abstract: 'Economic hardship is a driver of entry into sex work, which is

  associated with high HIV risk. Yet, little is known about economic abuse

  in women employed by sex work (WESW) and its relationship to uptake of

  HIV prevention and financial support services. This study used

  cross-sectional baseline data from a multisite, longitudinal clinical

  trial that tests the efficacy of adding economic empowerment to

  traditional HIV risk reduction education on HIV incidence in 542 WESW.

  Mixed effects logistic and linear regressions were used to examine

  associations in reported economic abuse by demographic characteristics,

  sexual behaviors, HIV care-seeking, and financial care-seeking. Mean age

  was 31.4 years. Most WESW were unmarried (74\%) and had less than

  primary school education (64\%). 48\% had savings, and 72\% had debt.

  93\% reported at least one economic abuse incident. Common incidents

  included being forced to ask for money (80\%), having financial

  information kept from them (61\%), and being forced to disclose how

  money was spent (56\%). WESW also reported partners/relatives spending

  money needed for bills (45\%), not paying bills (38\%), threatening them

  to quit their job(s) (38\%), and using physical violence when earning

  income (24\%). Married/partnered WESW (OR = 2.68, 95\% CI:1.60-4.48),

  those with debt (OR = 1.70, 95\% CI:1.04-2.77), and those with sex-work

  bosses (OR = 1.90, 95\% CI:1.07-3.38) had higher economic abuse.

  Condomless sex (beta = +4.43, p < .05) was higher among WESW

  experiencing economic abuse, who also had lower odds of initiating PrEP

  (OR = .39, 95\% CI:.17-.89). WESW experiencing economic abuse were also

  more likely to ask for cash among relatives (OR = 2.36, 95\%

  CI:1.13-4.94) or banks (OR = 2.12, 95\% CI:1.11-4.03). The high

  prevalence of HIV and economic abuse in WESW underscores the importance

  of integrating financial empowerment in HIV risk reduction interventions

  for WESW, including education about economic abuse and strategies to

  address it. Programs focusing on violence against women should also

  consider economic barriers to accessing HIV prevention services.'
affiliation: 'Mayo-Wilson, LJ (Corresponding Author), Univ N Carolina, Gillings Sch
  Global Publ Hlth, 170 Rosenau Hall, Chapel Hill, NC 27599 USA.

  Jennings Mayo-Wilson, Larissa, Univ N Carolina, Gillings Sch Global Publ Hlth, 170
  Rosenau Hall, Chapel Hill, NC 27599 USA.

  Jennings Mayo-Wilson, Larissa, Johns Hopkins Univ, Sch Nursing, Commun Global \&
  Publ Hlth Div, Baltimore, MD USA.

  Yen, Bing-Jie; Wright, Brittanni N., Indiana Univ, Dept Appl Hlth Sci, Ctr Sexual
  Hlth Promot, Sch Publ Hlth, Bloomington, IN USA.

  Nabunya, Proscovia; Bahar, Ozge Sensoy; Kiyingi, Joshua; Nabayinda, Josephine; Ssewamala,
  Fred M., Washington Univ St Louis, Brown Sch, St Louis, MO USA.

  Nabunya, Proscovia; Bahar, Ozge Sensoy; Kiyingi, Joshua; Mwebembezi, Abel; Nabayinda,
  Josephine; Ssewamala, Fred M., Int Ctr Child Hlth \& Dev, Masaka, Uganda.

  Filippone, Prema L.; Witte, Susan S., Columbia Sch Social Work, New York, NY USA.

  Mwebembezi, Abel, Reach Youth Uganda, Kampala, Uganda.

  Kagaayi, Joseph, Rakai Hlth Sci Program, Kalisizo, Uganda.

  Tozan, Yesim, New York Univ, Coll Global Publ Hlth, New York, NY USA.'
article-number: 08862605221093680
author: Jennings Mayo-Wilson, Larissa and Yen, Bing-Jie and Nabunya, Proscovia and
  Bahar, Ozge Sensoy and Wright, Brittanni N. and Kiyingi, Joshua and Filippone, Prema
  L. and Mwebembezi, Abel and Kagaayi, Joseph and Tozan, Yesim and Nabayinda, Josephine
  and Witte, Susan S. and Ssewamala, Fred M.
author-email: larissajmw@gmail.com
author_list:
- family: Jennings Mayo-Wilson
  given: Larissa
- family: Yen
  given: Bing-Jie
- family: Nabunya
  given: Proscovia
- family: Bahar
  given: Ozge Sensoy
- family: Wright
  given: Brittanni N.
- family: Kiyingi
  given: Joshua
- family: Filippone
  given: Prema L.
- family: Mwebembezi
  given: Abel
- family: Kagaayi
  given: Joseph
- family: Tozan
  given: Yesim
- family: Nabayinda
  given: Josephine
- family: Witte
  given: Susan S.
- family: Ssewamala
  given: Fred M.
da: '2023-09-28'
doi: 10.1177/08862605221093680
earlyaccessdate: MAY 2022
eissn: 1552-6518
files: []
issn: 0886-2605
journal: JOURNAL OF INTERPERSONAL VIOLENCE
keywords: 'HIV; sexual risk behaviors; economic abuse; female sex workers;

  violence; Uganda'
keywords-plus: 'INTIMATE PARTNER VIOLENCE; CONDOM USE; RISK-FACTORS; INSECURITY;

  BEHAVIORS; SCALE; MEN'
language: English
month: JAN
number: 1-2
number-of-cited-references: '47'
orcid-numbers: 'Jennings Mayo-Wilson, Larissa/0000-0001-9349-2283

  Wright, Brittanni/0000-0003-2051-8205'
pages: NP1920-NP1949
papis_id: 08496794daaa85b27091818b16fe95f2
ref: Jenningsmayowilson2023economicabuse
researcherid-numbers: 'DSILVA, BROOKE/HCI-4879-2022

  '
times-cited: '0'
title: 'Economic Abuse and Care-seeking Practices for HIV and Financial Support Services
  in Women Employed by Sex Work: A Cross-Sectional Baseline Assessment of a Clinical
  Trial Cohort in Uganda'
type: article
unique-id: WOS:000796226800001
usage-count-last-180-days: '3'
usage-count-since-2013: '10'
volume: '38'
web-of-science-categories: Criminology \& Penology; Family Studies; Psychology, Applied
year: '2023'