Original article
Correlates of Early versus Later Initiation into Sex Work in Two Mexico–U.S. Border Cities

https://doi.org/10.1016/j.jadohealth.2009.06.011Get rights and content

Abstract

Purpose

To examine correlates of early initiation into sex work in two Mexico–U.S. border cities.

Methods

Female sex workers (FSWs) ≥18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent baseline interviews. Correlates of initiation into sex work before age 18 were identified with logistic regression.

Results

Of 920 FSWs interviewed in Tijuana (N = 474) and Ciudad Juarez (N = 446), 9.8% (N = 90) were early initiators (<18 years) into sex work. Median age of entry into sex work was 26 years (range: 6–58). After adjusting for age, compared to older initiators, early initiators were more likely to use inhalants (21.1% vs. 9.6%, p = .002), initiate sex work to pay for alcohol (36.7% vs. 18.4%, p < .001), report abuse as a child (42.2% vs. 18.7%, p < .0001), and they were less likely to be migrants (47.8% vs. 62.3%, p = .02). Factors independently associated with early initiation included inhalant use (adjOR = 2.39), initiating sex work to pay for alcohol (adjOR = 1.88) and history of child abuse (adjOR = 2.92). Factors associated with later initiation included less education (adjOR = 0.43 per 5-year increase), migration (adjOR = 0.47), and initiating sex work for better pay (adjOR = 0.44) or to support children (adjOR = 0.03).

Conclusions

Different pathways for entering sex work are apparent among younger versus older females in the Mexico–U.S. border region. Among girls, interventions are needed to prevent inhalant use and child abuse and to offer coping skills; among older initiators, income-generating strategies, childcare, and services for migrants may help to delay or prevent entry into sex work.

Section snippets

Study population

As described elsewhere [25], FSWs were recruited at municipal clinics, through personal referrals, nongovernment organizations, or using street outreach. For this analysis, we used data from baseline assessments in Tijuana (N = 474) and Ciudad Juarez (N = 450), which occurred between March 2004 and March 2006. Eligible participants were women 18 years or older who self-identified as FSWs (having traded sex for drugs, money, or other material benefit), reported unprotected vaginal or anal sex with a

Results

Of 924 FSWs interviewed, 920 reported their age initiation into sex work; of those, 90 (9.8%) had initiated sex work before the age of 18 and hence were considered early initiators. Median age of entry into sex work was 26 years (range: 6–58); for early initiators it was 16 (range: 6–17), and for later initiators it was 27 (range: 18–58). At baseline, almost all women currently had children, whereas approximately half were single. Over half of the women had used some drug prior to initiation

Discussion

This study's findings suggest different pathways for entering sex work between younger versus older women living in two Mexico–U.S. border cities. We found differences in sociodemographic characteristics, history of drug use, history of abuse, and influences for entering sex work between the women who initiated sex work before the age of 18 versus those who initiated sex work later in their lives. Early initiation into sex work was independently associated with history of emotional abuse,

Human Participant Protection

The protocol for the research study on which this article is based was reviewed and approved by UCSD's Human Research Protection Program (HRPP). The HRPP is a federally accredited Institutional Review Board (IRB) whose Federal-wide Assurance Number is FWA00004495.

Contributors

With the guidance and supervision of doctoral advisor S.A. Strathdee, O. Loza originated the present analysis, analyzed and interpreted data, and prepared the article. T.L. Patterson provided and interpreted data and revised the article. V.D. Ojeda guided the interpretation and discussion of migration and public health implications and revised the article. H. Amaro contributed to the discussion of inhalant use and public health implications and revised the article. R. Lozada was the Tijuana

Acknowledgments

This research was made possible with support from NIH Grants R01 MH065849 (T.L. Patterson, P.I.), R01 DA023477 (S.A. Strathdee, P.I.), and Diversity Supplements R01 DA019829-02S1 and DA019829-02S2 (S.A. Strathdee, P.I.). The authors gratefully acknowledge the cooperation of the staff and participants of Proyecto Mujer Segura (NIH R01 MH065849) and of the following organizations: the Municipal and State Health Departments of Tijuana, Baja California and Ciudad Juárez, Chihuahua; Salud y

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