Adverse health outcomes among people who inject drugs who engaged in recent sex work : findings from a national survey
Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved..
OBJECTIVES: This study explores trends in sex work among people who inject drugs (PWID) by gender and the relationship between sex work and adverse health outcomes including overdose, injection-site, and blood-borne virus (BBV) infections.
STUDY DESIGN: The Unlinked Anonymous Monitoring Survey of PWID is an annual cross-sectional survey that monitors BBV prevalence and behaviours, including transactional sex, among PWID recruited through specialist services in England, Wales, and Northern Ireland.
METHODS: Trends in sex work among PWID (2011-2021) were described. Data were analysed to assess differences between PWID who engaged in sex work in the past year (sex workers [SWs]) and those who did not (non-SWs) by gender (Pearson Chi2 tests) (2018-2021). Associations between sex work in the past year and adverse health outcomes were investigated using logistic regression.
RESULTS: Between 2011 and 2021, sex work among PWID remained stable, with 31% of women and 6.3% of men who inject, reporting having ever engaged in sex work, and 14% of women and 2.2% of men engaging in sex work in the past year. Between 2018 and 2021, SWs had greater odds of reporting symptoms of an injection-site infection (adjusted odds ratio (aOR): 1.68 [95% confidence interval {CI}: 1.31-2.16], P < 0.001) and reporting overdose (aOR: 2.21 [CI: 1.74-2.80], P < 0.001) than non-SWs had in the past year. Among men, SWs had 243% greater odds of having HIV than non-SWs (aOR: 3.43 [CI: 1.03-11.33], P = 0.043).
CONCLUSIONS: Our findings highlight disproportionate vulnerability and intersection of overlapping risk factors experienced by PWID SWs and a need for tailored interventions which are inclusive and low-threshold.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:225 |
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| Enthalten in: |
Public health - 225(2023) vom: 05. Dez., Seite 79-86 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Emanuel, E [VerfasserIn] |
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| Links: |
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| Themen: |
Infections |
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| Anmerkungen: |
Date Completed 05.12.2023 Date Revised 05.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.puhe.2023.09.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM364144424 |
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| 245 | 1 | 0 | |a Adverse health outcomes among people who inject drugs who engaged in recent sex work |b findings from a national survey |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a OBJECTIVES: This study explores trends in sex work among people who inject drugs (PWID) by gender and the relationship between sex work and adverse health outcomes including overdose, injection-site, and blood-borne virus (BBV) infections | ||
| 520 | |a STUDY DESIGN: The Unlinked Anonymous Monitoring Survey of PWID is an annual cross-sectional survey that monitors BBV prevalence and behaviours, including transactional sex, among PWID recruited through specialist services in England, Wales, and Northern Ireland | ||
| 520 | |a METHODS: Trends in sex work among PWID (2011-2021) were described. Data were analysed to assess differences between PWID who engaged in sex work in the past year (sex workers [SWs]) and those who did not (non-SWs) by gender (Pearson Chi2 tests) (2018-2021). Associations between sex work in the past year and adverse health outcomes were investigated using logistic regression | ||
| 520 | |a RESULTS: Between 2011 and 2021, sex work among PWID remained stable, with 31% of women and 6.3% of men who inject, reporting having ever engaged in sex work, and 14% of women and 2.2% of men engaging in sex work in the past year. Between 2018 and 2021, SWs had greater odds of reporting symptoms of an injection-site infection (adjusted odds ratio (aOR): 1.68 [95% confidence interval {CI}: 1.31-2.16], P < 0.001) and reporting overdose (aOR: 2.21 [CI: 1.74-2.80], P < 0.001) than non-SWs had in the past year. Among men, SWs had 243% greater odds of having HIV than non-SWs (aOR: 3.43 [CI: 1.03-11.33], P = 0.043) | ||
| 520 | |a CONCLUSIONS: Our findings highlight disproportionate vulnerability and intersection of overlapping risk factors experienced by PWID SWs and a need for tailored interventions which are inclusive and low-threshold | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Infections | |
| 650 | 4 | |a Injecting drug use | |
| 650 | 4 | |a People who inject drugs | |
| 650 | 4 | |a Sex work | |
| 650 | 4 | |a Surveys and questionnaires | |
| 650 | 4 | |a United Kingdom | |
| 700 | 1 | |a Slater, L |e verfasserin |4 aut | |
| 700 | 1 | |a Croxford, S |e verfasserin |4 aut | |
| 700 | 1 | |a Edmundson, C |e verfasserin |4 aut | |
| 700 | 1 | |a Ibitoye, A |e verfasserin |4 aut | |
| 700 | 1 | |a Njoroge, J |e verfasserin |4 aut | |
| 700 | 1 | |a Ijaz, S |e verfasserin |4 aut | |
| 700 | 1 | |a Hope, V |e verfasserin |4 aut | |
| 700 | 1 | |a Platt, L |e verfasserin |4 aut | |
| 700 | 1 | |a Phipps, E |e verfasserin |4 aut | |
| 700 | 1 | |a Desai, M |e verfasserin |4 aut | |
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