Identifying Patterns of Social and Economic Hardship Among Structurally Vulnerable Women: A Latent Class Analysis of HIV/STI Risk

AIDS Behav. 2017 Oct;21(10):3047-3056. doi: 10.1007/s10461-017-1673-1.

Abstract

Women who are structurally vulnerable are at heightened risk for HIV/STIs. Identifying typologies of structural vulnerability that drive HIV/STI risk behavior is critical to understanding the nature of women's risk. Latent class analysis (LCA) was used to classify exotic dancers (n = 117) into subgroups based on response patterns of four vulnerability indicators. Latent class regression models tested whether sex- and drug-related risk behavior differed by vulnerability subgroup. Prevalence of vulnerability indicators varied across housing instability (39%), financial insecurity (39%), limited education (67%), and arrest history (36%). LCA yielded a two-class model solution, with 32% of participants expected to belong to a "high vulnerability" subgroup. Dancers in the high vulnerability subgroup were more likely to report sex exchange (OR = 8.1, 95% CI, 1.9-34.4), multiple sex partnerships (OR = 6.4, 95% CI, 1.9-21.5), and illicit drug use (OR = 17.4, 95% CI, 2.5-123.1). Findings underscore the importance of addressing inter-related structural factors contributing to HIV/STI risk.

Keywords: Exotic dance club; HIV; Sexually transmitted infections; Social determinants.

MeSH terms

  • Adult
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Middle Aged
  • Poverty*
  • Prevalence
  • Risk Factors
  • Risk-Taking
  • Sexual Behavior
  • Sexually Transmitted Diseases / epidemiology*
  • Social Determinants of Health*
  • Substance-Related Disorders / epidemiology*
  • Vulnerable Populations*