African Sex Workers Face Social, Economic Obstacles to Safe Sex

Newswise — African commercial sex workers who face hostile police and a public that stigmatizes their work are less likely to use condoms, says Tulane University researcher Sohail Agha. Agha's research on commercial sex workers in Lusaka, Zambia, is published in the July-August issue of Culture, Health & Sexuality.

"We estimate that seven out of 10 prostitutes in Lusaka have HIV/AIDS," says Agha. "We know that condom use is essential to preventing the spread of the disease, but very little was known about the economic and social opportunities available to the women and what affects their ability to use condoms."

Agha worked with a Zambian nurse to interview sex workers about their work. Although their awareness of HIV and the importance of condoms was high, they described considerable obstacles when trying use condoms. These obstacles include the loss of business and the possibility of being viewed as having HIV themselves. Most of the women agreed that they had no other means of making enough money to support themselves and their family, due in part to having little or no education.

Agha and his colleague found that women were more likely to use condoms if they were working outside a hotel or on the street as opposed to those women who worked in nightclubs.

"Issues of personal identity were critical in determining whether sex workers used condoms," Agha says. "Those based in night clubs did not consider themselves to be sex workers and had lower personal risk perceptions than those working on the streets."

The women also were more likely to use condoms if they had dependents. They were less likely to use condoms with regular clients or if they needed to make more money.

According to Agha, the aggressive approach of the Zambian police to keeping the streets free of sex workers combined with the stigma attached to prostitution puts sex workers at a disadvantage when asking for condom use, even when they know condoms are essential to protecting themselves against HIV/AIDS.