Prevalence of Rape and Client-Initiated Gender-Based Violence Among Female Sex Workers: Kampala, Uganda, 2012

Abstract

We utilized data from the 2012 Crane Survey in Kampala, Uganda to estimate prevalence of rape among female sex workers (FSWs) and to identify risk factors for and prevalence of client-initiated gender-based violence (GBV) among FSWs. Participants were recruited using respondent-driven sampling. Analyses were weighted using RDSAT-generated individualized weights for each of the five dependent GBV outcomes. Analyses were conducted utilizing SAS 9.3. Among 1,467 FSWs who were interviewed, 82 % (95 % CI: 79–84) experienced client-initiated GBV and 49 % (95 % CI: 47–53) had been raped at least once in their lifetime. GBV risk increased with increasing frequency of client demands for unprotected sex, length of time engaged in sex work, and FSW alcohol consumption. Risk decreased when sex with clients occurred at the FSW’s or client’s house or a hotel compared to when sex occurred in open spaces. Our findings demonstrate a high prevalence of GBV among FSWs. This research reinforces the urgent need for GBV prevention and response strategies to be integrated into FSW programming and the continuing need for GBV research among key populations.

Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice

“…Physical and sexual gender-based violence (GBV), that is, violence perpetrated based on sex, gender identity or perceived adherence to socially defined gender norms,3 is an important structural driver of FSWs' HIV risk behaviour and infection in sub-Saharan Africa and elsewhere 4–7. While regional data are limited, GBV appears to be a persistent and significant threat to FSWs,4 7 8 affecting approximately 50% of FSWs in the past 6 months alone in Kampala, Uganda 9. Gender-based power differentials and criminalisation of sex work fuel GBV against FSWs and the concomitant HIV risk,10 often against a backdrop of endemic GBV.…”

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

“…Sex work is illegal; this affects not only the safety and security of the women engaged in this work, but also their access to services. Working conditions discourage disclosure and invite discrimination even at health facilities; targeted harassment by law enforcement agencies (as well as regular partners and clients) acts as real or potential barriers to healthcare access and specifically HIV-related services (Chersich et al, 2013;Mbonye, Nakamanya, Nalukenge, et al, 2013;Schulkind et al, in press;Schwitters et al, 2014). These challenges also affect the sustained access of women living with HIV to care programmes, and their continuation on ART.…”

High rates of Unintended Pregnancies among Young Women Sex Workers in Conflict-affected Northern Uganda: The Social Contexts of Brothels/Lodges and Substance Use

“…Qualitative narratives from Ugandan sex workers illustrate how clients often take advantage of drunk sex workers by coercing them into unprotected sex 30 . In Kampala, sex workers' alcohol use has been found to be independently associated with HIV infection 36 , 37 and violence 38 , similar associations have been consistently documented across settings in Sub-Saharan Africa 39 . In Mombasa, Kenya, alcohol use in sex work transactions was linked to higher rates of sexual violence, which increased HIV acquisition risk for sex workers 27 .…”