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“Amar te Duele” (“Love Hurts”): Sexual Relationship Power, Intimate Partner Violence, Depression Symptoms and HIV Risk Among Female Sex Workers Who Use Drugs and Their Non-commercial, Steady Partners in Mexico

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Abstract

A significant body of research among female sex workers (FSWs) has focused on individual-level HIV risk factors. Comparatively little is known about their non-commercial, steady partners who may heavily influence their behavior and HIV risk. This cross-sectional study of 214 FSWs who use drugs and their male steady partners aged ≥18 in two Mexico-U.S. border cities utilized a path-analytic model for dyadic data based upon the Actor-Partner Interdependence Model to examine relationships between sexual relationship power, intimate partner violence (IPV), depression symptoms, and unprotected sex. FSWs’ relationship power, IPV perpetration and victimization were significantly associated with unprotected sex within the relationship. Male partners’ depression symptoms were significantly associated with unprotected sex within the relationship. Future HIV prevention interventions for FSWs and their male partners should address issues of sexual relationship power, IPV, and mental health both individually and in the context of their relationship.

Resumen

Una cantidad significativa de investigación con mujeres trabajadoras sexuales (MTS) se ha enfocado en factores de riesgo de VIH a nivel individual. A manera comparativa, muy poco se conoce sobre sus parejas estables, no comerciales quienes pueden influenciar considerablemente su comportamiento y riesgo de VIH. Este estudio transversal de 214 MTS y sus parejas masculinas estables mayores de 18 años en dos ciudades fronterizas de México-EUA empleó un modelo de cadenas causales analítico para datos duales basados en el Modelo de Interdependencia Actor-Pareja para examinar relaciones entre poder de relación sexual, violencia intima de la pareja (VIP), depresión y sexo sin protección. La relación de poder y consumación de VIP en las MTS estaban significativamente asociadas con el sexo sin protección en la relación. Los síntomas de depresión de las parejas masculinas estaban significativamente asociados con relaciones sexuales sin protección en la pareja. Las intervenciones futuras de prevención de VIH para MTS y sus parejas masculinas deberían abordar aspectos tales como poder en la relación sexual, VIP, y salud mental tanto a nivel individual como en el contexto de su relación

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Acknowledgments

The authors respectfully acknowledge the participation of all the men and women in this study who shared their stories with us. Without them this work would not be possible. We also thank the U.S.-Mexico bi-national investigators and staff. Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under awards number K01 DA026307, and R01 DA027772.

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Authors and Affiliations

  1. Department of Psychiatry, University of California—San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0849, USA

    Monica D. Ulibarri

  2. Department of Psychology, San Diego State University, San Diego, CA, USA

    Scott Roesch

  3. El Colegio de La Frontera Norte-Secretaria de Salud, Ensenada, Baja California, Mexico

    M. Gudelia Rangel

  4. Departamento de Ciencias Médicas, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Chihuahua, Mexico

    Hugo Staines

  5. Department of Preventive Medicine and School of Social Work, University of Southern California, Los Angeles, CA, USA

    Hortensia Amaro

  6. Division of Global Public Health, School of Medicine, University of California—San Diego, La Jolla, CA, USA

    Steffanie A. Strathdee

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  1. Monica D. Ulibarri
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  2. Scott Roesch
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  3. M. Gudelia Rangel
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Correspondence to Monica D. Ulibarri.

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Ulibarri, M.D., Roesch, S., Rangel, M.G. et al. “Amar te Duele” (“Love Hurts”): Sexual Relationship Power, Intimate Partner Violence, Depression Symptoms and HIV Risk Among Female Sex Workers Who Use Drugs and Their Non-commercial, Steady Partners in Mexico. AIDS Behav 19, 9–18 (2015). https://doi.org/10.1007/s10461-014-0772-5

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