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Structural and environmental barriers to condom use negotiation with clients among female sex workers: Implications for HIV-prevention strategies and policy

Author

Listed:
  • Shannon, K.
  • Strathdee, S.A.
  • Shoveller, J.
  • Rusch, M.
  • Kerr, T.
  • Tyndall, M.W.

Abstract

Objectives. We investigated the relationship between environmental- structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of "hot spots" for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estimate the relationship between environmental-structural factors and being pressured by a client into unprotected sexual intercourse. Results. In multivariate analyses, being pressured into having unprotected sexual intercourse was independently associated with having an individual zoning restriction (odds ratio [OR]=3.39; 95% confidence interval [CI]=1.00, 9.36), working away from main streets because of policing (OR=3.01; 95% CI=1.39, 7.44), borrowing a used crack pipe (OR=2.51; 95% CI=1.06, 2.49), clientperpetrated violence (OR=2.08; 95% CI=1.06, 4.49), and servicing clients in cars or in public spaces (OR=2.00; 95% CI=1.65, 5.73). Conclusions. Given growing global concern surrounding the failings of prohibitive sex-work legislation on sex workers' health and safety, there is urgent need for environmental-structural HIV-prevention efforts that facilitate sex workers' ability to negotiate condom use in safer sex-work environments and criminalize abuse by clients and third parties.

Suggested Citation

  • Shannon, K. & Strathdee, S.A. & Shoveller, J. & Rusch, M. & Kerr, T. & Tyndall, M.W., 2009. "Structural and environmental barriers to condom use negotiation with clients among female sex workers: Implications for HIV-prevention strategies and policy," American Journal of Public Health, American Public Health Association, vol. 99(4), pages 659-665.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2007.129858_9
    DOI: 10.2105/AJPH.2007.129858
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    Cited by:

    1. Deanna Kerrigan & Andrea Wirtz & Stefan Baral & Michele Decker & Laura Murray & Tonia Poteat & Carel Pretorius & Susan Sherman & Mike Sweat & Iris Semini & N'Della N'Jie & Anderson Stanciole & Jenny B, 2013. "The Global HIV Epidemics among Sex Workers," World Bank Publications - Books, The World Bank Group, number 12217.
    2. Richardson, Lindsey & Wood, Evan & Kerr, Thomas, 2013. "The impact of social, structural and physical environmental factors on transitions into employment among people who inject drugs," Social Science & Medicine, Elsevier, vol. 76(C), pages 126-133.
    3. Elena Argento & Shira Goldenberg & Melissa Braschel & Sylvia Machat & Steffanie A Strathdee & Kate Shannon, 2020. "The impact of end-demand legislation on sex workers’ access to health and sex worker-led services: A community-based prospective cohort study in Canada," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-10, April.
    4. Shirley J Semple & Eileen V Pitpitan & David Goodman-Meza & Steffanie A Strathdee & Claudia V Chavarin & Gudelia Rangel & Karla Torres & Thomas L Patterson, 2017. "Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-16, October.
    5. Shalini Bharat & Bidhubhusan Mahapatra & Suchismita Roy & Niranjan Saggurti, 2013. "Are Female Sex Workers Able to Negotiate Condom Use with Male Clients? The Case of Mobile FSWs in Four High HIV Prevalence States of India," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-8, June.
    6. Erin E Conners & Brooke S West & Alexis M Roth & Kristen G Meckel-Parker & Mei-Po Kwan & Carlos Magis-Rodriguez & Hugo Staines-Orozco & John D Clapp & Kimberly C Brouwer, 2016. "Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-14, May.
    7. Sherman, Susan G. & Lilleston, Pamela & Reuben, Jacqueline, 2011. "More than a dance: The production of sexual health risk in the exotic dance clubs in Baltimore, USA," Social Science & Medicine, Elsevier, vol. 73(3), pages 475-481, August.
    8. Jessica McCann & Gemma Crawford & Jonathan Hallett, 2021. "Sex Worker Health Outcomes in High-Income Countries of Varied Regulatory Environments: A Systematic Review," IJERPH, MDPI, vol. 18(8), pages 1-16, April.
    9. Lianne A Urada & Donald E Morisky & Nymia Pimentel-Simbulan & Jay G Silverman & Steffanie A Strathdee, 2012. "Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-9, March.
    10. Jennie Pearson & Sylvia Machat & Jennifer McDermid & Shira M. Goldenberg & Andrea Krüsi, 2023. "An Evaluation of Indoor Sex Workers’ Sexual Health Access in Metro Vancouver: Applying an Occupational Health & Safety Lens in the Context of Criminalization," IJERPH, MDPI, vol. 20(3), pages 1-15, January.
    11. Shirley J Semple & Jamila K Stockman & Eileen V Pitpitan & Steffanie A Strathdee & Claudia V Chavarin & Doroteo V Mendoza & Gregory A Aarons & Thomas L Patterson, 2015. "Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-15, November.

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