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<p>Syndemic conditions of sex work and violence are associated with elevated HIV risk for trans women. Less is known about the types of violence experienced by trans women who engage in sex work. We examined the prevalence of types of violence for trans women engaged in sex work and correlates of interpersonal violence (IPV). Data were from National HIV Biobehavioral Surveillance among trans women in San Francisco, 2023–2024. Demographic characteristics, substance use, sex work, and IPV were selfreported. Multivariable logistic regression identified factors associated with IPV among trans women engaged in sex work. Of 117 trans women engaged in sex work, over half were aged 18–39 (50.4%), Hispanic/Latina (54.3%), US-born (58.1%), had a high school education or less (59.0%), and earned &lt; $40,000 USD/year (80.8%). Trans women engaged in sex work were more likely to experience sexual assault by steady partners (6.8% vs. 1.4%, X<sup>2</sup> = 7.25, p = 0.019), physical attack by casual partners (6.0% vs. 0.9%, X<sup>2</sup> = 7.56, p = 0.010), and physical attack by steady partners (12.1% vs. 3.2%, X<sup>2</sup> = 10.08, p = 0.001) than those not engaged in sex work. Among trans women engaged in sex work, those aged 18–39 years (vs. ≥ 40, aOR 9.38, p &lt; 0.001) and those using methamphetamine (vs. none, aOR 4.82, p = 0.004) had higher odds of IPV. Results point to an unmet need for IPV and trauma services focused on trans women who engage in sex work. Economic interventions that reduce reliance on sex work for income may present the best opportunity for violence prevention. </p>

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Multi-level Risks Associated with Partner and Client Violence Among Trans Women Who Do Sex Work in San Francisco, 2023–2024

  • 期刊论文

  • 发表日期：

    2026年4月29日

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  • Iris R. O’Neal,
  • Erikka Palafox,
  • Bow Suprasert,
  • Glenda N. Baguso,
  • Sophie E. Chritton,
  • Raul Ruiz,
  • Willi McFarland,
  • Erin C. Wilson

摘要

Syndemic conditions of sex work and violence are associated with elevated HIV risk for trans women. Less is known about the types of violence experienced by trans women who engage in sex work. We examined the prevalence of types of violence for trans women engaged in sex work and correlates of interpersonal violence (IPV). Data were from National HIV Biobehavioral Surveillance among trans women in San Francisco, 2023–2024. Demographic characteristics, substance use, sex work, and IPV were selfreported. Multivariable logistic regression identified factors associated with IPV among trans women engaged in sex work. Of 117 trans women engaged in sex work, over half were aged 18–39 (50.4%), Hispanic/Latina (54.3%), US-born (58.1%), had a high school education or less (59.0%), and earned < $40,000 USD/year (80.8%). Trans women engaged in sex work were more likely to experience sexual assault by steady partners (6.8% vs. 1.4%, X2 = 7.25, p = 0.019), physical attack by casual partners (6.0% vs. 0.9%, X2 = 7.56, p = 0.010), and physical attack by steady partners (12.1% vs. 3.2%, X2 = 10.08, p = 0.001) than those not engaged in sex work. Among trans women engaged in sex work, those aged 18–39 years (vs. ≥ 40, aOR 9.38, p < 0.001) and those using methamphetamine (vs. none, aOR 4.82, p = 0.004) had higher odds of IPV. Results point to an unmet need for IPV and trauma services focused on trans women who engage in sex work. Economic interventions that reduce reliance on sex work for income may present the best opportunity for violence prevention.