Risk Environments and Substance Use Among Mexican Female Sex Work on the U.S.–Mexico Border

• Author: Kathryn M. Nowotny,Avelardo Valdez,Alice Cepeda,Nalini Negi,Tasha Perdue
• Published date: 01 October 2017
• DOI: 10.1177/0022042616678609
• Date: 01 October 2017
• Subject Matter: Articles

Journal of Drug Issues

2017, Vol. 47(4) 528 –542

© The Author(s) 2016

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DOI: 10.1177/0022042616678609

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Article

Risk Environments and Substance

Use Among Mexican Female Sex

Work on the U.S.–Mexico Border

Kathryn M. Nowotny1, Alice Cepeda2, Tasha Perdue2,

Nalini Negi3, and Avelardo Valdez2

Abstract

We use a risk environment framework to qualitatively examine pathways into substance

use and abuse among Mexican female sex workers on the U.S.–Mexico border. Life history

interviews and ethnographic observations were conducted with female sex workers to uncover

how the border context shapes patterns of substance use. The findings illustrate that, for many

women, initiation into sex work is contextualized within immigration, the global economy,

and demands and desire for financial autonomy. Paradoxically, many find autonomy within

sex work as they increase their ability to support their families and themselves. As women

become more entrenched in sex work, however, they are put on a path toward substance

abuse beginning with alcohol then cocaine and heroin. This identification of specific substance

use pathways and trajectories has important implications for the development of prevention

and intervention programs that can help curtail problematic drug use that can lead to negative

health consequences.

Keywords

female sex workers, HIV risk, drug use, Mexico

Engaging in sex work along the U.S.–Mexico border has been identified as a potential risk factor

for HIV infection and transmission (Brouwer et al., 2006; Bucardo, Semple, Fraga-Vallejo,

Davila, & Patterson, 2004; Magis-Rodriguez et al., 2005; Maxwell et al., 2006). Studies have

documented this populations’ HIV infection risks associated with their sex risk behaviors (Booth,

Watters, & Chitwood, 1993; Cepeda, Nowotny, & Valdez, 2015; Cook & Clark, 2005; Leigh,

1990; Wang, Li, Stanton, Zhang, & Fang, 2010). The research has often focused on the risks and

epidemiological patterns of drug using sex workers, including injecting drug use (Strathdee et al.,

2011; Strathdee, Lozada, et al., 2008; Strathdee, Philbin, et al., 2008). However, this research has

not fully examined the processes and pathways by which alcohol and drug use patterns are shaped

by women’s entrance into sex work. This article uses a risk environment framework to qualita-

tively examine these pathways to substance use and abuse among Mexican female sex workers

1University of Miami, Coral Gables, FL, USA

2University of Southern California, Los Angeles, CA, USA

3University of Maryland, Baltimore, MD, USA

Corresponding Author:

Kathryn M. Nowotny, Department of Sociology, University of Miami, 5202 University Drive, Merrick Building, Room

120, Coral Gables, FL 33146, USA.

Email: Kathryn.Nowotny@Miami.edu

678609JODXXX10.1177/0022042616678609Journal of Drug IssuesNowotny et al.

research-article2016