Dataset Information

The Relationship Between Economic Deprivation, Housing Instability and Transactional Sex Among Women in North Carolina (HPTN 064).

ABSTRACT: Transactional sex is associated with socioeconomic disadvantage and HIV risk but few studies in the United States (US) have examined both individual and area-level predictors of transactional sex or distinguished transactional sex from sex work. We combined data from HIV Prevention Trials Network 064 study and the US Census to estimate prevalence ratios (PR) for the relationship between census-level and individual measures of economic deprivation and housing instability on transactional sex in 417 women in North Carolina. Increased transactional sex was associated with food insecurity (PR 1.86; 95%; CI 1.57, 2.19), housing instability (PR 1.33; 95% CI 1.11, 1.59), substance abuse (PR 1.90; 95% CI 1.64, 2.19) and partner incarceration (PR 1.32; 95% CI 1.09, 1.61). Census-level indicators were not associated with transactional sex, adjusted for individual-level covariates. Interventions should support housing stability and financial opportunities among southern African American women to reduce HIV risk, particularly among women with incarcerated partners.

SUBMITTER: Stoner MCD

PROVIDER: S-EPMC7374930 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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The Relationship Between Economic Deprivation, Housing Instability and Transactional Sex Among Women in North Carolina (HPTN 064).

Stoner Marie C D MCD Haley Danielle F DF Golin Carol E CE Adimora Adaora A AA Pettifor Audrey A

AIDS and behavior 20191101 11

Transactional sex is associated with socioeconomic disadvantage and HIV risk but few studies in the United States (US) have examined both individual and area-level predictors of transactional sex or distinguished transactional sex from sex work. We combined data from HIV Prevention Trials Network 064 study and the US Census to estimate prevalence ratios (PR) for the relationship between census-level and individual measures of economic deprivation and housing instability on transactional sex in 4 ...[more]

PMID: 31332597

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Project description:IntroductionThe purpose of this study was to examine the relationship between socio-demographic characteristics, risky sexual behaviour, alcohol use and transactional sex among female bar workers in Yaounde, Cameroon.Materials and methodsA cross-sectional survey was conducted among a representative sample of 410 female bar workers, recruited through a modified version of venue-based cluster sampling technique from May to June 2017. Transactional sex was defined as having received money/gifts in exchange for sex with any sexual partner in the past 12 months. Logistic regression models were performed to identify the factors associated with transactional sex. The level of statistical significance was set at p< = 0.05.ResultsAbout 14.9% (n = 61) of respondents reported to have engaged in transactional sex, 83.7% (n = 338) had multiple sexual partners at the time of the study, 14.4% (n = 55) had sex with one or more of their male customers in the past 6 months. Almost 73.4% (n = 301) reported alcohol use. Of these, 37.2% (n = 112) were frequent alcohol consumers. About 17.6% (n = 72) reported to have had unprotected sex under the influence of alcohol in the past 6 months. Multivariate logistic regression analysis showed that those who engaged in transactional sex were more likely to have had sex with a male customer in the past 6 months (aOR = 7.34; 95% CI, 3.63-16.98), had sex under the influence of alcohol in the past 6 months (aOR = 2.42; 95% CI, 1.18-4.96) and frequent alcohol consumers (aOR = 2.06; 95%CI, 1.04-4.10). Respondents who had their last sexual intercourse 4 weeks or more prior to the study (aOR = 0.26; 95% CI, 0.08-0.84) were less likely to have engaged in transactional sex.ConclusionsOur study concludes that female bar workers are exposed to male customers and engage in risky sexual practices including transaction sex. Most of them also consume alcohol which increases their risk of HIV and STI acquisition. They are a high-risk group that need to be targeted with HIV prevention interventions.

Project description:Natural disasters, such as hurricanes, often negatively affect the economic wellbeing of affected individuals. Under such conditions, women may engage in transactional sexual behaviors in order to compensate for lost income and provide for their households. In this study, we evaluated the relationship between hurricane impact and transactional sex and if this relationship was moderated, or mediated, through economic factors. Between December 2017 and February 2018, approximately one year after the area was hit by a category 4 hurricane (Hurricane Matthew), we interviewed a random sample of female microfinance members (n = 304) in Okay, Haiti. We estimated the association between hurricane impact and transactional sex using log-binomial regression. Next, we tested for economic moderation of this relationship by incorporating interaction terms between hurricane impact and food insecurity, poverty, and loss of income generating materials in three separate log-binomial models. Finally, we assessed possible mediation of this relationship by loss of income generating resources and a latent variable, economic stress, using a structural equation model. We found participants who had experienced hurricane impact were 58% more likely to have engaged in transactional sex [prevalence ratio (95% confidence interval): 1.58 (1.19-2.09)]. This relationship was significant and strongly positive among women who were food insecure and had high poverty but not so among women who were food secure and had low poverty, respectively. The final structural equation model (with fit: χ2 = 19.700, degrees of freedom = 15; CFI = 0.958; TLI = 0.941; RMSEA = 0.040) revealed that the relationship was not mediated through economic factors. However, the association between hurricane impact and transactional sex remained significant while controlling for these economic factors. Notably, the findings that the relationship between hurricane impact and transactional sex was moderated, but not mediated, by economic factors implies populations at-risk of experiencing natural disasters should be preemptively targeted with economic interventions to build capacity and resilience before such a disaster hits.

Dataset Information

The Relationship Between Economic Deprivation, Housing Instability and Transactional Sex Among Women in North Carolina (HPTN 064).

Publications

The Relationship Between Economic Deprivation, Housing Instability and Transactional Sex Among Women in North Carolina (HPTN 064).

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