Mobility study of young women who exchange sex for money or commodities using Google Maps and qualitative methods in Kampala, Uganda

We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population. Participants were recruited from a clinic i...

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Published inBMJ open Vol. 11; no. 5; p. e043078
Main Authors King, Rachel, Muhanguzi, Eva, Nakitto, Miriam, Mirembe, Miriam, Kasujja, Francis Xavier, Bagiire, Daniel, Seeley, Janet
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 19.05.2021
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Abstract We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population. Participants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection. Adolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15-24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 'queen mothers' and 6 male partners MEASURES: Participants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data. Interviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers. Young women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns. NCT03203200.
AbstractList Objectives We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population.Setting Participants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection.Participants Adolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15–24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 ‘queen mothers’ and 6 male partnersMeasures Participants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data.Results Interviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers.Conclusions Young women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns.Trial registration number NCT03203200.
Objectives We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population. Setting Participants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection. Participants Adolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15–24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 ‘queen mothers’ and 6 male partners Measures Participants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data. Results Interviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers. Conclusions Young women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns. Trial registration number NCT03203200 .
OBJECTIVESWe aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population. SETTINGParticipants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection. PARTICIPANTSAdolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15-24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 'queen mothers' and 6 male partners MEASURES: Participants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data. RESULTSInterviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers. CONCLUSIONSYoung women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns. TRIAL REGISTRATION NUMBERNCT03203200.
ObjectivesWe aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population.SettingParticipants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection.ParticipantsAdolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15–24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 ‘queen mothers’ and 6 male partnersMeasuresParticipants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data.ResultsInterviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers.ConclusionsYoung women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns.Trial registration numberNCT03203200.
We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how mobility may hinder access to health services and enhance HIV risk in a highly vulnerable population. Participants were recruited from a clinic in Kampala, Uganda set up for women at high risk of HIV infection. Adolescent girls and young women engaged in sex for money and/or commodities are at particular risk in countries with high HIV prevalence and high fertility rates. High mobility increases exposure to HIV risk. Women participants were eligible for the parent study if aged 15-24 years, HIV negative and engaged in sex work. For this substudy, 34 qualitative interviews were held with 14 sex workers (6 HIV positive, 8 HIV negative), 6 health worker/policy makers, 3 peer educators, 5 'queen mothers' and 6 male partners MEASURES: Participants used Google Maps to identify work venues at 12-month and 18-month study visits. We also conducted 34 interviews on mobility with: high-risk women, male partners, health workers and sex-worker managers. Topics included: distance, frequency and reasons for mobility. We used Python software to analyse mapping data. Interviews found in depth narratives describing lack of education and employment opportunities, violence, lack of agency, social, sexual and familial support networks and poverty as a complex web of reasons for high mobility among young sex workers. Young women at high risk are highly mobile. Reasons for mobility impact access and retention to health services and research activities. Strategies to improve retention in care should be cognisant and tailored to suit mobility patterns. NCT03203200.
Author Kasujja, Francis Xavier
Bagiire, Daniel
Mirembe, Miriam
Seeley, Janet
Nakitto, Miriam
King, Rachel
Muhanguzi, Eva
AuthorAffiliation 1 Institute for Global Health Sciences, Department of Medicine , University of California San Francisco , San Francisco , California , USA
4 Department of Global Health & Development , London School of Hygiene and Tropical Medicine , London , UK
3 Department of Epidemiology and Biostatistics , School of Public Health, Makerere University , Kampala , Uganda
2 Social Aspects of Health Across the Lifecourse , MRC/UVRI and LSHTM Uganda Research Unit , Entebbe , Uganda
AuthorAffiliation_xml – name: 3 Department of Epidemiology and Biostatistics , School of Public Health, Makerere University , Kampala , Uganda
– name: 1 Institute for Global Health Sciences, Department of Medicine , University of California San Francisco , San Francisco , California , USA
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  surname: Seeley
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  organization: Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK
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Keywords HIV & AIDS
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qualitative research
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2024102810020146000_11.5.e043078.39
2024102810020146000_11.5.e043078.38
Camlin (2024102810020146000_11.5.e043078.28) 2019; 57
2024102810020146000_11.5.e043078.37
2024102810020146000_11.5.e043078.36
2024102810020146000_11.5.e043078.35
Mbonye (2024102810020146000_11.5.e043078.6) 2013; 13
Hernando (2024102810020146000_11.5.e043078.33) 2015; 70
McGrath (2024102810020146000_11.5.e043078.30) 2015; 2
2024102810020146000_11.5.e043078.49
2024102810020146000_11.5.e043078.48
Stover (2024102810020146000_11.5.e043078.2) 2014; 66
2024102810020146000_11.5.e043078.47
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2024102810020146000_11.5.e043078.40
Servin (2024102810020146000_11.5.e043078.24) 2015; 6
Vandepitte (2024102810020146000_11.5.e043078.18) 2011; 38
Camlin (2024102810020146000_11.5.e043078.31) 2017; 74
Camlin (2024102810020146000_11.5.e043078.32) 2018; 21
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Snippet We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to gauge how...
ObjectivesWe aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to...
OBJECTIVESWe aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to...
Objectives We aimed to assess mobility patterns and reasons for high mobility among young women engaged in sex work within a randomised controlled trial to...
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SourceType Open Website
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StartPage e043078
SubjectTerms Adolescent
Community
Counseling
Data collection
Disease prevention
Female
Females
HIV
HIV Infections - epidemiology
HIV/AIDS
Human immunodeficiency virus
Humans
Infections
Life Sciences
Male
Python
Randomized Controlled Trials as Topic
Sex industry
Sex Work
Sex Workers
Sexual Behavior
Sexually transmitted diseases
STD
Uganda - epidemiology
Womens health
Workers
Young Adult
Young adults
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Title Mobility study of young women who exchange sex for money or commodities using Google Maps and qualitative methods in Kampala, Uganda
URI https://www.ncbi.nlm.nih.gov/pubmed/34011583
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Volume 11
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