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Table 1 Studies describing determinants associated with STBBI-related outcomes among cisgender female sex workers in high-income countries

From: Preventing sexually transmitted and blood borne infections (STBBIs) among sex workers: a critical review of the evidence on determinants and interventions in high-income countries

Study Details Outcome Examined Multivariable Associations Reported
Author/Year Country Study Design/Dates Population STBBI Outcome Condom Use Outcome Individual & Interpersonal Determinants Structural Determinants
Argento et al., 2014 [29] Canada (Vancouver) Cross-sectional 2010–2013 369 female sex workers (trans inclusive)   Inconsistent condom use with intimate partners Inconsistent condom use was positively associated with having a cohabiting (aOR 5.43, 95%CI 2.53–11.66) or non-cohabiting intimate partner (aOR 2.15, 95%CI 1.11–4.19) (versus casual partner), providing drugs (aOR 3.04, 95%CI 1.47–6.30) or financial support to an intimate partner (aOR 2.46, 95%CI 1.05–5.74), physical intimate partner violence (aOR 2.20, 95%CI 1.17–4.12), and an intimate partner providing physical safety (aOR 2.08, 95%CI 1.11–3.91); non-injection drug use was inversely associated (aOR 0.32, 95%CI 0.17–0.60)  
Argento et al., 2015 [61] Canada (Vancouver) Cross-sectional 2010–2013 654 female sex workers (trans inclusive)   Client condom refusal   Social cohesion had an independent protective effect on client condom refusal (aOR 0.97, 95 %CI 0.95–0.99)
Cohan et al., 2006 [96] USA (San Francisco) Cross-sectional 1999–2004 783 sex workers (419 female, 187 male, 126 trans) Prevalence of STI: gonorrhoea (12.4%), chlamydia (6.8%), syphilis (1.8%), or herpes simplex virus 2 (34.3%)   STIs were positively associated with African American ethnicity (aOR 3.3, 95%CI 1.3–8.3), male gender (aOR 1.9, 95%CI 1.0–3.6), and work-related violence (aOR 1.9, 95%CI 1.1–3.3) STIs were inversely associated with working collectively (aOR 0.4, 95%CI 0.1–0.9)
Deering et al., 2013 [77] Canada (Vancouver) Cross-sectional 2010–2011 490 female sex workers (trans inclusive)   Being offered or accepting more money for sex without a condom Offered and accepting more money for sex without a condom was positively associated with being a sexual minority (aOR 2.72, 95%CI 1.35–5.46), less than daily crystal meth (aOR 2.95, 95%CI 1.27–6.87), speedball injection (aOR 6.93, 95%CI 1.60–29.94), having more clients per week (1.03, 95%CI 1.01–1.06), clients have other sex worker partners (1.83, 95%CI 1.19–2.84), and client violence (aOR 2.18, 95%CI 1.10–4.34) Offered and accepting more money for sex without a condom was inversely associated with soliciting for clients in indoor settings (aOR 0.15, 95%CI 0.04–0.54)
Goldenberg et al., 2014 [31] Canada (Vancouver) Cross-sectional 2010–2011 508 female sex workers (trans inclusive) Prevalence of HIV (11.2%), combined STI/HIV (20.9%)   HIV infection was positively associated with early sex work initiation: < 18 years vs. 18+ years (aOR 2.49, 95%CI 1.35–4.64), < 16 years vs. 16+ years (aOR 1.88, 1.03–3.42)  
Goldenberg et al., 2015 [38] Canada (Vancouver) Prospective cohort 2010–2013 715 female sex workers (trans inclusive) HCV prevalence (43.6%); HCV incidence (4.28 events per 100 person-years)   HCV incidence was inversely associated with age (aHR 0.91, p = 0.04), and positively associated with STI co-infection (aHR 3.45, p = 0.04), and crack use (aHR 4.24, p = 0.05); HIV co-infection was also positively associated with incidence of HCV in a separate model.  
Kweon et al., 2006 [39] Korea Cross sectional Jan-July 2004 1527 female sex workers (HIV negative, non-IDU) HCV prevalence (1.4%)   HCV was positively associated with history of acupuncture (aOR 3.3, 95%CI 1.16–9.34) and diabetes (aOR 11.2, 95%CI 2.63–47.8)  
Lee et al., 2010 [36] Korea Cross-sectional June-Nov 2008 999 female sex workers Prevalence of chlamydia (12.8%) Condom use last night; last month Higher prevalence of chlamydia was positively associated with younger age and higher inconsistency of condom use.  
Mc Grath-Lone et al., 2014 [83] England Cross-sectional Jan-Dec 2011 2704 female sex workers Prevalence of HIV (0.2%), syphilis (0.1%), chlamydia (10.1%), gonorrhoea (2.7%), HCV (0.2%)    Being a migrant sex worker vs. UK-born was inversely associated with prevalence of chlamydia (aOR 0.59, 95%CI 0.46–0.79)
Platt et al., 2011 [30] England (London) Cross-sectional 2008–2009 268 female sex workers (indoor-working) Prevalence of HIV (1.1%), syphilis (2.2%), chlamydia or gonorrhoea (6.4%)   STBBI prevalence was positively associated with age 23–36 years vs. 17–22 years (aOR 12.3, 95%CI 1.44–105.1) and having an intimate partner (aOR 3.0, 95%CI 1.03–8.73) STBBI prevalence was positively associated with having no contact with outreach services (aOR 3.6, 95%CI 1.14–10.5)
Shannon et al., 2007 [25] Canada (Vancouver) Cross-sectional 2004 198 female sex workers (trans inclusive) HIV prevalence (26%)   HIV infection was positively associated with early (< 18 years of age) sex work initiation (aOR 1.8, 95%CI 1.3–2.2), Aboriginal ethnicity (aOR 2.1, 95%CI 1.4–3.8), daily cocaine injection (aOR 2.2, 95%CI 1.3–3.5), daily crack smoking (aOR 2.7, 95%CI 2.1–3.9), and unprotected sex with intimate partner (aOR 2.8, 95%CI 1.9–3.6).  
Shannon et al., 2009 [60] Canada (Vancouver) Cross-sectional Apr-Sept 2006 205 female sex workers (trans inclusive)   Pressured into unprotected sex by client Client condom refusal was positively associated with sharing a crack pipe with client (aOR 2.5, 95%CI 1.06–2.49) and client violence (aOR 2.08, 95%CI 1.06–4.49) Client condom refusal was positively associated with working in outdoor/public spaces (aOR 2.00, 95%CI 1.65–5.73), having a workplace zoning restriction from prior charges (aOR 3.39, 95%CI 1.00–9.36), and policing-related displacement (aOR 3.01, 95%CI 1.39–7.44)
Sou et al., 2015 [85] Canada (Vancouver) Cross-sectional 2010–2013 182 migrant female sex workers (trans inclusive)   Inconsistent condom use by client   Inconsistent condom use by clients was positively associated with difficulty accessing condoms (aOR 3.76; 95%CI 1.13–12.47); and inversely associated with servicing clients indoors (aOR 0.34, 95%CI 0.15–0.77) and education (aOR 0.22, 95%CI 0.09–0.50)
Surratt et al., 2012 [49] USA (Miami, Florida) Cross-sectional 2006–2010 562 female sex workers (drug users)   Unprotected vaginal sex Unprotected sex was positively associated with age (aOR 1.03, 95%CI 1.01–1.05) and client violence (aOR 1.82, 95%CI 1.22–2.72)  
Surratt et al., 2012 [35] USA (Miami, Florida) Cross-sectional 2007–2010 562 female sex workers (drug users) HIV prevalence   HIV prevalence was positively associated with early initiation into sex work before age 18 (aOR 2.10, 95%CI 1.25–3.54) HIV prevalence was positively associated with history of foster care (aOR 3.68, 95%CI 1.62–8.35)