title: The Prevalence and Correlates of Physical and Sexual Violence Affecting Female Sex Workers in Swaziland.
abstract: Female sex workers (FSW) have a heightened vulnerability to violence and negative sexual/reproductive health outcomes. Limited research has examined how experiencing physical and sexual violence (PSV) mediates risk for poor health outcomes among FSW in Swaziland. The present analyses aim to contribute to literature linking violence with poor health outcomes, high-risk behaviors, and reduced health service-seeking among FSW. Data were analyzed from a cross-sectional study conducted in Swaziland between July and September 2011 with 325 adult women who reported exchanging sex for money, goods, or favors in the last 12 months, recruited through respondent-driven sampling (RDS). Logistic regression was used to assess the relationship between PSV and ancillary violence/abuse exposures, risk behaviors, and sexual/reproductive and mental health outcomes. PSV was conceptualized as either ever having been beaten up as a result of selling sex or ever being forced to have sex since the age of 18, or both. Prevalence of PSV in this sample was 59.0% in crude estimation, and 48.4% (95% confidence interval [CI]:[39.2,57.6]) with RDS weighting. Separate RDS-weighted estimates of being beaten up as a result of sex work and ever being forced to have sex were 32.4% (95%CI=[24.4,40.4]) and 33.1% (95%CI =[25.0,41.2%]), respectively. Experiencing PSV was associated with being blackmailed (adjusted odds ratio [aOR]= 1.93, 95%CI= [1.07,3.52]), non-injection drug use in the last 12 months (aOR= 1.84, 95%CI= [1.02,3.33]), and feeling afraid to seek health services as a result of selling sex (aOR = 1.74, 95%CI= [1.01,2.99]). Given these findings, violence prevention strategies should be prioritized in programs that address Swazi FSW health, empowerment, and safety.
authors.affiliation: 1 Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Blair O
authors.initials: BO
authors.lastname: Berger
authors.affiliation: 1 Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Grosso
authors.affiliation: 2 Futures Group, Washington, DC, USA.
authors.forename: Darrin
authors.initials: D
authors.lastname: Adams
authors.affiliation: 1 Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.affiliation: 3 Rock of Hope, Mbabane, Swaziland.
authors.forename: Bhekie
authors.initials: B
authors.lastname: Sithole
authors.affiliation: 3 Rock of Hope, Mbabane, Swaziland.
authors.forename: Xolile S
authors.initials: XS
authors.lastname: Mabuza
authors.affiliation: 4 Swaziland National AIDS Program, Mbabane, Swaziland.
authors.forename: Mpumelelo J
authors.initials: MJ
authors.lastname: Mavimbela
authors.affiliation: 1 Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Baral
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D013541:Eswatini; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D000066550:Physical Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D012309:Risk-Taking; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology
keywords: Swaziland; female sex workers; human rights; sexual/reproductive health; violence