Examining partnership-health associations among full-service sex workers

Abstract

Generally, romantically partnered individuals report better health than romantically unpartnered individuals. Known increasingly as positive “partnership-health” associations, these may be less frequent among minority or marginalized individuals. Full-service sex workers (FSSW) are relatively common in the U.S., report relatively poor health, and engage in professional behavior that may influence their personal romantic relationships. Therefore, we assessed partnership-health associations among U.S. FSSW. Study researchers collaborated with local and national sex worker organizations, both to design an online survey of relationships and health, and to recruit participants. Here, we used t-tests to compare the health of romantically partnered versus unpartnered FSSW. Health domains assessed included mental health, e.g. depression, anxiety; physical health, e.g. sleep, fatigue; and health behaviors, e.g. substance use, sexual behavior. Results indicated that partnered FSSW reported using fewer measured drugs, using these drugs less often, and trended toward using condoms with paying partners more. However, partnered FSSW also reported more fatigue. No other group-level differences in health were reported. Overall, few positive partnership-health associations were reported among FSSW, adding to extant work indicating partnership-health associations may be attenuated within partnerships involving minority or marginalized individuals. Implications for future research, clinical work with FSSW, and health-related policy are discussed.

Keywords:

• Partnership-health
• partnership
• health
• sex workers
• full-service sex workers

Acknowledgements

We would like to acknowledge our community collaborators in their assistance with developing and disseminating this study. The following organization has provided assistance and has approved their disclosure in this manuscript: Practical Audacity.

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

This project was supported by a grant from the American Psychological Foundation, the Drs. Rosalee G. and Raymond A. Weiss Research and Program Innovation Grant.

Notes on contributors

Steve N. Du Bois

Dr. Steve N. Du Bois is an Assistant Professor of Psychology at the Illinois Institute of Technology and a Licensed Clinical Psychologist. His research focuses broadly on health, and specifically on health behavior change, health in romantic relationships, and health as it relates to social justice. His recent published work includes results of a pilot intervention aiming to increase treatment engagement among African American individuals living with HIV and serious mental illness; and, an examination of associations between policy and health among transgender individuals and among lesbian and gay individuals, using BRFSS data.

Lynn Kannout

Lynn Kannout is a Doctoral Student in Clinical Psychology at the Illinois Institute of Technology. Her research focuses on the association between exposure to systemic oppression and related physical and mental health outcomes, in historically marginalized communities. Her recent published work examines associations between HIV discrimination, internalized stigma, and cognitive escape.

Stephen D. Ramos

Stephen D. Ramos is a PhD Candidate in Clinical Psychology at the Illinois Institute of Technology. His research focuses on HIV, health behaviors, and health in marginalized communities. His recent published work includes a within-group comparison of health among transgender individuals and a qualitative investigation of HIV-related stress.