Gender Based Violence among Sex Workers and A Call to Action

Despite calls for the decriminalization of sex work, it remains illegal in many countries including Uganda under Section 139 of the Penal Code Act Cap 120. The illegal nature of sex work increases stigma and the marginalization of sex workers, leaving them at higher risk of experiencing GBV.

Female sex workers (FSWs) are an often-marginalized population further contributing to the unequal power differentials between clients and FSWs that influence the occurrence of GBV.  Female sex workers are disproportionately affected by Gender-based violence (GBV), yet little is known about the violence they face, its gender-based origins, and responses to GBV. The International Labor Office classifies sex workers as a high-risk group for experience of GBV by their clients, brothel owners and other controllers, law enforcement officials, intimate partners, families, neighbors, and other sex workers. The illegality of sex work in Uganda further inhibits sex workers ability to report GBV and negotiate safe sex with clients.

Further, the causes of GBV are complex and multifactorial including societal and individual factors  GBV has been linked to high rates of morbidity and mortality including gynecological problems, depression, post-traumatic stress disorder, substance dependence, suicide, and sexually transmitted infections including HIV .

Notably, data from the 2012 Crane Survey in Kampala, Uganda estimates prevalence of rape among female sex workers (FSWs) and identifies risk factors for and prevalence of client-initiated gender-based violence (GBV) among FSWs. Analyses were conducted utilizing SAS. 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, being offered more money for condomless sex having had a condom slip or break and difficulty suggesting condoms with non-paying partners and FSW alcohol consumption. Their findings demonstrate a high prevalence of GBV among FSWs.

We hereby call upon the different actors to:

  • Reinforce the urgent need for GBV prevention and response strategies to be integrated into FSW programming and the continuing need for GBV research among FSWs.
  • Provide a foundation on which HIV programs can integrate GBV and HIV services.
  • Make an integrated, multisectoral GBV-HIV strategy that attends to structural risk is needed to enhance safety, HIV prevention and access to care and justice.
  • There is need to generate high-quality evidence on the nature of GBV experienced by FSWs, to describe the consequences of and responses to GBV from the perspective of KP members, and to inform HIV service delivery policies and programming in Uganda by making it more responsive to the needs of FSWs victims of GBV.
  • SW programs should build on existing initiatives to address GBV in the general population and to more systematically integrate gender into SW programming.
  • There is need to conduct gender transformative trainings with police, health care workers and peers to sensitize these groups to the needs of SWs and provide them with skills in first-line support tailored to SWs
  • Document violence faced by SWs and demand for action by government.
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