BACKGROUND Economic hardship (e.g., difficulty to pay for basic needs) has been associated with increased HIV/STI risk among female sex workers (FSW), and may be exacerbated by high levels of substance use. Few studies have assessed the intersection of economic hardship, substance use, and HIV/STI risk among FSW. METHODS Quantitative data were collected via questionnaires among 469 FSW residing in Tijuana and Ciudad Juarez, Mexico. Using logistic regression, we assessed the role of economic hardship on the association between substance use (past 30-days alcohol use, drug use, or injection drugs use with clients, and past 6-months drug use) and testing positive for an STI (also an indicator of HIV risk). RESULTS Drug use in the preceding six months was significantly associated with testing positive for an STI (AOR = 1.8, CI: 1.1 = 2.9, p = .02); no difference in this association was found by whether women reported economic hardship. Past 30-day drug use with clients was associated with STI infection, but only among those who did not report economic hardship (AOR = 1.5, 95% CI: 1.1-1.9, p < .01). CONCLUSIONS Findings suggest that economic hardship influences the association between substance use and increased risk for HIV/STI among FSW; however, these associations may be more complex than previously hypothesized.

中文翻译：

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墨西哥女性性工作者的药物使用、经济脆弱性和艾滋病毒/性传播感染风险。

背景技术经济困难（例如，难以支付基本需求）与女性性工作者（FSW）中艾滋病毒/性传播感染风险增加有关，并且可能因高水平的物质使用而加剧。很少有研究评估 FSW 中的经济困难、药物滥用和艾滋病毒/性传播感染风险的交叉点。方法 通过对居住在墨西哥蒂华纳和华雷斯城的 469 名 FSW 进行问卷调查收集定量数据。使用逻辑回归，我们评估了经济困难对物质使用（过去 30 天饮酒、吸毒或与客户注射吸毒，以及过去 6 个月吸毒）和 STI 检测呈阳性之间关联的作用（也是艾滋病毒风险的指标）。结果 前六个月吸毒与 STI 检测呈阳性显着相关（AOR = 1.8，CI：1.1 = 2.9，p = .02）；妇女是否报告经济困难并没有发现这种关联存在差异。过去 30 天的客户吸毒行为与 STI 感染有关，但仅限于那些没有报告经济困难的客户（AOR = 1.5，95% CI：1.1-1.9，p < .01）。结论 研究结果表明，经济困难会影响 FSW 中物质使用与 HIV/STI 风险增加之间的关联；然而，这些关联可能比之前假设的更为复杂。