TY - JOUR
T1 - The Prevalence and Correlates of Physical and Sexual Violence Affecting Female Sex Workers in Swaziland
AU - Berger, Blair O.
AU - Grosso, Ashley
AU - Adams, Darrin
AU - Ketende, Sosthenes
AU - Sithole, Bhekie
AU - Mabuza, Xolile S.
AU - Mavimbela, Mpumelelo J.
AU - Baral, Stefan
N1 - Funding Information:
The authors first thank the female sex workers who agreed to participate in this study. They also acknowledge the leadership of Rebecca Fielding-Miller and the support of Mark Berry and Virginia Tedrow in implementing this study. They would also like to acknowledge Babazile Dlamini and Edward Okoth of Population Services International/Swaziland for their leadership in operationalizing the project. They thank the members of the Swaziland Most-at-Risk Populations (MARPs) technical working group, as well as the Swaziland Ministry of Health and other Swazi government agencies for providing important guidance on this work. They acknowledge Jennifer Albertini and Natalie Kruse-Levy from USAID in Swaziland for their significant technical guidance and Alisen Cheng and Sarah Sandison from USAID in Washington for their technical input and oversight on this project.
Funding Information:
The authors first thank the female sex workers who agreed to participate in this study. They also acknowledge the leadership of Rebecca Fielding-Miller and the support of Mark Berry and Virginia Tedrow in implementing this study. They would also like to acknowledge Babazile Dlamini and Edward Okoth of Population Services International/Swaziland for their leadership in operationalizing the project. They thank the members of the Swaziland Most-at-Risk Populations (MARPs) technical working group, as well as the Swaziland Ministry of Health and other Swazi government agencies for providing important guidance on this work. They acknowledge Jennifer Albertini and Natalie Kruse-Levy from USAID in Swaziland for their significant technical guidance and Alisen Cheng and Sarah Sandison from USAID in Washington for their technical input and oversight on this project. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by USAID/Project SEARCH, Task Order No. 2, funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00032-00, and the President’s Emergency Plan for AIDS Relief.
Publisher Copyright:
© The Author(s) 2016.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Female sex workers (FSW) have a heightened vulnerability to violence and negative sexual/reproductive health outcomes. Limited research has examined how experiencing physical and sexual violence (PSV) mediates risk for poor health outcomes among FSW in Swaziland. The present analyses aim to contribute to literature linking violence with poor health outcomes, high-risk behaviors, and reduced health service-seeking among FSW. Data were analyzed from a cross-sectional study conducted in Swaziland between July and September 2011 with 325 adult women who reported exchanging sex for money, goods, or favors in the last 12 months, recruited through respondent-driven sampling (RDS). Logistic regression was used to assess the relationship between PSV and ancillary violence/abuse exposures, risk behaviors, and sexual/reproductive and mental health outcomes. PSV was conceptualized as either ever having been beaten up as a result of selling sex or ever being forced to have sex since the age of 18, or both. Prevalence of PSV in this sample was 59.0% in crude estimation, and 48.4% (95% confidence interval [CI]:[39.2,57.6]) with RDS weighting. Separate RDS-weighted estimates of being beaten up as a result of sex work and ever being forced to have sex were 32.4% (95%CI=[24.4,40.4]) and 33.1% (95%CI =[25.0,41.2%]), respectively. Experiencing PSV was associated with being blackmailed (adjusted odds ratio [aOR]= 1.93, 95%CI= [1.07,3.52]), non-injection drug use in the last 12 months (aOR= 1.84, 95%CI= [1.02,3.33]), and feeling afraid to seek health services as a result of selling sex (aOR = 1.74, 95%CI= [1.01,2.99]). Given these findings, violence prevention strategies should be prioritized in programs that address Swazi FSW health, empowerment, and safety.
AB - Female sex workers (FSW) have a heightened vulnerability to violence and negative sexual/reproductive health outcomes. Limited research has examined how experiencing physical and sexual violence (PSV) mediates risk for poor health outcomes among FSW in Swaziland. The present analyses aim to contribute to literature linking violence with poor health outcomes, high-risk behaviors, and reduced health service-seeking among FSW. Data were analyzed from a cross-sectional study conducted in Swaziland between July and September 2011 with 325 adult women who reported exchanging sex for money, goods, or favors in the last 12 months, recruited through respondent-driven sampling (RDS). Logistic regression was used to assess the relationship between PSV and ancillary violence/abuse exposures, risk behaviors, and sexual/reproductive and mental health outcomes. PSV was conceptualized as either ever having been beaten up as a result of selling sex or ever being forced to have sex since the age of 18, or both. Prevalence of PSV in this sample was 59.0% in crude estimation, and 48.4% (95% confidence interval [CI]:[39.2,57.6]) with RDS weighting. Separate RDS-weighted estimates of being beaten up as a result of sex work and ever being forced to have sex were 32.4% (95%CI=[24.4,40.4]) and 33.1% (95%CI =[25.0,41.2%]), respectively. Experiencing PSV was associated with being blackmailed (adjusted odds ratio [aOR]= 1.93, 95%CI= [1.07,3.52]), non-injection drug use in the last 12 months (aOR= 1.84, 95%CI= [1.02,3.33]), and feeling afraid to seek health services as a result of selling sex (aOR = 1.74, 95%CI= [1.01,2.99]). Given these findings, violence prevention strategies should be prioritized in programs that address Swazi FSW health, empowerment, and safety.
KW - Swaziland
KW - female sex workers
KW - human rights
KW - sexual/reproductive health
KW - violence
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U2 - 10.1177/0886260516629385
DO - 10.1177/0886260516629385
M3 - Article
C2 - 26872508
AN - SCOPUS:85050695062
SN - 0886-2605
VL - 33
SP - 2745
EP - 2766
JO - Journal of Interpersonal Violence
JF - Journal of Interpersonal Violence
IS - 17
ER -