Abstract: Binge Use of Amphetamine-Type Stimulants and Exposure to Violence Among a Cohort of Women Engaged in Sex Work in Cambodia (Society for Prevention Research 21st Annual Meeting)
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178 Binge Use of Amphetamine-Type Stimulants and Exposure to Violence Among a Cohort of Women Engaged in Sex Work in Cambodia

Schedule:
Wednesday, May 29, 2013
Pacific D-O (Hyatt Regency San Francisco)
* noted as presenting author
Marie-Claude Couture, PhD, Researcher, University of California, San Francisco, San Francisco, CA
Neth Sansothy, MD, Co-Investigator, National Institute for HIV, AIDS, Dermatology and STDs, Phnom Penh, Cambodia
Jennifer Evans, MS, Senior Statistician, University of California, San Francisco, San Francisco, CA
Ellen Stein, MPH, Academic Coordinator, University of California, San Francisco, San Francisco, CA
Lisa Maher, PhD, Program Head and NHMRC Senior Research Fellow, University of New South Wales, Sydney, Australia
Keo Sichan, BA, Project Director, Cambodia Women's Development Association, Phnom Penh, Cambodia
Kimberly Page, PhD, Professor in Residence, University of California, San Francisco, San Francisco, CA
Background:  Amphetamine type stimulant (ATS) use, which is widespread among female sex workers (FSW) in Cambodia, increases HIV risk and may also be associated with social harms including violence. We examine associations between binge of ATS use and exposure to violence among FSW in Phnom Penh, Cambodia.

Methods:  220 young FSW recruited from entertainment establishments, brothels, streets and parks were enrolled in a prospective study (August 2009-2010). Socio-demographic, sexual and drug exposures, and experience of violence (emotional, physical and sexual) were surveyed. Generalized estimating equations (GEE) were performed to examine independent associations between recent ATS binge use and violence (emotional, physical and sexual).  

Results:  At baseline, 23.3% reported recent (last 3 months) ATS use and 15.0% reported recent binge use. Exposure to violence in the preceding year was high: 69.1% reported emotional; 35.5% moderate physical; 20.9% severe physical, and 26.8% reported sexual violence. Emotional and physical (moderate and severe) violence was higher among bingers than non-bingers. Recent binge use of ATS was independently associated with severe physical violence (Adjusted OR 4.48; 95% CI, 1.52-13.27) controlling for age, education, sex work venue and number of sex partners. Freelance/brothel sex work and higher number of sex partners were strongly associated with experiencing emotional and moderate physical violence.  

Conclusions:  High rates of binge ATS use and violence were found among Cambodian FSW, and recent binge ATS use increased risk of severe physical violence. Binge of ATS in combination with violence can make these women more vulnerable to HIV infection. Results underscore the need to develop comprehensive risk reduction interventions for FSWs addressing drug use, and associated negative social and health outcomes including violence and HIV infection.

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