The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini
BackgroundMinors who sell sex are likely to have complex mental health needs that may persist into adulthood. This topic is understudied in sub-Saharan Africa. This study hypothesized that adult female sex workers in Eswatini who started selling sex as minors have a higher prevalence of depression t...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-06-01
|
| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1048703/full |
| _version_ | 1827916272112762880 |
|---|---|
| author | Ashley Grosso Ashley Grosso Rebecca Fielding-Miller Sindy Matse Bhekie Sithole Stefan Baral |
| author_facet | Ashley Grosso Ashley Grosso Rebecca Fielding-Miller Sindy Matse Bhekie Sithole Stefan Baral |
| author_sort | Ashley Grosso |
| collection | DOAJ |
| description | BackgroundMinors who sell sex are likely to have complex mental health needs that may persist into adulthood. This topic is understudied in sub-Saharan Africa. This study hypothesized that adult female sex workers in Eswatini who started selling sex as minors have a higher prevalence of depression than those who started as adults. We also examined correlates of depression and underage initiation of selling sex, including stigma and condom-related behaviors.MethodsFrom October–December 2014, women aged 18 or older who sold sex in the past 12 months in Eswatini were recruited through venue-based sampling. Participants completed a survey including the 9-item Patient Health Questionnaire (PHQ-9) and a question about the age at which they first sold sex for money. T-tests, χ2 tests and multivariable logistic regression were used to assess associations.ResultsOverall, 43.1% of participants (332/770) had probable depression, and 16.6% (128/770) started selling sex as minors under the age of 18. Over half (55.5%, 71/128) of those who started selling sex as minors had depression. This was significantly higher than the 40.7% (261/642) prevalence of depression among participants who started selling sex as adults (p = 0.002). After adjusting for confounders, female sex workers who started selling sex as minors had higher odds of depression than those who started as adults (adjusted odds ratio [aOR] 1.70, 95% confidence interval 1.11–2.60).ConclusionResults highlight the need for trauma-informed and adolescent-friendly mental health services in settings free of stigma toward female sex workers in Eswatini. |
| first_indexed | 2024-03-13T03:12:47Z |
| format | Article |
| id | doaj.art-3b9e9f6f78df4051a66dfb4af90a75d3 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-13T03:12:47Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-3b9e9f6f78df4051a66dfb4af90a75d32023-06-26T10:41:46ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-06-011410.3389/fpsyt.2023.10487031048703The relationship between underage initiation of selling sex and depression among female sex workers in EswatiniAshley Grosso0Ashley Grosso1Rebecca Fielding-Miller2Sindy Matse3Bhekie Sithole4Stefan Baral5Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United StatesDepartment of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, United StatesHerbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United StatesMinistry of Health, Mbabane, EswatiniHealth Communication Capacity Collaborative, Mbabane, EswatiniDepartment of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesBackgroundMinors who sell sex are likely to have complex mental health needs that may persist into adulthood. This topic is understudied in sub-Saharan Africa. This study hypothesized that adult female sex workers in Eswatini who started selling sex as minors have a higher prevalence of depression than those who started as adults. We also examined correlates of depression and underage initiation of selling sex, including stigma and condom-related behaviors.MethodsFrom October–December 2014, women aged 18 or older who sold sex in the past 12 months in Eswatini were recruited through venue-based sampling. Participants completed a survey including the 9-item Patient Health Questionnaire (PHQ-9) and a question about the age at which they first sold sex for money. T-tests, χ2 tests and multivariable logistic regression were used to assess associations.ResultsOverall, 43.1% of participants (332/770) had probable depression, and 16.6% (128/770) started selling sex as minors under the age of 18. Over half (55.5%, 71/128) of those who started selling sex as minors had depression. This was significantly higher than the 40.7% (261/642) prevalence of depression among participants who started selling sex as adults (p = 0.002). After adjusting for confounders, female sex workers who started selling sex as minors had higher odds of depression than those who started as adults (adjusted odds ratio [aOR] 1.70, 95% confidence interval 1.11–2.60).ConclusionResults highlight the need for trauma-informed and adolescent-friendly mental health services in settings free of stigma toward female sex workers in Eswatini.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1048703/fullsex workersEswatinidepressionadolescentbarriers to care |
| spellingShingle | Ashley Grosso Ashley Grosso Rebecca Fielding-Miller Sindy Matse Bhekie Sithole Stefan Baral The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini Frontiers in Psychiatry sex workers Eswatini depression adolescent barriers to care |
| title | The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini |
| title_full | The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini |
| title_fullStr | The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini |
| title_full_unstemmed | The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini |
| title_short | The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini |
| title_sort | relationship between underage initiation of selling sex and depression among female sex workers in eswatini |
| topic | sex workers Eswatini depression adolescent barriers to care |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1048703/full |
| work_keys_str_mv | AT ashleygrosso therelationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT ashleygrosso therelationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT rebeccafieldingmiller therelationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT sindymatse therelationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT bhekiesithole therelationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT stefanbaral therelationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT ashleygrosso relationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT ashleygrosso relationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT rebeccafieldingmiller relationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT sindymatse relationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT bhekiesithole relationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini AT stefanbaral relationshipbetweenunderageinitiationofsellingsexanddepressionamongfemalesexworkersineswatini |