Citation

Footer KHA, Park JN, Allen ST, Decker MR, Silberzahn BE, Huettner S, Galai N, Sherman SG. Am. J. Public Health 2019; 109(2): 289-295.

Affiliation

Katherine H. A. Footer is with the Department of Health, Behavior, and Society, and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Ju Nyeong Park, Sean T. Allen, and Bradley E. Silberzahn are with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Michele R. Decker is with Johns Hopkins Bloomberg School of Public Health; Population, Family, and Reproductive Health; and School of Nursing. Steve Huettner is with Johns Hopkins School of Medicine. Noya Galai is with the Department of Epidemiology Johns Hopkins Bloomberg School of Public Health. Susan G. Sherman is with the Departments of Health, Behavior, and Society; Population, Family, and Reproductive Health; and Epidemiology, Johns Hopkins Bloomberg School of Public Health.

Copyright

(Copyright © 2019, American Public Health Association)

DOI

10.2105/AJPH.2018.304809

PMID

30571295

Abstract

OBJECTIVES: To characterize interactions that female sex workers (FSWs) have with the police and explore associations with client-perpetrated violence.

METHODS: Baseline data were collected April 2016 to January 2017 from 250 FSWs from the Sex Workers and Police Promoting Health in Risky Environments (SAPPHIRE) study based in Baltimore, Maryland. Interviewer-administered questionnaires captured different patrol or enforcement and abusive police encounters, experiences of client-perpetrated violence, and other risk factors, including drug use. We conducted bivariate and multivariable analysis in Stata/SE version 14.2 (StataCorp LP, College Station, TX).

RESULTS: Of participants, 78% reported lifetime abusive police encounters, 41% reported daily or weekly encounters of any type. In the previous 3 months, 22% experienced client-perpetrated violence. Heroin users (70% of participants) reported more abusive encounters (2.5 vs 1.6; P < .001) and more client-perpetrated violence (26% vs 12%; P = .02) than others. In multivariable analysis, each additional type of abusive interaction was associated with 1.3 times (95% confidence interval [CI] = 1.1, 1.5) increased odds of client-perpetrated violence. For patrol or enforcement encounters, this value was 1.3 (95% CI = 1.0, 1.7).

CONCLUSIONS: Frequent exposures to abusive police practices appear to contribute to an environment where client-perpetrated violence is regularly experienced. For FSWs who inject drugs, police exposure and client-perpetrated violence appear amplified. Public Health Implications. Structural interventions that address police-FSW interactions will help alleviate police's negative impact on FSWs' work environment. (Am J Public Health. Published online ahead of print December 20, 2018: e1-e7. doi:10.2105/AJPH.2018.304809).

Language: en