Policing the epidemic: High burden of workplace violence among female sex workers in conflict-affected northern Uganda.
Sex workers in sub-Saharan Africa experience a high burden of HIV with a paucity of data on violence and links to HIV risk among sex workers, and even less within conflict-affected environments. Data are from a cross-sectional survey of female sex workers in Gulu, northern Uganda (n = 400). Logistic regression was used to determine the specific association between policing and recent physical/sexual violence from clients. A total of 196 (49.0%) sex workers experienced physical/sexual violence by a client. From those who experienced client violence the most common forms included physical assault (58.7%), rape (38.3%), and gang rape (15.8%) Police harassment was very common, a total of 149 (37.3%) reported rushing negotiations with clients because of police presence, a practice that was significantly associated with increased odds of client violence (adjusted odds ratio: 1.61, 95% confidence intervals: 1.03-2.52). Inconsistent condom use with clients, servicing clients in a bar, and working for a manager/pimp were also independently associated with recent client violence. Structural and community-led responses, including decriminalisation, and engagement with police and policy stakeholders, remain critical to addressing violence, both a human rights and public health imperative.
a School of Population and Public Health , University of British Columbia , Vancouver , Canada.|b British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , Canada.
Katherine A
KA
Muldoon
c The AIDS Support Organization , Gulu , Uganda.
Monica
M
Akello
c The AIDS Support Organization , Gulu , Uganda.
Godfrey
G
Muzaaya
b British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , Canada.
Annick
A
Simo
a School of Population and Public Health , University of British Columbia , Vancouver , Canada.
Jean
J
Shoveller
a School of Population and Public Health , University of British Columbia , Vancouver , Canada.|b British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , Canada.|d Department of Medicine , University of British Columbia, St. Paul's Hospital , Vancouver , Canada.
Kate
K
Shannon
D000328:Adult; D016009:Chi-Square Distribution; D017280:Condoms / Q000706:statistics & numerical data*; D003416:Criminal Law; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016495:Police / Q000706:statistics & numerical data; D015995:Prevalence; D060386:Sex Workers / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D057545:Social Stigma; D014454:Uganda / Q000453:epidemiology; D064450:Workplace Violence / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D055815:Young Adult
HIV/AIDS; Sex work; criminalisation; northern Uganda; violence