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Severe Food Insecurity, Gender-Based Violence, Homelessness, and HIV Risk among Street-based Female Sex Workers in Baltimore, Maryland


Despite established links between food insecurity and HIV outcomes, no studies have examined the role of food insecurity among female sex workers (FSW) in the United States (US). The aim of this exploratory study was to identify correlates (structural vulnerability and health factors) of severe food insecurity among street-based FSW in Baltimore, Maryland using multivariable logistic regression. In adjusted models, FSW with severe food insecurity were at greater odds of recent homelessness, physical intimate partner violence, client condom refusal, and HIV infection. Multi-sectoral approaches must take into consideration the co-occurrence of structural and health vulnerabilities to food insecurity among FSW in the US, including those that address violence, housing, and HIV.

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This work was supported by the National Institute on Drug Abuse (R01DA038499-01), the National Institute of Diabetes and Digestive and Kidney Disease (R01 DK110048), and the National Institute of Minority Health and Health Disparities (U54 MD000538-15). The funders had no role in study design, data collection, or in analysis and interpretation of the results, and this paper does not necessarily reflect views or opinions of the funders.

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Correspondence to Susan G. Sherman.

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Lim, S., Park, J.N., Kerrigan, D.L. et al. Severe Food Insecurity, Gender-Based Violence, Homelessness, and HIV Risk among Street-based Female Sex Workers in Baltimore, Maryland. AIDS Behav 23, 3058–3063 (2019).

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  • Food insecurity
  • Female sex workers
  • Homelessness
  • Gender-based violence
  • HIV