ArticleHarm reduction journal2020
Structural vulnerabilities and HIV risk among sexual minority female sex workers (SM-FSW) by identity and behavior in Baltimore, MD.
Article in Harm reduction journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Structural Vulnerability in Health Research: A Systematic Mixed Studies Review.Journal of advanced nursing · 2026Pooled it
- Moderation Analysis of a couple-based HIV/STI Intervention Among Heterosexual Couples in the Criminal Legal System Experiencing Intimate Partner Violence: Results from a Randomized Controlled Trial.AIDS and behavior · 2023Trial
- Substance Use and HIV Risk Among African Refugee and Migrant Sex Workers in Italy: A Mixed-Methods Study Informed by Syndemic Theory.AIDS and behavior · 2026Article
- How survivors of exploitation who use drugs navigate systems of care: an analysis of survivor insights using the intersectional risk environment.Harm reduction journal · 2026Article
- Excess Burdens and Mental Health Consequences of Physical Violence Victimization Among Sexual Minority Adolescents and Young Adults in Colombia and Honduras: A Pooled Population-Based Study.Journal of interpersonal violence · 2025Article
- Substance Use and HIV Risk in a Syndemic Context: Vulnerabilities Among African Refugee Sex Workers in Italy.Research square · 2025Article
- Exploring HIV Risk Among Sexual Minority Women by Identity and Behavior in a Population-Based Sample of Low-Income Heterosexually Active Women.LGBT health · 2025Article
- Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.Journal of substance use and addiction treatment · 2025Article
- Mental health and the role of social support in the lives of vulnerabilized sexual minority women.PloS one · 2025Article
- Improving access to HIV care among people who inject drugs through tele-harm reduction: a qualitative analysis of perceived discrimination and stigma.Harm reduction journal · 2024Article
- Gender as a social and structural variable: research perspectives from the National Institutes of Health (NIH).Translational behavioral medicine · 2024Article
- Health Care Utilization and Care-seeking Behavior Among Vulnerabilized Sexual Minority Women: A Social-ecological Approach.Journal of health care for the poor and underserved · 2024Article
- Intimate Partner Violence Among Sexual Minority Women: A Scoping Review.Trauma, violence & abuse · 2023Article
- Brief Report: Social Factors Associated With Trajectories of HIV-Related Stigma and Everyday Discrimination Among Women Living With HIV in Vancouver, Canada: Longitudinal Cohort Findings.Journal of acquired immune deficiency syndromes (1999) · 2023Article
- Variation in HIV Transmission Behaviors Among People Who Use Drugs in Rural US Communities.JAMA network open · 2023Article
- Selling sex in the context of substance use: social and structural drivers of transactional sex among men who use opioids in Maryland.Harm reduction journal · 2022Article
- A Structural Competency Framework for Emergency Medicine Research: Results from a Scoping Review and Consensus Conference.The western journal of emergency medicine · 2022Article
- The Importance of Sexual Orientation in the Association Between Social Cohesion and Client Condom Coercion Among Women Who Exchange Sex in Baltimore, Maryland.AIDS and behavior · 2022Article
- Social and structural determinants of health associated with police violence victimization: A latent class analysis of female sex workers who use drugs in Kazakhstan.The International journal on drug policy · 2022Article
- Internet solicitation linked to enhanced occupational health and safety outcomes among sex workers in Metro Vancouver, Canada 2010-2019.Occupational and environmental medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundResearch suggests sexual minority female sex workers (SM-FSW) face elevated structural vulnerability and HIV risk compared to their heterosexual counterparts. Structural vulnerabilities reflect societal level factors (e.g., sexism, homophobia, racism) that constrain an individual's agency, particularly related to health outcomes. This study examines the association between SM status by identity and behavior, structural vulnerability, and HIV risk among a sample of street-based FSW.
methodsThe current study utilizes baseline data from the SAPPHIRE study, a prospective cohort of cis gender and transgender FSW in Baltimore, MD, recruited through targeted time-location sampling from April 2016 to January 2017. The current analysis focuses on cisgender women. The baseline survey ascertained demographics, substance use, intimate partner violence (IPV), and sex work characteristics. Multivariable models were constructed using self-identity and behaviorally defined SM status as independent variables with vulnerability outcomes (e.g., injection drug use, injection speedball, binge drinking, homelessness, physical IPV, ever had a pimp, and being a minor at sex work entry (age < 18)) as dependent variables.
resultsOf the participants (n = 247), 25.5% (n = 63) self-identified as a SM by identity (e.g., gay or bisexual), and 8.5% (n = 21) reported SM behavior (e.g., same-gender sexual behavior) in the past 3 months. 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 by behavior was associated with increased odds of binge drinking, homelessness, ever having a pimp, and being a minor at sex work entry.
conclusionThe 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.
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Registered trials
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