Incarceration and exposure to internally displaced persons camps associated with reproductive rights abuses among sex workers in northern Uganda

Abstract

These results suggest a critical need for removal of legal and social barriers to realising the SRH rights of all women, and ensuring safe, voluntary access to reproductive choice for marginalised and criminalised populations of FSWs.

High burden of previously undiagnosed HIV infections and gaps in HIV care cascade for conflict-affected female sex workers in northern Uganda

“…This study adds to the limited body of evidence describing the health and social inequities faced by conflict-affected women engaged in sex work and to our knowledge remains one of few studies reporting on the HIV ‘cascade of care’ among conflict-affected SWs in sub-Saharan Africa. 30–32,34 Over one-third of SWs living with HIV were newly diagnosed infections, which is higher than a recent study in Malawi (20%) 35 and lower than a study in Zimbabwe in which half of SWs with confirmed HIV infection were unaware of their status, with the majority not on ART. 8 Women reporting unstable housing and substance use were more likely to be newly diagnosed, whereas accessing condom demonstrations and greater number of lifetime pregnancies were protective, likely reflecting linkage to HIV testing and care services through accessing SRH and condom promotion services.…”

“…alcohol/drug use, inconsistent condom use with clients, intimate partners); and structural factors, including housing, migration history, current places of servicing clients (e.g. bar/club, lodge, hotel, highway/truckstop, clients, own place); intimate partner violence; 32 workplace violence by clients, police, and military; policing and criminalization (e.g. arrest, incarceration); and conflict-related exposures (e.g.…”

“…We drew on questionnaire and HIV serological data collected with 400 HIV-seropositive and seronegative women SWs in Gulu, Northern Uganda from May 2011 to January 2012 as part of the Gulu Sexual Health Study. 30,32 The study was conducted in partnership with The AIDS Service Organization (TASO) Gulu, a branch of the largest indigenous HIV service organization in East Africa, as well as SWs and youth, women’s, and health services organizations. As previously described, 31,33 procedures were guided by extensive consultation with community, SWs, and external stakeholders (NGOs, health services, police) and the research team included peers/SWs.…”

“…For example, our research with SWs in conflict-affected Northern Uganda has documented a high burden of HIV (33.8%) and associations between war-related human rights violations and incarceration with HIV-seropositivity 30,31 and gaps in access to sexual and reproductive rights. 32,33 However, evidence regarding engagement across the HIV cascade among SWs in conflict-affected settings remains sparse, despite evidence suggesting the potential for poorer outcomes. Therefore, the aim of this study was to examine the prevalence and associations of the HIV cascade of care, including new HIV diagnoses and ART uptake, among women SWs in conflict-affected setting in Gulu, Northern Uganda.…”

Sex Trade and Health Care Utilization Among People Living with HIV/AIDS

“…Surprisingly, those who sold sex also had greater odds of receiving recent psychological treatment, which was in the opposite direction of the hypothesis. Perhaps the finding may be explained by the fact PLWH who trade sex often face greater trauma or mental health diagnoses than those who don’t trade sex [65–67]. Studies show a high prevalence of mental health disorders among harder-to-reach persons living with HIV, and that poorer mental health was associated with sexual violence and stigma experiences [68], experiences also heightened by involvement in the sex trade.…”