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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

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

TitleAdapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania
Publication TypeJournal Article
Year of Publication2018
AuthorsLeddy, AM, Underwood, C, Decker, MR, Mbwambo, J, Likindikoki, S, Galai, N, Kerrigan, D
JournalAIDS Behav
Date PublishedMay 16
ISBN Number1090-7165
Accession Number29767818
KeywordsFemale sex workers, Gender-based violence, HIV, Sub-Saharan Africa, substance use
Abstract

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.

PMCID

PMC6239982