Client retention and health among sex workers in Nairobi, Kenya

Labor Pains: Work-Related Barriers to Access to Health Care for People Living with HIV in Hyderabad, India

To explore themes regarding work-related barriers to access to health care, we conducted 32 interviews, 16 with third gender people and 16 with cisgender women, all of whom were all living with HIV in Hyderabad, India. Most respondents were members of Dalit castes and had been living with HIV for several years at the time of the interview. Using thematic content analysis, interviews were coded by two researchers using a social determinants of health conceptual framework. Themes highlighted in this study include the burden of taking time off from work, the loss of pay associated with missing work, and the interruption of gendered care work responsibilities that respondents faced when seeking treatment. Findings from this study support the claim that equitable work policies and practices for marginalized laborers can increase access to medical care for people living with HIV.

The lived experience of violence and health-related risks among street sex workers in Uyo, Nigeria

This study examined the lived experience of violence and health-related risks among street sex workers in Uyo, Nigeria. Data were collected through in-depth, individual interviews with 27 female sex workers recruited through venue-based snowball sampling. Thematic coding and analysis were undertaken on interview transcripts. Findings show that sex workers experienced physical, emotional, sexual and economic violence linked to the criminalisation and stigmatisation of sex work. Violence, perpetrated by clients, police, sexual partners and co-sex workers, was used to coerce unprotected sex and free and unacceptable sexual services; to extort money; to prevent client-snatching; and as moral punishment. Violence harms sex workers' health, undermines condom negotiation and increases STI/HIV risk. Sex workers displayed agency by adopting safety strategies, including screening clients, collaboration, bribing the police for protection and self-defence. Agency was constrained by criminalisation and lack of legal protection. Within this context, the decriminalisation of sex work, the regulation of sex work premises, community mobilisation, economic empowerment and health services are relevant measures for addressing violence and improving sex workers' health.