title: Structural Determinants of Client Perpetrated Violence Among Female Sex Workers in Two Mexico-U.S. Border Cities.
abstract: Female sex workers (FSWs) are disproportionately affected by both HIV and gender-based violence, such as that perpetrated by clients (CPV). We used a structural determinants framework to assess correlates of physical or sexual CPV in the past 6 months among FSWs in the Mexico/U.S. border cities of Ciudad Juárez and Tijuana. Bivariate and multivariate logistic regression analysis identified individual, client, interpersonal, work environment and macrostructural factors associated with recent CPV. Among 496 FSWs, 5 % experienced recent CPV. Witnessing violence towards other FSWs in one's neighborhood (aOR 5.6, 95 % CI 1.8-17.2), having a majority of foreign (aOR 3.5, 95 % CI 1.4-8.4) or substance using (aOR 4.0, 95 % CI 1.5-10.4) clients, and being a street worker (aOR 3.0, 95 % CI 1.1-7.7) were independently associated with recent CPV. Our findings underscore the vulnerability of FSWs and the need to design policies and interventions addressing macro-level influences on CPV rather than exclusively targeting individual behaviors.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC-0507, La Jolla, San Diego, CA, 92093-0507, USA.|Joint Doctoral Program in Public Health, University of California San Diego and San Diego State University, San Diego, CA, USA.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Conners
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC-0507, La Jolla, San Diego, CA, 92093-0507, USA.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Ulibarri
authors.affiliation: Centro Nacional para la Prevención y el Control del VIH y el SIDA (CENSIDA), Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Magis-Rodriguez
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC-0507, La Jolla, San Diego, CA, 92093-0507, USA.
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.affiliation: Facultad de Medicina, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Mexico.
authors.forename: Hugo
authors.initials: H
authors.lastname: Staines-Orozco
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC-0507, La Jolla, San Diego, CA, 92093-0507, USA. kbrouwer@ucsd.edu.
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
mesh_terms: D000328:Adult; D002947:Cities; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006703:Ill-Housed Persons; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015999:Multivariate Analysis; D011477:Sex Work; D060386:Sex Workers; D012725:Sexual Behavior; D012747:Sexual Partners; D013179:Spouse Abuse; D013315:Stress, Psychological; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Client perpetrated violence; HIV; Sex work