Sex Workers and Syndemics: A Population Vulnerable to HIV and COVID-19

• Published in: Archives of sexual behavior Vol. 50; no. 5; pp. 2007 - 2016
• Main Authors: Rogers, Brooke G., Paradis-Burnett, Annaka, Nagel, Katherine, Yolken, Annajane, Strong, Sabrina H., Arnold, Trisha, Napoleon, Siena C., Maynard, Michaela, Sosnowy, Collette, Murphy, Matthew, Daley Ndoye, Colleen, Holcomb, Richard, Schierberl Scherr, Anna, Pinkston, Megan, Chan, Philip A.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2021; Springer Nature B.V
• Subjects: Adolescent; Adult; Behavioral Science and Psychology; Coronaviruses; COVID-19; COVID-19 - epidemiology; Disease transmission; Female; Gender Identity; HIV; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Male; Middle Aged; Narcotics; Original Paper; Psychology; Public Health; SARS-CoV-2; Sex industry; Sex Workers - statistics & numerical data; Sexual Behavior; Social Sciences; Syndemic; Vulnerable Populations; Young Adult; COVID-19; HIV; Syndemics; Street-based sex workers
• ISSN: 0004-0002; 1573-2800
• DOI: 10.1007/s10508-021-01940-x

COVID-19 has disproportionately affected vulnerable populations across the U.S. Street-based sex workers are one vulnerable population whose health and impact of COVID-19 have been understudied to date. The goal of this study was to evaluate findings from a community needs assessment with street-based sex workers on impact of COVID-19 on health behaviors and social circumstances. A brief survey was developed at a community-based harm reduction and recovery services organization. Surveys were administered by peer specialists to street-based sex workers during street outreach in April and May 2020. A total of 46 surveys were analyzed. Many individuals reported continuing to do sex work and use substances during the COVID pandemic. Slightly more than a quarter of individuals ( n  = 13; 28.3%) indicated using personal protective equipment while doing sex work and described challenges to using precautions when working with clients. Individuals had used marijuana ( n  = 32, 71.1%), cocaine ( n  = 17, 39.5%), prescription stimulants ( n  = 9, 21.4%), methamphetamines ( n  = 5, 11.9%), prescription opioids ( n  = 12, 27.3%), street opioids ( n  = 12, 27.3%), sedatives ( n  = 11, 25.0%), hallucinogens ( n  = 3, 6.8%), inhalants ( n  = 3, 7.0%), or some other substance ( n  = 4, 8.7%) in the past 30 days. About half (48.8%) reported that COVID-19 had a major impact on their lives. This study is among the first to characterize the impact of COVID-19 on street-based sex workers. From a public health standpoint, this group also represents a high-priority population given their vulnerability and close contact with others, which increases the potential for community spread.