title: Adverse pregnancy outcomes and sexual violence among female sex workers who inject drugs on the United States-Mexico border.
abstract: This study examines the prevalence of miscarriage/stillbirth among female sex workers who inject drugs (FSW-IDUs) and measures its associations with physical and sexual violence. Baseline data from 582 FSW-IDUs enrolled in an HIV intervention study in Tijuana and Ciudad Juárez, Mexico were used for current analyses. 30% of participants had experienced at least one miscarriage/stillbirth, 51% had experienced sexual violence, and 49% had experienced physical violence. History of miscarriage/stillbirth was associated with sexual violence (adjusted odds ratio [aOR] = 1.7, p = .02) but not physical violence. Additional reproductive risks associated with miscarriage/stillbirth included high numbers of male clients in the previous month (aOR = 1.1 per 30 clients, p = 0.04), history of abortion (aOR = 3.7, p < .001), and higher number of pregnancies (aOR = 1.4 per additional pregnancy, p < .001). Programs and research with this population should integrate reproductive health and consider gender-based violence.
authors.affiliation: San Diego State University/University of California, San Diego, USA.
authors.forename: Lotus
authors.initials: L
authors.lastname: McDougal
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Gudelia
authors.initials: G
authors.lastname: Rangel
authors.forename: Gustavo
authors.initials: G
authors.lastname: Martinez
authors.forename: Alicia
authors.initials: A
authors.lastname: Vera
authors.forename: Nicole
authors.initials: N
authors.lastname: Sirotin
authors.forename: Jamila K
authors.initials: JK
authors.lastname: Stockman
authors.forename: Monica D
authors.initials: MD
authors.lastname: Ulibarri
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D002140:California; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D012307:Risk Factors; D012742:Sex Offenses / Q000208:ethnology / Q000517:prevention & control / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D012931:Social Environment; D050497:Stillbirth / Q000453:epidemiology* / Q000208:ethnology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D047568:Unsafe Sex / Q000208:ethnology / Q000706:statistics & numerical data; D014754:Violence / Q000208:ethnology / Q000517:prevention & control / Q000706:statistics & numerical data*; D055815:Young Adult