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Gender violence, poverty and HIV infection risk among persons engaged in the sex industry: cross-national analysis of the political economy of sex markets in 30 European and Central Asian countries

Reeves, Aaron and Steele, S. and Stuckler, D. and McKee, M. and Amato-Gauci, A. and Semenza, Jan, C. (2017) Gender violence, poverty and HIV infection risk among persons engaged in the sex industry: cross-national analysis of the political economy of sex markets in 30 European and Central Asian countries. HIV Medicine. ISSN 1464-2662

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Abstract

Objectives: Persons engaged in the sex industry are at greater risk of HIV and other sexually transmitted infections than the general population. One major factor is exposure to higher levels of risky sexual activity. Expanding condom use is a critical prevention strategy, but this requires negotiation with those buying sex, which takes place in the context of cultural and economic constraints. Impoverished individuals who fear violence are more likely to forego condoms. Methods: Here we test the hypotheses that poverty and fear of violence are two structural drivers of HIV risk in the sex industry. Using data from the European Centre for Disease Prevention and Control and the World Bank for 30 countries, we evaluate poverty, measured by the average income per day per person in the bottom 40% of the income distribution, and gender violence, measured using homicide rates in women and the proportion of women exposed to violence in the last 12 months and/or since age 16. Results: We find that HIV prevalence among those in the sex industry is higher in countries where there are greater female homicide rates (β = 0.86, p = 0.018) and there is some evidence that self-reported exposure to violence is also associated with higher HIV prevalence (β = 1.37, p = 0.043). Conversely, HIV prevalence is lower in countries where average incomes among the poorest are greater (β = -1.05, p = 0.046). Conclusion: Our results are consistent with the theory that reducing poverty and exposure to violence may help reduce HIV risk among persons engaged in the sex industry.

Item Type: Article
Official URL: http://onlinelibrary.wiley.com/journal/10.1111/(IS...
Additional Information: © 2017 British HIV Association
Subjects: H Social Sciences > HT Communities. Classes. Races
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Research centres and groups > International Inequalities Institute
Identification Number: 10.1111/hiv.12520
Date Deposited: 14 Jun 2017 15:00
Last Modified: 19 Jun 2017 16:12
URI: http://eprints.lse.ac.uk/id/eprint/81265

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