title: Injection drug use as a mediator between client-perpetrated abuse and HIV status among female sex workers in two Mexico-US border cities.
abstract: We examined relationships between client-perpetrated emotional, physical, and sexual abuse, injection drug use, and HIV-serostatus among 924 female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-US border cities. We hypothesized that FSWs' injection drug use would mediate the relationship between client-perpetrated abuse and HIV-seropositivity. The prevalence of client-perpetrated emotional, physical, and sexual abuse in the past 6 months was 26, 18, and 10% respectively; prevalence of current injection drug use and HIV was 12 and 6%, respectively. Logistic regression analyses revealed that client-perpetrated sexual abuse was significantly associated with HIV-seropositivity and injection drug use, and that injection drug use was positively associated with HIV-seropositivity. Injection drug use partially mediated the relationship between client-perpetrated sexual abuse and HIV-seropositivity. Results suggest the need to address client-perpetrated violence and injection drug use when assessing HIV risk among FSWs.
authors.affiliation: Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, USA. mulibarri@ucsd.edu
authors.forename: Monica D
authors.initials: MD
authors.lastname: Ulibarri
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Emilio C
authors.initials: EC
authors.lastname: Ulloa
authors.forename: Remedios
authors.initials: R
authors.lastname: Lozada
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Fraga
authors.forename: Carlos
authors.initials: C
authors.lastname: Magis-Rodríguez
authors.forename: Adela
authors.initials: A
authors.lastname: De La Torre
authors.forename: Hortensia
authors.initials: H
authors.lastname: Amaro
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Campo
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult