Sexual violence against female sex workers in The Gambia: a cross-sectional examination of the associations between victimization and reproductive, sexual and mental health

Female sex workers (FSWs) frequently face violence in their working place. This study assessed the physical and sexual violence and associated factors among FSWs in Rwanda. A cross-sectional study was conducted among FSWs in Rwanda in 2015. Venue–Day–Time sampling method was used for recruitment. Descriptive analyses and logistic regression models were computed to assess factors associated with violence. In total, 1978 FSWs were recruited. A large proportion (18.3%) had been sexually abused outside of the family circle, and 37.8% had faced physical violence before 15 years of age. Clients were most often reported (67.0%) as perpetrators of physical violence in sex work. Being aged 25 years old and above, and having sexually transmitted infections (STIs) were positively associated with sexual violence (aOR = 2.1[95%CI: 1.80–2.39]) and (aOR = 3.0[95%CI: 1.01–2.14], respectively). Being aged 25 years old and above (aOR = 0.8[95%CI: 0.76–0.89]) and drinking alcohol every day (aOR = 0.6[95%CI: 0.42–0.87]) were negatively associated with physical violence. Sexual and physical violence was common among FSWs in Rwanda. Single FSWs are the most vulnerable to sexual violence. Alcohol consumption and having STIs are associated with violence against FSWs. Human rights and social protection as well as health promotion among FSWs is needed.

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The Prevalence and Correlates of Physical and Sexual Violence Affecting Female Sex Workers in Swaziland

Journal of Interpersonal Violence ◽

10.1177/0886260516629385 ◽

2016 ◽

Vol 33 (17) ◽

pp. 2745-2766 ◽

Cited By ~ 7

Author(s):

Blair O. Berger ◽

Ashley Grosso ◽

Darrin Adams ◽

Sosthenes Ketende ◽

Bhekie Sithole ◽

...

Keyword(s):

Health Outcomes ◽

Sexual Violence ◽

Risk Behaviors ◽

Sex Workers ◽

Female Sex Workers ◽

Poor Health ◽

Adult Women ◽

Cross Sectional ◽

Female Sex ◽

Selling Sex

Female sex workers (FSW) have a heightened vulnerability to violence and negative sexual/reproductive health outcomes. Limited research has examined how experiencing physical and sexual violence (PSV) mediates risk for poor health outcomes among FSW in Swaziland. The present analyses aim to contribute to literature linking violence with poor health outcomes, high-risk behaviors, and reduced health service-seeking among FSW. Data were analyzed from a cross-sectional study conducted in Swaziland between July and September 2011 with 325 adult women who reported exchanging sex for money, goods, or favors in the last 12 months, recruited through respondent-driven sampling (RDS). Logistic regression was used to assess the relationship between PSV and ancillary violence/abuse exposures, risk behaviors, and sexual/reproductive and mental health outcomes. PSV was conceptualized as either ever having been beaten up as a result of selling sex or ever being forced to have sex since the age of 18, or both. Prevalence of PSV in this sample was 59.0% in crude estimation, and 48.4% (95% confidence interval [CI]:[39.2,57.6]) with RDS weighting. Separate RDS-weighted estimates of being beaten up as a result of sex work and ever being forced to have sex were 32.4% (95%CI=[24.4,40.4]) and 33.1% (95%CI =[25.0,41.2%]), respectively. Experiencing PSV was associated with being blackmailed (adjusted odds ratio [aOR]= 1.93, 95%CI= [1.07,3.52]), non-injection drug use in the last 12 months (aOR= 1.84, 95%CI= [1.02,3.33]), and feeling afraid to seek health services as a result of selling sex (aOR = 1.74, 95%CI= [1.01,2.99]). Given these findings, violence prevention strategies should be prioritized in programs that address Swazi FSW health, empowerment, and safety.

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A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia

International Journal of STD & AIDS ◽

10.1177/0956462413498858 ◽

2013 ◽

Vol 25 (4) ◽

pp. 244-252 ◽

Cited By ~ 22

Author(s):

Sarah Peitzmeier ◽

Krystal Mason ◽

Nuha Ceesay ◽

Daouda Diouf ◽

Fatou Drame ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

The Gambia ◽

Cross Sectional ◽

Female Sex

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Intersections of Sex Work, Mental Ill-Health, IPV and Other Violence Experienced by Female Sex Workers: Findings from a Cross-Sectional Community-Centric National Study in South Africa

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211971 ◽

2021 ◽

Vol 18 (22) ◽

pp. 11971

Author(s):

Rachel Jewkes ◽

Minja Milovanovic ◽

Kennedy Otwombe ◽

Esnat Chirwa ◽

Khuthadzo Hlongwane ◽

...

Keyword(s):

Mental Health ◽

South Africa ◽

Substance Abuse ◽

Food Insecurity ◽

Childhood Trauma ◽

Sex Workers ◽

Female Sex Workers ◽

Poor Mental Health ◽

Cross Sectional ◽

Female Sex

Female sex workers (FSWs) are at increased risk of mental health problems, including mood disorders and substance abuse, and we need to understand the origins of these to treat and prevent them, and particularly understand how the context in which they sell sex impacts their mental health. We conducted a multi-stage, community-centric, cross-sectional survey of 3005 FSWs linked to SW programmes in twelve sites across all nine provinces of South Africa. We interviewed adult women who had sold sex in the preceding six months, who were recruited via SW networks. We found that FSWs have very poor mental health as 52.7% had depression and 53.6% has post-traumatic stress disorder (PTSD). The structural equation model showed direct pathways from childhood trauma and having HIV+ status to mental ill-health. Indirect pathways were mediated by food insecurity, controlling partners, non-partner rape, harmful alcohol use, substance use to cope with SW, indicators of the circumstances of SW, i.e., selling location (on streets, in taverns and brothels), frequency of selling and experiencing SW stigma. All paths from childhood trauma had final common pathways from exposure to gender-based violence (non-partner rape or intimate partner violence) to mental ill-health, except for one that was mediated by food insecurity. Thus, FSWs’ poor mental health risk was often mediated by their work location and vulnerability to violence, substance abuse and stigma. The potential contribution of legal reform to mitigate the risks of violence and mental ill-health are inescapable. Treatment of mental ill-health and substance abuse should be an essential element of FSW programmes.

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Correlates of condom use among female sex workers in The Gambia: results of a cross-sectional survey

PeerJ ◽

10.7717/peerj.1076 ◽

2015 ◽

Vol 3 ◽

pp. e1076 ◽

Cited By ~ 8

Author(s):

Ashley L. Grosso ◽

Esther L. Lei ◽

Sosthenes C. Ketende ◽

Sarah Peitzmeier ◽

Krystal Mason ◽

...

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

The Gambia ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Female Sex

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Sexual IPV and non-partner rape of female sex workers: findings of a cross-sectional community-centric national study in South Africa

SSM - Mental Health ◽

10.1016/j.ssmmh.2021.100012 ◽

2021 ◽

pp. 100012

Author(s):

Rachel Jewkes ◽

Kennedy Otwombe ◽

Kristin Dunkle ◽

Minja Milovanovic ◽

Khuthadzo Hlongwane ◽

...

Keyword(s):

South Africa ◽

Sex Workers ◽

Female Sex Workers ◽

National Study ◽

Cross Sectional ◽

Female Sex

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Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India

BMJ Open ◽

10.1136/bmjopen-2015-009774 ◽

2016 ◽

Vol 6 (5) ◽

pp. e009774

Author(s):

Marianne Legendre-Dugal ◽

Janet Bradley ◽

Subramanian Potty Rajaram ◽

Catherine M Lowndes ◽

Banadakoppa M Ramesh ◽

...

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Southern India ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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Early sex work initiation and condom use among alcohol-using female sex workers in Mombasa, Kenya: a cross-sectional analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2016-052549 ◽

2016 ◽

Vol 92 (8) ◽

pp. 593-598 ◽

Cited By ~ 9

Author(s):

Angela M Parcesepe ◽

Kelly L L'Engle ◽

Sandra L Martin ◽

Sherri Green ◽

Chirayath Suchindran ◽

...

Keyword(s):

Condom Use ◽

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional ◽

Female Sex ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe

BMJ Open ◽

10.1136/bmjopen-2017-018751 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018751 ◽

Cited By ~ 3

Author(s):

Rebecca Rhead ◽

Jocelyn Elmes ◽

Eloghene Otobo ◽

Kundai Nhongo ◽

Albert Takaruza ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Household Survey ◽

Hiv Treatment ◽

Sample Survey ◽

Physical And Mental Health ◽

Hiv Knowledge ◽

Cross Sectional ◽

Female Sex ◽

Treatment Services

ObjectiveGlobally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.MethodsData from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.ResultsHIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.ConclusionFSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.

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