Examining the associations between sex trade involvement, rape, and symptomatology of sexual abuse trauma

Patterns of Sexual Risk Behaviors and Sexuality-Related Risk Factors among Young Adults in Germany: Implications for Prevention and Therapy

Sexual risk behavior (SRB) includes behavioral (sex without contraception, sexualized substance use, sex work, sexual partner violence, other sexual activities that harm oneself or others) and affective subtypes (sexuality-related feelings of shame/guilt, relationship impairments) and leads to psychosocial and health-related consequences. Young adults comprise a vulnerable group regarding the development of SRB. The study aimed to identify SRB patterns among young adults and their relation to sexuality-related risk factors. A cross-sectional online survey measured behavioral and affective aspects of SRB with nine items. Latent class analysis was conducted to identify patterns of SRB. Gender, sexual orientation, age of first intercourse, number of sexual partners, hypersexuality, and sexual dysfunction were captured as risk factors via multinomial logistic regression. Within this convenience sample (n = 609; nfemale = 365; nmale = 245; Mage = 23.1 years), the SRB patterns unremarkable (67%; low values in all SRB subtypes), shame-ridden (17%; high values in sexual feelings of shame/guilt) and risky sexual behavior (16%; high values in all subtypes of SRB, especially sexualized drug use) were identified. The shame-ridden and risky patterns were strongly associated with higher hypersexuality values, the risky pattern moreover with being non-heterosexual, of younger age at first sexual experience, and a higher number of sexual partners. Male and sexual minority participants demonstrated SRB more often than females and heterosexuals. Within prevention and treatment of SRB, it seems beneficial to address sexuality-related feelings of shame/guilt and addictive patterns (concerning sexual behaviors/substances) via gender- and diversity-sensitive measurements.

Violence and victimisation in the lives of persons experiencing homelessness who use methamphetamine: A scoping review

Methamphetamine (MA) use among individuals who experience homelessness has tripled in recent years. This is a problematic trend given the harmful impacts of this substance on health and social well-being. While there is a large body of literature on the relationship between substance use and trauma, little is known about the scope of existing empirical literature exploring this topic related to MA use. Anecdotally, MA is frequently associated with violence and victimisation, which may be related to stigma associated with using MA. However, little is known about the scope of empirical literature exploring violence and victimisation in the lives of individuals who experience homelessness and use MA. We conducted a scoping review to fill this gap in existing literature using Arksey and O'Malley's methodological framework. Our search was conducted between January 2021 and March 2021 and was deployed in seven databases: Medline, Embase, CINAHL, PsycINFO, Sociological Abstracts, Nursing and Allied Health and AMED. Two independent raters screened 700 titles and abstracts after the removal of duplicates. A total of 54 articles were subjected to a full-text review and 20 articles met the inclusion criteria. We generated two themes: methamphetamine and victimisation and challenging behaviours. Six (30%) of the included articles explored MA use in relation to violence, while 18 (90%) explored experiences of victimisation among persons experiencing homelessness. Our findings highlight that individual who experience homelessness and use MA are particularly vulnerable to experiences of trauma. Though existing literature does acknowledge the challenging behaviour associated with MA use, only three existing studies demonstrated a relationship between MA use and physical violence. Research exploring the impacts of MA use on victimisation among persons who experience homelessness, and the development of interventions for managing challenging behaviours associated with MA use are needed.

Applying an Ecological Framework to Factors Associated With Non-Spousal Sexual Assault Among Women in Canada

An ecological framework is useful for understanding how individual, relationship, community, and societal level factors can affect women's vulnerability to sexual assault. However, most studies have focused on examining individual and relationship factors only, due to measurement challenges and a lack of data at the societal level. The purpose of this study was to use data from a nationally representative victimization survey to identify salient predictors of sexual assaults not committed by common-law or marital partners among women across all levels of the ecological framework. Out of 16,738 female respondents, 1.9% (n = 319) experienced one or more incidents of non-spousal sexual assault in the 12 months preceding the survey. Logistic regression modeling indicated that at the individual level, statistically significant factors associated with non-spousal sexual assault included age, Indigenous status, marital status, mental disability, education, main activity, and homelessness or precarious housing. Relationship level predictors of non-spousal sexual assault were a history of child sexual abuse and witnessing violence between parents. Community level predictors were a weak sense of belonging in the local community, low likelihood that neighbors would contact police if they witnessed family violence in the respondents' home, and high likelihood that neighbors would contact police if they witnessed other criminal behavior. Societal level factors were perceptions that local police do a poor job promptly responding to calls, perceptions that local police do a poor job treating people fairly, and having experienced discrimination in the previous 5 years. The results demonstrated that community and societal level factors are critical components of an ecological framework and are important to understanding and addressing the many factors which are independently associated with vulnerability to sexual assault.

Entry to Sex Trade and Long-Term Vulnerabilities of Female Sex Workers Who Enter the Sex Trade Before the Age of Eighteen

Female sex workers are a structurally vulnerable population, including critical insecurity such as having access to food and shelter. This risk may be heightened among individuals who enter sex work as minors. However, the reasons for entering sex work as a minor and the long-term structural risk implications are poorly understood. Here, we investigated the reasons for and long-term impact of trading sex before the age of eighteen on women's structural vulnerability among a cohort of 250 cisgender women involved in street-based sex work in Baltimore City, Maryland, USA. We used logistic regression to explore the role of age of entry on two structural vulnerability outcomes of interest (homelessness and recent food insecurity in the past 3 months). Overall, 73% of women entered the sex trade to get drugs, 36% of women entered to get basic necessities such as food or housing, and 17% of women entered to support their children or family. Of significance, 21% of those aged < 18 years at entry reported being either coerced, threatened, pressured, misled, tricked, or physically forced into trading sex compared to 5% in those who entered at an older age group (p value < 0.001). In adjusted analysis, women who first trade sex before the age of 18 had 4.54 increased odds of experiencing recent homelessness (95% CI 1.92-10.70) and had 3.14 times increased odds of experiencing recent food insecurity (95% CI 1.42-6.94). Those who entered as minors were also more likely to be HIV positive (11.3% vs 3.6%, p value = 0.02). This study highlights that those who trade sex at a younger age experience an ongoing cumulative vulnerability in comparison to those entering over the age of 18. These findings call for additional research into a more detailed understanding of young women's entry into the sex trade and trajectory. A focus on the importance of policy changes and structural interventions that directly alleviate young people's socio-economic disadvantage is needed.

Navigating Sex and Sexuality After Sexual Assault: A Qualitative Study of Survivors and Informal Support Providers

Qualitative interview data from 45 matched pairs of survivors disclosing sexual assaults and their primary informal support providers (e.g., friend, family member, significant other) were used to explore survivor and support provider perspectives on changes in sexuality postassault and how those close to them have been affected as a result. Changes in sexuality included loss of interest in sex, increase or change in sexual partners, engaging in sex work, and increased sexual behavior. Support providers generally regarded promiscuity as a risky sexual behavior. If the support provider was the survivor's sexual partner, he or she discussed exercising caution when navigating sexual intimacy with the survivor. Not all sexual encounters with romantic partners were positive; some survivors discussed being triggered (i.e., with post-traumatic stress disorder [PTSD] flashbacks) or experiencing the dissolution of their relationships due to the sexual impacts of their assault. Counseling implications are discussed in the context of improving survivors' sexual experiences in general and in romantic relationships postassault. Implications can also be applied to prevention, scholarship on sex work, and sexuality research.

"Mouth Wide Shut": Strategies of Female Sex Workers for Coping With Intimate Partner Violence

The aim of this study was to explore the relationship between possible violence suffered by female sex workers in their intimate relationships, with their affects, coping strategies, and emotional regulation to overcome such violence and improve their well-being. Structured personal interviews were carried out with female sex workers in three different settings: street, club, and flats. The sample was composed of 137 Spanish female sex workers (85.4% are foreign and 20% Spanish-born sex workers). High levels of tension and problems with their partners were linked to an affective imbalance and poor well-being. Positive affectivity determined the use of adaptive strategies, whereas negative affectivity predicted dysfunctional strategies. Three different path analyses and theoretical support concluded that self-control was the only strategy related to improve well-being in female sex workers who reported lower potential tension and difficulty in their intimate relationships. In contrast, inhibition was associated with an increase on distress levels when negative affectivity predominated and sex workers had reported potential tension and difficulty situations with their partners. It was a cross-sectional study, and thus we cannot infer causality or direction from the observed associations. Given these findings, violence prevention strategies in the intimate relationships should be prioritized in the prostitution context.