Substance Use among Female Sex Workers in Two US-Mexico Border Cities: Associations with Age of Entry

AbstractBackground: Research has documented consistent associations between entry into sex work as a minor and sexual HIV risk. However, previous studies have not examined whether substance use and related HIV risk are elevated among those who enter sex work under age 18. Methods: Quantitative data were collected via time-location sampling of 603 female sex workers (FSWs) ages 18 years and older residing in two Mexico-US border cities. Age of entry into sex work (categorized as 15 years or younger, 16–17 years, or 18 years and older) was assessed as a predictor of substance use (forced and voluntary) within the first month post-entry and recent (past 30 days) substance use with clients. Results: Compared to those who entered as adults, participants who entered sex work at age 15 or younger were significantly more likely to report drug use (AOR = 5.2, CI = 2.9–8.9) and forced drug use within the first 30 days of entry (AOR= 6.0, CI = 1.9–18.9), as well as past month drug use with clients (AOR= 3.4, CI = 1....