Identifying Patterns of Social and Economic Hardship Among Structurally Vulnerable Women: A Latent Class Analysis of HIV/STI Risk

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.