Sexual violence affecting female sex workers in Côte d’Ivoire: prevalence, context, and associated mental health and substance use outcomes

作者：Nuria Gallego Márquez, Nika Elmi, Carrie Lyons, Gnilane Turpin, Hector Moran, Ibrahima Ba, Nguissali Turpin, Emile Gouane, Evelyne Obodou, Daouda Diouf, Stefan Baral, Katherine B. Rucinski · 发表于：BMC Public Health · 年份：2024 · DOI：10.1186/s12889-024-20177-6 · 被引用次数：4 · 研究领域：Sex work and related issues、Sexuality, Behavior, and Technology、Adolescent Sexual and Reproductive Health

BACKGROUND: Female sex workers are disproportionately affected by sexual violence, which is associated with an increased risk of poor mental health outcomes, substance use, and decreased access to health resources. Understanding the pathways through which sexual violence impacts these outcomes can inform strategies that appropriately and effectively meet the health needs of sex workers. METHODS: This study investigated the prevalence of sexual violence among female sex workers in Côte d'Ivoire, and the relationship between sexual violence and adverse mental health and substance use outcomes. We examined survey data from female sex workers recruited between November 2019 and May 2020 across five regions of Côte d'Ivoire using respondent driven sampling (RDS), as part of an integrated bio-behavioral survey. The primary exposure of interest was self-reported lifetime experience of sexual violence, and the main outcomes of interest included depression, suicidal ideation, counselling seeking, alcohol consumption, and substance use. Multivariable logistic regression models investigated associations between exposure to sexual violence and the key mental health and substance use outcomes of interest. For each outcome, a directed acyclic graph was developed to identify a minimally sufficient set of covariates for adjustment. Additional sociodemographic characteristics, experiences, and sex work-related behaviors were explored in descriptive analyses using crude and RDS adjusted estima...