Patterns of Sex Work Client Solicitation Settings and Associations with HIV/STI Risk Among a Cohort of Female Sex Workers in Baltimore, Maryland

AIDS Behav. 2021 Oct;25(10):3386-3397. doi: 10.1007/s10461-021-03293-x. Epub 2021 May 11.

Abstract

Female sex workers' (FSWs) risk for HIV/STIs is influenced by their work environments. While previous research has characterized vulnerability in a single workplace, many FSWs solicit clients from multiple settings. Using latent class analysis (LCA), we examined client solicitation patterns and associated HIV/STI-related behaviors (consistent condom use with clients, asking clients about HIV/STIs, and past 6-month HIV/STI testing) among 385 FSWs in Baltimore, Maryland. The LCA yielded a three-class solution: predominantly street (61.2%), mixed street/venue (23.7%), and multisource (street, venue, and online) (15.1%). Consistent condom use differed significantly (p < 0.01) by class, with the mixed street/venue having the lowest (40.6%) rate and the multisource having the highest (70.6%). Classes differed on HIV/STI testing (p < 0.01), with the predominantly street class having the lowest testing rate (56.2%) and multisource with the highest (85.7%). These findings underscore the importance of considering how solicitation patterns are linked to HIV/STI susceptibility of FSWs and adapting interventions accordingly.

Keywords: HIV/STI; Latent class analysis; Sex work; Sexual risk behavior.

MeSH terms

  • Baltimore / epidemiology
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • Humans
  • Risk Factors
  • Sex Work
  • Sex Workers*
  • Sexually Transmitted Diseases* / epidemiology