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Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study
| Content Provider | Scilit |
|---|---|
| Author | Lancaster, Kathryn E. Lean, Sarah A. Mac Lungu, Thandie Mmodzi, Pearson Hosseinipour, Mina C. Hershow, Rebecca B. Powers, Kimberly A. Pence, Brian W. Hoffman, Irving F. Miller, William C. Go, Vivian F. |
| Copyright Year | 2017 |
| Description | Background: Alcohol use is pervasive among female sex workers (FSW) placing them at increased risk of violence and sexual risk behaviors. FSW often live and work where alcohol is highly normative. Objective: To understand the socioecological influences on hazardous alcohol use among FSW in Malawi. Methods: In 2014, 200 FSW identified through venue-based sampling in Lilongwe, Malawi, completed a quantitative behavioral survey, with a sub-sample participating in qualitative interviews. Multivariable log-binomial regression was used to identify associations between hazardous alcohol use (AUDIT score ≥ 7) and time in sex work, clients per week, unprotected sex, alcohol use with clients, and living environment. Qualitative interviews enhanced findings from quantitative data and identify emergent themes around socioecological influences on alcohol use. Results: Over 50% reported hazardous alcohol use and lived in an alcohol-serving venue. Hazardous alcohol use was associated with sex work duration of ≥2 years (aPR: 1.30; 95%CI: 1.02,1.65) and alcohol use at last sex with a client (aPR: 1.29; 95%CI: 1.06,1.57). FSW perceived alcohol as a facilitator for sex work by reducing inhibitions and attracting clients, but acknowledged alcohol leads to violence and/or unprotected sex. Despite these risks and a motivation to reduce use, FSW feared that refusing to drink would be tantamount to turning away clients. Conclusions: Although FSW recognized alcohol-related risks, the norms and power dynamics of sex work perpetuated hazardous alcohol use. Multilevel interventions are needed to collectively change norms around drinking and sex work that will enable FSW to reduce alcohol consumption when engaging in their work. |
| Related Links | http://europepmc.org/articles/pmc5884720?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884720/pdf |
| Ending Page | 791 |
| Page Count | 10 |
| Starting Page | 782 |
| ISSN | 10826084 |
| e-ISSN | 15322491 |
| DOI | 10.1080/10826084.2017.1365088 |
| Journal | Substance Use & Misuse |
| Issue Number | 5 |
| Volume Number | 53 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2017-10-11 |
| Access Restriction | Open |
| Subject Keyword | Journal: Substance Use & Misuse Substance Abuse Alcohol Use Motivations Norms Sex Work Sub-saharan Africa Violence |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health (social science) Public Health, Environmental and Occupational Health Psychiatry and Mental Health |
