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J Acquir Immune Defic Syndr. 2014 Jan 1;65(1):122-8. doi: 10.1097/QAI.0b013e3182a98ee6.

Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting.

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1
*Department of Medicine, Division of Global Public Health, University of California, San Diego, CA; †Department of Medicine, Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada; and ‡Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada.

Abstract

OBJECTIVES:

To explore factors associated with early sex work initiation and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs).

DESIGN:

Baseline data (2010-2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old.

METHODS:

SWs completed a questionnaire and HIV/sexually transmitted infection testing. Using multivariate logistic regression, we identified associations with early sex work initiation (<18 years old) and constructed confounder models examining the independent effect of early initiation on HIV and prostitution arrests among adult SWs.

RESULTS:

Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian born [adjusted odds ratio (AOR): 6.8, 95% confidence interval (CI): 2.42 to 19.02], inject drugs (AOR: 1.6, 95% CI: 1.0 to 2.5), and to have worked for a manager (AOR: 2.22, 95% CI: 1.3 to 3.6) or been coerced into sex work (AOR: 2.3, 95% CI: 1.14 to 4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3 to 3.2) and prostitution arrests (AOR: 2.0, 95% CI: 1.3 to 3.2).

CONCLUSIONS:

Adolescent sex work initiation is concentrated among marginalized, drug, and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs.

PMID:
23982660
PMCID:
PMC4056677
DOI:
10.1097/QAI.0b013e3182a98ee6
[Indexed for MEDLINE]
Free PMC Article
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