Social Cohesion Among Sex Workers and Client Condom Refusal in a Canadian Setting : Implications for Structural and Community-Led Interventions

UBC Faculty Research and Publications

Social Cohesion Among Sex Workers and Client Condom Refusal in a Canadian Setting : Implications for Structural and Community-Led Interventions Argento, Elena; Duff, Putu; Bingham, Brittany; Chapman, Jules; Nguyen, Paul; Strathdee, Steffanie A.; Shannon, K.

Abstract

Community empowerment can be a powerful determinant of HIV risk among sex workers (SWs). This study modeled the impact of social cohesion on client condom refusal among SWs in Vancouver. Longitudinal data were drawn from a prospective cohort of SWs (2010–2013). Lippman and colleagues’ Social Cohesion Scale measured SWs’ connectedness (i.e., perception of mutual aid, trust, support). Multivariable logistic regression examined the independent effect of social cohesion on client condom refusal. Of 654 SWs, 22 % reported baseline client condom refusal and 34 % over 3 years. The baseline median social cohesion score was 24 (IQR 20–29, range 4–45). In the final confounding model, for every one-point increase in the social cohesion score, average odds of condom refusal decreased by 3 % (AOR 0.97; 95 % CI 0.95–0.99). Community empowerment can have a direct protective effect on HIV risk. These findings highlight the need for a legal framework that enables collectivization and SW-led efforts in the HIV response.

Item Metadata

Title	Social Cohesion Among Sex Workers and Client Condom Refusal in a Canadian Setting : Implications for Structural and Community-Led Interventions
Creator	Argento, Elena; Duff, Putu; Bingham, Brittany; Chapman, Jules; Nguyen, Paul; Strathdee, Steffanie A.; Shannon, K.
Contributor	British Columbia Centre for Excellence in HIV/AIDS
Date Issued	2016-06
Description	Community empowerment can be a powerful determinant of HIV risk among sex workers (SWs). This study modeled the impact of social cohesion on client condom refusal among SWs in Vancouver. Longitudinal data were drawn from a prospective cohort of SWs (2010–2013). Lippman and colleagues’ Social Cohesion Scale measured SWs’ connectedness (i.e., perception of mutual aid, trust, support). Multivariable logistic regression examined the independent effect of social cohesion on client condom refusal. Of 654 SWs, 22 % reported baseline client condom refusal and 34 % over 3 years. The baseline median social cohesion score was 24 (IQR 20–29, range 4–45). In the final confounding model, for every one-point increase in the social cohesion score, average odds of condom refusal decreased by 3 % (AOR 0.97; 95 % CI 0.95–0.99). Community empowerment can have a direct protective effect on HIV risk. These findings highlight the need for a legal framework that enables collectivization and SW-led efforts in the HIV response.
Subject	Sex work; Community empowerment; Social cohesion; HIV prevention; Condom use
Geographic Location	Downtown-Eastside (Vancouver, B.C.)
Genre	Article; Postprint
Type	Text
Language	eng
Date Available	2018-06-05
Provider	Vancouver : University of British Columbia Library
Rights	Attribution-NonCommercial-NoDerivatives 4.0 International
DOI	10.14288/1.0368543
URI	http://hdl.handle.net/2429/66208
Affiliation	Medicine, Faculty of; Other UBC; Non UBC; Medicine, Department of
Citation	Argento, E., Duff, P., Bingham, B., Chapman, J., Nguyen, P., Strathdee, S.A., Shannon, Kate (2016). Social cohesion among sex workers and client condom refusal in a Canadian setting
Publisher DOI	doi:10.1007/s10461-015-1230-8
Peer Review Status	Reviewed
Scholarly Level	Faculty; Researcher
Rights URI	http://creativecommons.org/licenses/by-nc-nd/4.0/
Aggregated Source Repository	DSpace

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