title: Identifying Patterns of Social and Economic Hardship Among Structurally Vulnerable Women: A Latent Class Analysis of HIV/STI Risk.
abstract: Women who are structurally vulnerable are at heightened risk for HIV/STIs. Identifying typologies of structural vulnerability that drive HIV/STI risk behavior is critical to understanding the nature of women's risk. Latent class analysis (LCA) was used to classify exotic dancers (n = 117) into subgroups based on response patterns of four vulnerability indicators. Latent class regression models tested whether sex- and drug-related risk behavior differed by vulnerability subgroup. Prevalence of vulnerability indicators varied across housing instability (39%), financial insecurity (39%), limited education (67%), and arrest history (36%). LCA yielded a two-class model solution, with 32% of participants expected to belong to a "high vulnerability" subgroup. Dancers in the high vulnerability subgroup were more likely to report sex exchange (OR = 8.1, 95% CI, 1.9-34.4), multiple sex partnerships (OR = 6.4, 95% CI, 1.9-21.5), and illicit drug use (OR = 17.4, 95% CI, 2.5-123.1). Findings underscore the importance of addressing inter-related structural factors contributing to HIV/STI risk.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA. mreilly@jhu.edu.
authors.forename: Meredith L
authors.identifier: http://orcid.org/0000-0001-7561-8057
authors.initials: ML
authors.lastname: Brantley
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: German
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Sahnah
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Sherman
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D064890:Social Determinants of Health; D019966:Substance-Related Disorders / Q000453:epidemiology*; D035862:Vulnerable Populations
keywords: Exotic dance club; HIV; Sexually transmitted infections; Social determinants