TY - JOUR
T1 - Interpersonal Violence and Contraceptive Method Use by Women Sex Workers
AU - Zemlak, Jessica L.
AU - White, Rebecca Hamilton
AU - Nestadt, Danielle Friedman
AU - Alexander, Kamila A.
AU - Park, Ju Nyeong
AU - Sherman, Susan G.
N1 - Funding Information:
Supported by the National Institute of Drug Research under Grant R01DA038499-01 and the Johns Hopkins Center for AIDS Research under Grant 1P30AI094189 . Note: The funder had no role in study design, data collection, or in analysis and interpretation of the results, and this article does not necessarily reflect views or opinions of the funder.
Publisher Copyright:
© 2021 Jacobs Institute of Women's Health
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Objective: More than one-half of women sex workers (sex workers) in the United States experience interpersonal violence, defined as physical or sexual violence, by sexual partners, including clients or intimate partners. Women experiencing interpersonal violence by intimate partners often choose hidden, woman-controlled contraception (e.g., intrauterine devices, pills, or sterilization) because fear of violence can impede condom negotiation. Yet, little is known about how interpersonal violence relates to contraception among sex workers who may have different sexual partner perpetrators (clients and intimate partners). The purpose of this study was to examine associations between interpersonal violence perpetrated by clients or intimate partners and contraceptive use. Study Design: Data are from an observational, prospective cohort of sex workers, aged 18 to 49 in Baltimore, Maryland (N = 218). Bivariate and multivariable logistic regression were used to assess associations between lifetime interpersonal violence and past 3-month contraceptive use. The outcome was any woman-controlled contraceptive use versus partner-controlled or no contraception. Results: Nearly all sex workers (96.5%) reported contraceptive use, with most using male condoms (69%), nearly one-half using woman-controlled methods (43%), and 25% using dual methods (e.g., condoms and a woman-controlled method). Lifetime experiences of interpersonal violence by clients (58%) and intimate partners (52%) were prevalent. Sex workers who experienced interpersonal violence by intimate partners had over twice the odds of woman-controlled contraceptive use (adjusted odds ratio, 2.48; 95% confidence interval, 1.36–4.54). Conclusions: Findings highlight the importance of relationship context in the associations between interpersonal violence and use of woman-controlled contraceptive methods among sex workers, because only violence experiences by intimate partners were associated with increased odds of woman-controlled contraceptive method use.
AB - Objective: More than one-half of women sex workers (sex workers) in the United States experience interpersonal violence, defined as physical or sexual violence, by sexual partners, including clients or intimate partners. Women experiencing interpersonal violence by intimate partners often choose hidden, woman-controlled contraception (e.g., intrauterine devices, pills, or sterilization) because fear of violence can impede condom negotiation. Yet, little is known about how interpersonal violence relates to contraception among sex workers who may have different sexual partner perpetrators (clients and intimate partners). The purpose of this study was to examine associations between interpersonal violence perpetrated by clients or intimate partners and contraceptive use. Study Design: Data are from an observational, prospective cohort of sex workers, aged 18 to 49 in Baltimore, Maryland (N = 218). Bivariate and multivariable logistic regression were used to assess associations between lifetime interpersonal violence and past 3-month contraceptive use. The outcome was any woman-controlled contraceptive use versus partner-controlled or no contraception. Results: Nearly all sex workers (96.5%) reported contraceptive use, with most using male condoms (69%), nearly one-half using woman-controlled methods (43%), and 25% using dual methods (e.g., condoms and a woman-controlled method). Lifetime experiences of interpersonal violence by clients (58%) and intimate partners (52%) were prevalent. Sex workers who experienced interpersonal violence by intimate partners had over twice the odds of woman-controlled contraceptive use (adjusted odds ratio, 2.48; 95% confidence interval, 1.36–4.54). Conclusions: Findings highlight the importance of relationship context in the associations between interpersonal violence and use of woman-controlled contraceptive methods among sex workers, because only violence experiences by intimate partners were associated with increased odds of woman-controlled contraceptive method use.
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U2 - 10.1016/j.whi.2021.08.001
DO - 10.1016/j.whi.2021.08.001
M3 - Article
C2 - 34493434
AN - SCOPUS:85114220057
SN - 1049-3867
VL - 31
SP - 516
EP - 522
JO - Women's Health Issues
JF - Women's Health Issues
IS - 6
ER -