{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:46:16Z","timestamp":1792280776227,"version":"4.4.0"},"reference-count":63,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009041","name":"national department of health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009041","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000943","name":"albert and margaret alkek foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000943","id-type":"DOI","asserted-by":"publisher"}]},{"name":"networking hiv\/aids community of south africa","award":["NAC-SW-2016-1"],"award-info":[{"award-number":["NAC-SW-2016-1"]}]},{"name":"uc san diego center for aids research international pilot grant application","award":["2P30AI036214-24"],"award-info":[{"award-number":["2P30AI036214-24"]}]},{"DOI":"10.13039\/100004440","name":"wellcome trust","doi-asserted-by":"publisher","award":["214204\/A\/18\/Z"],"award-info":[{"award-number":["214204\/A\/18\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sex workers in South Africa experience high levels of trauma and mental health issues, but little is known about their drug and alcohol use. This study assessed the prevalence of substance use and its key risk factors amongst female sex workers (FSWs) at two sites in South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two cross-sectional studies were conducted, in Soweto and Klerksdorp, South Africa. Using respondent-driven sampling (RDS) 508 FSWs in Soweto and 156 in Klerksdorp were enrolled. A study-specific survey was used to collect social and demographic information, substance use, mental ill-health, and HIV status. Raw and RDS-adjusted data were analyzed using Chi-squared tests of association. Weighted and unweighted Poisson regression models were used to assess key risk factors for alcohol and drug use at both univariate and multivariate levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 664 FSWs, 56.2% were binge drinkers and 29.4% reported using drugs within the last year. Living in a home with regular food (RR: 1.2597, 95% CI: 1.1009\u20131.4413) and being HIV positive (RR: 1.1678, 95% CI: 1.0227\u20131.3334) were associated with a higher risk of binge drinking. Having symptoms suggestive of post-traumatic stress disorder (RR: 1.1803, 95% CI: 1.0025\u20131.3895) and past year physical\/sexual abuse from either intimate (RR: 1.3648, 95% CI: 1.1522\u20131.6167) or non-intimate partners (RR: 1.3910, 95% CI: 1.1793\u20131.6407) were associated with a higher risk of drug use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In conclusion, our findings demonstrate a high prevalence of alcohol and drug use among FSWs in Soweto and Klerksdorp with site-specific contextual dynamics driving substance use. Site differences highlight the importance of tailoring site-specific substance use harm mitigation for this key population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0261855","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T13:44:48Z","timestamp":1642772688000},"page":"e0261855","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Key risk factors for substance use among female sex workers in Soweto and Klerksdorp, South Africa: A cross-sectional study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1201-2204","authenticated-orcid":true,"given":"Ellis Jaewon","family":"Yeo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khuthadzo","family":"Hlongwane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy","family":"Otwombe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-3686","authenticated-orcid":true,"given":"Kathryn L.","family":"Hopkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebrahim","family":"Variava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Martinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffanie A.","family":"Strathdee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Coetzee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minja","family":"Milovanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"pone.0261855.ref001","volume-title":"Global Status Report on Alcohol and Health","author":"World Health Organization","year":"2018"},{"issue":"4","key":"pone.0261855.ref002","doi-asserted-by":"crossref","first-page":"434","DOI":"10.15288\/jsa.2004.65.434","article-title":"Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Town, South Africa","volume":"65","author":"LC Simbayi","year":"2004","journal-title":"J Stud Alcohol"},{"key":"pone.0261855.ref003","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1747-597X-4-11","article-title":"Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa","volume":"4","author":"WM Wechsberg","year":"2009","journal-title":"Subst Abuse Treat Prev Policy"},{"issue":"2","key":"pone.0261855.ref004","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/alcalc\/agp095","article-title":"Alcohol use among female sex workers and male clients: an integrative review of global literature","volume":"45","author":"Q Li","year":"2010","journal-title":"Alcohol Alcohol Oxf Oxfs"},{"issue":"6","key":"pone.0261855.ref005","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","article-title":"Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption\u2014II","volume":"88","author":"JB Saunders","year":"1993","journal-title":"Addict Abingdon Engl"},{"key":"pone.0261855.ref006","unstructured":"UCSF, Anova Health Institute, WRHI. 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