title: Violence, stigma and mental health among female sex workers in China: A structural equation modeling.
abstract: Intimate partner violence is prevalent among female sex workers (FSWs) in China, and it is significantly associated with mental health problems among FSWs. However, limited studies have explored the mechanisms/process by which violence affects mental health. The purpose of this study was to explore the relationships among partner violence, internalized stigma, and mental health problems among FSWs. Data were collected using a self-administered cross-sectional survey administered to 1,022 FSWs in the Guangxi Zhuang Autonomous Region (Guangxi), China during 2008-2009. We used structural equation modeling to test the hypothesized relationships. Results indicated that violence perpetrated by either stable sexual partners or clients was directly and positively associated with mental health problems. Violence also had an indirect relation to mental health problems through stigma. Results highlight the need for interventions on counseling and care for FSWs who have experienced violence and for interventions to increase FSWs' coping skills and empowerment strategies.
authors.affiliation: a Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , Michigan , USA.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.affiliation: a Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , Michigan , USA.|b South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: a Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , Michigan , USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: c Guangxi Center for Disease Control and Prevention (CDC) , Nanning , China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: c Guangxi Center for Disease Control and Prevention (CDC) , Nanning , China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: d Department of Family Medicine and Public Health Sciences , Wayne State University School of Medicine , Detroit , Michigan , USA.
authors.forename: Jinping
authors.initials: J
authors.lastname: Xu
authors.affiliation: c Guangxi Center for Disease Control and Prevention (CDC) , Nanning , China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Tang
authors.affiliation: a Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , Michigan , USA.
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D006801:Humans; D008603:Mental Health / Q000706:statistics & numerical data*; D016272:Occupational Health / Q000706:statistics & numerical data; D012307:Risk Factors; D011477:Sex Work / Q000523:psychology* / Q000706:statistics & numerical data; D060386:Sex Workers / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: China; female sex worker; mental health; stigma; violence