The social, structural and environmental production of HIV transmission risk among women in survival sex work : evidence from the Maka project partnership
Bibliographic record
Abstract
Background: Given the limited contextual understanding of the HIV risk environment of survival sex workers in resource rich settings, the objectives of this thesis were: To explore the role of social and structural violence and gendered power relations in mediating women’s negotiation of HIV prevention; To examine the relationship between drug sharing with clients and the negotiation of sexual and drug transmission risk; To model the impact of early sexual abuse on subsequent HIV infection; To investigate the relationship between environmental and structural factors and the negotiation of condom use with clients. Methods: Qualitative and quantitative data were drawn from a community-based research project partnership in Vancouver, Canada. Women engaged in street-based sex work were invited through targeted peer outreach and time-space sampling to participate in interview-administered questionnaires, HIV screening, and social mapping. Additionally, women were purposively sampled to participate in focus group discussions about the contextual factors shaping HIV prevention. Results: Analysis of the narratives of sex workers revealed the paramount role of social and structural violence in mediating women’s agency and access to resources and ability to practice HIV prevention. Drug sharing with clients was shown to be an important risk marker for elevated violence and unprotected sex. Early sexual abuse before 12 years was independently associated with HIV infection, and any sexual abuse before 18 years was associated with suicidal ideations and generational vulnerability to sex work. Finally, structural and environmental barriers, including violence, displacement, and servicing clients in public spaces, were shown to elevate women’s sexual HIV risk through being pressured into unprotected sex by a client. Conclusions: The findings support the urgent need for social and environmental-structural HIV prevention efforts, in particular legal reforms, concomitantly with gender-sensitive harm reduction, that facilitate sex worker’s ability to negotiate condom use in safer sex work environments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".