Abstract
BackgroundPhysical and sexual violence heighten STI/HIV risk for women in sex work. Against this backdrop, we describe the nature of abuse against women in sex work, and its STI/HIV implications, across perpetrators.MethodsAdult women involved in sex work (n = 35) in Baltimore, MD participated in an in-depth interview and brief survey.ResultsPhysical and sexual violence were prevalent, with 43% reporting past-month abuse. Clients were the primary perpetrators; their violence was severe, compromised women’s condom and sexual negotiation, and included forced and coerced anal intercourse. Sex work was a factor in intimate partner violence. Police abuse was largely an exploitation of power imbalances for coerced sex.ConclusionsFindings affirm the need to address physical and sexual violence, particularly that perpetrated by clients, as a social determinant of health for women in sex work, as well as a threat to safety and wellbeing, and a contextual barrier to HIV risk reduction.
Highlights
Physical and sexual violence heighten STI/HIV risk for women in sex work
For women in the general population, it is widely understood that intimate partners are the predominant perpetrators of physical and sexual violence [19,20] including that which results in homicide [21]
We sought to describe the nature of physical and sexual violence and mistreatment by perpetrator type, and clarify how such experiences relate to HIV risk, among women involved in sex work in Baltimore, US
Summary
Physical and sexual violence heighten STI/HIV risk for women in sex work. Against this backdrop, we describe the nature of abuse against women in sex work, and its STI/HIV implications, across perpetrators. Social and physical context [2], in which FSWs live and work is central to their HIV risk [3,4], in part by compromising their ability to reduce exposures to harm or enact harm-reduction behaviors. In Moscow, abuse from clients, but not pimps, heightened STI/HIV prevalence [7] These data demonstrate the need to understand potential differences in the nature and HIV impact of abuse against FSWs, so as to optimize prevention and intervention efforts. Against this backdrop, we sought to describe the nature of physical and sexual violence and mistreatment by perpetrator type, and clarify how such experiences relate to HIV risk, among women involved in sex work in Baltimore, US
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