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Abstract #51 - Sex Workers
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Session: 15.2: Sex Workers (Parallel) on Monday @ 14.30-16.00 in Auditorium Chaired by Tonya Thurman, Angels Jaen
Authors: Presenting Author: Dr. Xiaoming Li - Wayne State University, United States
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Additional Authors:
Dr Kouassi Auguste Eric Komena,
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Aim: Global literature suggests that gatekeepers exert enormous influences on lives of female sex workers (FSW). Meanwhile, due to the nature of illegality and stigmatization attributed to sex work, FSW are usually disempowered in the power dynamics with gatekeepers and suffer various mental health issues. However, virtually no available studies have examined the FSW-gatekeeper relationship ("F-G relationship") and its impacts on FSW's mental health. The current study aims to quantitatively measure the impact of F-G relationship on FSW's mental health when controlling possible confounders which were previously identified as risk factors of mental health problems among FSW.
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Method / Issue: The current study was conducted in 2008-2009 in two cities of southwest China. A total of 1,022 FSW were recruited through community outreach from nine different types of commercial sex establishments. Complete data regarding the F-G relationship were available from 968 (94.72%) participants. The measures of mental health status among FSW included depression (α=0.89), social isolation (α=0.74), hopefulness (α=0.65), suicidal intention or attempt, and perceived stigma (α=0.89). Confounders of mental health problems included alcohol use, drug use and experience of violent victimization. Both bivariate and multivariate analyses were employed to depict the association between F-G relationship and measures of FSW's mental health.
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Results / Comments: Findings of the current study revealed that FSW with a good relationship with their gatekeepers reported a better mental health status. After adjusting for demographics and potential confounders of mental health, F-G relationship was positively associated with hopefulness (B=0.09, 95%CI=0.01, 0.16), but negatively associated with perceived stigma (B=-0.25, 95%CI=-0.44, -0.07), suicidal intention or attempt (aOR=0.90, 95%CI=0.83, 0.99), and loneliness problems (B=-0.29, 95%CI=-0.47,-0.12). In addition, women who had alcohol and drug use problems, ever experienced partner violence and worked longer in the city were at a higher risk of depression problems (p<.05).
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Discussion: F-G relationship is an independent predictor of mental health of FSW over and above potential confounders including partner violence and substance use. Future health promotion programs targeting FSW need to recognize the role of gatekeepers in the life of FSW and hold them accountable in a socially and legally acceptable way in safeguarding or improving mental health status of FSW in China. In addition, efforts are needed to openly address the existence and harm reduction of this occupation as well as increase more public awareness regarding FSW's individual rights and well-being.
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