Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in northern Mexico
Article first published online: 5 OCT 2012
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Volume 108, Issue 1, pages 161–170, January 2013
How to Cite
Morris, M. D., Lemus, H., Wagner, K. D., Martinez, G., Lozada, R., Gómez, R. M. G. and Strathdee, S. A. (2013), Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in northern Mexico. Addiction, 108: 161–170. doi: 10.1111/j.1360-0443.2012.04016.x
- Issue published online: 26 DEC 2012
- Article first published online: 5 OCT 2012
- Accepted manuscript online: 6 JUL 2012 07:44AM EST
- Manuscript Accepted: 2 JUL 2012
- Manuscript Revised: 6 FEB 2012
- Manuscript Received: 10 NOV 2011
- National Institute on Drug Abuse (NIDA). Grant Numbers: R01DA023877, R01DA023877-02S2
- Childhood abuse;
- injection drug use;
- sex work;
- substance abuse
To identify factors associated with time to initiation of (i) sex work prior to injecting drugs initiation; (ii) injection drug use prior to sex work initiation; and (iii) concurrent sex work and injection drug use (i.e. initiated at the same age) among female sex workers who currently inject drugs (FSW–IDU).
Parametric survival analysis of baseline data for time to initiation event.
Tijuana and Ciudad Juarez situated on the Mexico–US border.
A total of 557 FSW–IDUs aged ≥18 years.
Interview-administered surveys assessing context of sex work and injection drug use initiation.
Nearly half (n = 258) initiated sex work prior to beginning to inject, a third (n = 163) initiated injection first and a quarter (n = 136) initiated both sex work and injection drug use concurrently. Low education and living in Ciudad Juarez accelerated time to sex work initiation. Being from a southern Mexican state and initiating drug use with inhalants delayed the time to first injection drug use. Having an intimate partner encourage entry into sex work and first injecting drugs to deal with depression accelerated time to initiating sex work and injection concurrently. Early physical abuse accelerated time to initiating sex work and injection, and substantially accelerated time to initiation of both behaviors concurrently.
Among female sex workers who currently inject drugs in two Mexican–US border cities, nearly half appear to initiate sex work prior to beginning to inject, nearly one-third initiate injection drug use before beginning sex work and one-quarter initiate both behaviors concurrently. Predictors of these three trajectories differ, and this provides possible modifiable targets for prevention.