0973 Romantic Partnership Mitigates the Influence of Anxiety and Mood on Sleep Disturbance in Full-Service Sex Workers

Abstract Introduction In the United States, an estimated 1-2 million full-service sex workers (FSSW) face notable physical and mental health challenges, including increased depression, anxiety, and sleep difficulties as compared to the general population (Ramos et al., 2022). The "partnership-health associations" concept suggests that romantic relationships may protect mental and physical well-being (Du Bois et al., 2021). Notably, a recent study found no significant health outcome differences between partnered and non-partnered FSSW at the univariate level (Du Bois et al., 2023). This secondary analysis aims to explore whether partnership buffers the link between mood, anxiety, and sleep disturbance among FSSW. Methods 83 FSSW completed the Patient Reported Outcomes Measure Information System-29 (PROMIS-29) online from November 2019-February 2020. Four moderation analyses, utilizing PROCESS, examined anxiety and depression as predictor variables and global sleep disturbance score as an outcome, with partnership status (partnered versus non-partnered) as the moderating variable. Results The sample was primarily white (81.9%), non-Hispanic (77.1%), and cisgender female (66.3%), with a mean age of 28.01 (±4.25) years. The overall model for partnership status as a moderator of the association between anxiety and sleep disturbance was significant (F(3, 79)=17.65,p.001,R2=.40). The interaction effect showed a significant link between increased anxiety and sleep disturbance for both non-partnered FSSW (b=0.88,SE=0.13,t(79)=6.74, p.001) and partnered FSSW (b=0.35,SE=0.14,t(79)=2.48,p.05), with a more pronounced association for non-partnered FSSW. Similarly, the overall model for the association between depression and sleep disturbance was significant (F(3, 79)=12.50,p.001,R2=.32). The interaction effect indicated a significant link between increased depression and sleep disturbance for both non-partnered FSSW (b=0.75,SE=0.13,t(79)=5.61,p.001) and partnered FSSW (b=0.34,SE=0.15,t(79)=2.18,p.05), with a more pronounced association for non-partnered individuals. Conclusion Analyzing mental-physical health associations at a multivariable level provides a nuanced understanding that partnership may protect against unfavorable mood, anxiety, and sleep health associations in FSSW. Future studies should include a larger sample size and explore specific underlying mechanisms by which romantic partnership relates to a protective effect of low mood and high anxiety on sleep, both in FSSW and other groups who experience health inequities. Support (if any) American Psychological Foundation, The Drs. Rosalee G. and Raymond A. Weiss Research and Program Innovation Grant