ArticleSubstance use & misuse2018
Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study.
Article in Substance use & misuse, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 29 citations in OpenAlex.
- Article
- Intimate partner sexual violence is associated with unhealthy alcohol use among Kenyan women engaged in sex work.Drug and alcohol dependence reports · 2025Article
- Testing a systematically braided alcohol reduction and HIV status neutral intervention among people receiving STI care in Malawi: study protocol for a pilot hybrid type 1 effectiveness-implementation randomized controlled trial.Frontiers in public health · 2025Article
- Determinants of depressive and alcohol use disorders among female sex workers in Ethiopia: evidence from a national bio-behavioral survey, 2020.BMC psychiatry · 2024Article
- Examining HIV Knowledge and Sexually Risky Behaviors among Female Sex Workers in Kampala, Uganda.International journal of environmental research and public health · 2024Article
- Article
- Sexual practices, their influencers, and utilization of HIV services among female sex workers in Mombasa County, Kenya.The Pan African medical journal · 2024Article
- Sexualized Substance Use among Female Sex Workers in Iran: Findings from a Nationwide Survey.Substance use & misuse · 2023Article
- Postnatal depression and its social-cultural influences among adolescent mothers: A cross sectional study.PLOS global public health · 2023Article
- Harmful Alcohol Use and Associated Socio-Structural Factors among Female Sex Workers Initiating HIV Pre-Exposure Prophylaxis in Dar es Salaam, Tanzania.International journal of environmental research and public health · 2022Article
- History of Sex Work Is Associated with Increased Risk of Adverse Mental Health and Substance Use Outcomes in Transgender Adults.International journal of environmental research and public health · 2022Article
- Harmful Alcohol and Drug Use Is Associated with Syndemic Risk Factors among Female Sex Workers in Nairobi, Kenya.International journal of environmental research and public health · 2022Article
- Article
- Article
- Determinants and consequences of heavy episodic drinking among female sex workers in Ethiopia: A respondent-driven sampling study.PloS one · 2021Article
- Factors associated with alcohol use before sex among HIV-negative female sex workers in Zambia.International journal of STD & AIDS · 2020Article
- Female sex workers in Kigali, Rwanda: a key population at risk of HIV, sexually transmitted infections, and unplanned pregnancy.International journal of STD & AIDS · 2019Article
- Contraceptive use, prevalence and predictors of pregnancy planning among female sex workers in Uganda: a cross sectional study.BMC pregnancy and childbirth · 2019Article
- You can't do this job when you are sober: Heroin use among female sex workers and the need for comprehensive drug treatment programming in Kenya.Drug and alcohol dependence · 2019Article
- Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania.AIDS and behavior · 2018Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAlcohol use is pervasive among female sex workers (FSW) placing them at increased risk of violence and sexual risk behaviors. FSW often live and work where alcohol is highly normative.
objectiveTo understand the socioecological influences on hazardous alcohol use among FSW in Malawi.
methodsIn 2014, 200 FSW identified through venue-based sampling in Lilongwe, Malawi, completed a quantitative behavioral survey, with a sub-sample participating in qualitative interviews. Multivariable log-binomial regression was used to identify associations between hazardous alcohol use (AUDIT score ≥ 7) and time in sex work, clients per week, unprotected sex, alcohol use with clients, and living environment. Qualitative interviews enhanced findings from quantitative data and identify emergent themes around socioecological influences on alcohol use.
resultsOver 50% reported hazardous alcohol use and lived in an alcohol-serving venue. Hazardous alcohol use was associated with sex work duration of ≥2 years (aPR: 1.30; 95%CI: 1.02,1.65) and alcohol use at last sex with a client (aPR: 1.29; 95%CI: 1.06,1.57). FSW perceived alcohol as a facilitator for sex work by reducing inhibitions and attracting clients, but acknowledged alcohol leads to violence and/or unprotected sex. Despite these risks and a motivation to reduce use, FSW feared that refusing to drink would be tantamount to turning away clients.
conclusionsAlthough FSW recognized alcohol-related risks, the norms and power dynamics of sex work perpetuated hazardous alcohol use. Multilevel interventions are needed to collectively change norms around drinking and sex work that will enable FSW to reduce alcohol consumption when engaging in their work.
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