Age Matters: Determinants of sexual and reproductive health vulnerabilities amongst young women who sell sex (16–24 years) in Zimbabwe

Crankshaw, Tamaryn L.; Chareka, Samantha; Zambezi, Pemberai; Poku, Nana K.

doi:10.1016/j.socscimed.2020.113597

Cited by 16 publications

(23 citation statements)

References 25 publications

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“…The key word search for studies was: Female sex workers (Note of terminology: most public health publications use the term ‘female sex workers’. In this paper, we prefer the person-first approach, using women who sell sex; this is in line with other authors (Crankshaw et al 9 ) OR sex workers AND cervical cancer OR HPV AND (list of countries (Angola OR Botswana OR Burundi OR Comoros OR Democratic Republic of Congo OR Eritrea OR Eswatini OR Swaziland OR Ethiopia OR Kenya OR Lesotho OR Madagascar OR Malawi OR Mauritius OR Mozambique OR Namibia OR Rwanda OR Seychelles OR South Africa OR South Sudan OR Tanzania OR Uganda OR Zambia OR Zimbabwe)) OR Eastern Africa OR Southern Africa. The search was restricted to the last 10 years (2010–2020, plus the first 3 months of 2021) to ensure that the information is current.…”

Section: Methodssupporting

confidence: 72%

Human Papilloma Virus infection and cervical cancer among women who sell sex in Eastern and Southern Africa: A scoping review

Macleod

Reynolds

2021

Womens Health (Lond Engl)

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Objectives: Women who sell sex have a high prevalence of human papilloma virus, which may cause cervical cancer. The objective of this review was to collate findings on prevalence, associated factors, screening, service provision and utilization of services in relation to human papilloma virus and cervical cancer among women who sell sex in Eastern and Southern Africa. Methods: A scoping review methodology was employed. Inclusion criteria were as follows: (1) empirical papers, (2) of studies conducted in Eastern and Southern Africa, (3) published in the last 10 years, and (4) addressing women who sell sex in relation to (5) human papilloma virus and cervical cancer. A thorough search of a range of databases surfaced 66 papers. Both authors applied inclusion and exclusion criteria, resulting in 14 papers being reviewed. Results: The reported prevalence of high-risk human papillomavirus virus varied between 23.6% and 70.5%. HIV sero-positivity, other sexually transmitted infections and Epstein-Barr virus were associated with human papilloma virus and high-grade cervical lesions. High-risk human papilloma virus was associated with women who reported younger age at first intercourse, non-barrier contraceptive use, and no history of condom use. For screening, there was overall agreement between physician- and self-collected samples. Contradictory results were found for visual inspection with acetic acid. Screening services utilization was associated with provider’s recommendation, history of sexually transmitted infections, frequency of facility visit and history of vaginal examination. A diagonal programme led to an increase in screening, attributed to the targeted services. Conclusions: Context is important in planning cervical cancer services. There is a need for enhanced sexually transmitted infections and viral management within cervical cancer prevention. Women who sell sex should be empowered in self-collection of stored-dry specimens, especially in resource-constrained regions. Cervical cancer screening services should be honed to the needs of women who sell sex.

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Section: Methodssupporting

confidence: 72%

Human Papilloma Virus infection and cervical cancer among women who sell sex in Eastern and Southern Africa: A scoping review

Macleod

Reynolds

2021

Womens Health (Lond Engl)

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“…This finding should be further explored as the opposite trend has been observed in other studies, especially with HIV infection with older age associated with HIV infection ( 13 , 16 , 33 ). However, one hypothesis could be that young FSW lack the experience necessary to protect them against STI, such as inexperience in dealing with clients or in negotiating condom use ( 34 ). Young FSW face particular vulnerabilities putting them at heightened risk for STI and HIV, which should be specifically addressed in national strategies and policies of HIV and STI control.…”

Section: Discussionmentioning

confidence: 99%

High burden of self-reported sexually transmitted infections among female sex workers in Togo in 2021

Bitty-Anderson

Gbeasor-Komlanvi

Bakoubayi

et al. 2022

Front. Public Health

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BackgroundSexually Transmitted Infections (STI) remain a public health challenge, especially for Female Sex Workers (FSW) who are particularly vulnerable. In sub-Saharan Africa where the overlapping epidemics of STI and HIV are concentrated among key populations, epidemiological data are needed in order to better understand STI trends in this population. The aim of this study was to assess the prevalence of self-reported STI symptoms and their risk factors among FSW in Togo in 2021.MethodsA cross-sectional study was completed in June and July 2021 among FSW in two cities of Togo: in Lomé (capital city, south of Togo) and in Kara (north of Togo). A snowball sampling method was used and after consent, a standardized questionnaire was administered by trained research staff to collect information on STI. A multivariate logistic regression model was used to identify factors associated with self-reported STI.ResultsA total of 447 FSW, 300 in Lomé and 147 in Kara participated in this study. Median age was 30 [IQR: 24–38] and STI symptoms in the previous 12 months were reported by 191 FSW [42.7%, 95% CI: (38.1–47.5)], among whom 116 (60.7%) sought medical care. The most common reported symptoms were abnormal vaginal discharge (n = 78; 67.2%) and vaginal itching (n = 68; 58.6%). Current STI symptoms (at the time of the survey) were reported by 88 FSW (19.7%). In multivariable logistic regression, self-reported STI symptoms in the previous 12 months was negatively associated with living in the Lomé and older age and positively associated with having more than 15 clients in the previous week and being victim of violence.ConclusionsFindings from this study reveal that the self-reported STI burden is relatively high among FSW Togo. Additional strategies are needed at the structural, medical, political and social levels to curb this trend and effectively aim at the elimination of STI epidemics by the year 2030.

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“…Our Zimbabwean research highlighted how older sex workers (>20/21 years) refused to share information about abusive clients with younger peers and younger women (<18/19 years) were generally distrustful of adult and older peer educators, who were also sex workers themselves (Crankshaw et al, 2021).…”

Section: Peer-reviewed Articlementioning

confidence: 90%

“…This paper is based on empirical case studies in four countries, which were carried out between 2019 and 2021 (for country level analyses please see Aantjes et al, 2021;Freedman et al, 2021;Crankshaw et al, 2021;Chareka et al, 2021). The case studies involved a review of national sex work laws and policies, in-depth and semi-structured interviews as well as focus group discussions (FGDs) with young women aged between 18-24 years on issues related to their sexual and reproductive health and rights (SRHR) 2 .…”

Section: Methodsmentioning

confidence: 99%

Impacts of Colonial Legacies on the Rights and Security of Sex Workers in Southern Africa

Aantjes¹,

Crankshaw²,

Freedman³

2022

ijgsl

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This article will explore the relationship between sex work and the law in four Southern African countries – Madagascar, Mozambique, Zambia and Zimbabwe – to shed light on the persistent barriers to promoting the rights and security of sex workers. In these countries, as across Southern Africa, criminal laws on sex work introduced by colonial powers have profoundly shaped contemporary societal attitudes towards sex work and women who sell sex. More recently, the question of sex work has often been linked to HIV and AIDS and decriminalisation has been promoted as part of a wider strategy to protect ‘key populations’, including sex workers, who are perceived as being at greater risk of HIV infection. Based on our research with young women engaged in selling sex, we found that repression continues in various forms within and outside of the law. Though sex work is no longer fully criminalised in most countries in the region, the relics of the colonial past permeate contemporary norms and attitudes to sex work thus locking the selling of sex within the grey areas of the law and contributing to situations of vulnerability for sex workers. Our four case studies demonstrate that transformations in dominant social norms and representations around sex work have been far slower and less far reaching than many assumed they would be, even in the countries which have adopted more progressive laws and policies. The situations of vulnerability experienced by sex workers also escalated during the COVID-19 crisis, highlighting the critical need for state intervention to improve their legal, economic and social position.

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Age Matters: Determinants of sexual and reproductive health vulnerabilities amongst young women who sell sex (16–24 years) in Zimbabwe

Cited by 16 publications

References 25 publications

Human Papilloma Virus infection and cervical cancer among women who sell sex in Eastern and Southern Africa: A scoping review

Human Papilloma Virus infection and cervical cancer among women who sell sex in Eastern and Southern Africa: A scoping review

High burden of self-reported sexually transmitted infections among female sex workers in Togo in 2021

Impacts of Colonial Legacies on the Rights and Security of Sex Workers in Southern Africa

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