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Syndemic Factors and Resiliency Among Latina Immigrant Indirect Sex Workers in an Emergent Immigrant City

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Abstract

Female sex workers (FSW) constitute a highly vulnerable population challenged by numerous co-existing, or syndemic, risk factors. FSW also display resilience to these, and some evidence suggests that resilience may be associated with protective factors that improve health outcomes. We conducted in-depth interviews with indirect sex workers (n = 11) and their clients (n = 18). Interviews were coded utilizing an iterative, modified constant comparison method to identify emergent themes. We identified five syndemic risk factors (difficulty finding work due to undocumented status, shame and mental health hardship, lack of social support, alcohol use, and violence) and five resilient factors (rationalizing sex work, identifying as a “decent” woman, fulfilling immigrant goals, reducing alcohol consumption, and creating rules to reduce risk of violence and HIV/STIs). Understanding the syndemic risk factors and resiliency developed by FSW is important to develop tailored, strength-based interventions for HIV/STIs and other risks.

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Acknowledgements

This research was funded by a faculty developmental grant from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. We would also like to thank Maria Carrasco, Marina Palma Lima, and Monica Miranda for their assistance in this project.

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Authors and Affiliations

  1. Center for Child and Community Health Research, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason F. Lord Bldg, Center Tower, Suite 4200, Baltimore, MD, 21224, USA

    Suzanne Dolwick Grieb

  2. Center for Salud/Health and Opportunity for Latinos, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Alejandra Flores-Miller

  3. Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Susan G. Sherman

  4. Center for Clinical Global Health Education, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Kathleen R. Page

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  1. Suzanne Dolwick Grieb
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  2. Alejandra Flores-Miller
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  3. Susan G. Sherman
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  4. Kathleen R. Page
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Correspondence to Suzanne Dolwick Grieb.

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Grieb, S.D., Flores-Miller, A., Sherman, S.G. et al. Syndemic Factors and Resiliency Among Latina Immigrant Indirect Sex Workers in an Emergent Immigrant City. J Immigrant Minority Health 21, 1070–1076 (2019). https://doi.org/10.1007/s10903-018-0819-1

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