2026 Theses Doctoral

Beyond Income: Profiles of Financial Precarity and Intimate Partner Violence Among Women in Sex Work in Kazakhstan

Levin, Kimberly D.

Women engaged in sex work (WESW) who also use drugs navigate extremely complex financial lives, yet they remain vastly understudied in terms of financial circumstances and their relationship to intimate partner violence (IPV). Most of the current literature on WESW primarily focuses on outcomes pertaining to drug use and HIV risk, and this population is often treated as a monolithic group of individuals. Despite high rates of IPV among WESW, there is limited scholarship examining violence through a lens of financial precarity. This dissertation addressed that gap by examining whether distinct profiles of WESW who also use drugs in Kazakhstan exist based on financial risk factors and whether those profiles differ in experiences of IPV. Using baseline data from Project Nova, a two-arm randomized control trial testing a microfinance-based HIV risk reduction intervention, latent profile analysis (LPA) was conducted to identify profiles based on nine financial indicator variables including income, proportion of income from sex work, number of dependents, debt, homelessness, and economic exploitation and restriction from intimate partners. This analysis was grounded in the Theory of Gender and Power, Risk Environment Theory, and Syndemic Theory. Three distinct profiles emerged: Economically Restricted Workers, characterized by low income and high economic control from partners; Economically Autonomous Workers, characterized by moderate income and substantially lower economic control; and Highest Earning, Highest Burdened Workers, characterized by the highest income, highest number of dependents, and high economic control. Secondary analysis revealed that Economically Restricted Workers and Highest Earning, Highest Burdened Workers experienced significantly higher rates of verbal, physical, isolation threat, and severe IPV from intimate partners compared to Economically Autonomous Workers. The finding that the lowest and highest earning profiles experienced similar rates of violence while the moderate-income, low economic control profile experienced significantly less demonstrates that income alone may not function as a protective factor against IPV in this context. Rather, it is economic autonomy, or the absence of partner control over financial resources, that more closely aligns with reduced violence. These findings challenge assumptions within microfinance literature that increased income uniformly reduces vulnerability, suggesting that intervention design should also address relational power and economic control, not income alone, to meaningfully reduce IPV for this population.