“It's All About Making a Life”

Onyango, Monica Adhiambo; Adu‐Sarkodie, Yaw; Agyarko-Poku, Thomas; Asafo, Mabel Kissiwah; Sylvester, Joy; Wondergem, Peter; Green, Kimberly; Wambugu, Samuel; Brennan, Alana T.; Beard, Jennifer

doi:10.1097/qai.0000000000000455

Cited by 42 publications

(17 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of violence and unprotected sex with alcohol use among FSW has been well-documented globally (Chersich et al, 2007; El-Bassel, Witte, Wada, Gilbert, & Wallace, 2001; Li, Li, & Stanton, 2010; Mbonye, Rutakumwa, Weiss, & Seeley, 2014; Onyango et al, 2015; Wechsberg, Luseno, & Lam, 2005). Yet, knowledge has been limited on how FSW understand these risks within the context of their own alcohol use.…”

Section: Discussionmentioning

confidence: 99%

“…FSW use alcohol to facilitate sex work, and both FSW and clients often consume alcohol at the time of sex (Chersich et al, 2007; de Graaf, Vanwesenbeeck, van Zessen, Straver, & Visser, 1995; El-Bassel, Witte, Wada, Gilbert, & Wallace, 2001; Li, Li, & Stanton, 2010). FSW use alcohol to reduce their insecurities or become more comfortable when approaching potential clients (Onyango et al, 2015). Clients also often purchase alcohol for FSW prior to sex to establish the sexual transaction (Li, Li, & Stanton, 2010; Wojcicki & Malala, 2001).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

Lancaster

MacLean

Lungu

et al. 2017

Substance Use & Misuse

View full text Add to dashboard Cite

Background Alcohol use is pervasive among female sex workers (FSW) placing them at increased risk of violence and sexual risk behaviors. FSW often live and work where alcohol is highly normative. Objective To understand the socioecological influences on hazardous alcohol use among FSW in Malawi. Methods In 2014, 200 FSW identified through venue-based sampling in Lilongwe, Malawi, completed a quantitative behavioral survey, with a sub-sample participating in qualitative interviews. Multivariable log-binomial regression was used to identify associations between hazardous alcohol use (AUDIT score ≥ 7) and time in sex work, clients per week, unprotected sex, alcohol use with clients, and living environment. Qualitative interviews enhanced findings from quantitative data and identify emergent themes around socioecological influences on alcohol use. Results Over 50% reported hazardous alcohol use and lived in an alcohol-serving venue. Hazardous alcohol use was associated with sex work duration of ≥2 years (aPR: 1.30; 95%CI: 1.02,1.65) and alcohol use at last sex with a client (aPR: 1.29; 25%CI: 1.06,1.57). FSW perceived alcohol as a facilitator for sex work by reducing inhibitions and attracting clients, but acknowledged alcohol leads to violence and/or unprotected sex. Despite these risks and a motivation to reduce use, FSW feared that refusing to drink would be tantamount to turning away clients. Conclusions Although FSW recognized alcohol-related risks, the norms and power dynamics of sex work perpetuated hazardous alcohol use. Multilevel interventions are needed to collectively change norms around drinking and sex work that will enable FSW to reduce alcohol consumption when engaging in their work.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

Lancaster

MacLean

Lungu

et al. 2017

Substance Use & Misuse

View full text Add to dashboard Cite

show abstract

“…In general, the way in which YWSS sell sex is poorly understood and often excluded from the literature on FSW due to the considerable ethical considerations in including YWSS under age 18 in research [ 20 , 21 ]. Increasingly, however, there have been calls to move beyond simplistic portrayals of all underage YWSS as “trafficking victims” in order to gather data that are required for effective methods of reaching this vulnerable population, including offering services that are likely to be acceptable and taken up by YWSS, rather than driving them further underground and into higher risk situations [ 10 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Reaching young women who sell sex: Methods and results of social mapping to describe and identify young women for DREAMS impact evaluation in Zimbabwe

et al. 2018

View full text Add to dashboard Cite

Young women (aged 15–24) who exchange sex for money or other support are among the highest risk groups for HIV acquisition, particularly in high prevalence settings. To prepare for introduction and evaluation of the DREAMS programme in Zimbabwe, which provides biomedical and social interventions to reduce adolescent girls’ and young women’s HIV vulnerability, we conducted a rapid needs assessment in 6 towns using a “social mapping” approach. In each site, we talked to adult sex workers and other key informants to identify locations where young women sell sex, followed by direct observation, group discussions and interviews. We collected data on socio-demographic characteristics of young women who sell sex, the structure and organisation of their sexual exchanges, interactions with each other and adult sex workers, and engagement with health services. Over a two-week period, we developed a “social map” for each study site, identifying similarities and differences across contexts and their implications for programming and research. Similarities include the concentration of younger women in street-based venues in town centres, their conflict with older sex workers due to competition for clients and acceptance of lower payments, and reluctance to attend existing services. Key differences were found in the 4 university towns included in our sample, where female students participate in diverse forms of sexual exchange but do not identify themselves as selling sex. In smaller towns where illegal gold panning or trucking routes were found, young women migrated in from surrounding rural areas specifically to sell sex. Young women who sell sex are different from each other, and do not work with or attend the same services as adult sex workers. Our findings are being used to inform appropriate intervention activities targeting these vulnerable young women, and to identify effective strategies for recruiting them into the DREAMS process and impact evaluations.

show abstract

“…Most participants reported engaging in transactional sex and feeling comfortable doing so, viewing the exchange of money, gifts, and favors as a natural and positive activity. This is not surprising in a low-resource environment, given evidence from Ghana and elsewhere that young people are often persuaded or inclined to exchange sex for money or goods [ 13 , 28 , 32 , 36 , 37 ]. The Ghana Men’s Study found participation in transactional sex among MSM aged 18-35 years to be 60% in Kumasi and 65% nationwide [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“Too Much Sex and Alcohol”: Beliefs, Attitudes, and Behaviors of Male Adolescents and Young Men Who have Sex with Men in Ghana

Sabin¹,

Beard²,

Agyarko-Poku³

et al. 2018

TOAIDJ

Self Cite

View full text Add to dashboard Cite

Background:Research suggests that men who have sex with men (MSM) often engage in high-risk sex and use illicit substances.Objective:To increase understanding of HIV knowledge and vulnerability among adolescent and young adult MSM, with a focus on alcohol and drug use and transactional sex.Methods:We conducted in-depth interviews and Focus Group Discussions (FGDs) with adolescent (aged 15-17 years) and young adult (aged 18-29 years) MSM in Kumasi, Ghana. MSM who reported recent alcohol and/or substance use or engagement in transactional sex were eligible. Questions covered HIV-related knowledge, experiences with substance-use and transactional sex, and attitudes regarding sexual risk-taking and HIV-related services. Data were analyzed thematically using NVivo 10.0 software.Results:Ninety-nine MSM participated in 44 interviews and 8 FGDs. Most were attending or had completed secondary school. HIV knowledge was high, but with major gaps. Most consumed alcohol; one-fourth used drugs. Alcohol and substances were consumed to enhance pleasure during sex with another man. Transactional sex was common and positively viewed. Half of the participants used condoms inconsistently or never, and self-perceived HIV risk was high. Nearly half faced stigma-related barriers to accessing HIV-related services.Conclusion:As Ghana strives to achieve the UNAIDS’s 90-90-90 global targets (90% of people living with HIV know their status, 90% who know their status are on sustained treatment, and 90% of those on treatment are virally suppressed), we recommend enhancing MSM-targeted prevention programs, improving care options, and increasing use of critical clinical HIV-services by ensuring that MSM receive unbiased, confidential care.

show abstract

“It's All About Making a Life”

Cited by 42 publications

References 20 publications

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

Reaching young women who sell sex: Methods and results of social mapping to describe and identify young women for DREAMS impact evaluation in Zimbabwe

“Too Much Sex and Alcohol”: Beliefs, Attitudes, and Behaviors of Male Adolescents and Young Men Who have Sex with Men in Ghana

Contact Info

Product

Resources

About