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. 2022 Aug;26(8):2632-2642.
doi: 10.1007/s10461-022-03599-4. Epub 2022 Feb 5.

The Importance of Sexual Orientation in the Association Between Social Cohesion and Client Condom Coercion Among Women Who Exchange Sex in Baltimore, Maryland

Jennifer L Glick  1 , S Wilson Beckham  2 , Rebecca Hamilton White  2 , Danielle Friedman Nestadt  2 , Carmen H Logie  3 , Noya Galai  4 , Susan G Sherman  2
Affiliations

The Importance of Sexual Orientation in the Association Between Social Cohesion and Client Condom Coercion Among Women Who Exchange Sex in Baltimore, Maryland

Jennifer L Glick et al. AIDS Behav. 2022 Aug.

Abstract
in English, Spanish

Among women who exchange sex (WES), social cohesion is associated with multi-level HIV-risk reduction factors, and client condom coercion (CCC) is associated with increased HIV-risk. Sexual minority WES (SM-WES) face exacerbated HIV-risk, yet relevant research is scant. We examined the role of sexual orientation in the relationship between social cohesion and CCC among cisgender WES (n = 384) in Baltimore, Maryland using stratified logistic regression, controlling for potential confounders. Forty-five percent of WES experienced CCC. SM-WES reported significantly higher social cohesion than heterosexual WES. The relationship between social cohesion and CCC differed by sexual orientation. Among SM-WES, higher social cohesion was independently associated with decreased odds of experiencing CCC, controlling for food insecurity, crack use, police harassment, and method of finding clients. Among heterosexual WES, no significant association was found. Ongoing research and practice with WES should (1) collect sexual orientation data to allow for deeper understanding and tailored interventions, (2) leverage and nurture social cohesion and (3) tailor interventions to populations with attention to sexual orientation.

Among women who exchange sex (WES), social cohesion is associated with multi-level HIV-risk reduction factors, and client condom coercion (CCC) is associated with increased HIV-riskEntre las mujeres que intercambian sexo (WES), la cohesión social atenúa el riesgo de VIH, y la coerción del uso del condón por parte de clientes (CCC) amplifica el riesgo de VIH. Las WES de minorías sexuales (SM-WES) experiencian un riesgo elevado de VIH, pero las investigaciónes relevantes son pocas. En este papel, examinamos la contribución de la orientación sexual en modificando la relación entre la cohesión social y la CCC entre WES cisgénero (n = 384) en Baltimore, Maryland, utilizando regresión logística estratificada, ajustando por posibles factores de confusión. Cuarenta y cinco por ciento de WES reportaron experiencias de CCC. SM-WES exhibieron cohesión social significativamente más alta que las WES heterosexuales. La relación entre la cohesión social y CCC fue moderada por la orientación sexual. Entre SM-WES, la cohesión social se asoció independientemente con menores probabilidades de reportar experiencias de CCC, ajustando por la inseguridad alimentaria, el uso de crack, el acoso policial y el método de encontrar a clientes. Entre las WES heterosexuales, la misma asociación no fue significativa. La investigación y la práctica con WES deben 1) recopilar datos de orientación sexual para permitir una comprensión más profunda e intervenciones personalizadas, 2) aprovechar y fomentar la cohesión social y 3) adaptar las intervenciones a estas poblaciones con atención a la orientación sexual.

Keywords: Client condom coercion; Sexual orientation; Social cohesion; Women who exchange sex (WES).

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Conflict of interest statement

Conflict of interest Susan Sherman is an expert witness in opioid legislation on the plaintiff’s side. No other conflicts to declare.

Figures

Figure 1.
Figure 1.
Hypothesized Relationships between Social Cohesion and Client Condom Coercion among WES
See this image and copyright information in PMC

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