L violence from police reported in the quantitative study may be underreported, as forced sex from police in exchange for freedom from harassment or prosecution is common and may not even be viewed as sexual violence or rape. Women do not always define these traumatic events as violence, but the trauma can be felt without that labelling. Our qualitative findings emphasize that victimization of sex workers is highly traumatizing. For women selling sex for drugs or money, sexual violence can include not getting paid for sex, sexual harassment, sexual exploitation and rape [21]. In a study of almost 900 female sex workers conducted in St. Petersburg and Orenburg, sexual coercion by police (reported by 38 of women) and rape during sex work (reported by 64 ) were associated with IDU and binge alcohol use [22]. The relationship NSC309132 web between police and women who order Zebularine inject drugs, particularly those involved in transactional sex, is complex, as sexual coercion can involve offers of protection from prosecution, detention or police harassments [22,24]. In this study, the police exploitation of the illegal nature of sex work, referred to as subbotnik, is a euphemism referring to police demanding sex in exchange for leniency towards pimps and sex workers [25]. A recent study conducted in Moscow emphasized that this practice exposes both sex workers and police officers to substantial HIV risks, as coerced sex with police is associated with increased risks of HIV and other sexually transmitted infections [26]. Our study findings add that the coercive character of subbotnik is based on a power imbalance between police and vulnerable women, which facilitates human rights abuse and the circle of coercion and victimization. Our qualitative analyses indicate that that sexual violence from police is common, unchecked, and incites helplessness and trauma for women in ways that may exacerbate risky drug use, while those unaffected by the issue remain unaware, impeding their ability to serve as allies against this violence. The qualitative data also suggest that sexual violence is under-recognized, including by male PWID, while our quantitative data indicate that the phenomenon of police sexual violence is persuasive. According to existing literature, sexual violence from police does not seem to be limited to St. Petersburg. A study conducted in other parts of Russia (Moscow, Barnaul and Volgograd) described variety of policeperpetrated violence, including extreme forms such as torture and rape, as acts of “moral” punishment of PWID and to extort confessions from them [6]. Women believed the law enforcement and legal systems to be corrupt and ineffective. Stigma, police abuse and fear of police deter women from seeking help when they experience violence perpetrated by clients or others [7]. Police sexual violence and coercion occur in other countries. In a study of over 300 women in a US drug court, 25 reported a lifetime history of sexual encounters with police. Of those women, 96 had sex with an officer on duty, 77 had repeated exchanges, 31 reported rape by anLunze K et al. Journal of the International AIDS Society 2016, 19(Suppl 3):20877 http://www.jiasociety.org/index.php/jias/article/view/20877 | http://dx.doi.org/10.7448/IAS.19.4.officer and 54 were offered favours by officers in exchange for sex [27]. This study’s quantitative data were collected until 2010 and the qualitative data in 2012. We did not find any indications for policy or other changes in.L violence from police reported in the quantitative study may be underreported, as forced sex from police in exchange for freedom from harassment or prosecution is common and may not even be viewed as sexual violence or rape. Women do not always define these traumatic events as violence, but the trauma can be felt without that labelling. Our qualitative findings emphasize that victimization of sex workers is highly traumatizing. For women selling sex for drugs or money, sexual violence can include not getting paid for sex, sexual harassment, sexual exploitation and rape [21]. In a study of almost 900 female sex workers conducted in St. Petersburg and Orenburg, sexual coercion by police (reported by 38 of women) and rape during sex work (reported by 64 ) were associated with IDU and binge alcohol use [22]. The relationship between police and women who inject drugs, particularly those involved in transactional sex, is complex, as sexual coercion can involve offers of protection from prosecution, detention or police harassments [22,24]. In this study, the police exploitation of the illegal nature of sex work, referred to as subbotnik, is a euphemism referring to police demanding sex in exchange for leniency towards pimps and sex workers [25]. A recent study conducted in Moscow emphasized that this practice exposes both sex workers and police officers to substantial HIV risks, as coerced sex with police is associated with increased risks of HIV and other sexually transmitted infections [26]. Our study findings add that the coercive character of subbotnik is based on a power imbalance between police and vulnerable women, which facilitates human rights abuse and the circle of coercion and victimization. Our qualitative analyses indicate that that sexual violence from police is common, unchecked, and incites helplessness and trauma for women in ways that may exacerbate risky drug use, while those unaffected by the issue remain unaware, impeding their ability to serve as allies against this violence. The qualitative data also suggest that sexual violence is under-recognized, including by male PWID, while our quantitative data indicate that the phenomenon of police sexual violence is persuasive. According to existing literature, sexual violence from police does not seem to be limited to St. Petersburg. A study conducted in other parts of Russia (Moscow, Barnaul and Volgograd) described variety of policeperpetrated violence, including extreme forms such as torture and rape, as acts of “moral” punishment of PWID and to extort confessions from them [6]. Women believed the law enforcement and legal systems to be corrupt and ineffective. Stigma, police abuse and fear of police deter women from seeking help when they experience violence perpetrated by clients or others [7]. Police sexual violence and coercion occur in other countries. In a study of over 300 women in a US drug court, 25 reported a lifetime history of sexual encounters with police. Of those women, 96 had sex with an officer on duty, 77 had repeated exchanges, 31 reported rape by anLunze K et al. Journal of the International AIDS Society 2016, 19(Suppl 3):20877 http://www.jiasociety.org/index.php/jias/article/view/20877 | http://dx.doi.org/10.7448/IAS.19.4.officer and 54 were offered favours by officers in exchange for sex [27]. This study’s quantitative data were collected until 2010 and the qualitative data in 2012. We did not find any indications for policy or other changes in.
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