An assessment of sex work in Swaziland: barriers to and opportunities for HIV prevention among sex workers

Abstract

The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pleasure or “sensation seeking”, and freedoms from the burden of marriage as perceived benefits of sex work. We also found that penile-vaginal sex was not universal in male-female sexual encounters; and motivation by sex workers for non-condom use included intention to earn more money from unprotected sex, desire for sexual pleasure, and not having time to use condoms. Many sex workers expressed doubts over an alternative lifestyle, even if that change afforded them money to meet their daily necessities. The findings from this study suggest that treating sex workers as a homogenous group that is driven into, or maintain sex work only because of poverty may be problematic, and could hamper HIV-relevant interventions aimed at reducing their vulnerability to sexually transmitted infections.

Female Sex Workers, Male Circumcision and HIV: A Qualitative Study of Their Understanding, Experience, and HIV Risk in Zambia

“…Previous research has shown that the lives of FSWs in sub-Saharan Africa frequently include interpersonal violence, police harassment, and alcohol and drug use [14], [24]–[27]. Our data concur, highlighting the alcohol use, violence, and unprotected sex with sexual partners that increase FSWs' vulnerability to HIV infection.…”

Prevalence and correlates of anal intercourse among female sex workers in eSwatini

“…AI practice is often more common among FSW who suffer physical [17,[19][20][21][22] or sexual violence [17,18]. Previous research on Swazi FSW points to conditions where AI is likely to be commonly practised and to frequently be condomless [23][24][25][26]. Sex work is illegal in eSwatini, and as such is hidden, marginalised and stigmatised [23,24].…”

The Knowledge and Behaviour of Female Sex Workers towardsthe Risk of HIV/AIDS: A Review.

“…However, a research reported that sex work could give them more money and pleasure, also because they did not regard life outside sex work as a viable option (Chipamaunga et al, 2010). Generally, studies found that financial need is the reason for initiating and maintaining sex work, because in some countries most of sex workers were from poor socio-economic status and broken family (Giri et al, 2012).Other factors such as lack of education, poverty, domestic violence, marital breakup, family responsibility, lack of support by family members, harassment, and abuse in society and in workplace are the main reasons for women coming to this profession as well (Charles et al, 2013).…”

“…In many discussions about knowledge, attitude, and practice model, knowledge has been known as a prerequisite for the intentional performance of health-related behavior (Chipamaunga et al, 2010). Individual perception of susceptibility to HIV/AIDS and benefits of condom use are important factors in determining condom use and cognitive information through health education is an effective promotion (Ye et al, 2012).…”

“…Each country has been implementing various methods to increase the sex workers knowledge and motivation in HIV/AIDS preventions. However, based on the fact that the prevalence of HIV/AIDS among sex workersestimates higher than the general population (Chipamaunga, Muula, & Mataya, 2010), more effective programs should be identified and implemented.Decisions about further programs should be based on best available information (Pattanaphesaj & Teerawattananon, 2010). Therefore, this paper will try to analyze and discuss knowledge, behavior, perception, attitude, and practice or female sex workers towards HIV/AIDS in several countries, in order to find out some new ideas about HIV/AIDS prevention programs particularly for sex worker groups.…”