title: Homelessness among a cohort of women in street-based sex work: the need for safer environment interventions.
abstract: BACKGROUND
  Drawing on data from a community-based prospective cohort study in Vancouver, Canada, we examined the prevalence and individual, interpersonal and work environment correlates of homelessness among 252 women in street-based sex work.
  
  
  METHODS
  Bivariate and multivariate logistic regression using generalized estimating equations (GEE) was used to examine the individual, interpersonal and work environment factors that were associated with homelessness among street-based sex workers.
  
  
  RESULTS
  Among 252 women, 43.3% reported homelessness over an 18-month follow-up period. In the multivariable GEE logistic regression analysis, younger age (adjusted odds ratio [aOR] = 0.93; 95%confidence interval [95%CI] 0.93-0.98), sexual violence by non-commercial partners (aOR = 2.14; 95%CI 1.06-4.34), servicing a higher number of clients (10+ per week vs < 10) (aOR = 1.68; 95%CI 1.05-2.69), intensive, daily crack use (aOR = 1.65; 95%CI 1.11-2.45), and servicing clients in public spaces (aOR = 1.52; CI 1.00-2.31) were independently associated with sleeping on the street.
  
  
  CONCLUSIONS
  These findings indicate a critical need for safer environment interventions that mitigate the social and physical risks faced by homeless FSWs and increase access to safe, secure housing for women.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: Putu
authors.initials: P
authors.lastname: Duff
authors.forename: Kathleen
authors.initials: K
authors.lastname: Deering
authors.forename: Kate
authors.initials: K
authors.lastname: Gibson
authors.forename: Mark
authors.initials: M
authors.lastname: Tyndall
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
mesh_terms: D000328:Adult; D017677:Age Distribution; D001955:British Columbia; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors; D012449:Safety; D060386:Sex Workers / Q000523:psychology* / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012931:Social Environment; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data