TY - JOUR
T1 - Daily activity spaces and drug use among female sex workers living with HIV in the Dominican Republic
AU - Felker-Kantor, Erica
AU - Polanco, Caluz
AU - Perez, Martha
AU - Donastorg, Yeycy
AU - Andrinopoulos, Katherine
AU - Kendall, Carl
AU - Kerrigan, Deanna
AU - Theall, Katherine
N1 - Funding Information:
We thank the research participants for their willingness to participate in the study. We acknowledge the hard work and time devoted by the local study team in the DR. The study was supported by grants from the National Institutes of Health (E. Felker-Kantor, NIH/NIDA 5F31DA042714 and D. Kerrigan, NIH/NIMH 5R01MH110158).
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/3
Y1 - 2021/3
N2 - The purpose of this study was to explore the daily activity spaces of female sex workers living with HIV in the Dominican Republic and assess the relationship between activity path and location-based risk exposure measures and daily drug use. The study employed a micro-longitudinal observational study design using an innovative 7-day travel diary to capture daily activity routes and a 7-day mobile health (mHealth) daily diary to collect daily substance use behaviors among 51 female sex workers. To estimate between-subject variability, a series of crude and adjusted modified log-Poisson repeated measures regression models with generalized estimating equations, clustering by individual with a compound symmetry working correlation structure were fit to estimate the relative risks and 95% confidence intervals. Controlling for individual level factors, findings showed that female sex workers exposed to a higher number of risk outlets (e.g., liquor stores, bars, hotels, nightclubs, brothels, etc.) within 200 and 100-meters of sex work locations were at an increased risk of daily drug use (RRadj: 1.03, 95%CI: 1.01, 1.05, RRadj: 1.05, 95%CI: 1.01, 1.09). No association was detected between activity path exposure and daily drug use. These findings illustrate the importance of moving beyond static residential neighborhood boundaries for measuring risk exposures and highlight the significant role that daily work environments have on drug harms among a highly stigmatized and vulnerable population.
AB - The purpose of this study was to explore the daily activity spaces of female sex workers living with HIV in the Dominican Republic and assess the relationship between activity path and location-based risk exposure measures and daily drug use. The study employed a micro-longitudinal observational study design using an innovative 7-day travel diary to capture daily activity routes and a 7-day mobile health (mHealth) daily diary to collect daily substance use behaviors among 51 female sex workers. To estimate between-subject variability, a series of crude and adjusted modified log-Poisson repeated measures regression models with generalized estimating equations, clustering by individual with a compound symmetry working correlation structure were fit to estimate the relative risks and 95% confidence intervals. Controlling for individual level factors, findings showed that female sex workers exposed to a higher number of risk outlets (e.g., liquor stores, bars, hotels, nightclubs, brothels, etc.) within 200 and 100-meters of sex work locations were at an increased risk of daily drug use (RRadj: 1.03, 95%CI: 1.01, 1.05, RRadj: 1.05, 95%CI: 1.01, 1.09). No association was detected between activity path exposure and daily drug use. These findings illustrate the importance of moving beyond static residential neighborhood boundaries for measuring risk exposures and highlight the significant role that daily work environments have on drug harms among a highly stigmatized and vulnerable population.
KW - Dominican Republic
KW - Drug use
KW - Female sex workers
KW - HIV/AIDS
KW - Risk environments
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U2 - 10.1016/j.healthplace.2021.102527
DO - 10.1016/j.healthplace.2021.102527
M3 - Article
C2 - 33588303
AN - SCOPUS:85100813210
SN - 1353-8292
VL - 68
JO - Health and Place
JF - Health and Place
M1 - 102527
ER -