Client-Initiated Violence Against Zambian Female Sex Workers: Prevalence and Associations With Behavior, Environment, and Sexual History

Malama, Kalonde; Sagaon-Teyssier, Luis; Parker, Rachel; Tichacek, Amanda; Sharkey, Tyronza; Kilembe, William; Inambao, Mubiana; Price, Matt A.; Spire, Bruno; Allen, Susan

doi:10.1177/0886260519860083

Cited by 10 publications

(14 citation statements)

References 28 publications

(29 reference statements)

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“…Childhood maltreatment was a strong predictor of IPV perpetration in adulthood among men in Burundi 129. Across many countries, forced sexual debut was a risk factor for IPV in later life among female sex workers,88 126 130 131 and among adolescent girls and young women 111 116 132…”

Section: Resultsmentioning

confidence: 99%

Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

Mannell¹,

Lowe²,

Brown³

et al. 2022

BMJ Glob Health

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IntroductionViolence against women (VAW) affects one in three women globally. In some countries, women are at much higher risk. We examined risk factors for VAW in countries with the highest 12-month prevalence estimates of intimate partner violence (IPV) to develop understanding of this increased risk.MethodsFor this systematic review, we searched PUBMED, CINAHL, PROQUEST (Middle East and North Africa; Latin America and Iberia; East and South Asia), Web of Science, EMBASE and PsycINFO (Ovid) for records published between 1 January 2000 and 1 January 2021 in English, French and Spanish. Included records used quantitative, qualitative, or mixed-methods, reported original data, had VAW as the main outcome, and focused on at least one of 23 countries in the highest quintile of prevalence figures for women’s self-reported experiences of physical and/or sexual violence in the past 12 months. We used critical interpretive synthesis to develop a conceptual model for associations between identified risk factors and VAW.ResultsOur search identified 12 044 records, of which 241 were included for analysis (2 80 360 women, 40 276 men, 274 key informants). Most studies were from Bangladesh (74), Uganda (72) and Tanzania (43). Several quantitative studies explored community-level/region-level socioeconomic status and education as risk factors, but associations with VAW were mixed. Although fewer in number and representing just one country, studies reported more consistent effects for community-level childhood exposure to violence and urban residence. Theoretical explanations for a country’s high prevalence point to the importance of exposure to other forms of violence (armed conflict, witnessing parental violence, child abuse) and patriarchal social norms.ConclusionAvailable evidence suggests that heightened prevalence of VAW is not attributable to a single risk factor. Multilayered and area-level risk analyses are needed to ensure funding is appropriately targeted for countries where VAW is most pervasive.PROSPERO registration numberThe review is registered with PROSPERO (CRD42020190147).

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Section: Resultsmentioning

confidence: 99%

Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

Mannell¹,

Lowe²,

Brown³

et al. 2022

BMJ Glob Health

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“…An established prospective cohort of HIV-uninfected high-risk women (HRW) in Lusaka and Ndola, Zambia was examined. 11–13 The women included were either FSWs or single mothers with children under the age of five (SM) referred to the Zambia-Emory HIV Research Project (ZEHRP) from local post-natal clinics or invited from community outreach at sex work hot spots.…”

Section: Methodsmentioning

confidence: 99%

Sociodemographic factors and STIs associated withChlamydia trachomatisandNeisseria gonorrhoeaeinfections in Zambian female sex workers and single mothers

et al. 2020

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Sexually transmitted infections (STIs) in women caused by Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) are epidemiologically distinct. In this study, associations with sociodemographic and clinical risk factors are explored separately for CT and NG. Multivariate logistic regression (MLR) models quantify associations between potential CT and/or NG risk factors within a cross-sectional study of high-risk women in two Zambian cities, Lusaka and Ndola. CT was associated with living in Lusaka, younger age, and literacy. Long-acting reversible contraception (LARC) was predictive of CT in Ndola, but protective in Lusaka. In Lusaka only, CT was associated with lower education and reported unprotected sex. NG was associated with younger age, lower education, concurrent Trichomonas vaginalis, bacterial vaginosis, and incident syphilis infection. Signs and symptoms were rare and not associated with either infection. CT was more prevalent, nearly 11%, compared to NG, 6.8%. The higher prevalence of CT could explain the lack of association with other STIs. The associations observed with NG could be the result of high-risk sexual networks or lack of protective immunity. Risk factors for CT and NG are distinct and may differ geographically, which should be considered when developing diagnostic tools or guiding presumptive treatment in specific populations.

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“…Informal security arrangements within lodges or bars offer some form of protection. Research in Zambia (Malama et al, 2019) confirms that recruiting clients from the streets is a risk factor for violence. Sex taking place in open spaces rather than houses or hotels (Schwitters et al, 2015), and sex occurring in clients’ homes (Malama et al, 2019) were found to be associated with violence.…”

Section: Resultsmentioning

confidence: 94%

“…Research in Zambia (Malama et al, 2019) confirms that recruiting clients from the streets is a risk factor for violence. Sex taking place in open spaces rather than houses or hotels (Schwitters et al, 2015), and sex occurring in clients’ homes (Malama et al, 2019) were found to be associated with violence. Malama et al(2019) report that the odds of client-initiated physical violence were higher for Zambian WSS who lived in the capital of Lusaka than those living in the second largest city, Ndola.…”

Section: Resultsmentioning

confidence: 94%

Violence Against Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review

Macleod

Reynolds

Delate³

2023

Trauma, Violence, & Abuse

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Women who sell sex (WSS) are vulnerable to violence. We present a scoping review of the last decade of research on the prevalence and incidence of, factors associated with, and services regarding violence against WSS in Eastern and Southern African (ESA). A systematic search of various databases resulted in 20 papers being reviewed. Inclusion criteria, applied by the first two authors, were as follows: empirical papers, key research problem is violence against WSS, and conducted in ESA countries. The lifetime prevalence of violence revealed in the studies ranged from 21% to 82%. A pattern of generalized violence against WSS from paying clients, male partners, strangers, family members, friends/acquaintances, and the authorities emerged. Factors associated with violence included the context within which the sex work occurs, alcohol use, type of sex exchange interactions, and personal factors (low education, low income, marriage, youth, high client volume, time in sex work, forced sexual debut, and internalized sex work stigma). WSS seldom access services after violence. Evaluations of two programs, a woman-focused HIV intervention, and the Diagonal Interventions to Fast-Forward Reproductive Health project, showed improvements in gender-based violence services. Findings suggest that targeted programmes should be paired with improving general health services and focus on promoting collective agency among WSS.

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Client-Initiated Violence Against Zambian Female Sex Workers: Prevalence and Associations With Behavior, Environment, and Sexual History

Cited by 10 publications

References 28 publications

Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

Sociodemographic factors and STIs associated withChlamydia trachomatisandNeisseria gonorrhoeaeinfections in Zambian female sex workers and single mothers

Violence Against Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review

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