Work-related mobility and experiences of gender-based violence among female sex workers in Iringa, Tanzania: a cross-sectional analysis of baseline data from Project Shikamana

Abstract

ObjectivesTo examine how work-related mobility among female sex workers (FSWs) is associated with gender-based violence (GBV) in Iringa, Tanzania.DesignCross-sectional analyses were conducted on baseline data gathered between October 2015 and April 2016 from FSWs participating in Project Shikamana, a community empowerment-based combination HIV prevention intervention.SettingParticipants were recruited for the baseline study using venue-based time-location sampling in two communities in Iringa, Tanzania.ParticipantsFSWs were eligible for participation if they were 18 years or older and had exchanged sex for money within the past month. Four-hundred ninety-six FSWs participated in the baseline survey.Primary and secondary outcome measuresAny recent experience of GBV was examined by recent work-related mobility among FSWs. Any recent experience of GBV was also disaggregated by severity for analyses. All bivariate and multivariate binary and multinomial logistic regressions adjusted for intraclass correlations among women recruited from the same venues.ResultsForty per cent of participants experienced recent physical or sexual violence, and 30% recently experienced severe physical or sexual violence. Thirty-three per cent of participants recently exchanged sex for money outside of their district or region, and 12% were both intraregionally and inter-regionally mobile for sex work. Intraregionally and inter-regionally mobile FSWs had 1.9 times greater odds of reporting recent GBV (adjusted OR: 1.89; 95% CI: 1.06 to 3.38; p=0.031) compared with non-mobile FSWs and a 2.5 times higher relative risk for recent experience of severe GBV relative to no recent GBV (relative risk ratio: 2.51; 95% CI: 1.33 to 4.74; p=0.005).ConclusionsMobility for sex work may increase FSWs’ exposure to GBV, particularly more severe GBV. The vulnerability of mobile FSWs to violence, particularly severe forms, demands inclusive services that are accessible to mobile FSWs.

Client-perpetrated gender-based violence among female sex workers in post-conflict Gulu district, Northern Uganda: a cross-sectional study

“…Moreover, to the best of our knowledge, this is the first study on the relationship between client-perpetrated GBV and sex work-related mobility in post-conflict settings. However, our finding is consistent with previous studies reporting that mobile FSWs were at increased odds of client-perpetrated GBV (9,10,30). This is because mobile FSWs tend to have less control over their work environment and many of the male clients of FSWs tend to refuse to use condoms with the new coming mobile FSWs (30).…”

“…Only a few studies examined the relationship between client-perpetrated GBV and FSWs’ monthly income. In Tanzania, the income level did not significantly affect the occurrence of client-perpetrated GBV (10). However, in Northern Ethiopia low earning FSWs were more likely to suffer from client-perpetrated GBV (34).…”

“…However, the relationship between GBV and HIV is bidirectional since survivors of GBV also tend to have a greater risk of acquiring HIV infection (7,8). Secondly, compared to FSWs who provide sexual services from one locality, mobile sex workers are more likely to get exposed to client-perpetrated GBV (9,10). Additionally, a systematic review revealed that both alcohol and illicit drug use increase intimate and nonintimate partner GBV among FSWs (11).…”

A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa

“…A multi-country study revealed the odds of experiencing IPV was 33% higher amongst women who were employed in comparison to those who were unemployed [ 58 ]. Researchers found that health care workers were more likely to experience GBV [ 57 , 58 , 61 ], particularly emotional violence. Nurses and midwives [OR: 4.06; 95% CI (1.20, 13.74)] were more likely to experience workplace violence in comparison to other health care workers [ 28 , 30 ] ( Table 1 ).…”

Treatment as Prevention: Concepts and Challenges for Reducing HIV Incidence

“…Baseline data are available. 64,69 Results presented at conferences suggest that intervention participants were significantly less likely to become infected with HIV at follow-up, had lower HIV incidence, reported more consistent condom use, and experienced less gender-based violence compared to participants in the control group. 70,71 Final results are forthcoming.…”