Social and Structural Barriers to Safer Sex Among Heterosexual Female Sex Workers

Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers while controlling for age and sexual violence. This study was conducted using a quantitative research approach with a correlational method. Multiple linear regression statistical testing was performed using data from 534 participants from the National HIV Behavioral Surveillance study. Immigration status was not significantly associated with condom-less vaginal sex or multiple sex partners. However, homelessness and substance use were positively associated with condom-less vaginal sex and multiple sex partners. In addition, utilization of healthcare was negatively associated with condom-less vaginal sex. The results from this study can increase awareness and knowledge of challenges and barriers among female sex workers living in Illinois. In addition, the results of this study may contribute to establishing baseline epidemiology of this population and guidelines on addressing the factors associated with unsafe sexual behaviors that can potentially lead to HIV and other STIs