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J Pers 72 2 — The presence of any type of disorder was less common in women who were Chittagong into the business but more prevalent in those women who Prostitutes Chittagong this work Prostitutes Mongo support their families. Annu Rev Public Health 26 —

Their main motives for sex work were coercion In total, FSW A mental disorder within the past 12 months was reported by FSW Prevalence rates of any mental disorder and SUD were higher in women who did sex work to support their family, whereas mood disorders were more frequent in those who Prostitutes Chittagong the money to pay debts.

Participants with any disorder were significantly older than those without M age: Conclusion: Our study revealed that FSW in Chittagong are very vulnerable and highly impaired, as expressed by high rates of abuse and mental disorders. Coercion is very common and many FSW are required Prostitutes Chittagong work in the sex business because they need the money to support their families.

As a disadvantaged and marginalized population, female sex workers Prostitutes Chittagong frequently suffer from coercion, stigmatization, and severe health impairments 12.

Our study revealed that FSW in Chittagong are very vulnerable and highly impaired, as expressed by high rates of abuse and mental disorders. Chittagong Sex Guide advises where to find sex, working girls, prostitution, street hookers, brothels, red-light.

From a public health Prostitutes Chittagong, most research has focused on sexually transmitted diseases and drug abuse, but less so on mental health and contributing psychological factors. To estimate the burden of sex work on global public health, comprehensive investigations of this vulnerable and often victimized population are urgently needed 3. Moreover, because sex work is highly dependent on socio-cultural and economic Prostitutes Chittagong, evaluations are required that focus on populations other than in Western countries.

The occurrence of physical abuse was Prostitutes Chittagong related to increased rates of depression, but no associated effect was found for rape or sexual abuse.

The study areas included the divisions of Dhaka and Chittagong. The study noted that most of the prostitute boys were drop-outs from schools, came from poor. Mental Health and Functioning of Female Sex Workers in Chittagong, Bangladesh Prostitutes Chittagong. Date Where to find a Prostitutes.

However, in this study, the diagnosis of depression was based on a simple cut-off value derived from a screening instrument. However, again Prostitutes Chittagong screening questionnaires were applied to assess mental health. The validity of this study was limited by the very small number of FSW participants and by the reliance upon a self-report screening questionnaire to assess Prostitutes Chittagong health problems.

Only a few quantitative studies have utilized reasonably large samples and, most importantly, structured clinical interviews, for systematically assessing mental health among FSW. Positive associations Prostitutes Chittagong any type of mental disorder included violence and rape in the sex business, the number of working days per week, or a lack of social support.

The present study was designed to adapt the methodology used in that Zurich evaluation and to Prostitutes Chittagong that approach to a sample within a country that differs both socio-economically and culturally from Switzerland. Our main objective is to cross-validate the relationship between sex work and mental health problems in a sample of FSW from Bangladesh.

Although our investigation was mostly exploratory, we hypothesized that the prevalence rates of mental disorders would be considerably higher for FSW than for the general population, based Prostitutes Chittagong outcomes previously reported in the scientific literature.

This is similar to the findings of Mroczek and Almeida

This Non-Governmental Organization NGO is dedicated to improve the situation of sex workers and homeless children and youths by providing support, education, and access to health services.

The total number of FSW in Chittagong is unknown but is estimated to be at least With the help of some FSW who collaborate closely Prostitutes Chittagong PARC, a local Prostitutes Chittagong coordinator identified approximately FSW from the Prostitutes Chittagong localities and facilities known to be frequently attended by FSW, of whom were randomly contacted directly at these different locations within Chittagong.

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Of the women who were approached and introduced to the Prostitutes Chittagong aims, agreed Prostitutes Chittagong participate response rate: Interviews were conducted between September and February by five specially trained research associates at PARC offices, and all participants gave their fully informed consent depending on their level of literacy written or verbal. Depending on the duration of the interview, all participants received a small expense allowance of if completed in 1 day to if completed in up to 3 days Bangladeshi Taka after completion of the interviews corresponds to approximately 2.

The basic questionnaire was adapted from one previously Prostitutes Chittagong for a study of FSW in Zurich, Switzerland 7. This fully structured questionnaire gathered socio-demographic data, including information about working Prostitutes Chittagong and motivation to participate in sex work. The questionnaire was carefully evaluated by the local investigator of the study group Md Nazrul Islam before application to the study participants to ensure that the translated version conformed to Bangladeshi socio-cultural characteristics.

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The MH-CIDI determines the presence of mental disorders within the past 12 months according to the Prostitutes Chittagong and criteria of the DSM-IV 9 and has demonstrated acceptable reliability and validity 10 Prostitutes Chittagong diagnoses considered here are comprised of mood disorders major depression disorder, dysthymia, recurrent brief depression, or bipolar disorders I and IIanxiety disorders agoraphobia, panic disorder, generalized anxiety disorder, obsessive—compulsive disorder, post-traumatic stress disorder, social phobia, Prostitutes Chittagong specific phobiasubstance use disorders SUD alcohol abuse and dependence or drug abuse and dependenceand impulse-control disorders conduct disorder, intermittent explosive disorder, attention deficit disorder, oppositional defiant disorder, anorexia, or bulimia nervosa.

Afterwards, the translation was edited, culturally adjusted, and field Prostitutes Chittagong by mental health professionals, including Md Nazrul Islam, for use in Bangladesh. In addition to provide a translation of the English version for use in Bangladesh, Md Nazrul Islam trained 15 lay interviewers in Chittagong, from whom the five best suited were selected according to their level of performance, accuracy, and patience for conducting the actual interviews.

Prostitutes Chittagong ordered categorical variables for abuse were entered as dependent variables and the diagnostic variables as predictors into a series of categorical regression analyses. Associations with continuous variables, such as age or income, were examined Prostitutes Chittagong a series of one-way ANOVAs. The basic characteristics of the Prostitutes Chittagong are shown in Table 1.

Most of the participants were uneducated, single, and had no other job Prostitutes Chittagong prostitution. The mean age at which these persons had begun their sex work was Mean income varied greatly, with the SD being almost as high as the mean.

Only a minority worked in a sex club or brothel 8. In all, women Only 15 women 5. Social support was generally low, with only 58 Prostitutes Chittagong A total of 43 women Mood disorders Prostitutes Chittagong reported for 11 participants 4.

Finally, impulse-control disorders were determined for 24 participants 9. A mental disorder from within any group described above was reported by participants The number of co-occurring disorders was 1 for 46 persons Contrary to our expectations, however, no diagnosis of mood, anxiety, SUD, or impulse-control disorder Prostitutes Chittagong significantly related to the occurrence of sexual or physical abuse.

The prevalence of mental disorders related to different motives to work in the commercial sex business is shown in Table 3. The presence of any type of disorder was less common in women who were forced Prostitutes Chittagong the business but more prevalent in those women who did this work to support their families.

Mood disorders were more frequent in women who did the job to pay their debts, whereas SUD were more common in those FSW who were required Prostitutes Chittagong support their families. Table 3.

Mental Health and Functioning of Female Sex Workers in Chittagong, Bangladesh

The feelings of being rejected or avoided by others were not related to either any particular mental disorder Prostitutes Chittagong one of the groups of disorders. On a descriptive level, the prevalence of any mental disorder revealed a clear U-shaped distribution across categories Prostitutes Chittagong quality of life, with increased prevalence rates at both the negative completely dissatisfied and, even more pronounced, the positive very satisfied poles Figure 2.

Except for mood disorders, the same trend Prostitutes Chittagong found in all disorder groups. Mood disorder occurred only in persons at the lower end of the scale, i. Figure 2.

Prostitutes Chittagong Relationship between quality of life and occurrence of any mental disorder. Level of education, relationship status, having children, or details of sex work, i.

However, the current age of a participant and the age at which she began sex work were significantly associated with the prevalence of any mental disorder.

Those who Prostitutes Chittagong criteria for any type of disorder were significantly older M age: Figure 3. The aim of this study Prostitutes Chittagong to provide a comprehensive survey of mental health problems and contributing psychological factors within a rather large sample of FSW in Chittagong, Bangladesh. Although some individuals voluntarily enter the commercial sex industry, most are forced.

Accordingly, these women display a wide variety of characteristics and motivations. A small minority of autonomous women are satisfied with their jobs, experience little burden, and enjoy Prostitutes Chittagong high incomes.

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Persons in the sample described here tend to belong to the latter type. Those women typically Prostitutes Chittagong high rates of mental disorders, are in poor general health, and experience abundant violence, coercion, and exploitation 4712 — Overall, the present FSW sample from Chittagong was very vulnerable and impaired, and most women participated only reluctantly Prostitutes Chittagong the commercial sex business.

The vast majority The month prevalence rate for any disorder was However, and most importantly, even this alarmingly high prevalence rate necessarily Prostitutes Chittagong the true impact of mental health problems, since various severe mental disorders, such as personality disorders and psychotic disorders, were not assessed.

A recent review on mental disorders in Bangladesh estimated that the rate of mental disorders based on structured interviews and community samples varies between Karim and colleagues 17 have reported a prevalence rate of Our month estimate of Furthermore, the high prevalence of mental Prostitutes Chittagong in FSW has been confirmed by other studies that used sufficiently large samples from distinct countries, such as Switzerland 7 and Nepal 4.

If one considers that SUD among FSW increases their risk for various Prostitutes Chittagong, including sexually transmitted diseases, exploitation, and violence Prostitutes Chittagong14then the extensive Prostitutes Chittagong of alcohol and drugs poses a particular threat to their physical health and Prostitutes Chittagong.

Although earlier research has shown that sex work can be a particular means by which one can finance a substance dependency 131920we did not find an association between SUD and the self-reported need to obtain money for drug purchases.

This finding is congruent with a thorough review by Vanwesenbeeck 21who stressed that substance use appears to be a causal risk factor for sex work only in specific subgroups of street-working FSW, such as homeless youths, but not in other FSW subgroups. Abuse and maltreatment are very common in various FSW subgroups, although not in all 67 In Prostitutes Chittagong present study, Those numbers illustrate the marked vulnerability of many FSW and the need for both prevention and intervention campaigns for those women.

We also found a particular association between emotional abuse and SUD, which Prostitutes Chittagong in accord with the notion that substance use places certain FSW at greater risk for abuse and coercion 2 Age was positively related to the prevalence and co-occurrence of mental disorders, indicating that younger FSW are more Prostitutes Chittagong than older ones, or, alternatively, that older women show heightened reactivity to stress.

One explanation might be that the pernicious effects of the sex business accumulate Prostitutes Chittagong time until the psychological resources of a sex worker are exhausted and she is no longer able to cope with such adversities.

This is similar Prostitutes Chittagong the findings of Mroczek and Almeida This possibility also implies that the risk for a mental disorder increases with the period of time that someone has been part of this industry.

Another Prostitutes Chittagong finding is the lower prevalence of any mental disorder in women who were forced to work in this business when compared to women who worked voluntarily as FSW. That is, FSW who are compelled to enter the Prostitutes Chittagong industry because of other factors than coercion were more likely to develop a mental disorder, or, alternatively, were driven into the sex business because of a pre-existing mental disorder.

Prostitutes Chittagong psychopathology in FSW who were not coerced might be explained by either control Prostitutes Chittagong 23 or cognitive dissonance Presumably, psychological strain is more impairing and burdensome than pure physical coercion, because psychological resources form the fundament for mental well-being. Therefore, as long as those foundations are not compromised, many psychological mechanisms can be implemented to foster mental resistance and enhance resilience, as discussed previously Prostitutes Chittagong Thus, not only are interventions required that reduce harm to FSW 1 but more research is also needed that is specifically aimed at the roles of resilience and protective factors in the face of adversity.

Prostitutes Chittagong, we were surprised to find that, among FSW who were completely dissatisfied with their quality of life, the majority We do Prostitutes Chittagong know whether this finding is due to a distorted perception and a reduced self-awareness in women with severe mental disorders, or whether it truly reflects a positive relationship between satisfaction and psychopathology, which would appear counterintuitive.

For instance, many persons with SUD or manic patients markedly overestimate their subjective quality of life. We therefore suggest that reports of high quality of life in persons with severe psychopathology are mainly due to distorted perception and altered self-awareness. The two major limitations of this study Prostitutes Chittagong its cross-sectional design, which Prostitutes Chittagong causal reasoning, and our reliance on self-report instruments, which may have biased the Prostitutes Chittagong through method effects, such as reduced self-awareness or social desirability.

Nevertheless, despite these shortcomings, the present study provides Prostitutes Chittagong evidence that, in less developed countries, FSW comprise mostly street workers who are among the most impaired and vulnerable populations worldwide 13.

In developing Prostitutes Chittagong, the reliance upon mental health services for Prostitutes Chittagong illness is substantially lower than in Western countries 16 With respect to Bangladesh, Hossain and colleagues 15 have specifically noted that service delivery and provision of adequate treatments for mental disorders is largely insufficient. Prevention programs and harm-reduction campaigns are urgently needed for FSW who are regularly exploited, stigmatized, and marginalized, and who are even more vulnerable because of their poor physical and mental health 1.