Suicidal ideation among women who engage in sex work and have a history of drug use in Kazakhstan
Vélez-Grau C. El-Bassel N. McCrimmon T. Chang M. Terlikbayeva A. Primbetova S. Mergenova G. S Witte S.
September 2021Elsevier GmbH
Mental Health and Prevention
2021#23
Suicide rates in Kazakhstan rank fourth worldwide. Suicidal ideation is a strong predictor of death by suicide. Yet there is limited information about factors associated with suicidal ideation among women who engage in sex work (WESW) with a history of drug use. Guided by the Diathesis-Stress Theory of Suicide, this study examined the risk and protective factors associated with suicidal ideation among WESW in Kazakhstan. Data drew from the baseline assessments from a sample of four hundred women who participated in a cluster randomized control trial comparing a treatment arm which received a combination of HIV Risk Reduction (HIVRR) and microfinance intervention, and a control arm which received HIVRR alone. Multiple logistic regression models controlling for sociodemographic characteristics examined the effects of risk and protective factors on suicidal ideation. More than half of the participants (52.5%) reported suicidal ideation in the past seven days. Women with vulnerabilities such as child sexual abuse and harmful alcohol use and stressors such as stigma were more likely to think about suicide compared with those who did not. Keeping income from sex work was associated with a lower risk of suicidal ideation. HIV interventions targeting WESW and use drugs must include a mental health component to decrease the risk of suicidal ideation among this group. Womens ability to keep income from sex work suggests the potential to strengthen womens financial stability as a source of empowerment, which may in turn lessen the detrimental effects of childhood adversities and life stressors experienced by WESW.
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Silver School of Social Work, New York University, United States
McSilver Institute for Poverty Policy and Research, USA 1 Washington Square NNew York, New York, 10003, United States
Columbia University School of Social Work, USA 1255 Amsterdam Ave, New York, NY 10027, United States
Global Health Research Center of Central Asia 38B, Shashkina Str. 050040, Almaty, Kazakhstan
Silver School of Social Work
McSilver Institute for Poverty Policy and Research
Columbia University School of Social Work
Global Health Research Center of Central Asia 38B
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