Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Harrison Ndetan

Abstract

HIV status among female sex workers (FSWs) continues to be a significant public health concern. Condom use is associated with HIV cases among FSWs. Gender-based violence (GBV) plays a role in FSWs HIV status. While studies have investigated the relationship between GBV and condom use, little is known about the impact of factors such as perpetrator type and substance use. I aimed to examine whether perpetrator type and substance use affect the relationship between GBV and condom use among FSWs in Tanzania. Secondary data analysis was performed on 1,502 FSWs extracted from the 2020 Tanzanian, John Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), HIV study. Using SPSS version 25, multivariable logistic regression analyses were performed to assess the impact of perpetrator types and subsequently substance use on the relationship between GBV and condom use. Of the 159 (10.5%) FSWs who reported experiencing GBV, 69 (84.25%) reported using condoms with 14% increased odds (OR = 1.14, 95% CI: 0.61-2.11) compared to those who did not. Including perpetrator types in the model resulted in 12% increased odds with no further change due to alcohol/substance use. Neither of these were statistically significant (p > 0.05). These analyses established no statistically significant relationship between GBV and condom use, with no further influence due to perpetrator types and alcohol/substance use. Findings may lead to social change through sexual health prevention programs by focusing on improving FSWs’ sexual health habits and reducing the number of new HIV cases. Future studies should assess this relationship further using a more representative sample size of FSWs.

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