Mujeres unidas: Addressing substance use, violence, and hiv risk through asset-based community development for women in the sex trade

Abstract

This paper examines the prevalence of and potential for community mobilization (CM) and its association with HIV/STI risk, substance use, and violence victimization among women, particularly those using substances, in the sex trade in Tijuana, Mexico. Methods: 195 women participated in Mujeres Unidas (K01DA036439 Urada) under a longitudinal survey study, “Proyecto Mapa de Salud” (R01DA028692, PI: Brouwer). Local health/social service providers (N = 16) were also interviewed. Results: 39% of women who participated in community mobilization activities used substances. In adjusted analyses (n = 135), participation in CM activities (n = 26) was more likely among women who did not report substance use (AOR: 4.36, CI: 1.11–17.16), perceived a right to a life free from violence (AOR: 9.28, CI: 2.03–59.26), talked/worked with peers in the sex trade to change a situation (AOR: 7.87, CI: 2.03–30.57), witnessed violence where they worked (AOR: 4.45, CI: 1.24–15.96), and accessed free condoms (AOR: 1.54, CI: 1.01–2.35). Forty-five of the women using substances demonstrated their potential for engaging in asset-based community development (ABCD) with service providers in Mujeres Unidas meetings. Conclusion: Women using substances, vs. those who did not, demonstrated their potential to engage in ABCD strategies. Women’s empowerment, safety, and health could be enhanced by communities engaging in ABCD strategies that build and bridge social capital for marginalized women who otherwise have few exit and recovery options.