Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting.

2013 | J Acquir Immune Defic Syndr

Abstract:

OBJECTIVES:: To explore factors associated with early sex work initiation, and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs).

DESIGN:: Baseline data (2010-2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time-location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old.

METHODS:: SWs completed a questionnaire and HIV/STI testing. Using multivariate logistic regression, we identified associations with early sex work initiation (<18 years old) and constructed confounder models examining the independent effect of early initiation on HIV and prostitution arrests among adult SWs.

RESULTS:: Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian-born (Adjusted Odds Ratio (AOR): 6.8, 95% Confidence Interval (CI): 2.42-19.02), inject drugs (AOR: 1.6, 95%CI: 1.0-2.5), and to have worked for a manager (AOR: 2.22, 95%CI: 1.3-3.6) or been coerced into sex work (AOR: 2.3, 95%CI: 1.14-4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3-3.2) and prostitution arrests (AOR: 2.0, 95%CI: 1.3-3.2).

CONCLUSIONS:: Adolescent sex work initiation is concentrated among marginalized, drug and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs.

BC Centre for Excellence in HIV/AIDS

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Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting.

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