Work-related mobility and experiences of gender-based violence among female sex workers in Iringa, Tanzania: a cross-sectional analysis of baseline data from Project Shikamana

ObjectivesTo examine how work-related mobility among female sex workers (FSWs) is associated with gender-based violence (GBV) in Iringa, Tanzania.DesignCross-sectional analyses were conducted on baseline data gathered between October 2015 and April 2016 from FSWs participating in Project Shikamana, a community empowerment-based combination HIV prevention intervention.SettingParticipants were recruited for the baseline study using venue-based time-location sampling in two communities in Iringa, Tanzania.ParticipantsFSWs were eligible for participation if they were 18 years or older and had exchanged sex for money within the past month. Four-hundred ninety-six FSWs participated in the baseline survey.Primary and secondary outcome measuresAny recent experience of GBV was examined by recent work-related mobility among FSWs. Any recent experience of GBV was also disaggregated by severity for analyses. All bivariate and multivariate binary and multinomial logistic regressions adjusted for intraclass correlations among women recruited from the same venues.ResultsForty per cent of participants experienced recent physical or sexual violence, and 30% recently experienced severe physical or sexual violence. Thirty-three per cent of participants recently exchanged sex for money outside of their district or region, and 12% were both intraregionally and inter-regionally mobile for sex work. Intraregionally and inter-regionally mobile FSWs had 1.9 times greater odds of reporting recent GBV (adjusted OR: 1.89; 95% CI: 1.06 to 3.38; p=0.031) compared with non-mobile FSWs and a 2.5 times higher relative risk for recent experience of severe GBV relative to no recent GBV (relative risk ratio: 2.51; 95% CI: 1.33 to 4.74; p=0.005).ConclusionsMobility for sex work may increase FSWs’ exposure to GBV, particularly more severe GBV. The vulnerability of mobile FSWs to violence, particularly severe forms, demands inclusive services that are accessible to mobile FSWs.

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Mobility for sex work and recent experiences of gender-based violence among female sex workers in Iringa, Tanzania: A longitudinal analysis

PLoS ONE ◽

10.1371/journal.pone.0252728 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252728

Author(s):

Zoé Mistrale Hendrickson ◽

Anna M. Leddy ◽

Noya Galai ◽

S. Wilson Beckham ◽

Wendy Davis ◽

...

Keyword(s):

Sexual Violence ◽

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Community Empowerment ◽

Recent Experience ◽

Gender Based Violence ◽

Female Sex ◽

Gender Based

Female sex workers are highly mobile, which may influence their risk of experiencing physical and sexual violence. However, there remains a paucity of research, particularly longitudinal, from Sub-Saharan Africa exploring mobility and gender-based violence among female sex workers. To address this gap, this study examined the longitudinal relationship between work-related mobility and recent experience of physical or sexual gender-based violence from a client or partner among female sex workers in Iringa, Tanzania. A secondary data analysis was conducted using baseline and 18-month follow-up data from Project Shikamana, a community empowerment-based combination HIV prevention intervention. Responses from 387 female sex workers aged 18 years and older participating in both baseline and follow-up were analyzed. Unadjusted and adjusted Poisson regression models with robust variance estimations, accounting for clustering of female sex workers’ responses over time, were fit. Final models adjusted for socio-demographic characteristics and aspects of participants’ living situations and work environments. Recent physical or sexual violence from a client or partner was common (baseline: 40%; follow-up: 29%). Twenty-six percent of female sex workers at baseline, and 11% at follow-up, had recently traveled outside of Iringa for sex work. In the final adjusted longitudinal model, female sex workers recently mobile for sex work had a 25% increased risk of any recent experience of physical or sexual gender-based violence when compared with their non-mobile counterparts (adjusted incidence rate ratio: 1.25; 95% CI: 1.03–1.53; p<0.05). Interventions must identify ways–such as mobile support services, linkages and referrals to health and other social services while traveling, or the use of mobile or digital technology–to address mobile female sex workers’ unique needs while traveling. Future quantitative and qualitative research is needed to understand the context of female sex workers’ mobility and how and why mobility influences risk environments and experiences of gender-based violence.

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Client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-046894 ◽

2021 ◽

Vol 11 (9) ◽

pp. e046894

Author(s):

Simple Ouma ◽

Rawlance Ndejjo ◽

Catherine Abbo ◽

Nazarius M Tumwesigye

Keyword(s):

Low Income ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Hiv Positive ◽

Northern Uganda ◽

Gender Based Violence ◽

Cross Sectional ◽

Female Sex ◽

Gender Based

Study objectiveTo determine the prevalence and associated factors of client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda.Design and settingsWe conducted a cross-sectional study among female sex workers in Gulu district in conflict-affected Northern Uganda.ParticipantsThe study participants included 300 female sex workers aged 18+ years. The participants were selected using simple random sampling from a database of female sex workers maintained at a national non-governmental organisation in Gulu.Outcome measureThe outcome measure was self-reported exposure to client-perpetrated gender-based violence.MethodsWe used a pretested semistructured questionnaire to collect data on sociodemographic characteristics, sex work-related characteristics, alcohol use, illicit drug use, HIV status and self-reported exposure to client-perpetrated gender-based violence. Then, data were entered into Epi Info V.7 and analysed using Stata V.14.0.ResultsAmong participants, 61.0% reported client-perpetrated gender-based violence. Economic (58.7%) and emotional (52.0%) violence were the most common forms of client-perpetrated gender-based violence in this population. Independently, being: street-based (adjusted OR=9.66, 95% CI 2.78 to 33.5), mobile (adjusted OR=3.21, 95% CI 1.83 to 5.64), HIV-positive (adjusted OR=1.90, 95% CI 1.09 to 3.31) and a low-income earner (<USh200 000 monthly) (adjusted OR=2.26, 95% CI 1.18 to 4.30) were positively associated with exposure to client-perpetrated gender-based violence.ConclusionsThere is a high prevalence of client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda. Furthermore, female sex workers who were street-based, mobile, HIV-positive and low-income earners were more likely to experience client-perpetrated gender-based violence. The ministry of health and the development partners need to provide targeted public health interventions to prevent and manage the rampant gender-based violence among this underserved population.

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Client-perpetrated gender-based violence among female sex workers in post-conflict Gulu district, Northern Uganda: a cross-sectional study

10.1101/2020.11.02.20224527 ◽

2020 ◽

Author(s):

Simple Ouma ◽

Rawlance Ndejjo ◽

Catherine Abbo ◽

Nazarius Mbona Tumwesigye

Keyword(s):

Sex Work ◽

Low Income ◽

Sex Workers ◽

Cross Sectional Study ◽

Hiv Positive ◽

Gender Based Violence ◽

Cross Sectional ◽

Work Related ◽

Post Conflict ◽

Gulu District

Background: Gender-based violence (GBV) among female sex workers (FSWs) negatively affects their mental wellbeing and sexual and reproductive health and rights. This study aimed to determine the prevalence and associated factors of client-perpetrated GBV among FSWs in post-conflict Gulu district, Northern Uganda. Methods: A cross-sectional study was conducted among 300 FSWs aged 18+ years who were operating in Gulu district. Participants were selected using simple random sampling and interviewed between March and June 2020. Pre-tested semi-structured questionnaires were utilized to collect information on socio-demographic and sex-work-related characteristics, alcohol and illicit drug use, HIV status, and exposure to client-perpetrated GBV. Data were entered into EPI INFO 7 and analyzed using logistic regression with the aid of STATA 14.0. Results: Sixty one percent (61.0%) of the participants reported client-perpetrated GBV. The most common forms of GBV in this population were economic (58.7%) and emotional (52.0%) violence. Meanwhile, sexual violence (21.0%) was the least common form of GBV among the study participants. At multivariate level; street-based sex work (aOR=9.66, 95%CI: 2.78-33.5), mobile sex work (aOR=3.21, 95%CI: 1.83-5.64), HIV-positive status (aOR=1.90, 95%CI: 1.09-3.31), and low monthly income below 50th percentile {<200,000 UGX}(aOR= 2.26, 95% CI: 1.18-4.30) remained independently associated with client-perpetrated GBV. Conclusion: Our findings revealed a high prevalence of client-perpetrated GBV driven by street-based sex work, sex work-related mobility, HIV-positive status, and low income. Therefore, interventions to address client-perpetrated GBV should target FSWs who are street-based, HIV-positive, mobile, and with low income.

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