Characterizing the relationship between incarceration and structural risks among female sex workers in Iran: findings of a nationwide biobehavioral surveillance survey

Purpose: Given the adverse impacts of enforcement-based approaches toward sex work on female sex workers' (FSWs') health, safety, and well-being, we explored the prevalence and correlates of recent incarceration among FSWs in Iran. Methods: From January to August 2015, we recruited FSWs from 21 harm reduction facilities and 152 FSWs from street venues in 13 major cities across Iran. Correlates of recent (i.e., last year) incarceration were assessed through an exploratory multivariable logistic regression model. Results: A total of 90 of 1326 (6.8%) FSWs reported a recent incarceration; primary reasons for incarceration were drug-related (n = 48/90; 52.9%). Having a recent incarceration was significantly and positively associated with history of illicit drug use/injection (adjusted odds ratio [aOR] = 3.22, 95% confidence interval [CI]: 1.67, 6.19), rape in last year (aOR = 2.67, 95% CI: 1.65, 4.31), unstable housing (aOR = 2.28, 95% CI: 1.16, 4.91), and working in brothels (aOR = 2.22, 95% CI: 1.18, 4.16). Conclusions: In sum, recent incarceration was significantly associated with history of drug use and sociostructural vulnerabilities. Taken together, these data suggest the potential health impacts of the integration of programs to mitigate substance use, sexual violence, and living conditions into comprehensive services for FSWs in Iran.