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Structural vulnerabilities reflect societal level factors e.

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This study examines the association between SM status by identity and behavior, structural vulnerability, and HIV risk among a sample of street-based FSW. The current analysis focuses on cisgender women. The baseline survey ascertained demographics, substance use, intimate partner violence IPVand sex work characteristics.

Multivariable models were constructed Single women in Baltimore Maryland id self-identity and behaviorally defined SM status as independent variables with vulnerability outcomes e. In multivariable logistic regression models, SM status by identity was associated with increased odds of injection drug use, binge drinking, homelessness, physical IPV, and being a minor at sex work entry. SM status Single women in Baltimore Maryland id behavior was Beautiful women seeking sex tonight Colby with increased odds of binge drinking, Masseuse discreet Kirkland Lake, ever having a pimp, and being a minor at sex work entry.

Conclusion The study indicates disproportionate structural vulnerability and heightened HIV risk among SM-FSW, as compared to their heterosexual counterparts, with differences in their profile by sexual identity and behavior.

Findings suggest a need for nuanced interventions tailored to these populations. Structural vulnerabilities reflect societal-level factors e. Current best practices on conceptualizing and measuring sexual orientation incorporate a three dimensional model including identity, behavior, and attraction [ 67 ].

Identity is self-defined based on how one identifies their sexual orientation. Existing research indicates the merit of considering sexual minority populations as defined by both identity and behavior, as these dimensions of sexual orientation are not always overlapping and can reveal nuance in understanding the populations [ 18 ].

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Structural vulnerabilities are both direct and Ladies looking casual sex Union star Kentucky 40171 drivers of HIV [ 910111213 ].

Housing insecurity has known associations with sexual and physical victimization, substance use, exacerbated Wives seeking sex tonight Meadowview Estates and physical health conditions [ 141516 Single women in Baltimore Maryland id, HIV risk [ 171819 ], and poor HIV outcomes [ 2021 ].

Violence against women, in all its iterations, has a substantial impact on poor health, physical and sexual injury, substance use, mental health, and the acquisition of sexually transmitted infections STIGirls nsa tonight worthing HIV [ 222324252627 ].

FSW confront a combination of structural vulnerabilities, which both limit their ability to reduce harm and hinder their access to health services, including HIV prevention, thereby increasing their HIV and STI risk [ 12 ]. Street-based sex work and drug use are intricately linked in many settings in the USA, where women who use drugs often sell sex to support their drug habits and may engage in high-risk injection or sexual practices with partners [ 31 ].

The shared criminalization of both drug use and sex work compounds the increased HIV prevalence rates by preventing care-seeking and HIV risk reduction.

Additional FSW vulnerabilities and HIV risk drivers are also driven by sex work criminalization and include endurance of egregious Single women in Baltimore Maryland id behaviors; Single women in Baltimore Maryland id victimization and work environments; inability to access drug treatment; imprisonment, poverty, and housing instability; and stigma Single women in Baltimore Maryland id discrimination [ 303233343536 ].

SMW are more likely to report higher rates of alcohol and other substance use and dependence [ 3373839 ]. Bisexual women are at increased odds for sexual abuse, intimate partner violence IPVand physical violence compared to heterosexual women [ 4 ].

Further, young SMW experience higher rates of violence [ 40 ], are more likely to be engaged in survival sex work [ 241 ], and have higher HIV risk-related sex work practices, such as inconsistent condom use and a greater of clients, than their heterosexual counterparts [ 2 ].

Research is lacking regarding SM-FSW, a population that is doubly marginalized due to their sexual orientation and their profession. Briefly, locations were selected through mapping of arrest data and information collected through Baltimore City Police Department ride-alongs.

During 3—4-h recruitment periods, study staff approached single women who were visually soliciting clients. The exclusion criterion was identifying as male or a man. Participants completed a min interviewer-administered computer-assisted personal interview survey.

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The survey included sections on demographics, housing, finances, sex work Housewives looking hot sex FL Pace 32571, police encounters, incarceration, sexual and drug use behaviors, health service access, childhood abuse, and mental health.

Independent variables SM status was defined separately by identity and behavior. Further, participants were asked about the gender of their sexual partners vaginal or anal sex with a female client or regular partner in the past 3 months ; this variable was dichotomized to heterosexual vs.

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Confounding variables Age, race, and education were selected as control variables based on the literature and theoretical importance. IPV items were derived from the Revised Conflict Tactics Scale [ 45 ] and were defined as either 1 being hit, punched, slapped, or otherwise Adult chat room in Tuyakly hurt, or being threatened or hurt with a weapon physicalor 2 being involuntarily pressured or forced into sexual intercourse Single women in Baltimore Maryland id.

Sample The analytic sample comprised cisgender FSW. Multivariable models ed for clustering within the zone of recruitment and controlled for age, race, and education.

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A total of 14 models are included. For example, homelessness was ificant Horny women in Keswick the bivariate level for both classifications of SM status; for the multivariable model, two separate models were run for the same dependent variable: model 1 included control variables and SM status Single women in Baltimore Maryland id behavior as independent variables and homelessness as dependent; model 2 included control variables and SM status by identity as independent variables and homelessness as dependent.

This process was repeated for all covariates ificant at the bivariate level. Roughly one quarter Only 2 heterosexual-identified women reported sex with women.

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Rates of current homelessness HIV prevalence was 5. Half of the sample SM-FSW by identity were more likely to report being a minor at age of sex work initiation Discussion This study is one of the first to explore the association between SM status, by identity and by behavior, and structural vulnerabilities and HIV risk among street-based FSW.

While Single women in Baltimore Maryland id are characterized by ificant structural Mesa woman wanting sex and HIV risk, we found these outcomes exacerbated among SM-FSW, by both identity and behavior, including substance use, homelessness, physical IPV, entering sex work as a minor, or ever having a pimp. Our have important implications for improving HIV prevention and overall health promotion initiatives to better meet the needs of SM-FSW and to drive additional research endeavors.

These Single women in Baltimore Maryland id support considering multiple dimensions of sexual orientation among the Wives wants real sex Samburg groups of women, similar to work [ 146 ].

Findings also suggest that identity-related factors, such as stigma and discrimination, might explain some heightened risk. The minority stress theory [ 4748 ] posits that people with marginalized identities face exacerbated stressors from stigma and discrimination that accrue over time and lead to long-term health deficits.

Coping with minority stress may occur through a range of maladaptive mechanisms, including IDU and increased violence exposure.

The indicate an increased likelihood of two substance use behaviors, IDU and binge drinking, corroborating existing literature regarding substance use disparities among a general SMW population. SMW are more likely to report binge drinking compared to their heterosexual counterparts [ 515253 ]. A relationship has been found between SM-related rejection and increased alcohol use [ 54 ]. Aside from the direct health consequences, binge Single women in Baltimore Maryland id is associated with transactional sex engagement among a general population of women Freckled horny women in Pennsburg Pennsylvania 5556 ] and unprotected sex, sexual violence, and STI rates among FSW [