Harm Reduction Journal volume 17 , Article number: 43 Cite this article. Metrics details. Research 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.
This study examines the association between SM status by identity and behavior, structural vulnerability, and HIV risk among a sample of street-based FSW.
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. 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. The 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. Structural vulnerabilities reflect societal-level factors e.
Current best practices on conceptualizing and measuring sexual orientation incorporate a three dimensional model including identity, behavior, and attraction [ 6 , 7 ]. Identity is self-defined based on how one identifies their sexual orientation. Existing research indicates the merit of considering sexual minority populations as defined by both identity and behavior, as these dimensions of sexual orientation are not always overlapping and can reveal nuance in understanding the populations [ 1 , 8 ].
