.67 [2.22-6.05]). Conclusion These data demonstrate high prevalence of restless sleep among street-based FSW with higher risk among those who experience intersecting vulnerabilities and multiple exposures to violence. Trauma-informed structural interventions may improve sleep quality among this population. Support This work was supported by the National Institute of Drug Research (R01DA038499-01).

Do men who have sex with men who report alcohol and illicit drug use before/during sex (chemsex) present moderate/high risk for substance use disorders?

2020 ◽  
Vol 209 ◽  
pp. 107908 ◽  
Author(s):  
Thiago S. Torres ◽  
Leonardo S. Bastos ◽  
Luciana Kamel ◽  
Daniel R.B. Bezerra ◽  
Nilo M. Fernandes ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Sex With Men
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