Associations Between Sex Work and Stimulant Use by Gender Among People Who Use Methamphetamine in the Mexico-U.S. Border
BACKGROUND: The literature indicates that there is a strong association between sexual risk behaviors for sexually transmitted infections and drug use, specifically sex work and stimulant use, respectively. Along the Mexico-U.S. border, Cd. Juarez and Tijuana are cities with high rates of drug use and availability due to lying on major drug trafficking routes into the U.S. There is minimal literature available on sex work among men not exclusively men who have sex with men, and stimulant use in the border region. AIMS: The aim of this study is to (1) summarize the measures for sociodemographic characteristics, sexual risk behaviors, and drug use by gender, and determine the association between (2) border crossing and living (3) sexual risk behaviors, and (3) drug use by engagement in sex work in the last 12 months. METHODS: This proposed secondary data analysis will be based on data from a cross-section study of 150 adults who were 21 years old or older, who used methamphetamine in the past three months, and currently living in Cd. Juarez. The measures will include socio-demographic characteristics, sex work characteristics, border living and crossing, sexual risk behaviors, meth use initiation, and stimulant use. To determine associations with engaging in sex work in the last 12 months and these measures, appropriate bivariate analyses were performed stratified by gender. Adjusted results were performed with logistic regression. RESULTS: All participants in the parent study were included in this secondary analysis (N=150). Among the 50 trans/women who participated in the study, 14 engaged in sex work in the last 12 months and 18 in their lifetime. Among the 100 men who participated in the study, 15 did so in the last 12 months and 19 did so in their lifetime. There were similar findings among trans/women and men. For border living and crossing, among the trans/women who engaged in sex work there significant finding in crossing the border in the last 12 months into the U.S. (p=0.002) and El Paso (p=0.002) and for the men who engaged in sex work (p=0.023) and into El Paso (p=0.028) compared to those who did not engage. For sexual risk behaviors, there were significant differences in the frequency of being penetrated during anal sex without lubricant by the last sexual partner in the last 12 months (p=.011) for the women and for the men (p=0.039) for those who engaged in sex work compared to those who did not. In regard drug use, there were significant differences in initiating meth use due to being surrounded by friends and acquaintances who use drugs (p=.047) and acquiring meth from a friend (p=0.005) the first time it was consumed and had higher odds of ever using inhalants (p=0.031), cocaine and heroin together (p=0.001), cocaine/crack and heroin together (p=0.004), and injecting cocaine/crack (p=0.009). For the men, there were no significant differences in regards meth use initiation, but there were significant differences in ever using cocaine/heroin together (p<0.001), cocaine/crack, and heroin together (p<0.001), and injecting cocaine/crack (p=0.003). CONCLUSIONS: Results indicated that there are significant differences by engagement in sex work in the last 12 months and crossing the border and into El Paso in the last 12 months. Also, rates for using lube during anal sex by engagement in sex work and stimulant use among trans/women and men. After adjusting for age, marital status, and type of participant, the most significant associations with engagement in sex work in the last 12 months persisted. DISCUSSION: In the study, trans/women and men had similar findings for border living and crossing, sexual risk behaviors, and stimulant use. Therefore, future interventions for reducing drug use and sexual risk behaviors can be used to address occupation risks related to sex work. Prevention and harm reduction approaches for HIV and other sexually transmitted infections outbreaks that address sexual risk behaviors may need to be adapted for people who use stimulant drugs during sex or while engaging in sex work.
Health sciences|Public health|Behavioral psychology
Maldonado, Itzahi Rodela, "Associations Between Sex Work and Stimulant Use by Gender Among People Who Use Methamphetamine in the Mexico-U.S. Border" (2020). ETD Collection for University of Texas, El Paso. AAI28262431.