Sex work and mobility: a new challenge for Ethiopian AIDS policy

Sex work and mobility: a new challenge for Ethiopian AIDS policy

Published Jan 2007

Authors

Lorraine van Blerk, false

Publisher

Focus countries

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Sex work and mobility: a new challenge for Ethiopian AIDS policy

Sex work is often cited in research as a key factor in HIV transmission. Past research has focused on men’s mobility, in particular their use of sex workers while working away from home. However, it is also important to consider the mobility of sex workers themselves as contributing to the AIDS pandemic in Ethiopia.

Research from BrunelUniversity in the UK studied the lives of 60 young female commercial sexworkers in two Ethiopian cities: Addis Ababa, the capital, and Nazareth, alarge regional centre located on a trade route between the capital and thecoast. Both cities have fairly large transient populations. The girls were agedbetween 14 and 19 years of age, with approximately 22 percent drawn fromred-light areas while 37 percent worked as streetwalkers and 41 percent worked inbars.

The research usedfocus group discussions, semi-structured health interviews, informaldiscussions with the girls and interviews with staff from organisations workingwith sex workers. Some of the girls also drew their own mobility maps, showingthe places they went to find work.

Key reasons formobility among young sex workers included a desire to improve workingconditions, to access a different or wider group of clients, to look for newadventures, excitement or more lucrative business, and to avoid facing stigmaor losing clients if they became ill with HIV. Some also moved to avoid fightsor maltreatment either by clients or bar owners. Others changed location todevelop or avoid personal relationships with clients. The findings showed that:

  • the girls mostly came from poor ruralareas, where condom use is low
  • thegirls engage in unprotected sex with boyfriends and cannot always insiston using condoms with forceful clients
  • those who moved to trade orentertainment centres often consumed alcohol with clients, making themmore at risk of engaging in unprotected sex
  • those who moved to hide the fact theymay be HIV-positive placed new clients at risk
  • those working in red-light areas andbars also experienced restricted mobility, particularly if they becameindebted to the owners and had to work long hours
  • girls with restricted mobility also hadproblems accessing services, often due to owners’ mistrust ofnon-governmental organisations (NGOs)
  • more mobile sex workers found itdifficult to participate in long-term programmes or stay in contact with NGOs.

The researchconcludes that sex worker mobility has three major consequences: increasing therisk of HIV infection among the girls themselves, making them a risk factor forthe spread of AIDS, and limiting their access to services and information. Theresearcher recommends that AIDS prevention strategies in Ethiopia target sexworkers and take their mobility into account. She suggests that:

  • policymakers set up a nationallydirected service network where service providers share information
  • projects share AIDS education packagesand provide information to take away as a reminder, such as picture-basedleaflets
  • temporary or mobile health careservices set up in popular seasonal locations
  • policies also address restrictedmobility through financial training including savings and credit schemesto reduce debt
  • mobile outreach services take healthand social care into girls’ workplaces.

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