Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania.

Journal: AIDS and behavior

Volume: 22

Issue: 10

Year of Publication: 2019

Affiliated Institutions:  Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. anna.leddy@ucsf.edu. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Abstract summary 

Female sex workers (FSWs) in sub-Saharan Africa are disproportionately affected by HIV and gender-based violence (GBV). Substance use overlaps with these co-occurring epidemics to further increase FSWs' risk for negative health outcomes. We explored the relationship between substance use, GBV, and consistent condom use utilizing baseline data from a cohort of 496 FSWs in Tanzania. Results demonstrate high levels of alcohol use and GBV, and low levels of consistent condom use. Frequent intoxication during sex work was associated with increased odds of recent GBV (aOR 1.64, 95% CI 1.07, 2.49; p value 0.02) and reduced odds of consistent condom use with clients (aOR 0.58, 95% CI 0.37, 0.92; p-value 0.02). We adapt the risk environment framework to contextualize our findings in the social and structural context and to gain insight into intervention approaches to address the intersecting challenges of substance use, GBV, and HIV among FSWs in Tanzania and similar settings.

Authors & Co-authors:  Leddy Anna M AM Underwood Carol C Decker Michele R MR Mbwambo Jessie J Likindikoki Samuel S Galai Noya N Kerrigan Deanna D

Study Outcome 

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Statistics
Citations :  Baral S, Beyrer C, Muessig K, Poteat T, Wirtz AL, Decker MR, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. The LancetInfectious diseases. 2012;12(7):538–49.
Authors :  7
Identifiers
Doi : 10.1007/s10461-018-2156-8
SSN : 1573-3254
Study Population
Female
Mesh Terms
Adolescent
Other Terms
Female sex workers;Gender-based violence;HIV;Sub-Saharan Africa;Substance use
Study Design
Cohort Study
Study Approach
Country of Study
Tanzania
Publication Country
United States