Exposure to Police and Client Violence Among Incarcerated Female Sex Workers in Baltimore City, Maryland.

Abstract

<i>Objectives.</i> To determine the rate and correlates of incarceration among street-based female sex workers (FSWs).<i>Methods.</i> From April 2016 to January 2017, FSWs (n = 250) in Baltimore City, Maryland, were enrolled in a 12-month prospective cohort study. We analyzed baseline data and used zero-inflated negative binomial regression to model the incarceration rate.<i>Results.</i> Overall, 70% of FSWs had ever been incarcerated (mean = 15 times). In the multivariable analysis, incarceration rate was higher for FSWs exposed to police violence, non-Hispanic White FSWs, and women who used injection drugs daily. Risk for ever being incarcerated was higher for FSWs exposed to police or client violence, non-Hispanic Black FSWs, women who used injection or noninjection drugs daily, and those with longer time in sex work.<i>Conclusions.</i> Incarceration was associated with exposure to violence from both police and clients. Daily drug use and time in sex work appeared to amplify these risks. Although non-Hispanic Black women were at greater risk for ever being incarcerated, non-Hispanic White women were incarcerated more frequently.<i>Public Health Implications.</i> Decriminalization of sex work and drug use should be prioritized to reduce violence against FSWs.