Table 1 Study sample characteristics and associations with mental health problems and recent suicidal thoughts/behaviours
|  | N(%) (N = 1003) | % with depression and/or anxiety (N = 243) | % with PTSD (N = 138) | % with reported recent suicidal thoughts/behaviours (N = 101) | ||
|---|---|---|---|---|---|---|
Level 1: Adverse Childhood Experiences and distal socio-demographic characteristics | ||||||
 Age (years) | < 25 |  | 212 (11.7%) | 8.4 | 9.4 | 10.3 |
25–34 |  | 353 (39.4%) | 37.5 | 35.8 | 41.6 | |
35+ | Â | 438 (48.9%) | 54.1 | 54.8 | 48.1 | |
 Adverse Childhood Experience | Lived on the street | No | 878 (88.0%) | 83.3 | 82.2 | 73.8 |
Yes | 125 (12.0%) | 16.7 | 17.8 | 26.2 | ||
Adverse family/household experiencea | No | 113 (11.3%) | 5.6 | 4.5 | 3.9 | |
Yes | 883 (88.7%) | 94.4 | 95.5 | 96.1 | ||
Experienced emotional abuse | No | 324 (32.1%) | 19.5 | 18.3 | 14.2 | |
Yes | 678 (67.9%) | 80.5 | 81.7 | 85.8 | ||
sexual and/or physical violence | No | 212 (20.7%) | 9.6 | 8.7 | 7.7 | |
Yes | 791 (79.3%) | 90.4 | 91.3 | 92.4 | ||
War/community violence | No | 95 (10.1%) | 4.7 | 4.8 | 8.7 | |
Yes | 907 (89.9%) | 95.3 | 95.2 | 91.3 | ||
Total number of ACEs reported | < 4 | 281 (28.7%) | 13.9 | 11.4 | 15.0 | |
5–8 | 540 (54.1%) | 51.9 | 55.5 | 41.7 | ||
9–12 | 170 (17.2%) | 34.2 | 33.1 | 43.3 | ||
 Literacy | Illiterate |  | 166 (17.6%) | 19.7 | 17.9 | 27.4 |
Literate | Â | 837 (82.4%) | 80.4 | 82.1 | 72.7 | |
 Religion | Catholic |  | 375 (36.9%) | 33.6 | 31.8 | 36.1 |
Protestant | Â | 534 (54.4%) | 55.0 | 60.3 | 48.6 | |
Muslim | Â | 46 (4.6%) | 6.3 | 5.2 | 8.7 | |
Other/None | Â | 46 (4.6%) | 5.1 | 2.8 | 6.5 | |
 Socio-economic status (SES) | Low/low-middle |  | 401 (39.3%) | 42.4 | 36.1 | 56.4 |
Middle | Â | 200 (19.9%) | 21.2 | 25.4 | 19.9 | |
Upper middle/upper | Â | 400 (40.8%) | 36.4 | 38.5 | 23.8 | |
Level 2: Proximal socio-demographic characteristics, sex work characteristics, sexual risk behaviours, HIV and STI prevalence | ||||||
 Marital status | Ever married | No | 216 (18.8%) | 15.4 | 15.1 | 16.4 |
Yes | 787 (81.2%) | 84.6 | 84.9 | 83.6 | ||
 No. of childrenb | None |  | 40 (3.4%) | 3.6 | 5.7 | 6.7 |
1–2 |  | 644 (66.1%) | 61.5 | 62.2 | 50.5 | |
3+ | Â | 264 (30.5%) | 34.9 | 32.1 | 42.8 | |
 Reports death of a childb |  | No | 829 (86.8%) | 81.6 | 83.7 | 81.1 |
Yes | 119 (13.2%) | 18.4 | 16.3 | 18.9 | ||
 Income | Additional income to sex work | No | 571 (56.4%) | 49.1 | 46.0 | 48.1 |
Yes | 432 (43.7%) | 50.9 | 54.0 | 51.9 | ||
 Hunger | Missed a meal in the last 7 days due to financial constraints | No | 670 (66.1%) | 51.6 | 53.2 | 43.4 |
Yes | 331 (33.9%) | 48.5 | 46.8 | 56.6 | ||
 Social support | Someone to talk to about your problems | No | 278 (27.5%) | 34.2 | 37.7 | 37.7 |
Yes | 725 (72.5%) | 65.9 | 62.3 | 62.3 | ||
 Non-consensual sexual debut | Tricked, pressured or physical forced into first sex | No | 695 (68.7%) | 51.8 | 44.0 | 51.7 |
Yes | 306 (31.3%) | 48.2 | 56.0 | 48.3 | ||
 Age first sex work | Mean (years) |  | 24.4 | 25.2 | 24.5 | 23.8 |
 Place of selling sex | Phone/internet/friends |  | 54 (5.4%) | 6.5 | 7.6 | 6.1 |
Home/middle men/markets | Â | 15 (1.6%) | 1.8 | 3.2 | 0 | |
Brothel/escort service/massage parlour | Â | 14 (1.5%) | 1.8 | 0.8 | 0 | |
Bar/club/lodge/social gatherings | Â | 620 (61.5%) | 55.4 | 60.0 | 64.1 | |
Street/bus/taxis | Â | 294 (30.0%) | 34.5 | 28.4 | 29.8 | |
 Place of sex work | Lodge/hotel/rented room |  | 907 (91.4%) | 90.3 | 85.6 | 86.2 |
Other public place | Â | 28 (2.8%) | 4.1 | 2.8 | 6.1 | |
Home | Â | 60 (5.8%) | 5.6 | 11.6 | 7.7 | |
 Client volume/week | Median |  | 3 | 3 | 3 | 4 |
< 5 |  | 607 (60.9%) | 64.7 | 62.9 | 59.2 | |
5–9 |  | 350 (24.8%) | 20.6 | 21.0 | 27.9 | |
10+ | Â | 137 (14.2%) | 14.7 | 16.1 | 12.9 | |
 Condom use last sex |  | No | 236 (22.8%) | 27.2 | 27.4 | 22.1 |
Yes | 765 (77.2%) | 72.8 | 72.6 | 77.8 | ||
 Anal sex with client | Last 7 days | No | 980 (98.4%) | 96.9 | 92.4 | 95.0 |
Yes | 16 (1.6%) | 3.2 | 7.6 | 5.0 | ||
 Sex work stigma | Any perceived stigma related to sex work | No | 140 (14.0%) | 4.8 | 8.4 | 6.2 |
Yes | 855 (86.0%) | 95.3 | 91.6 | 93.9 | ||
 Abortion/stillbirthc | Pregnancy that ended in stillbirth or abortion | No | 539 (55.4%) | 46.3 | 39.8 | 47.8 |
Yes | 412 (44.6%) | 53.8 | 60.2 | 42.3 | ||
 HIV status |  | Negative | 746 (72.0%) | 72.6 | 72.2 | 72.1 |
Positive | 257 (28.0%) | 27.3 | 27.8 | 27.9 | ||
 Chlamydia Trachomatis |  | Negative | 932 (94.3%) | 94.9 | 91.6 | 93.5 |
Positive | 67 (5.7%) | 5.1 | 8.4 | 6.5 | ||
 Neisseria Gonorrhoea |  | Negative | 975 (97.4%) | 97.8 | 98.8 | 98.9 |
Positive | 67 (2.6%) | 2.2 | 1.2 | 1.1 | ||
 Syphilis (Treponema pallidum) |  | Negative | 979 (97.9%) | 97.5 | 97.2 | 96.7 |
Positive | 20 (2.1%) | 2.5 | 2.8 | 3.3 | ||
 Bacterial vaginosis |  | Negative | 428 (42.1%) | 46.6 | 48.4 | 40.4 |
Positive | 199 (20.0%) | 20.3 | 17.9 | 16.9 | ||
Intermediate | 371 (37.9%) | 33.1 | 33.7 | 42.7 | ||
 Trichomonas vaginalis |  | Negative | 969 (97.0%) | 97.5 | 98.0 | 97.2 |
Positive | 31 (3.0%) | 2.5 | 2.0 | 2.8 | ||
Level 3a: Recent violence/arrest (last 6 months) | ||||||
 Any recent violence (physical/sexual/emotional) | No | 198 (19.3%) | 11.6 | 6.4 | 6.6 | |
Yes | 805 (80.7%) | 88.4 | 93.7 | 93.4 | ||
 Any recent sexual and/or physical non-IP violence | No | 456 (45.0%) | 30.8 | 27.8 | 23.5 | |
Yes | 547 (55.0%) | 69.2 | 72.2 | 76.5 | ||
 Any recent sexual and/or physical IP violence | No | 693 (69.1%) | 63.2 | 53.6 | 55.8 | |
Yes | 310 (30.9%) | 36.8 | 46.4 | 44.3 | ||
 Recent arrest |  | No | 701 (69.3%) | 64.1 | 61.1 | 52.5 |
Yes | 302 (30.7%) | 35.9 | 38.9 | 47.6 | ||
Level 3b: Harmful alcohol and/or substance use last 3 months | ||||||
 Alcohol use problem | ASSIST risk level | Low/none | 697 (70.1%) | 47.3 | 40.1 | 48.4 |
Moderate/high | 302 (29.9%) | 52.7 | 59.9 | 51.6 | ||
 Other substance use problemd | ASSIST risk level | Low/none | 681 (69.3%) | 53.8 | 56.0 | 49.7 |
Moderate/high | 322 (30.7%) | 46.2 | 44.0 | 50.3 | ||
Moderate/high | 455 (44.2%) | 64.9 | 68.7 | 67.8 | ||