Community empowerment can be
a powerful determinant of HIV risk among sex workers (SWs). This study modeled
the impact of social cohesion on client condom refusal among SWs in Vancouver.
Longitudinal data were drawn from a prospective cohort of SWs (2010-2013).
Lippman and colleagues' Social Cohesion Scale measured SWs' connectedness
(i.e., perception of mutual aid, trust, support).
Multivariable logistic
regression examined the independent effect of social cohesion on client condom
refusal. Of 654 SWs, 22 % reported baseline client condom refusal and
34 % over 3 years. The baseline median social cohesion score was 24
(IQR 20-29, range 4-45). In the final confounding model, for every one-point
increase in the social cohesion score, average odds of condom refusal decreased
by 3 % (AOR 0.97; 95 % CI 0.95-0.99).
Community empowerment can have
a direct protective effect on HIV risk. These findings highlight the need for a
legal framework that enables collectivization and SW-led efforts in the HIV
response.
Purchase full article at:
- 1Gender & Sexual Health Initiative, B.C. Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- 2Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
- 3Sex Workers United Against Violence (SWUAV), Vancouver, BC, Canada.
- 4Division of Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA, USA.
- 5Gender & Sexual Health Initiative, B.C. Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. gshi@cfenet.ubc.ca.
- 6Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. gshi@cfenet.ubc.ca.
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