Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya
Abstract Background Female sex workers (FSWs) are at high risk of mental health problems and suicide risk. Few longitudinal studies have examined risk factors for poor mental health among FSWs. Methods Maisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Program...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-01-01
|
| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425122000449/type/journal_article |
| _version_ | 1797782554336559104 |
|---|---|
| author | Alicja Beksinska Pooja Shah Mary Kungu Rhoda Kabuti Hellen Babu Zaina Jama Mamtuti Panneh Emily Nyariki Chrispo Nyabuto Monica Okumu Pauline Ngurukiri Erastus Irungu Rupert Kaul Janet Seeley Mitzy Gafos Tara S. Beattie Helen A. Weiss Joshua Kimani |
| author_facet | Alicja Beksinska Pooja Shah Mary Kungu Rhoda Kabuti Hellen Babu Zaina Jama Mamtuti Panneh Emily Nyariki Chrispo Nyabuto Monica Okumu Pauline Ngurukiri Erastus Irungu Rupert Kaul Janet Seeley Mitzy Gafos Tara S. Beattie Helen A. Weiss Joshua Kimani |
| author_sort | Alicja Beksinska |
| collection | DOAJ |
| description | Abstract
Background
Female sex workers (FSWs) are at high risk of mental health problems and suicide risk. Few longitudinal studies have examined risk factors for poor mental health among FSWs.
Methods
Maisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Programme clinics across Nairobi. Behavioural-biological survey data were collected at baseline (n = 1003, June–December 2019), midline (n = 366) (Jan–March 2020) and endline (n = 877) (June 2020–Jan 2021). Women reporting mental health problems were offered counselling services. Multivariable mixed logistic regression models were used to examine factors associated with mental health problems and suicidal behaviours.
Results
There was a decline in the proportion of women reporting any mental health problem (depression and/or anxiety and/or PTSD) (baseline: 29.9%, midline: 13.3%, endline: 11.8%). There was strong evidence that any mental health problem was associated with recent hunger (aOR 1.99; 95% CI 1.37–2.88) and recent violence from non-intimate partners (2.23; 95% CI 1.55–3.19). Recent suicidal behaviour prevalence was similar across survey rounds (baseline: 10.2%; midline: 10.2%; endline: 10.4%), and was associated with recent violence from non-intimate partners (aOR 1.96; 95% CI 1.31–2.95), recent hunger (aOR 1.69; 95% CI 1.15–2.47) and having an additional employment to sex work (aOR 1.50; 95% CI 1.00–2.23).
Conclusions
Our study found a decline in mental health problems but high levels of persistent suicidal behaviours among FSWs. Syndemic risk factors including food insecurity and violence were longitudinally associated with mental health problems and recent suicidal behaviours. There is a need for accessible mental health services for FSWs, alongside structural interventions addressing poverty and violence.
|
| first_indexed | 2024-03-13T00:12:34Z |
| format | Article |
| id | doaj.art-65f30d14dc324a0ebb8a497d359745b2 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-03-13T00:12:34Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-65f30d14dc324a0ebb8a497d359745b22023-07-12T08:58:17ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512022-01-01940141510.1017/gmh.2022.44Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, KenyaAlicja Beksinska0https://orcid.org/0000-0003-4908-1780Pooja Shah1Mary Kungu2Rhoda Kabuti3Hellen Babu4Zaina Jama5Mamtuti Panneh6Emily Nyariki7Chrispo Nyabuto8Monica Okumu9Pauline Ngurukiri10Erastus Irungu11Rupert Kaul12Janet Seeley13Mitzy Gafos14Tara S. Beattie15Helen A. Weiss16https://orcid.org/0000-0003-3547-7936Joshua Kimani17Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaDepartment of Medicine, University of Toronto, Toronto, CanadaDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKLondon School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Public Health, Department of Infectious Disease Epidemiology, MRC International Statistics & Epidemiology Group, London, UKUniversity of Nairobi College of Health Sciences, Institute of Tropical and Infectious Diseases, UK Partners for Health and Development in Africa (PHDA), Nairobi, KenyaAbstract Background Female sex workers (FSWs) are at high risk of mental health problems and suicide risk. Few longitudinal studies have examined risk factors for poor mental health among FSWs. Methods Maisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Programme clinics across Nairobi. Behavioural-biological survey data were collected at baseline (n = 1003, June–December 2019), midline (n = 366) (Jan–March 2020) and endline (n = 877) (June 2020–Jan 2021). Women reporting mental health problems were offered counselling services. Multivariable mixed logistic regression models were used to examine factors associated with mental health problems and suicidal behaviours. Results There was a decline in the proportion of women reporting any mental health problem (depression and/or anxiety and/or PTSD) (baseline: 29.9%, midline: 13.3%, endline: 11.8%). There was strong evidence that any mental health problem was associated with recent hunger (aOR 1.99; 95% CI 1.37–2.88) and recent violence from non-intimate partners (2.23; 95% CI 1.55–3.19). Recent suicidal behaviour prevalence was similar across survey rounds (baseline: 10.2%; midline: 10.2%; endline: 10.4%), and was associated with recent violence from non-intimate partners (aOR 1.96; 95% CI 1.31–2.95), recent hunger (aOR 1.69; 95% CI 1.15–2.47) and having an additional employment to sex work (aOR 1.50; 95% CI 1.00–2.23). Conclusions Our study found a decline in mental health problems but high levels of persistent suicidal behaviours among FSWs. Syndemic risk factors including food insecurity and violence were longitudinally associated with mental health problems and recent suicidal behaviours. There is a need for accessible mental health services for FSWs, alongside structural interventions addressing poverty and violence. https://www.cambridge.org/core/product/identifier/S2054425122000449/type/journal_articleFemale sex workersmental health |
| spellingShingle | Alicja Beksinska Pooja Shah Mary Kungu Rhoda Kabuti Hellen Babu Zaina Jama Mamtuti Panneh Emily Nyariki Chrispo Nyabuto Monica Okumu Pauline Ngurukiri Erastus Irungu Rupert Kaul Janet Seeley Mitzy Gafos Tara S. Beattie Helen A. Weiss Joshua Kimani Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya Cambridge Prisms: Global Mental Health Female sex workers mental health |
| title | Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya |
| title_full | Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya |
| title_fullStr | Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya |
| title_full_unstemmed | Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya |
| title_short | Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya |
| title_sort | longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in nairobi kenya |
| topic | Female sex workers mental health |
| url | https://www.cambridge.org/core/product/identifier/S2054425122000449/type/journal_article |
| work_keys_str_mv | AT alicjabeksinska longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT poojashah longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT marykungu longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT rhodakabuti longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT hellenbabu longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT zainajama longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT mamtutipanneh longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT emilynyariki longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT chrisponyabuto longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT monicaokumu longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT paulinengurukiri longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT erastusirungu longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT rupertkaul longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT janetseeley longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT mitzygafos longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT tarasbeattie longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT helenaweiss longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya AT joshuakimani longitudinalexperiencesandriskfactorsforcommonmentalhealthproblemsandsuicidalbehavioursamongfemalesexworkersinnairobikenya |