Promotion of Latina Health: Intersectionality of IPV and Risk for HIV/AIDS

Latina women in the United States are vulnerable to two intersecting public health concerns: intimate partner violence (IPV) and subsequent risk for HIV/AIDS infection. Examination of the cultural and contextual life factors of this understudied population is crucial to developing culturally relevant HIV interventions. 

Focus groups with Latinas (15 monolingual; 10 bilingual) who have experienced IPV were conducted. Monolingual and bilingual Latinas endorsed that they were concerned about HIV infection, naming partner infidelity and experiences of forced and coerced sex as primary reasons for their concern. However, monolingual participants had lower levels of HIV knowledge, spending much time discussing myths of HIV infection, whereas bilingual participants spent more time discussing specific prevention techniques, including challenges related to the violence in their relationships. 

These findings suggest that HIV/AIDS prevention programs for Latinas need to pay close attention to the different historical, contextual, and cultural experiences of this at-risk group of women.

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By:  Rountree MA1, Granillo T2, Bagwell-Gray M3.

• 1University of Texas at Austin School of Social Work, USA mrountree@mail.utexas.edu.
• 2Con Mi Madre, Austin, TX, USA.
• 3Arizona State University School of Social Work, Phoenix, USA. 
• Violence Against Women. 2016 Apr;22(5):545-64. doi: 10.1177/1077801215607358. Epub 2015 Oct 14.

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Bidirectional Associations between Externalizing Behavior Problems and Maladaptive Parenting within Parent-Son Dyads Across Childhood

Coercive parent-child interaction models posit that an escalating cycle of negative, bidirectional interchanges influences the development of boys' externalizing problems and caregivers' maladaptive parenting over time. However, longitudinal studies examining this hypothesis have been unable to rule out the possibility that between-individual factors account for bidirectional associations between child externalizing problems and maladaptive parenting. 

Using a longitudinal sample of boys (N = 503) repeatedly assessed eight times across 6-month intervals in childhood (in a range between 6 and 13 years), the current study is the first to use novel within-individual change (fixed effects) models to examine whether parents tend to increase their use of maladaptive parenting strategies following an increase in their son's externalizing problems, or vice versa. These bidirectional associations were examined using multiple facets of externalizing problems (i.e., interpersonal callousness, conduct and oppositional defiant problems, hyperactivity/impulsivity) and parenting behaviors (i.e., physical punishment, involvement, parent-child communication). 

Analyses failed to support the notion that when boys increase their typical level of problem behaviors, their parents show an increase in their typical level of maladaptive parenting across the subsequent 6 month period, and vice versa. Instead, across 6-month intervals, within parent-son dyads, changes in maladaptive parenting and child externalizing problems waxed and waned in concert. Fixed effects models to address the topic of bidirectional relations between parent and child behavior are severely underrepresented. 

We recommend that other researchers who have found significant bidirectional parent-child associations using rank-order change models reexamine their data to determine whether these findings hold when examining changes within parent-child dyads.

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By:  Besemer S1, Loeber R2, Hinshaw SP3, Pardini DA4.

• 1University of California, Berkeley, Institute of Human Development (http://ihd.berkeley.edu/), 1205 Tolman Hall, Berkeley, CA, 94720, USA. besemer@berkeley.edu.
• 2Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
• 3Department of Psychology, University of California Berkeley, Berkeley, CA, USA.
• 4School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ, USA.
• J Abnorm Child Psychol. 2016 Jan 18. 

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Sexual Violence Victimization and Associations with Health in a Community Sample of Hispanic Women

This study sought to add to the limited information currently available on circumstances of sexual violence victimization and associated negative health experiences among Hispanic women. 

Data come from a community sample of mostly Mexican women in an urban southwestern city. Household interviews were completed with a sample of 142 women during 3 months in 2010. 

Findings indicate that 31.2% of women reported rape victimization and 22.7% reported being sexually coerced in their lifetime. Victims of rape and/or sexual coercion were significantly more likely to report symptoms of depression and post-traumatic stress disorder (PTSD) during their lifetime. 

Among victims whose first unwanted sexual experience resulted in rape and/or sexual coercion, perpetrators were almost always someone known to the victims, and were mostly family members or intimate partners, depending on the victim's age. About one-fifth of victims were injured and 17.1% needed medical services. 

These findings suggest the need for more attention to the physical and mental health needs of sexually victimized Hispanic women.

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By:  Basile KC1, Smith SG1, Walters ML1, Fowler DN1, Hawk K2, Hamburger ME1.

• 1Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
• 2Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA. 

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Socio-Structural & Behavioral Risk Factors Associated with Trafficked History of Female Bar/Spa Entertainers in the Sex Trade in the Philippines

To explore factors associated with trafficking (deceptive/coercive entry to sex trade) among female bar/spa entertainers who traded sex in the Philippines.

Female bar/spa entertainers who traded sex in the past 6 months were recruited from 25bar/spa venues in Metro Manila (April 2009-January 2010) and assessed via cross-sectional survey data collection for HIV-risk-related socio-structural factors associated with deceptive/coercive entry into the sex trade. The study employed hierarchical linear modeling.

Of 166 bar/spa entertainers assessed, 19 (11.4%) reported being deceived/coerced (i.e. trafficked) into their first jobs. Trafficking history was independently associated with current drug use decreased availability of condoms at venues for entertainers and, conversely, increased peer support for practicing safer sex behaviors. Those deceived/coerced into their positions were more likely than non-trafficked women to have been recruited by an agency who came to their rural province as opposed to getting the job from advertisement or a friend/acquaintance.

The findings have implications for designing interventions to prevent and target trafficked women in the Philippines who may be more vulnerable to substance use and, potentially, HIV infection.

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By: Urada LA1, Halterman S2, Raj A3, Tsuyuki K3, Pimentel-Simbulan N4, Silverman JG3.

• 1Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA. Electronic address: lurada@ucsd.edu.
• 2School of Medicine, University of California, San Diego, La Jolla, CA, USA.
• 3Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
• 4Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines, Manila, Philippines. 

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"Right Here is the Gateway": Mobility, Sex Work Entry & HIV Risk Along the Mexico-U.S. Border

Women comprise an increasing proportion of migrants. Many voluntarily migrate for sex work or practice survival sex, while others may be trafficked for sexual exploitation. To investigate how the context of mobility shapes sex work entry and HIV risk, we conducted in-depth interviews with formerly trafficked women currently engaged in sex work (n=31) in Tijuana, Mexico and their service providers (n=7) in Tijuana and San Diego, USA from 2010–2011. 

Women’s experiences of coerced and deceptive migration, deportation as forced migration, voluntary mobility, and migration to a risk environment illustrate that circumstances driving and resulting from migration shape vulnerability to sex trafficking, voluntary sex work entry, and HIV risk. 

Findings suggest an urgent need for public health and immigration policies that provide integrated support for deported and/or recently arrived female migrants. Policies to prevent sex trafficking and assist trafficked females must also consider the varying levels of personal agency involved in migration and sex work entry.

Read more at: http://ht.ly/S77Kz 

By: SM Goldenberg,* JS Silverman,* D Engstrom,*** I Bojorquez-Chapela,** and SA Strathdee*

^**Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México

^***

^**Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México

^***

*Division of Global Public Health, University of California, La Jolla, CA, USA
**Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México
***School of Social Work, San Diego State University, San Diego, CA, USA

*Division of Global Public Health, University of California, La Jolla, CA, USA

*Division of Global Public Health, University of California, La Jolla, CA, USA

Sex Workers Perspectives on Strategies to Reduce Sexual Exploitation & HIV Risk: A Qualitative Study in Tijuana, Mexico

Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange) contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. 

From 2010-2011, we conducted in-depth interviews with sex workers (n = 31) in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to:

1. reduce susceptibility to sexual exploitation by providing social support and peer-based education;
2. mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and
3. provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. 

Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

Read more at: http://ht.ly/S746v 

Via: Goldenberg SM1, Engstrom D, Rolon ML, Silverman JG, Strathdee SA.

• 1BC Centre for Excellence in HIV/AIDS, Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada ; Department of Medicine, Division of Global Public Health, University of California San Diego, La Jolla, California, United States of America.

Exploring the Context of Trafficking & Adolescent Sex Industry Involvement in Tijuana, Mexico: Consequences for HIV Risk & Prevention

Coerced and adolescent sex industry involvement are linked to serious health and social consequences, including enhanced risk of HIV infection. Using ethnographic fieldwork, including interviews with 30 female sex workers with a history of coerced or adolescent sex industry involvement, we describe contextual factors influencing vulnerability to coerced and adolescent sex industry entry and their impacts on HIV risk and prevention. 

Early gender-based violence and economic vulnerability perpetuated vulnerability to coercion and adolescent sex exchange, while HIV risk mitigation capacities improved with increased age, control over working conditions, and experience. 

Structural interventions addressing gender-based violence, economic factors, and HIV prevention among all females who exchange sex are needed.

Via: http://ht.ly/S73TQ 

By: Goldenberg SM1, Silverman JG2, Engstrom D3, Bojorquez-Chapela I4, Usita P3, Rolón ML5, Strathdee SA2.

• 1University of British Columbia, Vancouver, Canada Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada sgoldenberg@cfenet.ubc.ca.
• 2University of California, San Diego, USA.
• 3San Diego State University, CA, USA.
• 4El Colegio de la Frontera Norte, Tijuana, Mexico.
• 5University of California, San Diego, USA Universidad Xochicalco, Tijuana, Mexico.