Adverse Pregnancy Outcomes and Sexual Violence Among Female Sex Workers Who Inject Drugs on the United States-Mexico Border

• Published in: Violence and victims 2013-01, Vol.28 (3), p.496-512
• Main Authors: McDougal, Lotus, Strathdee, Steffanie A., Rangel, Gudelia, Martinez, Gustavo, Vera, Alicia, Sirotin, Nicole, Stockman, Jamila K., Ulibarri, Monica D., Raj, Anita
• Format: Article
• Language: English
• Subjects: Abortion, Induced - statistics & numerical data; Abortion, Spontaneous - epidemiology; Abortion, Spontaneous - ethnology; Abortion, Spontaneous - prevention & control; Adolescent; Adult; Behavior; Behavioral Sciences; Borders; California; Counseling; Cross-Sectional Studies; Drug use; Emotional abuse; Female; Females; Health Surveys; Humans; Intervention; Males; Marriage and Family Counselling; Mexican Americans - statistics & numerical data; Mexico; Mexico - ethnology; Middle Aged; Miscarriage; Policy, Social Justice, and Human Rights; Population; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Complications - ethnology; Pregnancy Complications - prevention & control; Prostitution; Psychology; Reproductive health; Risk Factors; Sex Offenses - ethnology; Sex Offenses - prevention & control; Sex Offenses - statistics & numerical data; Sex Workers - education; Sex Workers - psychology; Sex Workers - statistics & numerical data; Sexual Assault; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - ethnology; Sexually Transmitted Diseases - prevention & control; Social and Personality Psychology; Social Environment; Social Work; Stillbirth - epidemiology; Stillbirth - ethnology; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - ethnology; Substance Abuse, Intravenous - prevention & control; Transients and Migrants - statistics & numerical data; Unsafe Sex - ethnology; Unsafe Sex - statistics & numerical data; Violence - ethnology; Violence - prevention & control; Violence - statistics & numerical data; Womens health; Workers; Young Adult
• ISSN: 0886-6708; 1945-7073
• DOI: 10.1891/0886-6708.11-00129

This study examines the prevalence of miscarriage/stillbirth among female sex workers who inject drugs (FSW-IDUs) and measures its associations with physical and sexual violence. Baseline data from 582 FSW-IDUs enrolled in an HIV intervention study in Tijuana and Ciudad Juárez, Mexico were used for current analyses. 30% of participants had experienced at least one miscarriage/stillbirth, 51% had experienced sexual violence, and 49% had experienced physical violence. History of miscarriage/stillbirth was associated with sexual violence (adjusted odds ratio [aOR] = 1.7, p = .02) but not physical violence. Additional reproductive risks associated with miscarriage/stillbirth included high numbers of male clients in the previous month (aOR = 1.1 per 30 clients, p = 0.04), history of abortion (aOR = 3.7, p < .001), and higher number of pregnancies (aOR = 1.4 per additional pregnancy, p < .001). Programs and research with this population should integrate reproductive health and consider gender-based violence.