Reducing the risk of HIV infection among South African sex workers: socioeconomic and gender barriers

• Published in: American journal of public health (1971) Vol. 85; no. 11; pp. 1521 - 1525
• Main Authors: Karim, Q A, Karim, S S, Soldan, K, Zondi, M
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.11.1995; American Public Health Association
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; AIDS/HIV; Attitude to Health; Barriers; Biological and medical sciences; Birth control; Condoms; Condoms - statistics & numerical data; Female; Health Knowledge, Attitudes, Practice; Health risk assessment; HIV; HIV Infections - etiology; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Male; Medical research; Medical sciences; Middle Aged; Prevention and actions; Prostitutes; Prostitution; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Risk reduction; Sex Factors; Sex industry; Sex Work - ethnology; Sex Work - statistics & numerical data; Socioeconomic Factors; South Africa; Specific populations (family, woman, child, elderly...); Surveys and Questionnaires; Tropical medicine; Truck stops; Violence; Women; South Africa; Africa; Human; Immunopathology; Sanitary program; High risk; Socioeconomic status; AIDS; Health education; Immune deficiency; Infection; Prevention; Prostitution; Low; Viral disease; Woman; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.85.11.1521

The social context within which women engaged in sex work at a popular truck stop in South Africa are placed at risk of human immunodeficiency virus (HIV) infection and the factors that influence their ability to reduce their risk were assessed. Using qualitative and quantitative techniques, an elected sex worker from within the group collected all data. Given the various pressing needs for basic survival, the risk of HIV infection is viewed as one more burden imposed on these women by their lack of social, legal, and economic power. Violence, or the threat thereof, plays an important role in their disempowerment. In the few instances in which sex workers were able to insist on condom use, it resulted in a decrease in earnings, loss of clients, and physical abuse. Recommendations to reduce the sex workers' risk for HIV infection include negotiation and communication skills to enable them to persuade their clients to use condoms; development of strategies through which they can maximally use their group strength to facilitate unified action; and accessibility of protective methods they can use and control, such as intravaginal microbicides.