Associations of cumulative violence and structural vulnerability with restless sleep among female sex workers in Baltimore, Maryland

Published:November 18, 2020DOI:https://doi.org/10.1016/j.sleh.2020.10.004

      Abstract

      Objective

      To investigate correlates of restless sleep among street-based female sex workers (FSW) in the United States, an understudied population experiencing high rates of structural vulnerabilities (eg, homelessness, food insecurity) and trauma.

      Methods

      Using data from a cohort of street-based cisgender FSW (n = 236; median age = 35 years, 68% non-Hispanic White), we examined cross-sectional associations of individual, interpersonal, and structural factors with frequent restless sleep over the past week (5-7 Vs <5 days).

      Results

      Participants reported a high prevalence of homelessness (62%), food insecurity (61%), daily heroin injection (53%), lifetime sexual or physical violence (81%), and frequent restless sleep (53%). Older age, food insecurity, poor self-rated health, and cumulative violence exposure were independently associated with frequent restless sleep.

      Conclusion

      Frequent restless sleep was prevalent among FSW with higher odds among those experiencing intersecting vulnerabilities and multiple exposures to violence. Further research on sleep health in this population is needed to understand its role in health risks.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Zee PC
        • Turek FW
        Sleep and health: everywhere and in both directions.
        Arch Intern Med. 2006; 166: 1686-1688https://doi.org/10.1001/archinte.166.16.1686
        • Edinger JD
        • Bonnet MH
        • Bootzin RR
        • Doghramji K
        • Dorsey CM
        • Espie CA
        • et al.
        Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine Work Group.
        Sleep. 2004; 27: 1567-1596https://doi.org/10.1093/sleep/27.8.1567
        • Roth T
        • Coulouvrat C
        • Hajak G
        • Lakoma MD
        • Sampson NA
        • Shahly V
        • et al.
        Prevalence and perceived health associated with insomnia based on DSM-IV-TR; international statistical classification of diseases and related health problems, tenth revision; and research diagnostic criteria/international classification of sleep disorders, second edition criteria: results from the America Insomnia Survey.
        Biol Psychiatry. 2011; 69: 592-600
        • Ancoli-Israel S
        Sleep and its disorders in aging populations.
        Sleep Med. 2009; 10: S7-S11
        • Meers J
        • Stout-Aguilar J
        • Nowakowski S
        Sex differences in sleep health.
        Sleep Heal. 2019; : 21-29https://doi.org/10.1016/B978-0-12-815373-4.00003-4
        • Petrov ME
        • Lichstein KL
        Differences in sleep between black and white adults: an update and future directions.
        Sleep Med. 2016; 18: 74-81https://doi.org/10.1016/j.sleep.2015.01.011
        • Bourgois P
        • Holmes SM
        • Sue K
        • Quesada J
        Structural vulnerability.
        Acad Med. 2017; 92: 299-307https://doi.org/10.1097/ACM.0000000000001294
        • Ara A
        • Jacobs W
        • Bhat IA
        • McCall WV
        Sleep disturbances and substance use disorders: a bi-directional relationship.
        Psychiatr Ann. 2016; 46: 408-412https://doi.org/10.3928/00485713-20160512-01
        • Jackson DB
        • Testa A
        • Vaughn MG
        • Semenza DC
        Police stops and sleep behaviors among at-risk youth.
        Sleep Heal. 2020;
        • Gallegos AM
        • Trabold N
        • Cerulli C
        • Pigeon WR
        Sleep and interpersonal violence: a systematic review.
        Trauma, Violence, Abus. 2019; (1524838019852633)https://doi.org/10.1177/1524838019852633
        • Ding M
        • Keiley MK
        • Garza KB
        • Duffy PA
        • Zizza CA
        Food insecurity is associated with poor sleep outcomes among US adults.
        J Nutr. 2015; 145: 615-621https://doi.org/10.3945/jn.114.199919
        • Gonzalez A
        • Tyminski Q
        Sleep deprivation in an American homeless population.
        Sleep Heal J Natl Sleep Found. 2020; https://doi.org/10.1016/j.sleh.2020.01.002
        • Decker MR
        • Crago AL
        • Chu SKH
        • Sherman SG
        • Seshu MS
        • Buthelezi K
        • et al.
        Human rights violations against sex workers: burden and effect on HIV.
        Lancet. 2015; 385: 186-199https://doi.org/10.1016/S0140-6736(14)60800-X
        • Deering KN
        • Amin A
        • Shoveller J
        • Nesbitt A
        • Garcia-Moreno C
        • Duff P
        • et al.
        A systematic review of the correlates of violence against sex workers.
        Am J Public Health. 2014; 104https://doi.org/10.2105/AJPH.2014.301909
        • Kecklund G
        • Axelsson J
        Health consequences of shift work and insufficient sleep.
        BMJ. 2016; 355https://doi.org/10.1136/bmj.i5210
        • Park JN
        • Decker MR
        • Bass JK
        • Galai N
        • Tomko C
        • Jain KM
        • et al.
        Cumulative violence and PTSD symptom severity among urban street-based female sex workers.
        J Interpers Violence. 2019; (088626051988469)https://doi.org/10.1177/0886260519884694
        • Allen ST
        • Footer KHA
        • Galai N
        • Park JN
        • Silberzahn B
        • Sherman SG
        Implementing targeted sampling: lessons learned from recruiting female sex workers in Baltimore,MD.
        J Urban Heal. 2019; 96: 442-451https://doi.org/10.1007/s11524-018-0292-0
        • Andresen EM
        • Malmgren JA
        • Carter WB
        • Patrick DL
        Screening for depression in well older adults: evaluation of a short form of the CES-D.
        Am J Prev Med. 1994; 10: 77-84
        • Bush K
        • Kivlahan DR
        • McDonell MB
        • Fihn SD
        • Bradley KA
        The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking.
        Arch Intern Med. 1998; 158: 1789-1795https://doi.org/10.1001/archinte.158.16.1789
      1. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). 2013. www.ptsd.va.gov.

        • Straus MA
        • Hamby SL
        • Boney-McCoy S
        • Sugarman DB
        The Revised Conflict Tactics Scales (CTS2).
        J Fam Issues. 1996; 17: 283-316https://doi.org/10.1177/019251396017003001
        • American Psychiatric Association [APA]
        Diagnostic and Statistical Manual of Mental Disorders (DSM-5®).
        5th ed. American Psychiatric Association, Arlington, VA2013
        • Rojo-Wissar DM
        • Davidson RD
        • Beck CJ
        • Kobayashi US
        • VanBlargan AC
        • Haynes PL
        Sleep quality and perceived health in college undergraduates with adverse childhood experiences.
        Sleep Heal. 2019; 5: 187-192https://doi.org/10.1016/j.sleh.2018.11.007
        • Rhodes T
        Risk environments and drug harms: a social science for harm reduction approach.
        Int J Drug Policy. 2009; 20: 193-201https://doi.org/10.1016/j.drugpo.2008.10.003
        • Goel N
        • Rao H
        • Durmer JS
        • Dinges DF
        Neurocognitive consequences of sleep deprivation.
        Semin Neurol. 2009; 29: 320-339https://doi.org/10.1055/s-0029-1237117