In Search of Safety, Negotiating Everyday Forms of Risk: Sex Work, Criminalization, and HIV/AIDS in the Slums of Kampala

Abstract

Kazinda, who helped keep me safe, clean, and healthy in Makindye. I give special thanks to Beyonce, Hajarah, and Diana, for standing beside me even when it was uncertain if I would be able to continue. I am especially grateful for the assistance of Daisy, Rose, Sarah, Gloria, and George, who made it possible for my research to endure. Finally, the words on these pages have no meaning, no reality, and no substance without every woman and man, who chose to connect with me during the arduous fourteen months of primary data collection in Kampala, thank you, forevermore. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for how women manage daily risks associated with sex work and criminalization. However, the dissertation also finds that women's social connections can undermine the strategies they need to manage their HIV/AIDS prevention and treatment.Consequently, the dissertation concludes that social connections undermine current HIV/AIDS policies because clinical HIV/AIDS interventions have been found to prioritize individual behavioral change practices that impair the complex interpersonal ix activities developed by women to stay alive. In response, this dissertation asserts that social networks are fundamental to the formation of sex work communities and to the survival of women in the sex trade and should be considered in future HIV policies and programs intending to intervene in the HIV epidemic of female commercial sex workers in Kampala, Uganda.x In order to develop a dissertation proposal it was important that I immerse myself, as much as possible, into the daily routines of the NGO. Doing so allowed me to cultivate ties with staff. These relationships offered a chance to attend outreaches at night. The combination of day and night visitations within the sex work areas provided a means of comparing and contrasting how women behaved in relation to the presence of men. My observations, in turn, began a series of internal questions concerning women's daily routines, their relationships with men and other women, and the resources they devise to counter explicit threats to their individual safety and security (gossip, coercive practices, jealousies, in-fighting, theft, police violence, abuse, and/or rape within their respective communities). I departed Uganda, with these thoughts in mind and eventually developed a successfully funded proposal that allowed me to move to Kampala on 2 June 2012. People, Policy, and PurposeUltimately, this dissertation is about policy. Specifically it is about the policy of HIV/AIDS relief in the East African context. Rather than beginning with an exploration of how HIV/AIDS policies impact people, this dissertation first describes how daily survival for women selling sex in Kampala has implications for policy designed to prevent and treat HIV/AIDS. At its core the research of this dissertation is concerned women and men (i.e. names and cell ph...

Understanding the contexts in which female sex workers sell sex in Kampala, Uganda: a qualitative study

“…Our participants met clients in physical spaces including venues and outdoor locations and using online spaces that included social media applications and websites. Earlier studies also found that women who sell sex in Kampala recruit clients in venues and outdoor locations like those we presented [11,17]. Our study goes a step further and highlights that some women met clients using virtual online spaces like social media platforms and websites.…”

“…Stigma has also been identified as an important influence on the way sex workers work and as a contributor to their risk environment. Stigma increases the risk of HIV acquisition to sex workers, yet it is experienced in several forms at the individual, interpersonal and structural levels [14,[16][17][18][19].…”

Social network and HIV risk behaviors in female sex workers: a systematic review

“… Gu et al, China [ 69 ] 200 FSWs who are injection drug users Cross- sectional Study Social support – 1.7 In final multivariate model, after adjusting for socio-demographic variables, perceived social support from family members and friends (OR = 0.39, 95 %CI = 0.12–0.44) had significant association with condom use. Cruz Serena, Uganda [ 80 ] FSWs who live in slums and brothel Qualitative Study-ethnography Intimacy Social support Social capital – 1.6 Social network through intimacy, trust, social support and social capital provides a basis for managing daily risk related living in brothel and HIV risk behaviors related sex work. Social relationships especially with other FSWs and their social support in brothel can help the FSWs when they encounter insecurity with money, physical harm, and illness.…”

“…The role of social capital in FSWs’ condom use was assessed in three studies [ 66 , 77 , 80 ]. One showed that participants who had a network with high levels of social cohesion, as a social capital construct, consistently used condoms with all partners 2.25 times more often than those who reported low levels of social cohesion (Adjusted OR = 2.25; 95% CI = 1.30, 3.90) [ 77 ].…”

“…In addition, people who had high levels of social participation consistently used condoms with non-paying partners nearly twice as often as those who had low levels of social participation (Adjusted OR = 1.99; 95% CI = 1.13, 3.51) [ 77 ]. The qualitative studies reported that the lack of social capital among FSWs decreased peer trust and cohesion, which were found to be essential for consistent condom use [ 66 , 81 ].…”