Table 4.

Adjusted associations between syndemic factors and syndemic scores and class membership among FSWs in Tijuana and Ciudad Juarez, Mexico (N=295).

	Class 2	Class 3	Class 4
	High Level of Perceived Barriers to PrEP Use AOR (95% CI)a	Perceived Financial Barriers to PrEP Use AOR (95% CI)a	Perceived Healthcare Access Barriers to PrEP Use AOR (95% CI)a
Syndemic factors
Hazardous alcohol consumption (past year)b	1.07 (0.57, 2.01)	0.61 (0.29, 1.27)	1.19 (0.46, 3.05)
Polydrug use (past month)c	1.52 (0.76, 3.04)	1.54 (0.70, 3.43)	2.70 (1.04, 7.04)
Depressiond	3.71 (1.90, 7.26)	3.77 (1.74, 8.18)	2.02 (0.69, 5.87)
Lifetime client perpetrated violencee	1.21 (0.64, 2.29)	0.66 (0.30, 1.48)	1.55 (0.59, 4.05)
Tested STI-positivef	3.10 (1.35, 7.10)	4.18 (1.67, 10.47)	1.57 (0.33, 7.40)
Nominal syndemic score
0 syndemic conditions	Ref	Ref	Ref
1	1.95 (0.72, 5.32)	1.57 (0.53, 4.62)	1.76 (0.41, 7.49)
2	1.29 (0.45, 3.67)	1.45 (0.47, 4.48)	1.19 (0.25, 5.53)
3	3.63 (1.24, 10.67)	2.46 (0.74, 8.23)	2.61 (0.45, 15.00)
4 or 5 syndemic conditions	6.30 (1.70, 23.35)	2.95 (0.59, 14.71)	5.72 (0.89, 36.63)
Ordinal syndemic score
# syndemic conditions	1.46 (1.13, 1.89)	1.28 (0.96, 1.71)	1.43 (0.94, 2.19)

Abbreviations: AOR=adjusted odds ratio; CI=confidence interval; FSW=female sex worker; PrEP=pre-exposure prophylaxis; STI=sexually transmitted infection.

Reference group = low level of perceived barriers to PrEP use.

^aAdjusted for age in years and education (completed secondary school vs. less than secondary school).

^bAlcohol Use Disorder Identification Test score ≥8.

^cUse of ≥2 illicit drugs (heroin; methamphetamine; cocaine; inhalants; ecstasy; tranquilizers; barbiturates) in the past month.

^dModerate or severe depression defined as a score ≥20 on the Beck Depression Inventory II (BDI-II).

^eLifetime experience of physical abuse or sexual violence perpetrated by a client.

^fTested positive for chlamydia, gonorrhea, or active syphilis.