TY  - JOUR
PY  - 2022//
TI  - Harmful alcohol and drug use is associated with syndemic risk factors among female sex workers in Nairobi, Kenya
JO  - International journal of environmental research and public health
A1  - Beksinska, Alicja
A1  - Nyariki, Emily
A1  - Kabuti, Rhoda
A1  - Kungu, Mary
A1  - Babu, Hellen
A1  - Shah, Pooja
A1  - Champions, The Maisha Fiti Study
A1  - Nyabuto, Chrispo
A1  - Okumu, Monica
A1  - Mahero, Anne
A1  - Ngurukiri, Pauline
A1  - Jama, Zaina
A1  - Irungu, Erastus
A1  - Adhiambo, Wendy
A1  - Muthoga, Peter
A1  - Kaul, Rupert
A1  - Seeley, Janet
A1  - Weiss, Helen A.
A1  - Kimani, Joshua
A1  - Beattie, Tara S.
SP  - e7294
EP  - e7294
VL  - 19
IS  - 12
N2  - BACKGROUND: Female Sex Workers (FSWs) are at high risk of harmful alcohol and other drug use. We use quantitative data to describe the prevalence of alcohol and other drug use and identify associated occupational and socio-economic risk factors, and aim to elucidate patterns of alcohol and drug use through information drawn from qualitative data. <br><br>METHODS: Maisha Fiti was a mixed-method longitudinal study conducted in 2019 among a random sample of FSWs in Nairobi, Kenya. We used baseline date from the behavioural-biological survey, which included the WHO Alcohol, Smoking and Substance Involvement Screening Test that measures harmful alcohol and other drug use in the past three months (moderate/high risk score: >11 for alcohol; >4 for other drugs). In-depth interviews were conducted with 40 randomly selected FSWs. <br><br>FINDINGS: Of 1003 participants, 29.9% (95%CI 27.0-32.6%) reported harmful (moderate/high risk) alcohol use, 21.5% harmful amphetamine use (95%CI 19.1-24.1%) and 16.9% harmful cannabis use (95%CI 14.7-19.2%). Quantitative analysis found that harmful alcohol, cannabis and amphetamine use were associated with differing risk factors including higher Adverse Childhood Experience (ACE) scores, street homelessness, food insecurity (recent hunger), recent violence from clients, reduced condom use, depression/anxiety and police arrest. Qualitative interviews found that childhood neglect and violence were drivers of entry into sex work and alcohol use, and that alcohol and cannabis helped women cope with sex work. <br><br>CONCLUSIONS: There is a need for individual and structural-level interventions, tailored for FSWs, to address harmful alcohol and other drug use and associated syndemic risks including ACEs, violence and sexual risk behaviours.<p />  <p>Language: en</p>
LA  - en
SN  - 1661-7827
UR  - http://dx.doi.org/10.3390/ijerph19127294
ID  - ref1
ER  -