Emanuel, E; Slater, L; Croxford, S; Edmundson, C; Ibitoye, A; Njoroge, J; Ijaz, S; Hope, V; Platt, L; Phipps, E; +1 more... Desai, M; (2023) Adverse health outcomes among people who inject drugs who engaged in recent sex work: findings from a national survey. Public health, 225. pp. 79-86. ISSN 0033-3506 DOI: https://doi.org/10.1016/j.puhe.2023.09.024
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Abstract
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.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Public Health, Environments and Society |
PubMed ID | 37922590 |
Elements ID | 211170 |
Official URL | http://dx.doi.org/10.1016/j.puhe.2023.09.024 |
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Licence: Creative Commons: Attribution 4.0
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