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RESEARCH ARTICLE

Correlates of alcohol and illicit drug use before commercial sex among transgender women with a history of sex work in China

Qian Wang A , Ruijie Chang A , Ying Wang A , Xueqin Jiang A , Shuxian Zhang A , Qiuming Shen A , Zixin Wang B , Tiecheng Ma C , Joseph T. F. Lau B D and Yong Cai A D
+ Author Affiliations
- Author Affiliations

A School of Public Health, Shanghai Jiao Tong University School of Medicine, No 227, South Chongqing Road, Shanghai 200025, China.

B Center for Health Behaviours Research, 5/F, School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region.

C Shenyang Consultation Centre of AIDS Aid and Health Service, Shenyang, China.

D Corresponding authors. Email: caiyong202028@hotmail.com; jlau@cuhk.edu.hk

Sexual Health 17(1) 45-52 https://doi.org/10.1071/SH18194
Submitted: 7 October 2018  Accepted: 13 August 2019   Published: 11 December 2019

Abstract

Background: Research on substance use among transgender female sex workers in China is scarce. The aims of this study were to examine: (1) the prevalence of alcohol or illicit drug use before commercial sex among this population; and (2) correlates of alcohol and illicit drug use. Methods: Complete survey data were analysed from 397 transgender female sex workers recruited from three of the largest cities in China: Shenyang, Shanghai and Guangzhou. Information was collected about demographics, alcohol or illicit drug use, alone or in combination, and their psychosocial correlates using structured questionnaires. Multinomial logistic regression models were used to examine the association between substance use and its correlates. Results: Before commercial sex, approximately one-third of the sample reported exclusive alcohol use (28.5%), 9.3% reported exclusive drug use and 7.3% reported combined use of alcohol and drugs. Before commercial sex, participants with low self-esteem had twice the odds of using alcohol exclusively (adjusted odds ratio (aOR) 2.05; 95% confidence interval (CI) 1.01–4.17), those with higher levels of loneliness had almost threefold the odds of exclusive drug use (aOR 2.92; 95% CI 1.21–7.07) and those with depression (aOR 2.97; 95% CI 1.11–7.96) and unknown HIV status (aOR 3.00; 95% CI 1.02–8.87) had threefold the odds of combined use of alcohol and drugs. Conclusion: Programs aimed at reducing alcohol or drug use among transgender female sex workers in China may consider adding components that help support mental health and encouraging HIV screening.

Additional keywords: depression, loneliness, perceived social support, self-esteem, transgender female sex workers.


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