Melissa A Stockton1, Brian W Pence2, David Mbote3, Emmanuel A Oga4, John Kraemer5,6, Joshua Kimani7, Stella Njuguna8, Joanna Maselko2, Laura Nyblade5. 1. Epidemiology Department, Gillings School of Global Public Health, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA. Stocktonmelisssa@gmail.com. 2. Epidemiology Department, Gillings School of Global Public Health, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA. 3. Kuria Foundation for Social Enterprise, Nairobi, Kenya. 4. Center for Applied Public Health Research, RTI International, 6110 Executive Boulevard, Rockville, MD, 20852, USA. 5. Global Health Division, International Development Group, RTI International, Washington, DC, USA. 6. Department of Health Systems Administration, Georgetown University, Washington, DC, USA. 7. University of Nairobi Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya. 8. Kenya Medical Research Institute, Nairobi, Kenya.
Abstract
OBJECTIVES: This study (1) estimated the association between experienced sex work-related stigma and moderate-to-severe depressive symptoms (hereafter depression), (2) examined independent associations between internalized stigma, experienced stigma, and depression among sex workers, and (3) investigated the potential modifying role of social support. METHODS: A cross-sectional survey was conducted among 729 male and female sex workers in Kenya. RESULTS: The prevalence of depression was 33.9%, and nearly all participants reported at least one of the experienced and internalized stigma items. Increasing levels of experienced stigma was associated with an increased predicted prevalence of depression [aPD 0.15 (95% CI 0.11-0.18)]. Increasing internalized stigma was independently associated with higher experienced stigma and depression and appeared to account for 25.5% of the shared variance between experienced stigma and depression after adjustment for confounders. Social support from same-sex sex workers did not appear to modify the association between experienced stigma and depression. CONCLUSIONS: Addressing the high levels of stigma that sex workers face and their mental health needs should be a public health and human rights imperative.
OBJECTIVES: This study (1) estimated the association between experienced sex work-related stigma and moderate-to-severe depressive symptoms (hereafter depression), (2) examined independent associations between internalized stigma, experienced stigma, and depression among sex workers, and (3) investigated the potential modifying role of social support. METHODS: A cross-sectional survey was conducted among 729 male and female sex workers in Kenya. RESULTS: The prevalence of depression was 33.9%, and nearly all participants reported at least one of the experienced and internalized stigma items. Increasing levels of experienced stigma was associated with an increased predicted prevalence of depression [aPD 0.15 (95% CI 0.11-0.18)]. Increasing internalized stigma was independently associated with higher experienced stigma and depression and appeared to account for 25.5% of the shared variance between experienced stigma and depression after adjustment for confounders. Social support from same-sex sex workers did not appear to modify the association between experienced stigma and depression. CONCLUSIONS: Addressing the high levels of stigma that sex workers face and their mental health needs should be a public health and human rights imperative.
Entities:
Keywords:
Depression; Discrimination; Kenya; Sex work; Stigma; Sub-Saharan Africa
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