title: Early Sex Work Initiation and Violence against Female Sex Workers in Mombasa, Kenya.
abstract: Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger. Logistic regression modeled recent violence as a function of early initiation, adjusting for drop-in center, age, education, HIV status, supporting others, and childhood abuse. Twenty percent of the sample reported early initiation of sex work. Although both early initiators and other FSWs reported commonly experiencing recent violence, early initiators were significantly more likely to experience recent physical and sexual violence and verbal abuse from paying partners. Early initiation was not associated with physical or sexual violence from non-paying partners. Many FSWs begin sex work before age 18. Effective interventions focused on preventing this are needed. In addition, interventions are needed to prevent violence against all FSWs, in particular, those who initiated sex work during childhood or adolescence.
authors.affiliation: Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ap3471@cumc.columbia.edu.|HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, 1501 Riverside Drive, New York, NY, USA. ap3471@cumc.columbia.edu.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Parcesepe
authors.affiliation: Population Health Sciences, School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: L'Engle
authors.affiliation: Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Martin
authors.affiliation: Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sherri
authors.initials: S
authors.lastname: Green
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Chirayath
authors.initials: C
authors.lastname: Suchindran
authors.affiliation: FHI 360, Nairobi, Kenya.
authors.forename: Peter
authors.initials: P
authors.lastname: Mwarogo
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections; D006801:Humans; D007630:Kenya; D011477:Sex Work; D060386:Sex Workers; D014754:Violence; D055815:Young Adult
keywords: Adolescence; Africa; Sex work; Violence